Health communication

By
Yamrot debela (BSC,MPH/HEHP)

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 Learning objectives

At the end of this class you are expected to:

Define health communication

Describe Principle of communication
Describe Types of communication
Discuses Communication models
Discuses Component of communication
Discuss stages of communication
List Barrier of effective communication

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 Definition of communication
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.

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.

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 Health communication

is the art and technique of informing,

influencing and motivating individuals or
larger audiences about important health
issues based on scientific and ethical
considerations.

It encompasses the study and use of

communication strategies to inform and
influence individual and community
decisions that enhance health
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 Principles of Health
communication

1. Perception: Perception of the sender & the

receiver should be closed as much possible
to create effective communication.
2. Sensory involvement/channel : The more
sensory organs involved in a communication
the more is its effectiveness from their
cumulative effect.
3. Face to face: The more communication
takes place face-to-face the more its
5 effectiveness.
Principles

4. Two-way : Any communication with two-way

process is effective because of opportunity for
simultaneous, timely & appropriate feedback

5. Clarity: Ideas, facts and opinions should be

clear to the sender before communication
happens.
6. Correct information: The sender should
have at hand correct, current and scientific
information before communication.
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 Principles

7. Completeness: Subject matter to be

communicated must be adequate and full.
This enables the receiver to understand the
central theme or idea of a message.

NB: The ultimate goal of all health

communication is to create behavioral
change.

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 Types of communication

One-way communication( One direction

flow)
The flow of information from the sender to the
receiver.
The communication is dominated by the
senders knowledge.
Information is transferred out towards the
receiver.
Does not consider feedback and interaction
with the sender.
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 One-way
Advantages
Faster

Disadvantages
No audience participation
Does not influence behavior
No feedback

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Two-way communication(two way flow)

The information flows from the sender to the

receiver and back from receiver to the sender
again in the other direction.
The receiver becomes the sender and the
sender in turn becomes a receiver.
More appropriate for problem-solving situations.

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 Two-way
Advantages
More audience participation
Learning is more democratic
Open to feedback
May influence behavior change

Disadvantages
Slower, takes more time

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 Communication models
Communication model generally
categorized into three;
1. Linear Model
is a one way model to communicate
with others.
It consists of the sender encoding a
message and channeling it to the
receiver in the presence of noise.
Linear model assumes that there is a
clear cut beginning and end to
communication.
It also displays no feedback from the
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 Examples
1. Aristotles communication model

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 Aristotle model of
communication
One of the earliest models of
communication
Aristotle represented communication
as m i g h t a n o r a t o r w h o s p e a k s t o
l a rg e audiences.
His model incorporates few elements.
I.Speaker
II.Message
III.Listener

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 2. Laswell model of communication

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 Laswell model of
communication...
This model includes considerations of a variety
of factors being considered to determine the
impact of a communication.

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 3. The Shannon-Weaver
Mathematical Model- 1949

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 The model introduces three elements:
a transmitter, a receiver, and sources of
noise.
E.g. telecommunications:

In telecommunication: Thetransmitter and

receiver would be the hardware used by the
sender and receiver during the act of
communication.
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 S & W's original model consisted of five
elements:
1.An information source, which produces
a message.
2. A transmitter, which encodes the
message into signals
3.A channel, to which signals are
adapted for transmission
4.A receiver, which 'decodes'
(reconstructs) the message from the signal.
5.A destination, where the message
arrives

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 2. Interactive Model

Is two linear models stacked on top of

each other.
The sender channels a message to the
receiver and the receiver then becomes
the sender and channels message to the
original sender.
This model has added feedback,
indicates that communication is not a
one way but a two way process.

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 Interactive Model

It also has field of experience which

includes cultural background, ethnicity
geographic location, etc.
There is feedback but it is not simultaneous.
The sender sends a message to the receiver,
then the original sender has to wait for the
message from the original receiver to react.
Or a question/answer session where you
just ask a question then you get an answer.

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 Examples

1. Schramms ...

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 2. Berlos model

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 Assumptions of Berlo's Model

1. There has to be a balance between the source

and the receiver if we want the communication
process to be efficient.
The balance exists in the following
Communication skills, Knowledge, Social
system, Culture, Attitude
2. The message construction should be observed
the following
Message element or content must be
appropriate to the receiver

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 Message structure of code includes the
encoding and decoding of messages
Encoding (written and spoken)
Decoding (listening , reading)
3. The most useful channel of communication
are the five senses.
Seeing, Hearing, Touching, Smelling
and Tasting

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 3. Transactional Model
Assumes that people are connected
through communication ; they engage in
transaction.

Firstly, it recognizes that each of us is a

sender- receiver, not merely a sender or
a receiver.

Secondly, it recognizes that

communication affects all parties involved.
So, communication is
fluid/simultaneous.
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Eg. Conversation
 Components of
communication
1) Source (sender)
Originator of message
Can be from an individual or groups, an
institution or organization
Has high source credibility
Trust and source of credibility may come from:
Personal qualities or actions
Qualification and training
A persons natural position in the family or
community
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 Characteristics of the source

Generally, the communicator/source should

possess the following xics:
Skill in communicating - verbal, written.
including treatment of message, etc.
Knowledge of the channel and audience.
Attitude towards the subject (topic), channel
and audience.
Source credibility
Skill in utilizing the channel
Confidence or attitude towards self.
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 2) Message
It consists of what is actually communicated.
Including the actual appeals, words, and pictures
and sounds.
A message is said to be good if it:
Is epidemiologically correct (evidence based)
Is affordable (feasible)
Requires minimum time/effort
Is realistic
Is culturally acceptable
Meets a felt need
Is easy to understand

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 Appeal

Appeal-is the way we organize the content of

the message to convince people.

For example what type of appeals might
convince persons with little or no schooling;
persons with high educational level; children;
and health workers?
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 Types of appeals in health
communication

1.Fear arousal appeal

The message is conveyed to frighten people

into action by emphasizing the serious
outcome from not taking action
Symbols such as dying persons, coffins,
grave stones, skulls may be used.
Evidence suggests that: Mild fear can
arouse interest, create concern & lead to
change. However, too much fear is not
appropriate for two reasons;
1st: It can lead to denying & rejecting the
message and results in laughter & failure to
take action
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2nd: It also involves ethical issues
 Fear arousing appeals

HIV/AI
Ds
makes
I am here, you to
my name is look
AIDS, take like
care this
HIV/AID
s
makes
you to
look
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like this
 Types of appeals
2.Humour
The message is conveyed in a funny way such
as cartoon
Humour is very good way of attracting interest
& attention
It is good to create a lasting memory but hard
to change beliefs and attitudes, it also may
not be funny for everyone

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 Humors.

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 Types of appeals
3.Logical / Factual appeal
The message is conveyed to convince
people by giving facts, figures and
information.
For example facts related to HIV/AIDS; its
causes, route of transmission, prevention
methods etc. Telling people the
percentage of people living with HIV virus.
It carries weight with a person of high
educational level.

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Types of appeals
4.Emotional appeal
The message is conveying to convince people
by arousing emotions, images & feelings
rather than giving facts & figures,
Example by showing smiling babies, wealthy
families with latrine etc, and associating with
FP education.
A Person with less education will often be
more convinced by simple emotional appeals
from people they trust.

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!!

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 Emotional appeals..

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Types of appeals

5.One sided message

Only presents the advantages of taking
action & does not mention any possible
disadvantages. E.g. educating the mothers
only about benefits of oral contraceptive
pill.

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 Types of appeals

6.Two sided message

Presents both the advantages &
disadvantages (pros & cons) of taking
action. Appropriate if
The audiences are exposed to different views
The audiences are literates
We are in face to face with individuals or
groups: it is easy to present both sides and
make sure that the audience understands
the issues
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Types of appeals

7.Positive appeals
Communications that ask people to do
something, e.g. breast feed your child, use a
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.
Positive compared with negative
appeals. Negative appeals use terms such as
avoid or dont to discourage people from
performing harmful behaviors. But most
41 health educators agree that it is better to be
3/20/17
positive & promote beneficial behavior.
 Effective Message Criteria/health
communication message review tool

1. The message must get & maintain attention

2.Put strongest points at the beginning of
message
3.The message must be clear
4.The action you are requesting is reasonably
easy
5.Make effective use of incentives
6. The messenger must be a credible source

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 Effective Message Criteria
7.Provide good evidence for threats and
benefits
8.Messages must be believable
9.Use an appropriate tone
10.Use an appropriate appeal
11.Do not harm audience

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3) Channel

A Channel is a physical means by which

message travels from a source to a receiver.
The commonest types of channels are verbal,
visual, printed materials or combined audio
visual and printed materials.

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Types of Communication Channels
1. Interpersonal channels - such as face to
face communication, home visits, group
discussions, and counselling- are generally
best for giving credibility to messages,
providing information, and teaching complex
skills that need two way communications
between the individual and the health workers
as a credible source of information.

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Types of Communication Channels

2. Broadcast channels: generally provide

broad coverage for communication messages,
reaching a large number of the target
audience quickly and frequently. For example,
Radio and television
3. Print channels - such as pamphlets, flyers,
and posters- are generally considered best for
providing a timely reminder of key
communication messages.

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 Channel selection criteria
Availability
Cost
Users preference & receivers' access
Adaptability to the communication
purpose/objective
Adaptability to the message content
Type of recipient & their stage in the adoption
process

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 4) Receiver (Audience)
The person or a group for whom the
communication is intended
Receiver decodes the message- the act of
interpreting message
The first step in planning any communication
is to consider the intended audience
Therefore, the communicator always has to
consider all aspects of the audience (the
culture, age, educational level, visual literacy
and media habits of the receiver while design
the message) by doing audience analysis.

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 Educational factors: can they read? What type
of appeals might convince them?

Socio-cultural factors: What do they already

believe and feel about the topic of
communication?

Patterns of communication: how people show

respect when talking to another person? What
time of the day and which programs do they
listen? Which places do they pass that might be
good places to put up posters?
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 5) Effect and feedback
Effect:- is the change in receivers knowledge,
attitude and practice or behavior
Positive
effect: when desired change in
knowledge, attitude, practice occurs;

Negativeeffect: when desired change in

knowledge, attitude & practice does not
occurs.
Feedback:- is the mechanism of assessing what
has happened on the receiver after
communication has occurred.
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 Methods of Communication
1. Intra - Personal communication
2. Inter - Personal communication
3. Mass communication
1. Intra-Personal communication
It takes place inside a person.
It includes the beliefs, feelings, thoughts and
justification we make for our actions.
E.g. a person may look at an object and
develop a certain understanding.

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 2. Interpersonal(face-to- face)Communication

Include all those forms of communication involving

direct interaction between two or more people who
are together at the same time and place.

E.g. between health extension worker and community

member, a teacher and students in a class.

Main effect=changes in attitude and behavior

= acquisition of problem solving skill.

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 Advantages
Dynamic or bi-directional
Feed back
Multisensory (channel)
Useful in all stages of adoption of
innovation
Useful when the topic is taboo or sensitive.

Limitations
Requires language ability of the source.
Requires personal status/credibility.
Needs professional knowledge and

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preparation.
3. Mass communication
It is a means of transmitting messages to a
large audience that usually reaches a large
segment of the population.
It uses mass media.

Main effect of this type of communication is:

Increased knowledge/awareness
Influence behaviors at the early stages.
Useful to communicate new ideas to early
adopters (opinion leaders).

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 Advantage:
Reach many people quickly
They are believable especially when the
source is a credible one
They can provide continuing reminders and
reinforcement.

Limitation:
One sided (linear)
Doesnt differentiate the target

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 Forms of
communication

Forms of
Communication

Verbal or oral Non-verbal Written

communicati communicati communicati
on on on

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 Forms of comm

1) Oral or Verbal communication

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 Forms of comm

It is communication by Word of mouth.

The message is received through our ear.
May also use mechanical devices such as
telephone, radio, Public address system etc.

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 2.Written Communication

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 Forms of comm

It involves the exchange of facts, ideas, and

opinions through a written instrument
/materials.
E.g. letters notes, leaflets, reports,
handouts, bulletins, newspaper.

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 3. Non-verbal communication

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 Forms of comm
Much communication also takes place through non-
verbal communication.

But most of us think a great deal about choosing

the words we say when talking with another person
and forget to plan for our non-verbal
communication.

The fact is, the gestures we use, how we look at

people, our tone of voice, how we are seated and
our clothes can all have an impact on the way
people interpret what we say.
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 Stages of Health Communication

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 Stages of Health
Stage 1. Reaching the intended audience
Communication cannot be effective unless it is
seen or heard by its intended audience.
A common cause of failure in this stage is
lecturing the converted
e.g. -posters placed at the clinic
Soln: Communication should be directed where
people are going to see or hear them.

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 Stages of Health

Stage 2. Attracting the audiences

attention
Any communication must attract attention so
that people will make the effort to listen and
read it.

Attention: is the process by which a person

selects part of the message to focus on while
ignoring others for the time being.

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 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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 Stages of Health

Stage 3. Understanding the massage

Another name for this stage is perception.

Perception is a highly subjective process.

For example, two people may hear the same

radio program or see the same poster and
interpret the message quite differentially from
each other and from the meaning intended by
the sender.
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 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 cannot absorb it at all

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 Stages of Health

Stage 4: Promoting Change (acceptance)

A communication should not only be received
and understood it should be believed &
accepted.

It is usually easier to promote a change when

its effects can be easily demonstrated

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 Stages of Health

Stage 5. Producing a Behavior Change

This can happen when the communication
has not been aimed at the belief that has
most influence on the persons behavior.
E.g. enabling factors: consider the enabling
factors

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 Stages of Health

Stage 6. 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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 Barriers to Effective
Communication

Barriers (obstacles) can inhibit communication,

resulting in misunderstanding, lack of response
or motivation and distortion of the message.

Can lead to conflicting of views, insecurity and

the inability to make effective decisions.

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 Common barriers to effective communication

1.Physical
Difficulties in hearing, seeing
In appropriate physical facilities(High tem., poor
ventilation)
Noise
Noise is a major distraction during communication.
a. Physical noise avoidable
b. Internal noise - any physiological or psychological
state that could undermine a persons ability to
communicate effectively:
Being ill
Overworked
Beset by personal problems.

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 2. Intellectual
The natural ability, home background,
schooling affects the perception/
understanding of the receiver for what he sees
& hears.
The ability of the facilitator/ education/
instructor.
3. Emotional
Readiness, willingness or eagerness of the
receiver
Emotional status of the educator

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 5. Cultural
Customs beliefs, religion, attitudes, economic
and social class differences,
language/vocabulary variation.
6. Status of the source
Status of the source either too high or too low as

compared to the audience also affects effectives

7. Inconsistencies between verbal & non-
verbal communication

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 How to achieve effective
communication
Communicating with small groups & being
direct
Using language easily understood & spoken
by the target group
Increasing the similarities b/n the sender &
receiver
Keeping the message short & clear
Putting yourself in the receivers shoes
Using multiple ways of communicating-
Verbal , written, audio or visual

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 Seven Cs of effective communication:

1. Command attention
2. Clarify the message
3. Communicate a benefit
4. Consistency count
5. Carter to the heart and head
6. Create trust
7. Call to action

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 Summary
Define health communication

What are the Communication models in

health education? Give examples for each.

Describe types of communication

What are the Component of communication

Describe Forms of communication

List Barriers of effective communication

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 Thank you

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