MEPS Pictogram Project

This project has been undertaken by MEPS to give health professionals a means of communicating medication instructions to people that they have no language in common with and / or who may be illiterate. MEPS members provide emergency relief and humanitarian aid relief where such a means of communication may well be required.

Introduction to the project through a video:

Video in English

Video in French (Vidéo en français)

 

 

KEY DOWNLOADS:

To download the latest version of the Pictogram (under a zip file), please click one of the following links:

Download Pictograms program NA [8Mb] (last update: June 2009)
(This is the North American version, which prints on Letter size paper)

Download Pictograms program EU [8Mb] (last update: June 2009)
(This is the European version, which prints on A4 size paper)

If you don't have Microsoft Access on your computer, you will also have to download Access Runtime (free download) on Microsoft website: click here

 

Click here to download the instructions of use

 

 

PICTOGRAMS: THE STORYBOOK CONCEPT

Pictograms should be a story (i.e. a series of pictures) rather than having one one complex diagram trying to convey a small series of actions. 
The story needs to depict the following concepts:

  • Indication
  • Quantity
  • Dosage form
  • Route
  • Frequency
  • Additional information
  • Alcohol restriction
  • Food requirement (relationship to meals)
  • Child protection

And each of these concepts needs to be broken down into the separate elements

The elements fall into two broad categories;
o Those have are generic and will be understood by people of any culture or background
(For example: two tablets)
o Those that require a culturally specific content in order to be understood
(For example: the type of food that is eaten)

The Pictogram storyboard should printed on letter size or A4 paper in either portrait or landscape orientation, depending on how the culture reads. It is comprised of 4 areas with a maximum of 4 pictograms in each row.

Download a sample Pictogram storyboard here

 

PROCESS: PICTOGRAM SET DEVELOPMENT

Once contact has been established with MEPS and you have been accepted as a participant in the project, the following process needs to be undertaken in order to develop a set of pictograms suitable for any particular culture:

o Select the culturally non-specific pictograms required for your circumstances.

o Determine what other pictograms are required to effectively instruct your target group in the appropriate administration of their medicines.

o Gather together a small group of individuals from the culture that you are targeting.  Determine what items/practices are appropriate to design into the culturally specific pictograms that you require.

o Consult more widely with members of the cultural community to discuss the ideas generated.

o Submit the ideas to the MEPS project coordinators.

o MEPS will get the graphic artists to generate the new designs. (It is important that the designs are done in a consistent style to reduce variability, inconsistencies and possible confusion).

o The culturally specific designs will be returned for validation within the culture.  The processes involved in the validation stage will vary depending on location and circumstances.

NOTE:  The designs will belong to MEPS and will be made available for general distribution.

 

PICTOGRAMS: TRIALS AND STUDIES

Assessment of the level of the understanding of Pictograms has been carried out in two university based studies, a MEPS workshop and in a field trial, carried out in Gabon, April 2005.
University Based Studies:

  • Pre-testing of pictograms used in medicines dispensed in missions of humanitarian relief
    (in collaboration with the University of Otago, New Zealand)
  • Pictographic Instructions for Medications: Do Other Cultures Interpret Them Accurately?
    (in collaboration with the University of British Columbia, Canada)

Details of these studies were given at the MEPS session, New Orleans in a presentation entitled: 
Pictograms: a Continuous Quality Improvement Initiative

MEPS Workshop, New Orleans, 2004
At the New Orleans Congress, LCol Vaillancourt gave the above presentation then followed on with the questions posed at the end of the presentation.  The outcome of this workshop is summarised on the Concept page.  The next phase was the filed trial of a specially designed set of pictograms.

Gabon Field Trial
In April 2005, a researcher went on a humanitarian mission to Gabon to trial a set of culturally specific pictograms. The aim of the trial was to:
To design, develop and evaluate a pictogram storyboard concept and individual pictograms in an operational context.
To assess patient comprehension of the pictogram elements and storyboard concept both at the time of dispensing and upon short term follow-up.

This field trial was conducted with Research Ethics Board Approval (Laurentian University).  The testing was conducted in conjunction with the Canada Africa Community Health Alliance and the Caravane Médicale pour le Gabon.

Some of the results of the Gabon trial were given in the presentation at the Cairo Congress:
Pictogram Use in Developing Countries 

The results are currently being further analysed and will be published in due course.

Find out more about this MEPS Pictogram through a more extensive description of the project and instructions: here.



PROJECT COORDINATOR:

Mrs Jane Dawson, New Zealand.

If you are interested in participating in this project, please contact Jane Dawson to state your interest.

Contact Jane

 

Project Supervisors:

LCol Régis Vaillancourt      
Immediate Past President MEPS
Mrs Jane Dawson Secretary MEPS