Designing for Low-Literacy Audiences in Healthcare: When “Read This” Just Doesn’t Cut It

"If the message cannot enter through the ears, no sense putting it on a scroll." — Swahili-inspired proverb

Let’s be real. You can build the sleekest mHealth app or the most high-tech patient portal, but if your audience can’t read more than their name (or even that), you’re just designing pretty frustration.

In many parts of Africa, health communication assumes every user is fluent in English, tech-savvy, and literate. But ask any community health worker (CHW) in Kibera, Kano, or Kombo North, and they’ll tell you: “Many of our people don't read words—they read people, pictures, and tone.”

So, how do you design healthcare tools for those who can’t—or won’t—read?

1. No Shame in the Game: Literacy ≠ Intelligence

First, let’s kill the stigma. Low literacy isn’t stupidity. It’s circumstance. Colonial education systems, poverty, and unequal access to schooling created generations of brilliant, wise elders who can quote proverbs but can’t spell "hypertension."

Designing for them isn’t charity—it’s smart UX.

2. Think Pictures, Not Paragraphs

Words are optional. Meaning is not.

Design tip: Use pictograms, emojis (judiciously), and intuitive icons. For example:

• 💊 for medicine

• 🚶‍♂️+🛏️= “Take after waking”

• 😷 + 👃 = “Blow your nose before inhaling”

Apps like Living Goods’ SmartHealth app use icons and visuals for CHWs who speak five languages but read none fluently (Living Goods, 2023).

Remember: A Ghanaian grandma may not read “apply topically twice daily,” but show her a diagram of a foot, a tube, and a clock—and she’s golden.

3. Voice Is the New Text

Can’t read? No problem—just listen.

WhatsApp audio? Radio-style health tips? IVR-based services like those from Viamo and mPharma?

Voice:

• Transcends literacy barriers

• Feels human and warm

• Works offline

In Ethiopia, the 960 platform delivers voice health messages in Amharic, Oromo, and Tigrinya—reaching millions who’ve never read a leaflet (UNICEF Ethiopia, 2022).

💡 Pro Tip: Use local accents and voices. No one trusts a robotic American voice telling them about malaria in Kisumu.

4. Test With Real People—Not Your Laptop Peers

User testing with low-literacy audiences means:

• Watching how they hold phones

• Seeing what confuses them

• Listening to questions they won’t ask

In one hilarious test in Mombasa, a CHW kept tapping the logo thinking it was the “home” button. That was the day the UX team learned: “If it looks tappable, it must do something.”

Designing for low literacy means humbling your ego. Your clever infographic is useless if it needs a PhD to decode.

5. Design With, Not For

The ultimate hack? Co-create.

• Invite CHWs, market traders, even herbalists to your design sessions.

• Ask them how they would explain HIV or blood pressure.

• Use their metaphors, not yours.

If you ask a Nigerian auntie to describe diabetes, she might say: “It’s when sugar lives in your blood and refuses to pay rent.” That’s more memorable than any WHO definition.

6. Use Colour and Context Cleverly

In Egypt, red might mean danger. In South Africa, green may imply go—but don’t assume universal colour meanings.

Also:

• Use contrast for visibility

• Show people that look like your audience

• Avoid overloaded screens

Don’t make a low-literacy user scroll through a hundred menu items. They’ll close your app and go straight to the herbalist next door.

7. Feedback, Not Fancy Words

People won’t read, but they’ll notice what happens when they tap.

Good UX says: "Yes! You did it!"
Bad UX says: "Error 404. Undefined class in route.method.handler."

Design in the language of feedback loops—not error codes.

Why It Matters

Designing for low-literacy populations isn’t a nice-to-have. It’s a life-saving necessity.

Whether it’s COVID-19 education, maternal health advice, or chronic disease management—your design is your medicine. And medicine should come with a spoon, not a dictionary.

Final Thought: “You don’t teach a fish to fly. You teach it to swim smarter.”

Stop forcing literacy where it doesn’t fit. Instead, design for how people already learn, remember, and survive. Speak in pictures, guide with voices, test in the field, and always—always—respect the intelligence behind the illiteracy.

Because at the end of the day, saving lives should never be dependent on reading ability.

References

Living Goods. (2023). SmartHealth: Digital tools for community health. https://livinggoods.org/what-we-do/digital-health/

Viamo. (2024). Making mobile meaningful for the next billion. https://viamo.io

UNICEF Ethiopia. (2022). Health communication through the 960 platform. https://www.unicef.org/ethiopia/stories/health-info-dial

mPharma. (2024). Accessible healthcare for all Africans. https://mpharma.com