Title: Interpersonal communication
Course: Immunization - Ethiopia (Full)

Interpersonal communication

Interpersonal communication is a term for face-to-face interaction with an individual, or a small group of people, for the exchange of information. Because it is a face-to-face interaction, the people involved have eye contact, they hear each other, and they can respond to each other’s ideas. Note that interpersonal communication is a two-way process, where everyone learns from each other — including you!

Interpersonal communication is vitally important in supporting the behaviour change process. In particular it is very good for:

- Persuading and convincing individuals and target audiences about the value of the proposed behaviour change, by explaining and responding to questions and doubts about immunization.
- Addressing rumours about adverse effects of immunization.
- Addressing any personal issues the caregivers may express.
- Helping to mobilise resources from the community to enhance the immunization programme, through advocacy efforts.
- Building consensus for a concerted effort, for example to bring all eligible children for immunization.
- Explaining to caregivers about the immunization status of the child.
- Telling the caregivers about the next immunization(s) that the child will need.

Interpersonal communication skills

Here is a reminder of the important interpersonal communication skills you learned about in the Health Education, Advocacy and Community Mobilisation Module.

- Welcome the client warmly and offer a seat.
- Empathise with the client.
- Speak in simple terms, using easy language; give examples that the caregiver is likely to understand.
- Motivate by praising the caregiver for bringing the child for immunization and encouraging them to return for the next dose.
- Listen actively. Active listening is very different from just hearing. It is listening to another person during a conversation in a way that shows your understanding and interest. It encourages the other person to be more involved in the conversation. You can show that you are actively listening by using gestures, saying ‘Aha!’, or repeating what the client has said (Figure 9.6).

Figure 9.6  Active listening encourages the client to trust you and express her concerns. (Photo: Basiro Davey)
- Use appropriate visual aids. The pictures you use should be relevant to the message you want to transmit, and appropriate to the local customs.
- Summarise what has been discussed at the end of the conversation. You should check and confirm areas of agreement and disagreement.

Asking questions sensitively

It is important to give your client a chance to ask questions. This will help you to see how much she has understood and accepted what you have discussed. You can also ask her questions that enable you to assess her attitudes and the likelihood of positive behaviour change. But questioning must be done sensitively!

What questions might you ask a mother in one-to-one interpersonal communication if you think she may drop out of the immunization programme?

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There are many questions you might ask, for example the ones suggested below. You may have thought of others.

- Ask specific questions such as ‘Which immunizations did your child have last time? How was his health afterwards? Did you have any concerns about the vaccination?

These questions help you to establish whether the mother understands which immunizations the child has had, and which ones remain to be completed.

- Ask ‘Is there anything that makes you feel unsure if you will bring your child back for the next immunization?’ If she says she is unsure, gently ask about her worries and try to reassure her.

Asking about a caregiver’s worries about immunization is an example of an open question, i.e. a question that encourages the client to answer in her own way and share her concerns with you. You should avoid asking closed questions where the caregiver can simply answer ‘Yes’ or ‘No’. A closed question does not allow you to check whether the client has really understood the question, or really knows the answer.

Here is an example of a closed question: ‘Did your child complete all her immunizations?’ Change this into an open question on the same topic.

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You could ask ‘Which immunizations has your child been given, and what age was she when she got them?’

When asking questions, always give time for the client to think and answer. Let the client answer freely and do not interrupt while the client is answering.