Health communication

BY
BIRTUKAN GIZACHEW(BSc, MPH)

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 Learning objectives

 At the end of this session you will be able to:

 Define communication and health communication
 Describe communication goals
 Explain models of communication
 Describe components of communication
 Explain types and forms of communication
 Discuss on Principles of communication
 Describe stages/skills of communication
 Differentiate approaches/skills of communication
 Describe barriers of communication
 Discuss DOT

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 Brain storming

What does communication mean?

What is HC?

 Is communication mere talking???

 When does talking become communication???

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 Definition of communication
 Communication is derived from the Latin word “communis” which means

to make common, to share information, ideas, attitude, to impart, to transmit.

 Communication is the process by which two or more people

exchange/share ideas, facts, feelings or impressions in ways that each

gains a common or mutual understanding.

 Health communication is the technique of informing, influencing,

and motivating individuals or large audiences about important health

issues on scientific and ethical considerations.
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 Definition……..

 The process always involves a sender and a receiver

regardless of the number of people concerned.

Health communication requires an appropriate design so as

transmit an effective message.

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 • Types of communication
There are two types of models:
1. Linear (one-way) model - there is only unidirectional flow of
information from the source to the receiver.
 The communication is dominated by the “sender's knowledge”.
(“Information is poured out”)
 No mention of the feedback/interaction with the sender
 used in advertising: designed to persuade the receiver to take
action prescribed by the sender.

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 one way…

Advantages Disadvantages

-Faster -Little audience participation

-Orderly -Learning is authoritative

-No feed back

-Does not/little influence of behavior

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 Com MODEL……..
2. Systematic (two-way) model - dynamic, bidirectional
 As the message is more complex, two-way communication
becomes essential.
 Information flows from the source to the receiver & back to the
source.
 Audience becomes the communicator (sender) & the sender in
turn becomes a communicant (audience).
 Feedback allows the sender to find out how the message is being
received- monitored and adapted to better suit the receiver’s
needs.

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 Com Models…

Advantages Disadvantages

-More audience participation -Slower

-Learning is more democratic -Not orderly

-Open for feedback

-Influence behavior change

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 Components/elements of communication
1) Source (sender)/Encoder
 Originator of message
 The sender should be the one who share similar
backgrounds with the receiver.
 makes the decision to communicate.
 Encoding: A process of conversation of subject matter(ideas
facts, feelings) in to symbol, signs, actions, pictures, audio-
visuals etc.

Qualities of source/Encoder

1. Empathetic -putting one self in the position of others.

2. Credibility
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 Components….
2) Message (what to say)
 Is a piece of information, ideas, fact, opinion, feeling or attitude

that passed from the sender to the receiver.

-It is considered important for the audience to know or to do.

 It is the subject matter of communication & exists in the mind of

the communicator.

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

organized so that it can persuade or convince people.

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 Message appeals……..
1. Fear arousal appeal
2. Humors
3. Logical / factual appeal
4. Emotional appeal
5. One sided message/appeals
6. Two sided message/appeals
7. Positive appeals
8. Negative appeals

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 Message appeals……..

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

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 Message appeals…

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 Fear arousal…

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 Message appeals…
2. Humors

• The message is conveyed in a funny way such as cartoon.

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 Message…

3. Logical / factual appeal

• The massage is conveyed to convince people by giving

facts, figures, and information

e.g. facts related to DM such as prevalence, mortality, etc.

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 Message…
4. Emotional appeal

• The massage is conveyed to convince people by

arousing emotions

e.g. by showing smiling babies associating with FP

education.

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 Emotional appeal…

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 Emotional appeals..

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 Emotional appeal

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 Message…
5. One sided message/appeals

• Only presents the advantages of taking action

Ex. Benefits of oral contraceptives, Exclusive BF

6. Two sided message/appeals

• Presents both the advantages & disadvantages (pros’ &

cons’) of taking action.
The audiences are literates.

 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 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.
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 3) Channel
 A Channel is a physical means(a bridge) by which message
travels from a source to a receiver. = medium of communication

1. Interpersonal channels - such as face to

face communication, home visits, group
discussions, and counselling.

 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 flyers, and
posters- As timely reminder of key
communication messages.

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 4) Receiver (Audience)
 The person or a group for whom the communication is intended
or the person who receive the message.

Decoding: A mental process by which the stimuli that has been

received through the sensory organs are given a proper meaning
according to the individuals way of thinking.

 The receiver converts the symbols, signs, words and pictures

etc. received from the sender to get meaning of the message
(interpreting messages).

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 5) Effect and feedback
Feedback :is the mechanism of assessing what has happened on
the receiver after communication has occurred.

 When the receiver of the message gives response to the sender.

 Helps to understand how well the messages have been received

by the receiver, understood, interpreted, and act up on it.

Effect: is the change in receiver’s knowledge, attitude and practice

or behavior. (Positive effect/ Negative effect)

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 Types of Communication
1. Intra - Personal communication
2. Inter - Personal communication
3. Mass communication
1. Intra-Personal communication
 It takes place inside a person/an individual.
 How people process and understand a message within.

 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
 Involving direct interaction between the source & receiver.

 It means interaction between two or more people who are

together at the same time and place.

 The powerful advantage of face-to-face communication over

mass media is, it gives the opportunity to ask the audience
questions and obtain their feedback.

E.g. between health extension worker and community member, a

teacher and students in a class.

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 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(Broad cast & printed media)

 The powerful advantage of mass media over face-to-face is rapid

spread of simple facts to a large population at a low cost.

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 Mass communication…….

Advantages
Limitations
 Can reach many people quickly.
 One sided(Linear)
 Believable ( if credible source)
 Does not differentiate the

target audience

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 Forms of communication
According to the way of expression there are three
methods/forms of communication.

Forms of Communication
Verbal or oral Non-verbal Written
communication communication communication

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 Forms of communication ………..

1. Oral or Verbal communication

 It is communication by Word of mouth/ speech or talk is the
widely adopted tool of communication.

 The message is received through our ear.

 May also use mechanical devices such as telephone, radio, Public

address system etc.

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 Forms….
2.Non-verbal communication
 In a normal conversation between two persons about

35% by words &

65% of the message is conveyed through non-verbally.

 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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 Non-verbal communication….

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 Facial expression..

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 Forms….
3.Written communication
 It involves the exchange of facts, ideas, and opinions through a
written instrument /materials.

E.g. letters, notes, leaflets, reports, handouts,

newspaper.

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 Communication stages
 In health education and health promotion we communicate for a
special purpose.

 To promote improvements in health through the modification of

the human, social and political factors that influence behaviors, a
successful communication must past through several stages.

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 Stages…….

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 Stages……
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 preaching to

the converted .

e.g. Posters placed at ANC clinic

These only reach the people who attend the services and
are already motivated

Solution: Communication should be directed where

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people are going to see or hear them.
 Stages…….
Stage 2. Attracting the audience’s 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.

Examples of failure at this stage are:

-Walking past the poster without bothering to look at it

-Turning off the radio programs or switching over.

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 Stages…..
Stage 3. Understanding the massage /perception
 Once the person pays attention to a message he/she
then tries to understand it.

 Perception is a highly subjective process

Examples of failures at this stage can take place when:

-Complex language
-unfamiliar technical words;
-Pictures containing complicated/unfamiliar diagrams
- Too much information
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 Stage 3. Understanding………….

I ODI ZED SAL T I N Y OU R DI ET AVOI DS GOI TER

G
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SEA SALT IS THE BEST SOLUTION FOR GOITER

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 Stages……
Stage 4: Promoting Change (acceptance)
 A communication should not only be received and
understood – it should be believed & accepted.

 Credible sources enhance acceptance

 It is usually easier to promote a change when they

have been -acquired only recently &
-easily demonstrated effects.

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 Stages……
Stage 5. Producing a Behavior Change
 Communication should be resulted in behavior change.

 However, a communication may result in a change in knowledge

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

Stage 6. Improvement in Health

 Communication should result in improvement in 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 of effective communication
Physical : difficulties in hearing, seeing

Intellectual: the natural ability, home background

Emotional: readiness, willingness or eagerness of the receiver/

emotional status of the educator.
Cultural: Customs S/he beliefs, religion,
attitudes, economic and social class
differences, language /vocabulary variation.

Status of the source of information:

-either too high or too low as compared to
the audience.
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 Diffusion of innovation theory (DOI)
Community-level models: are frameworks for understanding how
social systems function and change, and how communities and
organizations can be activated.

Mostly used in market advertisement of new

technologies.

Adoption of innovation: decisions to

adopt an innovation are made only after
multiple contacts with a variety of
communication channels over a long period.

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 Diffusion of innovation……
DOI:is a process by which innovation is
communicated through certain channels over time
among the members of a social system.

The four main elements of the definition

are:
I. Innovation
II. Communication channels
III. Time
IV. Social system

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 I. Innovation
122
idea, practice, or object that is perceived to be new
by an individual or other unit of adoption

 The Characteristics which determine an

innovation’s rate of adoption are:

1. Relative advantage
-is the degree to which an innovation is perceived as
better than the idea it replace

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 Characteristics…
2. Compatibility
123
-is the degree to which an innovation is perceived
as being consistent with the existing values, past
experiences, and needs of potential adopters
3. Complexity
-is the degree to which an innovation is perceived
as difficult to understand and use.
4. Trialability
-is the degree to which an innovation may be
experimented with on a limited basis
5. Observability -is the degree to which the results
of an innovation are visible to others

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124
II) communication channels
-It is the means by which messages get from one
individual to another.
Mass media, Interpersonal etc.
III) Time
 The three time factors are:
(a) innovation-decision process/The Adoption
Process/
(b)innovativeness or Adopters
(c) innovation's rate of adoption

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 a) The Innovation - Decision Process
125
 /The Adoption Process / - the process an
individual passes from first knowledge of an
innovation to confirmation of his decision.

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 b) ADOPTER CATEGORIES
128
 When people become “consumers” of an innovation they are
referred to as adopters

 There are five segments (adopter categories) in the diffusion

process based on the amount of time it took to adapt an
innovation. These are;

1. Innovators 4 .Late majority

2. Adopters 5. Laggards
3. Early majority

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 Adopter categories :
129

1. Innovators
 Are first to adapt an innovation (they want to be first
to do something)

 They are venturesome, independent, risky, daring

and desire for rush.

 They have the ability to understand and apply

complex technical knowledge (mostly they are
literates).

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 Innovators…….
130
 Have the ability to cope with high degree of
uncertainty about the innovation.

 Are few and changed very earlier.

 they have higher socioeconomic status than any

other group

 they require a shorter adoption period than any

other category

 Accounts 2.5%

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 adopter categories…
131

2. Early adopters
 Are very interested in innovation, but they do not
want to be first to be involved.
 Possess greatest degree of opinion leader ship in
most social systems ( are respected by peers)
 And are usually successful.
 Serve as role model for other members or society
 the next 13.5% of the individuals in a system to
adopt an innovation

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 adopter categories…
132
3. Early majority
 May be interested in innovation, but will need
some external motivation to get involved.
 Interact frequently with peers (sociable and
jockey)

 Deliberate (check and discuss) before adopting a

new idea.

 is the next 34% of the individuals in a system to

adopt an innovation.

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 adopter categories….

133

4. Late majority
 Are skeptical and cautious and will not adopt an
innovation until most people adopt.
 one-third of the members of a system
 Pressure from peers.
 And adapt because of economical necessity
 is the next 34% of the individuals in a system to
adopt an innovation.

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 adopter categories…

5. Laggards
134

 Will be the last to get involved in an innovation, if

they get involved in an innovation at all.

 Isolateds in the social systems

 Point of reference is in the past.

e.g. ‘Diro kere diro eko! Doro 25 santim neber’.

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 adopter categories…
 Suspicious of innovation
E.g. what if the ‘whites’ put virus in the
condom?

 But also are usually with limited resources.

 Innovation-decision making is lengthy

 are the last 16% of the individuals in a system

to adopt an innovation

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 16
%

34
%
34
%

13.5
%
2.5
%

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 c) THE RATE OF ADOPTION
 The relative speed with which an innovation is
136
adopted

 Measured by number of adopters at a given time

 Influenced by characteristics of the innovation

IV. SOCIAL SYSTEM

 a set of interrelated units that are engaged in joint
problem solving to accomplish a common goal.

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 Think the best,
Work for the best, then
Expect the best!
THANK YOU!

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