·         Effective communication; is a process of sharing information or ideas between two people.

·         The most common way of communicating with others are:

Ø  Body language

Ø  Drawing

Ø  Singing

Ø  Dancing

Ø  Writing etc.

·         Identify components of effective communication process;

Ø  Message 

Ø  Sender

Ø  Channel

Ø  Receiver

Ø  Code

Ø  Context

Ø  Feedback

·         Message (input); This is the encoded information.  It can be sent through language, pictures gestures, body movement and facial expression.

·         Qualities of a good message:

Ø  It must be clear, brief and presented in an understandable manner

Ø  It must be precise (to the point)

Ø  It must be compatible with reality, convincing and possible to be carried out.

·         Sender.; encodes the message (idea) thus he/she gives expression or structure to the content

·         Qualities of an effective sender include;

Ø  Having broad knowledge of the message

Ø  Having the ability to encode it so that it can be delivered,

Ø  Able to deliver it at an appropriate level for the receiver

·         Channel; are ways in which a message can send and received. Depending on the type of communication, the channel is made by air =oral communication, paper =written communication.

·         Receiver; Used to decodes the incoming message, translates it and thus receives the output. The receiver needs to be ready for the message, comfortable and in good health.

·         Code; is system of words, figures or symbol used to represent others especially

·  for purpose of secrecy.

·         Context; is statement or idea which are in terms of which it can be fully understood.

·         Feedback is the information provided to a performer during or after an activity that enables the performer to assess the success or failure of his or her performance. Or is information given in response of to a person’s message.




·         Purposes of feedback;

Ø  Allows us to look at our own knowledge, skills and attitudes

Ø  Provides an opportunity to improve our performance

Ø  Provides an opportunity to ask questions and support fellow participants

Ø  Corrects negative behaviour

·         Characteristics of Effective Feedback;

Ø  Should be specific, not general statements

Ø  Offer suggestions and respectful statements using words like ‘could’ or ‘you may want to consider…’

Ø  Should be given at the time of learning rather than later.  The sooner, the better

·         Rules of giving feedback;

Ø  Start with positive feedback

Ø  Feedback should be immediate

Ø  Feedback should be constructive

Ø  Feedback should be specific

Ø  Give feedback on concrete behaviour that can be changed

Ø  Ask first / explore the other person and take his / her resilience into account

Ø  Dose and prioritize feedback

Ø  Differentiate facts from emotions

Ø  Use I-message

Ø  Invite response after having given the feedback

·         Feedback ‘Do’s;

Ø  Be honest but also gentle

Ø  Give reasonable and practical suggestions for improvement

Ø  Think feedback as a gift you can give another

Ø  Use respectful statement like; you may want to consider…. instead of you should ….

·         Feedback ‘don’ts’;

Ø  Don’t critique personal characteristics

Ø  Critiques the skills that a person might be able to learn or improve upon

Ø  Avoid use of the word should

Ø  Don’t correct serious issues in the public

Ø  Don’t add personal statements such as; You always….

·         SOLER – a nonverbal method of communication and reflects active learning

Ø  S – squarely face the person

Ø  O – use open posture

Ø  L - lean toward the person

Ø  E - use eye contact

Ø  R – relax keep it natural






·         Main functions of a sender;

Ø  Confront; the message and the receiver confront here means to be able to face any person, task, thing or situation

Ø  Attention; be conscious of what is transmitted in order to encourage the receiver to take the message

Ø  Intention; Be clear about what your objectives are, the way you want to transmit your message and what kind of responses you expect from the receiver

·         Functions of the receiver;

Ø  Duplicate; Recapitulate the message making a true copy of the message

Ø  Understand; Make your own interpretation of the duplicated copy of the message, wrong duplication and interpretation leads to misunderstanding and then the communication breaks down

·         Acknowledgement is a continuous process that shows you are with the one who speaks. Demonstrate that you listened to the message, that you receive it and understand it.

·         There are four levels of communication;

Ø  Intrapersonal communication; This is communication within the self (reflection).  The sender and receiver is the same person.  There is no misinterpretation.

Ø  Interpersonal communication; This occurs between two people.  It can be between teacher or student, student/student

Ø  Group communication; This occurs within a group. It is used a lot in teaching and learning.  It has no definite pattern.

Ø  Cultural communication; Initiator often not known.  Is reflected by art, literature, rules values and customs.  It includes behaviours seen in marriages, births, and burials.

·         Principles of effective communication;

Ø  Ensures interaction.

Ø  Reduces unnecessary uncertainty

Ø  Requires planning and thinking in terms of outcomes

·         Factors influencing communication;

Ø  Emotions are a person’s subjective feelings. The way person or communicates will be influenced by emotions. A client who is angry will perceive nurse’s instructions differently than one who is not angry.

Ø  Knowledge; Communication can be difficult when a persons’ communicating have different levels of knowledge.

Ø  Attention; A listening or attention barrier can occur because of lack of concentration.

Ø  Age; can be an advantage or disadvantage to effective communication.

Ø Very young or very old clients may be unable to communicate fully because of physical or intellectual development.

Ø  Gender;roles may influence nurse-client interactions. For example, a nurse who believes men should be tough may find it difficult to see a male client cry.

Ø  Cultural norms and traditions; influence the behaviours of all people including you. Understanding and accepting differences are the keys to developing therapeutic communication

Ø  Social factors; Social acceptance of a particular illness plays a role in a person’s reaction to the illness. For example, sexually transmitted diseases may be more difficulty for the client to cope with than influenza

·         The three methods of communication;

Ø  Oral /verbal; Sending a verbal message Eg, Face-to- face meeting, radio, telephone

Ø  Written; Some record is kept Eg; Notice board, memo, letter, e-mail, fax

Ø  Visual; Using charts, graphs, videos and television to give a message internally and externally

·         Memo; A short note used within an organization

·         Factors to consider when choosing a method of communications;

Ø  Cost

Ø  Speed

Ø  Secrecy; Is the method confidential?

Ø  Record; Will a copy of the information exist?

Ø  Destination; is it internal or internal? How far is it going?

·         There are three types of flow of information within an organization;

Ø  Vertical communication; is the flow of information from up to down or from top to down. It should go at line of command. Example. A director when communicate with subordinate it does not report direct it should go step by step.

Ø  Horizontal type of communication; is the flow of communication across the organization, example; Manager and manager communicate about something or subordinate Vs subordinate or from one department to another department.

Ø  Grape Vine communication; is the type of communication which spread very far at any geographical position. This is normally oral and a lot of things talked whether bad or good.


·         Purposes of serial communication;

Ø  Giving instructions or order

Ø  Offering advice

Ø  Giving feedback on performance

Ø  Discussing emergences

Ø  Giving ideas

Ø  Reporting on progress of particular project or activity

Ø  Discussing potential problems which may hinder performance

Ø  Discussing job performance




·         Barriers of effective communication are;

Ø  A lack of skill and understanding of the structures of conversational interaction.

Ø  Inadequate knowledge of, or training in, other communication skills including body language and speed of speech.

Ø  Doctors undervaluing the importance of communicating.

Ø  A lack of inclination to communicate with patients. This can be due to lack of time, uncomfortable topics, lack of confidence and concerns relating to confidentiality

Ø  Lack of knowledge about the illness/condition or treatment

Ø  Human failings, such as tiredness and stress

Ø  Inconsistency in providing information

Ø  Language barriers

·         Skills; Refer to the ability to relate to others, to get him/her and other organized, to communicate in written, spoken or other forms.

·         Effective communication skills involve:

Ø  Active listening/reflective listening

Ø  Attending to a patient

Ø  Demonstrating a caring, respectful attitude 

Ø  Praising, encouraging patient

Ø  Speaking clearly and simply at a level the patient can understand

Ø  Encouraging patient to ask questions

Ø  Paraphrasing and summarizing o Asking checking questions.

·         Active listening skills; is the ability to accurately receive and interpret messages in the communication process.

·         Principals of listening are;

Ø  Stop Talking

Ø  Prepare Yourself to Listen, Relax, Focus on the speaker.

Ø  Put the Speaker at Ease; Help the speaker to feel free to speak.  Remember their needs and concerns

Ø  Remove Distractions; Focus on what is being said

Ø  Empathize; Try to understand the other person’s point of view.

Ø  Avoid Personal Prejudice; Try to be impartial

Ø  Listen to the Tone; Volume and tone both add to what someone is saying.

Ø  Listen for Ideas – Not Just Words, you need to get the whole picture, not just isolated bits and pieces.

Ø  Wait and Watch for Non-Verbal Communication; Gestures, facial expressions, and eye-movements can all be important.

·         Signs of active listening;

Ø  Smiles can be used to show that the listener is paying attention to what is being said or as a way of agreeing or being happy about the messages being received.

Ø  Eye Contact; It is normal and usually encouraging for the listener to look at the speaker.

Ø  Mirroring Automatic reflection/mirroring of any facial expressions used by the speaker can be a sign of attentive listening

Ø  Distraction; The active listener will not be distracted and therefore will refrain from looking at a clock or watch, playing with their hair or picking their fingernails.

·         Importance of listening skills;

Ø  Eliminates barriers to effective communication

Ø  The sender is encouraged to talk more

Ø  Both the sender and receiver feel respected and expected.

Ø  Avoids a lot of repetition thus saves time

Ø  Enhance mutual relation

Ø  Avoid wrong conclusion

·         Questioning skills; is the ability of collecting information from the patient through questions. E.g. open ended question or close ended question

·         Why Ask Questions?

Ø  To Obtain Information: The primary function of a question is to gain information – e.g. What time is it?

Ø  To help maintain control of a conversation; While you are asking questions you are in control of the conversation, assertive people are more likely to take control of conversations attempting to gain the information they need through questioning

Ø  Express an interest in the other person; Questioning allows us to find out more about the respondent, this can be useful when attempting to build rapport and show empathy or to simply get to know the other person better

Ø  To clarify a point; Questions are commonly used in communication to clarify something that the speaker has said

Ø  To test knowledge; Questions are used in all sorts of quiz, test and exam situations to ascertain the knowledge of the respondent

Ø  To encourage further thought; Questions may be used to encourage people think about something more deeply.

·         Observation Skills; Is the ability of the doctor or nurse to collect information from the patient through different senses. E.g. smell, hearing and touch

·         Rapport; is Building a comfortable connection so that people can share information. A close and harmonious relationship in which there is common understanding

·         How to build rapport;

Ø  Shake hands

Ø  Introduce yourself

Ø  Use same language as patient

Ø  Show patience

Ø  Do not interrupt

Ø  Make eye contact

Ø  Do not attend to other patients while busy with another

Ø  Say ‘yes’, ‘um-hum’ or use a non-verbal gesture so they know you are interested

·         Life skills; are group of empowering skills that enable people to cope with life and its challenges and changes.

·         Adolescence; is a time of physical, social and psychological transition between childhood and adulthood.


·         Personal skills such as;

Ø  self-awareness and management of feelings,

Ø  cognitive coping and problem-solving skills,

Ø  interpersonal skills such as assertive communication -help children to recover

Ø  emotionally and resume everyday activities.

·          Social determinants and risk factors that affect child and adolescent’s health are;

Ø  Injuries resulting from accidents or violence;

Ø  Mental health problems;

Ø  Problems resulting from substance use;

Ø  sexual and reproductive health problems (e.g. too-early pregnancy, mortality and morbidity during pregnancy and child birth including due to unsafe abortion, sexually transmitted infections including HIV, harmful traditional practices such as female genital mutilation, and sexual coercion

Ø  Problems resulting from under nutrition and over nutrition;

Ø  Endemic diseases (e.g. tuberculosis and malaria).

·         Human Rights Standards that Apply to Adolescents’ Reproductive Rights;

Ø  The right to life, liberty, and security

Ø  The right to reproductive self-determination

Ø  The right to consent to marriage

Ø  The right to health

Ø  The right to be free from discrimination

Ø  The right to not be subjected to torture or other cruel, inhuman, or degrading treatment or punishment

Ø  The right to be free from sexual violence

Ø  The right to education and information

·         Components of life skills;

Ø  Decision making

Ø  Problem solving

Ø  Creative thinking

Ø  Critical thinking

Ø  Effective communication

Ø  Interpersonal relationship skills

Ø  Self-awareness

Ø  Empathy; is the ability to imagine what life is like for another person, even in a situation that we may not be familiar with.

Ø  Coping with emotions

Ø  Coping with stress

·         Disability; is a physical or mental condition that limits a person’s movements, senses, or activities.

·         Hearing loss; is a full or partial decrease in the ability to detect or understand sounds. It can range from a mild hearing loss to total deafness





·          Caring for people with hearing loss;

Ø  Be aware of room or window lighting and position yourself to ensure maximum light on your face

Ø  Look directly to the person and speak clearly, especially if the person wishes to lip-read. Do not exaggerate lip movements or put your hand over your mouth while speaking.

Ø  Be flexible. If the person doesn’t understand something you say, reword it instead of repeating it. Use notes or visual expressions/clues to illustrate what you are saying

Ø  Reduce unnecessary background noise-this can interfere with hearing aids and make communication difficult.

Ø  Ask short clear questions that require only short answers.

Ø  Make sure the patient has understood you.

Ø  If necessary, write it down.

·         Vision loss or low vision; is a reduction in vision that can’t be corrected with standard glasses or contact lenses and it reduces a person’s ability to function at certain or all tasks.

·         Problem with vision are;

Ø  Inability to see images clearly and distinctly; •

Ø  Loss of visual field;

Ø  Inability to detect small changes in brightness; •

Ø  Colour blindness; and 

Ø  Sensitivity to light

·         Caring for people with vision loss;

Ø  Ask persons with vision loss what kinds of accommodations they will need when scheduling an appointment.

Ø  Every person with a visual impairment has a different level of sight.

Ø  DO NOT SHOUT. Vision problems and hearing loss are not necessarily related impairments.

Ø  When meeting, identify yourself and others with you.

Ø  When conversing in a group address people by name.

Ø  Offer assistance if it appears necessary but pay attention to the person response-take you cues from him or her

Ø  Do not presume that the person cannot see anything. If appropriate it is OK to ask what they can see.

Ø  When preparing printed information, for a person with low vision it is best to seek their advice for their preferred format for person documents.

Ø  General information for people with low vision should be provided in AERIAL 18 POINT BOLD.

Ø  The lighting needs of people with vision loss differ and may be significant. Many people see much more with stronger light and others do not





·         The following are some tips for talking with speech that is difficult to understand;

Ø  Some people may have difficulty understanding speech as well, but many do not, don’t assume.

Ø  Don’t raise your voice, they are not deaf

Ø  Talk in a quiet environment if possible.

Ø  Be patient and don’t take over the conversation because you are afraid you won’t understand the person speaking.

Ø  Don’t be afraid to ask the person to repeat themselves, they know them

speech is hard to understand

Ø  Ask the patient to say it, using different words if you can’t understand.

Ø  Ask if they can give you a clue to the subject or spell a word. (They may have a communication aid).

Ø  Don’t pretend you have understood if you haven’t

Ø  Ask if there is someone close by who may be able to interpret for you

Ø  Acknowledge if you have not been successful despite all efforts and ask whether the message was urgent

·         People who have a physical impairment;

Ø  Speak directly to the person and not with someone who may be assisting them

Ø  DON’T SHOUT. Deafness and physical disability are not related

Ø  Never stand by people who use wheelchair by patting them on the head or shoulder.

Ø  Ensure that there is a clear pathway to intended destinations and at meeting, ward or restaurants, make a chair-free space at the table for the person using the wheelchair to sit.

Ø  Push the person in the wheelchair only when asked.

Ø  Don’t take control without asking.

·         A cognitive impairment; is a disability which affects a person’s ability to process information. It may be due to an intellectual disability which a person was born with (such as Down syndrome) or it may be due to an injury to the brain later in life (such as an accident or stroke)

·         Stress: is the nonspecific reaction that people have to threatening demand from environment. Stress results when two or more incompatible demands on the body cause a conflict

·         Causes of stress;

Ø  Organization factors; Stress can result from job related factor, such as task overload, conflicting tasks, inability to do the task assigned because of lack of preparation or experience, and unclear or insufficient information regarding the assignment.

Ø  Interpersonal factors; To add to the pressure created by organizational changes, doctors must content with strained interpersonal relationships within the doctor’s profession and between doctors and other professions (e.g. administration, nurse)

Ø  Individual factors; Stress can result from personal factors as well. One of these factor is the rate of life change. Change throughout life such as marriage, pregnancy, or purchasing new home, generates stress.

Ø  Deficiency focusing: Is the habit of focusing on the negatives at the expense of the positives. There is a tendency to exaggerate weakness and disregard strengths.

Ø  Necessitating: Is a belief that it is imperative or necessary that particular task be done by a specific person; it is a belief structure that limits choice. Tasks become inflexible demand that must be met

Ø  Low skill recognition; Low skill recognition is a tendency not to recognize the role one’s own ability has played in producing one’s success; it affects both managers and staff doctors when they face something unfamiliar.

·         Consequence of stress;

Ø  Depression; which cause people to withdraw from family and friends, to be unable to experience emotions, and to feel helpless to change the situation

Ø  Abrupt changes in mood and behaviour, which may be exhibited as erratic behaviour;

Ø  Perfectionism, which is the setting of unreasonably high standards for oneself and thereby being under constant stress.

Ø  Physical illness, such as an ulcer, arthritis, colitis, hypertension, myocardial infarction, and migraine headaches.

Ø  Too much, prolonged worry, phobias, or persistent state of fear or free-floating anxiety that seems to have many alternating causes

·         Ways of Managing Stress;

Ø  Personal methods; One of the first steps in managing stress is to recognize stressors in the environment and control them

Ø  Role redefinition; involves clarifying roles and attempting to integrate or tie together the various roles individuals play.

Ø  Organization methods; Health worker are often in the position of helping others identify their levels of stress and stressors. if staff appears to be under a great deal of stress, the management must help identify the source and decide how these can be reduced or eliminated.

·         Critical thinking; is the ability to analyse our own surroundings and experiences objectively, and question why things are the way they are

·         Self-awareness; is about getting to know our self, as well as our feelings, desires and needs

·         Personality; Is the way we look, feel and behave. It is the totality of person’s being- not merely the external appearance but also other various traits. Enhancing and preparing one’s outer and inner self in order to bring about a positive change to their life.  

·         Elements of personal development;

Ø  Self-awareness

Ø  Goal settings

Ø  Creativity

Ø  Innovation

Ø  Human values

·         Interpersonal Skills; is the way a people develops and sustain interpersonal relations with all those he/ she has dealings with-bosses, co-workers, fellow students, customers/clients, suppliers, private and government organizations.

·         Communication skills; Refers to the effective way a person communicate with others through various channels-writing, speaking, listening and using positive body language.

·         Leadership qualities; Refers to the qualities which help a person behave in leadership position-getting work done willingly, excising participative leadership style and be role model by setting examples

·         Team management. Refer to the effectiveness with which a person demonstrates ability to build and manage team in order to achieve the desired goals and objectives

·         Stress management; the quality of keeping cool in stressful circumstances, identify the factors causing stress and find solutions to reduce- if not eliminate altogether- the stressors.

·         Integrity: A person’s honesty in dealing with others, loyalty, to one’s beliefs, values system etc.

·         Acceptance: by others who come into contact with a person, and recognizing and accepting them as a whole.

·         Discipline-refers to the person’s disciplined approach to life and work

·         Dedication- refers to the commitment a person shows towards the achievement of individual as well as group goals

·         Johari window; Is a simple and useful tool for understanding and training self- awareness, personal development, improving communication, interpersonal relationship, group dynamics, team development, and intergroup relations

·         Johari window four regions which are;

Ø  Open area, open self, free area, free self, or 'the arena ‘: what is known by the person about him/herself and is also known by others

Ø  Blind area, blind self, or 'blind spot ‘: what is unknown by the person about him/herself but which others know

Ø  Hidden area, hidden self, avoided area, avoided self or 'façade’: what the person knows about him/herself that others do not know

Ø  Unknown area or unknown self: what is unknown by the person about him/herself and is also unknown by others

·         SWOC; is an abbreviation of four words: Strengths, Weaknesses, Opportunities and Challenges

·         SWOC analysis; is a tool used to analyse the situation of an organization (i.e., conduct a situational analysis).

·         Strengths; are the qualities that enable you to fulfil your organizational mission.

·         Example of Strengths;

Ø  Well qualified and experienced staff

Ø  Such as a sufficient number of qualified medical doctors, laboratory technicians, nurses, etc.

Ø  Adequate financial resources

Ø  Modern, well-functioning equipment

·         Weaknesses; These are qualities that make it difficult to fulfil your organization’s mission and prevent your organization from reaching its fullest potential. Weaknesses include things that the organization does not do well. They are often negative things that prevent you from achieving goals and objectives

·          Example of weaknesses;

Ø  High employee turnover and inadequate human resources

Ø  Heavy debt loads

Ø  Cumbersome decision making

Ø  Poor teamwork

·         Opportunities; are presented by the environment within which your organization operates. These are often conditions in the external environment that favours the organization’s strengths

·         Examples of opportunities;

Ø  Community backup/support

Ø  High literacy rate in the community.

Ø  Government regulation/policies favouring the health sector or favouring

Ø  vulnerable groups

Ø  High per capita income

Ø  New technology, permitting greater efficiency in the delivery of health services

Ø  Public-private partnerships

·         Challenges; Conditions in the external environment that do not relate to existing organizational strengths, or conditions that favour areas of current weakness within an organization.

·         Examples of challenges/threats

Ø  Development partners (donors) discontinuing their support to the health sector

Ø  Emerging and re-emerging diseases (e.g. HIV and AIDS, TB, leprosy)

Ø  Unstable national economy

Ø  Government restrictions, such as budget cuts or an employment freeze.

·         Importance of SWOC Analysis:

Ø  SWOC analysis offers a strategic method for planning that is used to evaluate the strengths and weakness internally within the individual or organization, and also scans for opportunities and challenges outside the individual/ organization.

Ø  Identify business opportunities.

Ø  Provide guidelines for design of business strategy

Ø  Identify the competitive advantage of a particular organization.

·         Team; It is a group of people who come together in order;

Ø  Solve a problem

Ø  Meet an objective; or

Ø  Tackle an issues





·         How to build an effective team?

Ø  Get to know one another; Likes, dislikes attitudes, beliefs, aspiration, individual goals.

Ø  Establish consensus; Efforts have to be made to ensure that everybody’s view point is discussed but ultimately decisions are taken by consensus.

Ø  Identify available resources; Not only the resource which are readily available but also the ones which can be easily arranged.

Ø  Establish rules of behaviour; Members to demonstrate behaviour that encourages team spirit and respect for each other’s viewpoint





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