Neither radio nor TV had adequate outreach, and even if they had, language may well have proven problematic. Pictures avoided such problems, providing they could be delivered.

The choice as to whether to use colour or B&W was left aside – but it was accepted that whatever gave the better comprehension rates would be used.

The choice as to whether to use line drawings, full colour or even photographic images was difficult. Experience and research elsewhere in the region (particularly in Nepal) had shown that illiteracy often meant visual illiteracy as well. This, in its worst form, meant that illiterates could not even decipher a simple photograph since it was in 2-dimensions while their world was in 3-dimensions. We decided to consider this problem only if the field tests showed that the graphic images which we were to use to start, were not being understood.

By this time, it was obvious that any writing we might wish to put on the poster would be wasted because virtually all women in the province were illiterate. Rather, we decided to aim for high comprehension purely in the images we used.

Since only images would be used, technical terms only became important if training was required – so that the words that mothers used would be used by the health professionals doing the training, to ensure no misunderstandings.

At the time of defining the medium, the Afghan War (against the Russians) was at its height and we were dealing with Pakistani Baluch and Pukhtoon groups; many hundreds of thousands of refugees from Afghanistan; and supporting health programmes inside Afghanistan as well. While TV and radio transmissions were routinely jammed by the Russians, getting paper material across the border was simple. Thus, if we could prepare the poster so that Afghans could identify with it as well, then our target audience would be considerably larger.