Objective: To analyse the production and use of health education films in Kenya, Tanzania and Zambia. Design: Review of community health education films and their use by three partner organisations. Methods: A focused content analysis of 18 community health education films was conducted, and three exemplar films were selected for more detailed review. Interviews were carried out with four film production personnel and seven project workers using the films in health education projects in Kenya, Tanzania and Zambia. Concepts drawn from the Ottawa Charter for Health Promotion and Anchored Instruction informed the study. Findings: The films, produced primarily for use across sub-Saharan Africa, mostly conveyed biological information and addressed behavioural issues related to maternal and child health topics. The predominantly low-literacy audiences reached by the projects may further benefit from localised content highlighting the social determinants of health through engaging narrative formats. While the health education projects provided some opportunities to discuss the films after screening, linked problem-solving activities could raise awareness of the multiple factors influencing health and help community members formulate holistic action plans. Conclusion: The film production company responded to emerging findings, noting that more context-specific films should be produced, with community members being more fully involved in planning, production and evaluation. Such an approach could generate more relevant content and engage audiences more effectively in problem-solving related to health and wellbeing.