What Consent Formats Are Best Suited to Low-Literacy Populations?
Visual Consent Tools Where Literacy Levels are Low
Ensuring informed consent is one of the most important responsibilities in any research or data-collection activity. Yet traditional consent models rely heavily on written documentation, digital literacy, and legal phrasing that many participants cannot realistically access or understand. Even following all legal and ethical compliance in terms of data transfer, for NGO field researchers, community project managers, linguists, ethics reviewers, and data-collection leads working in diverse and often resource-limited settings, a central question emerges: How do we design consent processes that respect autonomy, protect individuals, and still function effectively where literacy levels are low?
This article explores practical and proven approaches to consent in low-literacy environments. It examines the barriers to traditional consent, compares alternative models, highlights the importance of cultural context, reviews legal and ethical frameworks, and shares real-world examples of inclusive consent in action. Through this, it aims to offer a detailed and implementable understanding of how to create accessible data participation processes that honour both the individual and the research mission.
Understanding Barriers to Traditional Consent
Traditional consent processes assume that participants can read and understand complex documents. They often require individuals to navigate written paragraphs filled with legal terminology, sign forms, or access digital platforms. In many communities, these assumptions break down quickly. Understanding the root causes of these barriers is essential to designing more accessible, culturally aligned consent experiences.
Low literacy is often the most visible barrier. Many individuals across Africa, Asia, and parts of Latin America do not have regular exposure to written materials, and reading ability may vary widely even within a single community. A written consent form can therefore create an immediate sense of exclusion and pressure. Participants may feel embarrassed to admit that they cannot read it, or they may sign without understanding because they trust the researcher or wish to avoid conflict. This creates an ethical gap between the researcher’s intention and the participant’s reality.
Another common barrier is limited digital access. As more research shifts to tablets, online forms, or mobile-based registration, the assumption grows that participants are comfortable with technology. In reality, many individuals have never used a touchscreen, lack a mobile device, or do not understand digital navigation prompts. Even in communities where smartphones are common, the concept of “agreeing” to conditions presented on a screen may not translate intuitively into informed participation. Digital consent cannot be assumed to be equivalent to informed consent.
Language barriers further complicate traditional models. Participants may speak a local language or dialect not fully represented within legal forms. Even when translations exist, the tone, vocabulary, and formality may feel foreign. Many communities rely on oral communication traditions, where meaning is frequently negotiated through conversation rather than fixed in writing. Consent processes that do not follow these familiar patterns may feel uncomfortable, untrustworthy, or simply confusing.
Finally, power dynamics shape the interaction. In many field settings, participants may perceive NGO staff, researchers, or health workers as authority figures. Declining participation may feel disrespectful or risky. Written agreements—especially those stamped, formalised, or associated with institutional logos—can reinforce the perception that declining is not truly an option. Without proactive mitigation of this power imbalance, consent becomes compliance rather than informed choice.
Recognising these barriers is the first step toward building a model of accessible data participation. Once these obstacles are acknowledged, organisations can design more intuitive, culturally resonant, and ethically robust consent pathways that respect the individual’s right to understand and choose freely.
Alternative Consent Models
To reach participants in low-literacy environments, consent formats must shift away from written text and toward communication methods that align with local realities. A range of alternative consent models exist, each offering new ways to support autonomy, comprehension, and transparency without relying on reading skills or digital proficiency. These alternatives can be used individually or in combination, depending on the community’s needs and ethical considerations.
One widely used approach is verbal consent. This method involves a trained field worker explaining the purpose of the project, the rights of the participant, the procedures involved, and any risks or benefits in clear, everyday language. Verbal consent can be recorded using an audio device, creating a documented record that satisfies legal and ethical requirements. This format allows participants to ask questions, receive clarifications, and enter a natural conversation rather than navigating a formal written process. Because it mirrors local communication norms, it often builds trust more effectively than paper-based forms.
Another increasingly popular model is audio-visual consent. This method uses video recordings where the researcher explains the study and the participant verbally indicates agreement on camera. Visual demonstrations or props can be used to illustrate complex concepts. Video consent is particularly helpful when working with diverse linguistic groups, as field workers can record explanations in multiple languages, ensuring consistent delivery across participants. It also provides clear proof that participants understood and voluntarily agreed.
For communities with very low literacy levels, pictorial consent tools are highly effective. These typically use illustrated cards or flipbooks that depict each key element of the consent process: confidentiality, voluntary participation, the right to withdraw, data use, and so on. Each illustration serves as a cue for the field worker to explain the concept aloud. Participants may be invited to point to images to indicate understanding or agreement. These tools reduce reliance on abstract legal language and instead use visual storytelling to communicate essential ideas. Pictorial consent is especially useful in multilingual contexts, where a single set of images can be used across several dialects with minimal adaptation.
Some organisations also use community-based consent models. Instead of approaching individuals directly, researchers may first present the project to local leaders—elders, chiefs, councils, or community health workers—who then help guide community members through the consent process. While the individual’s consent remains essential, these frameworks recognise the collective decision-making processes that many cultures naturally follow. When implemented responsibly, this approach can increase understanding and reduce anxiety about research participation.
Finally, iterative or ongoing consent is gaining traction. Rather than capturing consent once at the beginning, researchers check in with participants throughout the study to ensure continued understanding and willingness. This model acknowledges that consent is not a single event but a continuous conversation, particularly in environments where comprehension may shift with experience or where ongoing engagement is expected.
These alternative models show that consent does not need to be confined to written text. When adapted thoughtfully and ethically, verbal, audio-visual, pictorial, and community-aligned approaches can create inclusive, transparent, and trustworthy consent experiences that better serve low-literacy populations.
Cultural Context and Communication
Building accessible consent models requires more than simplifying language or replacing text with visuals. Meaningful consent emerges from approaches that respect cultural identity, communication norms, and local worldviews. In many communities, literacy levels and communication habits are closely tied to historical, social, and linguistic contexts. Ethical consent processes must therefore reflect not just how people communicate, but why communication takes the forms it does.
In oral cultures, the spoken word carries authority not because it is recorded, but because it is relational. Consent processes should therefore emphasise dialogue, reciprocity, and conversation rather than one-directional explanation. A field worker who spends time speaking with participants, inviting questions, and ensuring understanding through conversation mirrors local expectations of trust-building. This process often requires more time than written consent but results in stronger, more informed participation.
Cultural perceptions of authority also influence consent. In some communities, it is customary for individuals to defer to elders or leaders before making any significant decision. Researchers who ignore these social structures may unintentionally create conflict or misunderstanding. Recognising this, many organisations include a preliminary phase of community engagement. By meeting with local leaders, explaining the purpose of the project, and obtaining their support, researchers help integrate the consent process into culturally familiar decision pathways.
Language choice plays a central role. Many countries have dozens of languages and dialects, each associated with specific identities, regions, or social roles. Even when participants understand a lingua franca such as English, French, or Swahili, they may feel more comfortable receiving sensitive information in their home language. Consent scripts should therefore be translated by native speakers and tested through community review to ensure that key concepts—such as privacy, risk, or withdrawal—are communicated using culturally grounded explanations rather than literal translations.
Non-verbal communication also shapes how consent is received. Eye contact, hand gestures, tone of voice, and body posture vary significantly across cultures. A consent process delivered in a tone that appears rushed, formal, or impersonal may undermine participant confidence. Field workers must be trained not only in the content of consent but also in culturally appropriate delivery styles that convey respect and patience.
Visual communication, especially in pictorial consent formats, should also be culturally relevant. Images must accurately reflect local clothing, environments, and social relations. A consent card using illustrations that resemble Western classrooms or urban hospitals may feel disconnected from rural or traditional settings. Custom-designed visuals, built with input from community members, improve clarity and legitimacy.
Finally, time expectations matter. Some cultures value thoughtful deliberation before agreeing to participate. Researchers must allow space for participants to consult family, reflect, or ask further questions, rather than expecting immediate responses. Rushing the process contradicts the spirit of informed consent and risks miscommunication.
By grounding consent in culturally appropriate communication practices, researchers create environments where participants feel respected and understood. This strengthens the ethical foundation of data collection while supporting genuine voluntary participation.
Legal and Ethical Validation
While alternative consent models are essential in low-literacy environments, researchers must still ensure compliance with legal requirements and ethical standards. Fortunately, most regulatory frameworks—including GDPR in Europe, POPIA in South Africa, and international ethical review boards—already recognise and support non-written forms of consent as long as they are properly documented.
Under GDPR, consent must be freely given, specific, informed, and unambiguous. The regulation does not require written consent unless the context demands it; recorded verbal or audio-visual consent is explicitly acceptable. GDPR encourages the use of clear communication, particularly when engaging with vulnerable or marginalised groups. As long as the process demonstrates that the participant understood and agreed, alternative consent formats are valid.
POPIA, South Africa’s data-protection legislation, similarly emphasises meaningful participation and transparency. POPIA requires that data subjects be informed about how their information will be used. It allows organisations to capture consent through verbal statements, audio recordings, or any medium appropriate to the context. POPIA also highlights the importance of communicating in a form that is “reasonably understandable” to the individual—an important legal foundation for adapting consent in low-literacy settings.
Ethical review boards, including institutional review boards (IRBs) and research ethics committees, commonly approve alternative consent formats. Their primary concern is that participants understand the project and that researchers can verify voluntary participation. When submitting protocols for approval, researchers should provide detailed descriptions of the consent method, scripts, pictorial materials, or video explanations. Ethics boards often appreciate these adaptations, seeing them as evidence of careful and inclusive planning.
A central requirement across all frameworks is documentation. For verbal consent, researchers should maintain audio recordings and field notes. For pictorial consent, participants may point to symbols that indicate agreement, which can then be captured through photograph or audio confirmation. For video consent, the recording itself stands as evidence. Researchers must also ensure that participants can withdraw consent at any time, and the process for withdrawal must be explained using the same accessible format as the initial consent.
Confidentiality remains paramount regardless of the consent format. When recording verbal or video consent, researchers must ensure secure storage and restricted access. Recorded consent should not expose unnecessary personal information, and data-protection procedures must be communicated clearly to participants.
Ultimately, alternative consent models are not only compatible with legal and ethical frameworks—they often better embody the spirit of informed consent. Regulations aim to protect participants, and accessible consent models support that goal more effectively than traditional text-heavy documents.
Case Studies and Examples
Inclusive consent processes are not theoretical. NGOs, global health organisations, linguistic researchers, and humanitarian groups have implemented innovative consent models in real-world settings with significant success. These examples highlight practical lessons and demonstrate how alternative consent formats address low-literacy challenges while maintaining strong ethical standards.
One example comes from public-health fieldwork in East Africa, where researchers collecting speech samples from older adults discovered that written consent created anxiety and hesitation among participants. Many associated signing documents with legal conflict or government reporting. By shifting to verbal consent recorded on a mobile device, field workers created a relaxed, conversational dynamic. Participants engaged more openly, asked more questions, and felt in control of their decision. The shift not only improved comprehension but also increased participation rates without compromising ethical compliance.
In South Asia, literacy challenges combined with linguistic diversity prompted an NGO to develop pictorial consent cards. Each card included a simple illustration representing a core concept: confidentiality, purpose of data collection, risks, benefits, voluntary participation, and the right to withdraw. Field workers used the cards to guide conversations in local dialects. Participants reacted positively to the visual storytelling approach, and community elders noted that the illustrations made complex ideas easier to explain to younger family members. This approach became a long-term organisational standard for all community-level research.
A linguistic research project in West Africa used audio-visual consent to overcome language fragmentation across rural communities. Researchers pre-recorded consent scripts in five dominant languages and used handheld tablets to show participants short video explanations. After viewing the video, participants responded verbally on camera to indicate consent. This created a consistent and high-quality consent experience across geographically dispersed field sites. Ethics committees approved the process, citing its clarity and adaptability.
In Latin America, a community-based consent model was used for an environmental data-collection initiative. Before engaging individuals, researchers held open community discussions facilitated by local leaders. Individuals were then approached privately to ensure voluntary participation. This dual-layer model respected the collective decision-making culture while preserving individual autonomy. Researchers reported that participants felt more confident because community leaders had validated the project’s legitimacy.
These examples illustrate that consent processes become more effective when aligned with participant realities. Whether through spoken language, visuals, community trust structures, or technological adaptation, inclusive consent frameworks improve understanding, strengthen ethical integrity, and foster better research relationships.
Resources and Links
Wikipedia: Informed Consent – This resource provides a broad overview of the principles and history of informed consent across medical, research, and data-collection contexts. It explains how consent models have evolved globally and includes discussion on adaptations for multilingual, low-literacy, and culturally diverse environments. It is a valuable reference point for understanding the ethical foundations underlying alternative consent frameworks.
Featured Transcription Solution – Way With Words: Speech Collection – Way With Words provides comprehensive speech-collection services designed for real-world research environments across multiple languages, accents, and demographic groups. Their solutions support large-scale, ethical, and compliant audio data collection, including field projects in low-literacy or resource-limited areas. The service is ideal for organisations building speech datasets that require accurate documentation, clear participant communication, and culturally adapted collection workflows. Whether for AI development, linguistic research, or humanitarian projects, Way With Words delivers robust, ethically grounded speech-data solutions.