Health Communication

HEALTH COMMUNICATION
BY: TINSAE ABEYA (MPH IN HP/HB)

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.
2 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

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.

Cont…
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.

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.
Principles of Communication
Perception
Sensory involvement
Face-to-face
Feedback
Clarity
Information
Completeness

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”.

cont…
Advantages Disadvantages
-Faster -Little audience participation
-Orderly -Learning is authoritative
-No feedback
-Does not influence behavior

Cont…
M
S R
One-way communication
N.B.
 Unless mechanisms are set to get feedback from the
audience many mass media communications are one-way.

Cont…
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.

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

Cont…
Key
S =Source
M
M=Message
S C
R R= Receiver
C=Channel
F F=Feed back
Two-way communication

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.

Stage1. Reaching the intended audience
Communication can not 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.
Cont…
 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.

Stage 2. Attracting the audiences 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.

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 misunderstood at this stage and cause

communication failure.

Cont…
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.

Stage 4: Promoting change
(acceptance)
• A communication should be believed & accepted.
 Credible sources enhance acceptance.
 It is usually easier to promote a change when its effects can
be easily demonstrated.
• For example, ventilated improved pit latrines do not smell,

it is easier to promote change.

Stage 5. Producing a behavior change
 Communication should result in behavior change (change
in KABP).
• However, a communication may result in a change in beliefs

and attitudes but still does not influence behavior/action.
E.g lack of enabling factors to realize the behavior.

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.
Communication Stages Summary

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.

Cont…

Communication Process

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.

Cont…
 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.

Cont…
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.

Cont…
Messenger credibility is enhanced by:
» Power
» Perceived expertise
» Perceived honesty
» Attractiveness
» Being similar to the target audience

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.

Cont…
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).

Message appeals
 The way the content of the message could be organized
so that it can persuade or convince people.
32
Cont…
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 no schooling
 Mild fear may be appropriate
 Too much fear is not appropriate
33
Cont…
34
Cont…
2. Humors
 The message is conveyed in a funny way such as cartoon.
 Humor is very good way of attracting interest & attention.
 It can also serve a useful role to lighten the tension when
dealing with serious subjects.

 Enjoyment & entertainment can result in highly effective in
remembering and learning.
35
Cont…
3. Logical/factual appeal
 The massage is conveyed to convince people by giving
facts, figures and information,

 e.g. facts related to HIV/AID such as prevalence, morbidity
, mortality , rote of transmission etc.

 Logical appeals are good with a person of high educational
level.
36
Cont…
4. Emotional appeal
 The massage 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.
37
Emotional appeal
38
Cont…
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
39
Cont…
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
40
Cont…
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/field.
41
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.

Cont…
• The commonest types of channel are audio, visual,
printed materials or combined audio visual & printed
materials.

Cont…
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

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.

Cont…
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

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.

Cont…
Negative feedback: when the message has not been
understood.
• This kind of feedback, conveys lack of understanding.
• Positive feedback: when the receiver has understood the

source’s message.
• It does not necessarily mean that he or she agrees with the

source, just that the message was interpreted accurately.

Cont…
 Effective communicator is always;
Sensitive to feedback and
 Constantly modifies his or her messages as a result of
the feedback received.

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.

Cont…
 Finally, the receiver may not equipped 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
Cont…
1. Physical
 Difficulties in hearing, seeing
2. Intellectual
The natural ability, home background, schooling affects the
perception/understanding of the receiver for what he sees &

hears.
3. Emotional
Readiness, willingness or eagerness of the receiver

Cont…
4. Environmental
 Noise, invisibility, congestion,
5. Cultural
 Customs he beliefs, religion, attitudes, economic and social
class differences,
 language variation.

Cont…
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

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.

Attributes of Effective Health Communication
1. Accuracy ……free of errors and valid
2. Availability …place where audience access
3. Balance ……where appropriate present both risk
and benefits
4. Consistency …internally consistent over time and
consistent with information from other sources
5. Cultural competency ……culture sensitive
6. Evidence base …relevant scientific evidence

Cont…
7. Reliability ……source of content should credible
and-up-to date.
8. Reach …….should get the largest possible
population.
9. Repetition …repeat over a time either to reinforce
or to reach new generation.
10. Timelines …..deliver when the audience are most
receptive or in need of information.
11. Understandability ……consider language, reading
level, technical words.

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.

Cont…
 In most instances the key 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).
Cont…
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.

Cont…
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

Cont…
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.

Cont…
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).

Cont…
 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.

Cont…
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).

Cont…
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.

Forms of Communication

1. Verbal or Oral Communication

2. Non-verbal communication

Non-verbal communication…

Cont…

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.

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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HEALTH COMMUNICATION

BY: TINSAE ABEYA (MPH IN HP/HB)

 It is attached to almost anything that people do.

2 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

“communis” which means to make common, to share

people exchange ideas, facts, feelings or impressions in

3 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

process by which an idea is transferred from a source to a

informing, influencing, and motivating individuals,

4 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

-mobilize the community,

-implement health education programs &

-coordinate with different agencies.

6 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

receiver is one-way or unidirectional.

7 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

-Faster -Little audience participation

-Orderly -Learning is authoritative

-Does not influence behavior

8 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

 Unless mechanisms are set to get feedback from the

audience many mass media communications are one-way.

9 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

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.

10 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

-More audience participation -Slower

-Learning is more democratic -Not orderly

-Open for feedback

-Influence behavior change

11 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

12 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

health promotion–to promote improvement/change in

pass through several stages.

13 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

heard by its intended audience.

going to see or hear them.

find out where they might see posters, listening &

• posters placed at the clinic or

• talks given at antenatal clinics.

15 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

effort to listen and read it.

Examples of failure at this stage are:

• Walking past the poster without bothering to

• Not paying attention to the health talk or

demonstration at the clinic;

• Turning off the radio programs or switching over.

16 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

tries to understand it.

• The message should be perceived/understood as intended by

• Message may misunderstood at this stage and cause

17 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

• Complex language & unfamiliar technical words are used;

• Pictures containing complicated diagrams and distracting

• Pictures containing unfamiliar/strange subjects.

• Too much information is presented and people can not

18 BY: TINSAE ABEYA (MPH IN HP/HB) 06/25/2022

 It is usually easier to promote a change when its effects can

• For example, ventilated improved pit latrines do not smell,