Firanbon T (BSc, MPH/HPHB)
Department of Health, Behavior and Society
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At the end of this session, you will able to:-
• Define health communication
• List principles of communication
• Understand the models of communication
• Discuss forms of communication
• Familiar with the communication process
• Describe stage of communication
• Identify barriers to effective communication
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• What is communication?
• Does communication differ from
• What does health communication
• What are the roles of communication
in health education and health
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Communication is a process by which two or more people
exchange ideas, facts, feelings or impressions in ways that
each gains a common understanding of the message.
It helps to increases knowledge, mobilize the community
Influences perceptions, beliefs, attitudes and social norms
Demonstrates health related skills, Advocates for a health
Create behavioral change(ultimate goal)
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Principles of communication
i) Shared perception: for communication to be effective the
perception of the sender should be as close as possible to
the perception of the receiver.
ii) Sensory involvement: the more senses involved in
communication, the more effective it will be. If I hear, I forget. If I see, I
remember. If I do, I know.
iii) Face to face: when communication takes place in face-to-
face it is more effective.
iv) Feedback(Two-way): any communication without a two-way
process is less effective.
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v) Clarity: ideas, facts and opinions should be clear to the
sender before communication happens.
vi) Correct information: the sender should have at hand
correct, current and scientific information before
vii) Completeness: subject matter must be adequate and full
which enables the receiver to understand the central theme
or idea of a message.
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Components of communication
A) Source /sender/Encoder: The originator of the
• The source must encode or create a message.
• Encoding: is the process of turning thoughts into
communication. It means the creation of messages
which you want to communicate with other person.
B) Receiver/audience/Decoder: The person or the group
who receive the message
• Receiver decodes(interpret) the message
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Components of communication…..
• Decoding: is the process of turning communication into
thoughts. It means interpreting the meaning of the
• Receivers decode messages based on past experiences,
perceptions, thoughts and feelings.
C) Message: is a piece of information, ideas, facts, opinion,
feeling, attitude or a course of action that passed from the
sender to the receiver
• It is the subject matter of communication
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• Message appeals: The way the content of the message
could be organized so that it can persuade or convince
Why we consider different types of message appeals?
• Not everyone responds in the same way.
• What might persuade you to do something might be
quite different from what might persuade another person.
E.g. The type of appeals that could convince people with little or
no schooling might be different from those that convince people
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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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• The message is conveyed in
a funny way such as
• Humor very good way of
attracting interest &
• lighten the tension when
dealing with serious
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3. Logical / factual appeal
• The message is conveyed to convince people by
facts, figures and information.
e.g. Facts related to HIV/AIDS such as its prevalence,
causes, route of transmission, prevention methods,
• Logical appeals are good with a person of high
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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
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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
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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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7. Positive appeals
• Communications that ask people to do something,
e.g. breastfeed 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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•The channel is the way through which a message is
•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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• The commonest types of channel are audio, visual,
printed materials or combined audio visual & printed
Criteria: Channel selection
Users’ preference and receivers’ access
Adaptability to the communication
Adaptability to the message content
Type of recipient and their stage in the adoption
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• 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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• Negative feedback: when the message has not been
• This kind of feedback, conveys lack of understanding.
• Positive feedback: when the receiver has understood the
• It does not necessarily mean that he or she agrees with
the source, just that the message was interpreted
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Diagram: Communication Process
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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”.
N.B: Unless mechanisms are set to get feedback from the
audience many mass media communications are one-way.
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-Faster -Little audience participation
-Orderly -Learning is authoritative
-Does not influence behavior
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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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• C- Channel
• F- Feedback
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-More audience participation -Slower
-Learning is more democratic -Not orderly
-Open for feedback
-May influence behavior change
-More appropriate for problem-solving
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One way or two way communication?
Types/Methods of communication
There are two main types;
A) Interpersonal (face-to-face)
• It includes all those forms of communication
involving direct interaction between the source
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Example of interpersonal(face to face) communication
• 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.
• In this case, it is possible to cheek that you have been
understood & give further explanations.
• However, as the size of the group increases, it is more
difficult to have feed back & discussion.
• Main effect of this type of communication are changes in
attitude and behavior and acquisition of problem solving
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• Dynamic or bi-directional
• Feed back
• Multisensory (channel)
• Useful in all stages of
adoption of innovation
• Useful when the topic is
taboo or sensitive.
• Can fit to local needs
• Easily distorted( mostly
rely on word-of-mouth)
• Often needs multi-
• Needs personal status/
• Needs professional
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B) Mass media communication
• 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:
Broad cast media (radio & TV)
print media (papers, magazines, leaflets, posters ,
Folk media such as art, songs, plays, puppet shows &
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• The powerful advantage of mass media over face-to-face
is rapid spread of facts to a large population at a low
• Main effect of this type of communication are:
Influence behaviors at the early stages.
Useful to communicate new ideas to early adopters
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• Reach many people quickly.
• Accurate and believable
e.g. article on a newspaper,
or “voice” of highly
• Provide continuing
• One sided /no feedback
• Selective perception
• Does not differentiate the
• Only provides non-specific
make the message to fit to
the local needs of the
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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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2. 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
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• 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
• Make sure your body and your mind speak the same language !
• Culture also matters!
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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.
• Can be in the form of emails, letters, reports,
memos, leaflets, handouts, bulletins, newspaper.
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Noise/Barriers of Communication
• refers to forces within a communicator that interfere
with the ability to express or understand a message
• For instance:
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• involves biological factors in the receiver or sender that
interfere with accurate reception.
• For example:
difficulties in hearing or seeing
difficulties in understanding
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Environmental/ External noise/ physical barriers
• Includes those factors outside the receiver that make it
difficult to hear, as well as other kinds of distractions.
a smoky room,
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• Persistent patterns of
behavior, habits, beliefs,
customs, attitudes, religion,
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The Seven Cs of effective Communication
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• John Hubley 1993. Communicating health. An action guide
to health education and health promotion.
• Barnlund, D. C. (1970). A transactional model of
communication in K.K. Sereno and C.D. Mortenson
(Eds.), Foundations of communication theory (pp. 83-92). New
York, NY: Harper and Row.
• Ellis, R. and McClintock, A. (1990). You take my meaning:
Theory into practice in human communication. London:
• Schramm, W. (1997). The beginnings of communication study
in America. Thousand Oaks, CA: Sage.
• Shannon, C. and Weaver, W. (1949). The mathematical theory
of communication. Urbana, IL: University of Illinois Press.
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