Health

Communication
Beimnet
DK.(MPH/HPHB)

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 I. Introduction
II. Definition
III.Relevance to Health Education
IV.Principles of Communication
Presentation V. Communication Models
VI.Communication Stages
Outline
VII.Communication Process
VIII.Methods of Communication
IX.Forms of Communication
X. Qualities of
effective Communication
 I. Introduction

• It is evident that all meaningful social interaction can be called as

communication.
• Communication is an essential part of a human life. It is attached to almost
anything that people do.
• Is communication mere talking???
• When does talking become communication???

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 II. Definition

• The word communication is derived from the Latin word “communis”

which means to make common, to share information, ideas or attitude, to
impart, to transmit.
• Communication is the process by which two or more people exchange
ideas, facts, feelings or impressions in ways that each gains a common or
mutual understanding of the meaning and the use of the message.

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 Definition …

• Evert M. Rogers (1993), defined “communication as the process by which

an idea is transferred from a source to a receiver with intent to change
his/her behavior.”
• Health communication is the art and technique of informing, influencing,
and motivating individuals, institutions, and large public audiences about
important health issues based on sound scientific and ethical consideration.

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 III. Relevance to Health Education

• It helps to
-mobilize the community,
-implement health education programs &
-coordinate with different agencies.
• The ultimate goal of all communication is to create behavioral change.

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 IV. Principles of Communication

• Perception
• Sensory involvement
• Face-to-face
• Feedback

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 V. Communication Models

I) Linear (one –way) model

• The flow of information from the sender to the receiver is one-way or
unidirectional.
• The communication is dominated by the “sender’s knowledge”.

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 Communication Models…
Advantages Disadvantages
• Faster • Little audience participation
• Orderly • Learning is authoritative
• No feedback
• Does not influence behavior

One-way communication
N.B.
Unless mechanisms are set to get feedback from the audience many mass media
communications are one-way.

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 Communication Models…

II) Systems (Two –way)

• Information flows from the source to the receiver & back from receiver to
the source.
• This is reciprocal in which the communicant becomes the communicator &
the communicator in turn becomes the communicant.

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 VI. Communication Models…

Advantages
Disadvantages
• More audience participation
-Slower
• Learning is more -Not orderly
democratic
• Open for feedback
• Influence behavior
change

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Communication Models…

Key
S =Source
M=Message
C R= Receiver
C=Channel
S M R F=Feed back

Two-way communication

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 VI. Communication Stages
• Special purpose of communication in health education
and health promotion–to promote improvement/change in
health through the modification of the human, social and
political factors that influence behavior.

• To achieve this objective, a successful communication

must pass through several stages.

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Communication stages…
SENDER RECEIVER
Reaches senses
Gains attention
Message understood
Acceptance/change
BEHAVIOR CHANGE
CHANGE IN HEALTH

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 Stage1. Reaching the
intended audience
• Communication cannot be effective
unless it is seen or heard by its intended
audience.
• Communication should be directed
where people are going to see or hear
them.
• This requires sound study of your
intended audience to find out where they
might see posters, listening &
reading habits are.

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 Stage 1…

• A common cause of failure in

this stage is preaching the
converted .
e.g.
• posters placed at the clinic
or
• talks given at antenatal
clinics.
• These only reach to the people
who are already motivated &
attended the service.

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 Stage 2. Attracting
the audience's
attention
• Any communication must attract
attention so that people will make the
effort to listen and read it.
Examples of failure at this stage are:
• Walking past the poster without
bothering to look at it;
• Not paying attention to the health
talk or demonstration at the clinic;
• Turning off the radio programs or
switching over.

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 Stage 3.
Understanding
the message

• Once the person pays

attention to a message, he/she
then tries to understand it.
• The message should be
perceived/understood as
intended by the sender.
• Message may misunderstand at
this stage and cause
communication failure.

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 Stage 3…
Examples of failures at this stage can take
place when;
• Complex language & unfamiliar
technical words are used;
• Pictures containing complicated
diagrams and distracting details.
• Pictures containing unfamiliar/strange
subjects.
• Too much information is presented, and
people can not absorb it.

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Stage 3…

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Stage 3…

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Stage 4: Promoting • A communication should be believed & accepted.
change(acceptance) • Credible sources enhance acceptance.

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 Stage 5. Producing a
behavior change

• Communication should be resulted in

behavior change (change in KABP).
However, a communication may result in a
change in beliefs and attitudes but still
not influence behavior/action.
E.g., lack of enabling factors to realize the
behavior
.

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 Stage 6.
Improvement in
health
• Communication should result
in improvement in health.
• Improvement in health will only
take place if the behaviors have
been carefully selected so that
they really influence health.
• If your messages are based on
outdated & incorrect ideas,
people could follow your
advice, but their health would
not improve.

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Communication
Stages Summary
 VII. Communication
Process

• The communication process is a system that involves an interrelated,

interdependent group of elements working together as a whole to achieve a
desired outcome or goal.
• It is not a linear process rather it is a cyclical process that involve many
elements.
• Communication process involves eight elements.

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Communication Process…

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Communication Process…

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 1. Source/Encoder

• The communicator is the originator of the message.

• The sender begins the communication process by forming the ideas, intentions
and feelings that will be transmitted.

• Senders are required to filter out the details that are unimportant and focus on the
most relevant information.

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 Source/Encoder…

• The source, or encoder, makes the decision to communicate.

• The source also determines the purpose of the message to inform,

persuade, or entertain.

• Source should determine how the message gets from the source
to the receiver.

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 Source/Encoder…

• First, the source must encode or create a message.

• That is, the information that the source wishes to convey must be
put into a form that can be sent to the receiver.
Qualities of source/sender
1. Empathetic-putting oneself in the position of others.
2. Credibility-particularly the messengers.

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 Source/Encoder…

• Messenger credibility is enhanced by:

» Power
» Perceived expertise
» Attractiveness
» Being similar to the target audience

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 2. Message

• Message is a piece of information, ideas, facts, opinion, feeling, attitude or a course

of action that is passed from the sender to the receiver.
• It is the subject matter of communication-something that is considered important for
the audience to know or do.
• The code and content of the message should be appropriate to the receiver and
should be arranged in a way that it looks attractive.
• The content (idea, innovation, or technology) should be appropriate to the
audiences.
• Treatment (arrangement, organization and presentation of code and content).

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 Message…

Message appeals: The way the content of the message could be

organized so that it can persuade or convince people.
1. Fear arousal appeal
• The message is conveyed to frighten people into action by
emphasizing the serious outcome from not taking action.
➢ Appropriate with people who have no schooling.
➢ Mild fear may be appropriate
➢ Too much fear is not appropriate

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Message…

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 Message…

2. Humors
• The message is conveyed in a funny way such as cartoon.
• Humor very good way of attracting interest & attention.
• It can also serve as a useful role to lighten the tension when dealing
with serious subjects.
• Enjoyment & entertainment can result in highly effective
remembering and learning.

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Message…

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 Message…

3. Logical / factual appeal

• The message is conveyed to convince people by giving
facts, figures and information.
e.g., facts related to HIV/AIDS such as prevalence, morbidity,
mortality , route of transmission etc.
• Logical appeals are good with a person of high educational level.

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 Message…

4. Emotional appeal
• The message is conveyed to convince people by arousing emotions,
images & feelings rather than giving facts & figures.
e.g., by showing smiling babies, wealthy families with latrine etc,
and associating with FP education.
• More influence a persons with less education.

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 Message…
Emotional appeal…

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 Message…

5. One sided message/appeals

• Only presents the advantages of taking action & does not mention
any possible disadvantages.
• One sided message may be effective:
1) If the audience will not be exposed to different views.
2) If the communication is through mass media-selective perception.

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 Message…

6. Two-sided message/appeals
• Presents both the advantages & disadvantages (pros’ & cons’) of
taking action.

• Appropriate if ;
• The audiences are literates.
• The audiences are exposed to different views.
• We are in face-to-face with individuals or groups.

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 Message…

7. Positive appeals
• Communications that ask people to do something, e.g. breast feed
your child, use latrine.
8. Negative appeals
• Communications that ask people not to do something, e.g. do not
bottle feed your child, do not defecate in the bush.

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 3.Channel/medium

• The channel is the way through which a message is sent out.

• It is the physical bridge or the media by which the message travels between source and receiver.
• It is also called the medium of communication.

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 Channel/medium…

• The commonest types of channels are audio, visual, printed

materials or combined audio visual & printed materials.

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 Channel/medium…

Criteria: Channel selection

• Availability
• Cost
• Users’ preference and receivers’ access
• Adaptability to the communication purpose/objective
• Adaptability to the message content
• Type of recipient and their stage in the adoption process

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 4. Receiver/decoder –
‘audience’

• The person or the group for whom the communication is intended or the
person who receive the message.
• Receiver decodes the message- the act of interpreting messages.
• Receivers decode messages based on past experiences, perceptions,
thoughts and feelings.

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 Receiver/decoder…

• The 1st step in planning any communication is to consider the intended

audience.
• It is important to understand the audience from the following
perspective. Analysis …..segmentation ….audience profile

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 5. Feedback

• A communication is said to have feedback when the receiver of the message

gives his/her responses to the sender of the message.
• The sender must know how well the messages have been received by the
receiver, understood, interpreted, and act up on it.
• It completes the process of communication.

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 Feedback…

Effective communicator is always;

• Sensitive to feedback and
• Constantly modifies his or her messages as a result of the feedback
received.

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 6. Communication Context

• Communication context is the environment were communication takes

place.

• They are sources of noise which interfere with communication process.

I. physical context
II. cultural context
III. social-psychological context
IV. temporal (time) context

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 7. Barriers/Noise

• Barriers are any obstacles or difficulties that come in the way of

communication.
• It can occur at any stage of communication process.
• The source’s information may be insufficient or unclear. Or the message can
be ineffectively or inaccurately Encoded.
• The wrong channel of communication may be used.

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 Barriers/Noise…
• Finally, the receiver may not equip to handle the decoded message
in such a way as to produce the response (feedback) expected by the
source.

-Physical -Environmental

-Intellectual -Cultural

-Emotional -Status of the source

-Inconsistencies between verbal & non- verbal communication

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 How to achieve effective
communication ?
• Communicating with small groups and being direct.
• Using language easily understood and spoken by the target
group.
• Increasing the similarities between the sender and the
receiver.
• Keeping the message short and clear.
• Putting yourself in the receiver’s shoes.
• Using multiple ways of communicating – verbal, written,
audio or visual.
• Keeping confidences and listening.

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 VIII. Methods of
Communication
There are two main groups of methods;
1. Face-to-face (‘interpersonal’)
2. Mass media.
1. Interpersonal methods
• Face-to-face or interpersonal methods include all those forms of
communication involving direct interaction between the source & receiver.
• In most instances the decisive criterion for personal communication is.
– Communication at the same time &
– Communication at the same place.
• Examples of face-to-face communication with increasing audience size
are; one-to-one & counseling; small group (less than 12 persons);
intermediate group/lecture (between 12 and 30); and large group lecture/
public meeting (more than 30).

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 Methods of Communication…
• The powerful advantage of face-to-face communication over mass media is,
it gives the opportunity for the audience to ask questions and obtain their
feedback.
• However, as the size of the group increases, it is more difficult to have
feedback & discussion. So public meetings share many characteristics of
mass media in that they involve limited participation & feedback.
• Main effect =changes in attitude and behavior.
= acquisition of problem-solving skill.
Advantages :
1. Dynamic or bi-directional
2. Feedback
3. Multisensory (channel)
4. Useful in all stages of adoption of innovation

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 Methods of Communication…
5. Useful when the topic is taboo or sensitive
6. Can fit to local needs
7. Can be highly selective
Limitations:
• Easily distorted – as we mostly rely on word-of-mouth.
• Often needs multi-lingual.
• Needs personal status/ credibility.
• Needs professional knowledge & preparation.

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 Methods of Communication…
2. Mass media
• Mass communication is a means of transmitting messages, on an electronic
or print media, to a large segment of a population.
• The word media is currently used to refer not only broadcast media (such as
radio & TV) and print media (such as papers, magazines, leaflets & wall
posters) but also folk media (such has art, town criers, songs, plays, puppet
shows & dance).
• The powerful advantage of mass media over face-to-face is rapid spread
of simple facts to a large population at a low cost.
• Main effect
– Increased knowledge/awareness.
– Set & changes in norms and provide alternative behavior.

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 Methods of Communication…
Advantages:
1. They can reach many people quickly.
2. They are accurate and believable e.g. article on a newspaper, or “voice” of
highly respected person.
3. They can provide continuing reminders and reinforcement.
4. Useful to communicate new ideas to early adopters (opinion leaders).
Limitations:
1. One sided/poorly organized
2. Does not differentiate the target
3. Only provides non-specific information

Mind now!
A well-planned program will involve a carefully chosen mix of both approaches to
exploit their different advantages.

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IX. Forms of Communication

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1. Verbal or Oral Communication

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 When to use oral communication?
1. When the receiver is not particularly interested in receiving the
message.
2. It is important to get feedback.
3. The receiver is too busy or preoccupied to read.
4. The sender wants to persuade or convince.
5. When discussion is needed.
6.When criticism of the receiver is involved.
7.When the receiver prefers one-to-one contact.

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Non-verbal communication

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Non-verbal communication…

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 Non-verbal communication…
• Non-verbal communication refer to using a non-spoken symbol to
communicate a specific message.

Non-verbal messages can;

• Support verbal messages (clarify)

• Contradict verbal messages (mixed messages)

• Replace verbal messages (secrets)

❖ It is easy to lie with word but much more difficult with non-
verbal communication.

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Characteristics of non-verbal
communication

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 Non-verbal communication…
Bodily speaking…
• In a normal conversation between two persons, less than 35% of the social
meanings is actually transmitted by words.
• So, at least 65% of it is conveyed through the body (non-verbal channel).

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 Non-verbal communication…
A. Eyes
• The most powerful and most expressive part of the body.
• Maintaining good eye contact with others, says “I am interested, and I
respect you”.
• Be careful about cultural differences.
• No eye contact indicates lack of interest.
B. Facial expression
• Our face communicate emotion
• Understanding
• Ambiguous at times
• Can be deceptive

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Non-verbal communication…

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 Non-verbal communication…
C. Hand and arm gestures
• Further away from body
• Hands are the most sensitive
• Legs gives away a great deal of information
• Openness
D. Posture
• Culture dependent
• No universal language (meaning)
• Consider the context (the circumstances that form the setting for an
event, statement or idea, it helps make it full understood)
• Concurrence
• Body angle
• Standing straight can indicate confidence.
• Dragging your feet can indicate you are tired or reluctant to go where
you are going.

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 Non-verbal communication…
E. Voice Characteristics…
• Speaking loudly and quickly…Anger
• High pitch, fast rate, loud volume, and upward inflection……..Joy
F. Appearance
• Body shape
• Clothing
• Dressing up and dressing down
• Attractive look
G. Time (unspoken message)
• Arrive early & leave late!
• Clock watcher
• Amount of time spend on certain tasks or meeting
• Punctuality

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 Non-verbal communication…
H. Space
• Maintain the appropriate distance
• Remove any object between the speaker/listener
• Lean forward to express connection
Remember;
• Make sure your body and your mind speak the same language !

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 3. Written communication
• It involves the exchange of facts, ideas, and opinions through a written
instrument /materials.
• Successful written communication requires careful thought and clear planning.
A plain writing style should be used.
• Because it is easy to understand and reduces the chances of misunderstanding
and ambiguity.
Use Written Communication When:
1. The sender wants a record for future references.
2.The message is complex and requires study by the receiver.
3. The message includes a step-by- step procedure.
4. Oral communication is not possible because people are not in the same place and
at the same time.
5. There are many receivers.
6. The receiver prefers written.

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 X. Qualities of effective communication

• The communicator should be knowledgeable, positive attitude, skilled and

have credibility.
• The message should be simple (or brief & clear) meaningful, appropriate,
relevant, and timely (SMART).
• The channel should be familiar, appropriate, available & accessible.
• The receiver should also be responsible with proper attitude to receive the
information.

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