**Background:** Nutrition and health sensitization programs in low-income countries often rely on visual aids such as posters and picture boxes, but learning videos are increasingly recognized as potentially more effective, especially for low-literacy populations. In Benin, videos are rarely used in nutrition programs despite government recommendations. A prior quantitative study by the same research team in southern Benin found that videos did not outperform traditional tools in improving children's dietary diversity and meal frequency, but were associated with improved breastfeeding knowledge and practices. This qualitative follow-up study aimed to understand perceptions of videos versus posters among end-users and implementers.
**Methods:** This cross-sectional study was conducted in two rural districts (Bopa and Houéyogbé) in the Mono department of southern Benin, where food insecurity affects 41% and 34% of households respectively (vs. 10% nationally). Four villages were randomly selected from those not previously exposed to a 2015-2016 nutrition program using videos/posters. Participants included 42 mothers of children under 2 years, 39 community leaders, and 30 NHCWs from 30 identified institutions. Data collection involved semi-structured interviews with NHCWs and focus group discussions (9-11 participants each) with mothers and community leaders. Learning sessions on two topics—'Dietary diversity' and 'Hygiene and deworming'—were simulated using either posters (graphic with French text) or videos (in local languages). Topics and tools were randomly assigned across villages. Sessions were audio-recorded, transcribed, and analyzed thematically by two researchers. Direct non-participant observations assessed participant attention and concentration.
**Key Results:** Among the 23 of 30 institutions that organized nutrition sessions, only 1 used videos, while 11 used image/picture boxes and 6 used posters. At the village level, 48 of 81 participants had received prior nutritional advice, with 29 sessions using no media, 16 using picture boxes, and 3 using posters. Approximately 73% of NHCWs found videos more suited to rural communities than posters. Videos were described as innovative, attractive, and self-explanatory due to local language use. During video sessions, participants showed total calm and attentiveness, whereas poster sessions involved significant whispering. However, mothers with children found it difficult to stay focused during videos—one mother stated: 'During the video, my child was crying, so I missed a lot… But with the poster, even if my child is crying… when I come back, the picture is still there.' Videos were superior for conveying dynamic processes (e.g., how worms enter the body from dirty hands), while poster images were sometimes ambiguous—for example, a picture of a food net was misinterpreted as a mosquito net, and photos of worms were mistaken for 'a dish of macaroni/spaghetti.' Approximately half of NHCWs thought videos addressed topics better than posters, 20% preferred posters, and 33% saw no difference. Both mothers and community leaders found posters more effective for medium- and long-term memorization because static images could be viewed repeatedly at one's own pace. Major constraints for video use included lack of electricity and equipment in villages. The SWOT analysis highlighted that videos offer standardization of messages and self-utilization but limited time for reflection, while posters allow large amounts of information and permanent display but depend heavily on facilitator skills.
**Clinical Implications:** The findings suggest that videos should not replace traditional tools but rather complement them, with the choice of medium depending on the specific learning objectives and topic. Videos are particularly valuable for conveying dynamic processes and for populations with low literacy, while posters are better for memorization and presenting comprehensive information (e.g., all foods in a food group). The logistical barriers (electricity, equipment) could potentially be addressed through mobile phone-based delivery, though in this context smartphones are typically owned by men. Providing smartphones to community leaders, especially women's association leaders, is suggested as a practical solution. The authors caution that participant enthusiasm for videos may partly reflect novelty effects and may not persist, and that entertainment value does not automatically translate into behavior change—as shown by the team's prior quantitative findings. A mixed-media approach, combining videos for engagement and standardization with posters for reinforcement and self-paced learning, is recommended for optimizing nutrition and health education in similar rural African settings.