EVALUATING THE COMMUNICATIVE EFFECTIVENESS OF MULTIMODAL MATERNAL AND CHILD HEALTHCARE TEXTS IN MACHAKOS COUNTY, KENYA: A SOCIAL SEMIOTIC ANALYSIS

Ngina Evelyne Mutheu, Geoffrey Maroko, Omondi Oketch

Abstract


Maternal and child healthcare communication materials are widely used in Kenyan health facilities, yet their communicative effectiveness remains uncertain. This study evaluated the communicative effectiveness of multimodal maternal and child healthcare texts used in public health facilities in Machakos County, Kenya. Specifically, it sought to determine how effectively posters, brochures, and the national Mother and Child Health Handbook disseminate health information to expectant women and mothers of children aged 0–5 years. The study was anchored on an integrated theoretical framework incorporating Kress and van Leeuwen’s (2006) Social Semiotic Theory, which focused on analysing the visual mode; Halliday and Mathiessen’s (2014) focus on analysing the verbal mode; and Royce’s (2007) intersemiotic complementarity, which focused on analysing the interaction of the verbal and visual modes. The World Health Organisation framework of principles of effective communication was applied in evaluating the effectiveness of the MCH texts. An exploratory mixed-methods design was adopted, with qualitative analysis supported by quantitative descriptions of semiotic features. Data were drawn from 26 MCH texts comprising 18 posters, seven brochures, and one Mother and Child Health Handbook across ten public health facilities, together with key informant interviews and focus group discussions involving healthcare providers and intended users. Findings show that posters are the most effective because they integrate simple language, salient images, colour, and clear visual organisation; brochures are moderately effective, while the MCH Handbook is least effective as a standalone communication tool. Effectiveness is further constrained by technical terminology, English-dominant content, sociocultural mismatch, participant exclusion, disability-related accessibility gaps, weak visual hierarchy, and fragmented sequencing. The study concludes that communicative effectiveness depends on the meaningful integration of verbal and visual resources within users’ linguistic, cultural, and social contexts. The study therefore recommends simplifying technical language, expanding multilingual content, strengthening inclusive and culturally grounded representation, improving visual hierarchy and sequencing, and redesigning the MCH Handbook to support independent use by mothers and caregivers.

Keywords


multimodality, maternal and child health, health communication, Visual Social Semiotics, information dissemination, Machakos County

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References


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DOI: http://dx.doi.org/10.46827/ejphs.v9i3.281

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