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I believe that the most essential skill of the Primary Health Care workers is the ability to communicate well. This is because bringing health to people depends to a major extent on community participation. Primary Health Care programmes only function when community and families actively participate in changing some aspect of the environment and habit of life. This active participation is depending on the Primary Health Care workers being effective in communicating health-promoting messages to the community.

One of the features of Primary Health Care that makes it different from the medical care model is the emphasis on communication. Many of the components of Primary Health Care simply cannot take place unless the health care workers are effective communicators. For instance of situations where communication is necessary include all aspects of health education, encouraging community participation, developing intersectoral cooperation and sharing knowledge about health so that individual people can take more responsibility for looking after themselves. The emphasis on these areas is comparatively new; however medical care has always been more successful where there has been effective communication between the patient and the doctor or nurse. Therefore, communication skills are essential skills in providing health care.

What are the communication skills

The ability to convey information to another effectively and efficiently. Public Health practitioners with good verbal, non verbal and written communication skills help facilitate the sharing of information between people within a geographical community for its benefit.

Communication skills are essential. Most Community Health Practitioners would probably agree with this conclusion ˵Communication is a good issue˵. But what, exactly, are communication skills?

I can start off by saying that they are the skills used when one informs, persuades, explains, tells, listens makes clear, demonstrates etc. So, for example, right from training period, one must teach Primary Health Care workers how to ῝explain῞ as part of their communication skills. But what exactly is involved in ῝explaining῞? Meaningful communication must include two important elements: the audience and the goal. It should clearly define both within the context of your communication.  Different audiences require different approaches in order to get them to the desired goals that are the reason.

The purpose of the communication is to get the audience to the desired goal, where the goal can mean to inform, persuade, explain, or to get the audience to take action. To bring your audience to the desired goal,  that communication is a successful one.

Analysis Communication Skills

It would be impossible to teach the skills of public health care without knowing what those skills were.

In the same way, communication skills cannot be taught unless you first analyze what communication skills are needed. This analysis can be started by thinking about when the public health practitioner needs to communicate. For instant, it might be when the public health practitioner:

  • Explains to the community why nursing mothers should be immunized their baby;
  • Persuade individual, family and community to use a pit latrine;
  • Ask a community meeting to choose their Tuberculosis community volunteer;
  • Finds out why community members do not want to use Primary Health Care Centres;
  • Discusses with an agricultural adviser how nutrition can be improved in a community;
  • Explains to a patient what anaemia is and how it can be prevented;
  • Writes to request that the health centre roof is repaired.

The next stage of the analysis is to separate the facts or information from the skills of communication. For example, think about the situation when a public health practitioner explains to mother that her baby needs to be immunized. There will be some facts- what the word immunization means, what the mother will have to do, the benefits of immunization, etc. But there are also the skills involved in explaining—use of appropriate words which the mother will understand, arranging the facts in a logical order, asking the mother questions to find out whether she understands, etc. these are the skills which need to be taught.


Functonal Communication And Health Care Delivery Services

Each time one person is talking to another person or to an audience, it is believed that communication is talking place. The newscasters on the radio or television are believed to be communicating to the listeners and viewers respectively. In the health care delivery system, communication prevails among the patient, the doctor, and the nurse, and other medical/paramedical personnel. There can be no effective and efficient health delivery system without functional communication among the key actors in the system, the doctor, the nurse, the Community Health Practitioners, the patient etc. Communication therefore is an essential ingredient for effective and result-oriented performance in health care delivery. When a patient cannot communicate well with either the doctor or the nurse, he/she may likely contribute to inefficiency in the system. Secondly, a Community Health Extension Worker or Community Health Practitioners who cannot communicate effectively to the community being served on health extension services, he/she may likely complicate healthcare services delivery in that community. Thirdly, any Doctor who cannot communicate very well to either the nurse or the patient is a problem to the system. Simply put, without functional communication in healthcare delivery, there can be no positive interaction between the healthcare providers and the benefiting community/individual.


Communication has been defined in various ways

(i)  It is a way to share information and ideas with other people

(ii) It is the transmission of information with the purpose of influencing the audience.

(iii) It is a bridge between generating knowledge and utilizing knowledge

(iv) It involves the transfer of a message from a source to a receiver with a view of effect a charge in or a reaction from the receiver.

Effective communication can be defined as that message which, when well delivered by the source or sender.

Efficient communication can be defined as that message which, when well delivered very well understood and utilized by the receiver.

A functional communication therefore is an effective and efficient communication.
Components of Communication

  1. Source: The source is the originator, the sender, the initiator of the message.

A good source /sender must exhibit:

  • Credibility: having the technical expertise and being trustworthy. The nurse can only effect the doctor’s directives when he/she is aware the doctor has adequate knowledge of the subject matter.
  • Empathy: having the ability to empathies with the receive.
  1. Message: The message is the knowledge the communicator or source wishes the

receiver to act upon.    A good message must.

  • Have relative advantage
  • Be compatible, i.e consistent with what is prevalent
  • Be simple, not complex
  • Be triable
  • Be observable to produce better result
  • Be of minimal risk
  • Be Understood.
  1. Channel: The Channel is the medium through which the message is conveyed from the sender to the receiver (e. g Doctor’s Prescription, patient’s folder, verbal channel, routine preventive health care delivery mammals, etc
  2. Receiver: The receiver is the audience, the benefiting individual/community, the action- taker. The receiver, on receiving the message, decodes it and translates it to his/her own terms and then accepts and acts on it.

Types of Communication

There are two type of communication

  1. One way communication:- There is a one way communication in the church or mosque where the preacher has no time to check the understanding and acceptance of his message by the audience. The one way communication is faster and simpler. It often does not lead to change in behavior/action.
  2. Two way communication: – A communication is two way, when the sender checks to ensure that the receiver understands accepts his message and will act on it. It involves both the sender and the receiver equally in the exchange of ideas. It requires the communicator working hard. It requires the communicator to exhibit the ability to listen:
  • Before the communication, to ensure that the receiver is in a responsive frame of mind.
  • During the communication, to ensure that the discussion is useful
  • After the communication, to ensure that there is no misunderstanding or confusion about the message by the receiver.


The sender or communicator of a message must ensure the functionality of his/her message by ensuring the following seven stages:-

(i) Determine objective or desired result of communication.

(ii)            Translate objectives into a message

(iii) Gain attention of intended receiver

(iv) Send the message

(v)  Secure understanding and acceptance of message

(vi) Stimulate action on message

(vii) Ensure action takes place, (follow up)


  1. Noise: During the time message is transmitted, can hinder the understanding of

             the message by receiver. Noise can be manifested in;

  • Physical appearance –look, cloths, posture, etc
  • Language used
  • Voice deformity (cracked, sharp, stammering)
  • Bad writing/pen, inaudibility, etc
  1. Lack of understanding, (by receiver or between sender and receiver)
  2. Interpretation personalized interpretation
  3. Fear, (by receiver at action time)
  4. impatience
  5. Assumption
  6. Interest

Facts and Inferences and Functional Communication

Managers in the health delivery system must test information before acting on it otherwise; it will be difficult for them to maintain accuracy in the communication chain. When a message is transmitted along a chain of receiver, there is a risk that the message may become distorted by successive transmission. The more links there are in the chain, the greater the likelihood of distortion or breakdown in the communication process. It is therefore imperative that managers must differentiate between facts and inferences.


  • can be observed
  • Can be stated (as facts), by observer
  • do not beyond what has been observed.


  • Are guesses
  • Are assumptions
  • Are personal options/agenda opinions
  • Are extension of facts, based on assumptions.

When the receiver uses inferences instead of relying on facts, there is DISTORTION in communication and the communication is no more functional.


  • Desire to simplify
  • Desire to make message more meaningful
  • Desire to make message less disturbing or more pleasant
  • Various interpretation of message
  • Failure to distinguish between facts and inferences


Although the responsibility for communication rests primarily with the sender and the receiver work hard to experience satisfaction or pain and learn change. The rewards of a functional communication are neither the appearance of the process, nor the satisfaction of issuing instructions or giving advice. The reward is the achievement of results.

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