Non-verbal cues (NVC) encompass all the communication cues between people devoid of verbal utterances, for example, details of dress, eye contact, gestures, postures, paralinguistics, ofaltics, touch, distance just to mention but a few. Communication needs to generate trust and confidence in both the sender and the receiver of information. As such, this papers central focuses on how NVC can be used to foster effective communication in HIV/AIDS information dissemination and other health related disease such as COVID 19. It is necessary to disseminate information which is beneficiary to public health. According to Rogers [1] health communication is any type of human communication whose content is concerned with health. In other words, health communication promotes health information as to influence personal health choices by improving health knowledge. According to Faden [2] health communication seeks to refine communication strategies to inform people about ways to enhance health or to avoid specific health risks. It can be pointed out that there are many different ways by which humans can communicate and the most used method is through the spoken word. Health promotion exercises can require people to use different communication strategies such as NVC so as to promote the health of people. The researchers note that NVC can play a very fundamental and very critical role in human communication, in that they contribute significantly to messages given. Health communication is very efficient, effective and clear and major or key way of disseminating important health issues in any social settings, starting from the home, school, work place and society at large. Health communication can be central human process humans to embrace and adapt to health information at different levels. Tomori et al [3] assert that health communication has played a pivotal role in HIV prevention efforts since the beginning of the epidemic … provide education, counseling, psychosocial support, treatment supervision and other pragmatic assistance across the care continuum. Community treatment supporters reduce the burden on overworked medical providers, engage a wider segment of the community, and offer a more sustainable model for supporting people living with HIV.

According to Brulde [4] some of the key functions of health communication include the provision of relevant health information, persuasion to help motivate behaviors that improve health outcomes, and the facilitation and maintenance of social connections and a supportive social environment for the desired health behaviors. Thus Health communication (HC) is designed to influence individuals and communities where the aim is to improve health outcomes by sharing health related information. Health personnel who use NVC to accompany their oral messages are more likely to secure positive outcomes from their clientele, and are more likely to diagnose or detect emotional stress and comprehensiveness for better, favorable and improved outcomes. A brief overview of nonverbal cues considered essential in aiding health communication in this paper has been given below.

Kinesics is a non-verbal cue that is depicts by body movements. It is a word derived from the word “KINETIC” which means movement or motion. Kinesics comprises of facial expressions, eye contact, gestures, head and limbs movements and many more. Eye contact communicates fundamental messages consciously or unconsciously. A direct eye contact means that there is mutual understanding, openness and honesty and conversely an averted gaze can be construed as signifying fraudulence and shiftiness. According to Kendon [5] gestures are movements of the body especially hand or head in transmitting a message. Facial expressions are very crucial especially when dealing with people living with HIV. Smiling is always a positive response to give customers unlike wearing a rigid and expressionless face. When there is an interaction that includes patients it must be an obligation to smile because by so doing, one will be bringing them closer, winning their hearts. More so, this now displays that in many circumstances sometimes it is noble to give more credence to the nonverbal message because it carries the truth. Mansumoto [6] exemplifies this saying facial expressions are perhaps the most visible but also misinterpreted carrier of meaning. This is due to differences in cultures. Hence, Tabensky [7] propounds that when in conversation we rephrase others’ words, we may find that we are also ‘rephrasing’ their gestures. Gestures can tell a lot for example when confident you can simply tell by thumps in belt or pockets. Despair, anxiety, worry and fear which can be caused by lack of confidence on what the speaker is presenting can easily be seen by hand wringing, voice trailing and head shaking. This may impact negatively on HIV/AIDS infected and affected people because this will negatively transmit he message.

One of the NVC that plays a crucial role in the health education arena is haptics. It is depicted by touch. Touch can be usefully classified into five types [8] which are functional/professional, social/ polite, friendship/warmth, love/intimacy, and sexual/arousal. In workplaces the most touching is of type functional/professional and social/polite. When health communicators are dealing with their clientele there are cases when a slight of touch will be necessary most probably a handshake or a warm hug but it has to have restrictions and demarcations.There are times when communicators use the process and semiotic approach making presentations as an educating tool. Thus before these presentations there might be interaction with the audiences by way of shaking hands (hands should be sanitized after the handshakes) and making casual conversations. This interaction is essential because it helps in building the trust before the marketer takes the stage.

Another NVC that is in the communication line is paralinguistics which is depicted by the way we use our voice. The properties of the voice include diction, inflection, projection and even nasality. Personal rank and relationships between people controls voices and the way we use our voices can be used to indicate confidence, nervousness, confidentiality and other states of mind. Nasality has negative connotations and tends to be inversely correlated with perceptions of persuasiveness. This can work to the detriment of females who tend to have more nasal voices than males [9]. Most health institutions are conducting health education promotions, exhibitions and electronic awareness campaigns for infectious and contagious diseases such as HIV/AIDS, Covid 19 corona virus, cancer and many more but these health education ploys have to be in juxtaposition with non-verbal cues. It should be considered deeply by the Health institutions to ensure that when promoting health education through audio electronic media, paralinguistics should be taken care of. Voice variation is of paramount importance; the projection and articulation of the voice should be dealt with meticulously. Voices may be pitched lower or voices may be pitched higher especially when giving emphasis so that you win the hearts of the listeners. Voices should be audible enough to catch the attention to catch their attention too. However, the use of the voice should be regulated it should not be too high or too low, they should be confidently stable. Bell [10] suggests that “trembling voices are associated with fear and lack of confidence” thus if the health communicator cannot speak with the clients confidently, automatically the listeners will lose interest in the subject. This shows the significance of the use of paralinguistics in health communication. Therefore, if health institutions are to excel in health education, they need to put paralinguistics in an unfathomable consideration.

Ofaltics is another NVC that is found in communication and is depicted by good or bad smell. For some reasons, some people prefer to smell the breath of the person they are talking to Hall, [11]. As such, health communicators need to wash and to change clothes always; to change socks and shoes and to brush their teeth so as to induce a good smell which will not drive away customers. Smell is a major mode of communication and human beings tend to like good smell and this implies that the health communicators need to be smelling good all the time because it boosts the audience confidence and their listening span.

According to Merrier et al [12], appearance can be either a barrier or an asset in communication. The way how the marketing team dresses, talks and walks speaks volumes thus coming into effect as another indispensable NVC. Dress is one of the aspects in nonverbal communication that needs to be taken seriously. Dress can be used to communicate numerous messages and it is also a confidence booster to the one putting on it. Holistically, when people involved in healthcare communication need to take dress into bottomless consideration because it is one of the most effective nonverbal communicator. Ellis and Beattle [13] argue that language is of course aided by the multifarious non-verbal channel…posture…dressing…which makes conversation so fascinating and complex. Through dressing one can revile his/her status as dressing influences the way other people respond to you and the messages one sends every day.

Health communication can be used to induce behavioral change in people; it can motivate people to seek much needed HIV/AIDS related services. This means that the standards of living of people can be improvised by health communication. Societies have a combination of different people with different expectations and one of the fundamentals of health communication is to produce communication materials that satisfy and address the needs of all. This philosophy is of paramount importance because it then means that health issues will be getting attention as per the expectations of the people hence delivery of a better standard of living. Health communication may play significant and important roles in improving health care, information dissemination on health care services and their access and the enhancing of interpersonal health communication and counseling. Communication strategies may help people living with HIV/AIDS in many different ways such as adherence to medical prescriptions, fighting social stigma and sexual behavioral changes. Communication is at the heart of who people are as human beings. It is a way of exchanging information; it also signifies our symbolic capability.

It is indispensable to study the impact of non-verbal cues (NVC) in the health field because they have some profound and fundamental connotations that can be used to change human behavior to maximize returns on their business so as to prevent poor performance. According to Jones and LeBaron [14] in some respect, it is a false dichotomy to separate verbal and nonverbal communication thus they work in a complimentary nature. There is a growing need and demand for effective communication in health communication amid HIV/AIDS and Covid 19 pandemic so as to deliver effective behavioral changes that work to achieve positive results in for a people’s health. It can be argued that these efforts will have a positive impact on how people may get helpful information to help them make informed decisions in their health practices. This is the time more than ever when it is axiomatic that people should be informed about important health issues. One of the strategies to do this is through the televisions and media at large. There has to be sublime adverts so that people but these adverts have to be crafted considering time. Adverts should not be too long neither should they be too short. The best way to show the audience respect is to honor their time. This explicitly depicts the significance of chronemics health communication. Effective health communication can lead to positive health outcomes which will impact the national income by not spending much money on medication and by losing the working class through death thus becoming beneficiary to society at large. A health people are key to the growth of any nation in so many respect for example creation of employment, increase in national income, creation and improving the living standards of the people.

• To assess the impact of non-verbal cues (NVC) in health communication

• To equip the health communicators with some effective non-verbal communication in order to maximize the healthy outcomes

• What impact does non-verbal communication have in health communication?

• Does non-verbal communication (NVC) have the capacity to maximise returns in health communication?

This research was interested on generating knowledge on the impact of NVC in health communication arena. To this end the study is located in qualitative research paradigm. Convenience and purposive sampling were used for this study. To this end 30 health communicators were sampled. The researchers designed an experimental study in which participants watched two videos of unsuspecting health communicators making a health campaign presentation. In the video, some presenters did not use non- verbal cues; and some one used non -verbal cues such as kinesics, proxemics, paralinguistics and haptics. Those who used NVC were described as having higher returns while the inverse happened with those who played it straight and did not use NVC. In addition to this observation, in-depth interviews were used by researchers in soliciting data with regards to the implication of using NVC in health communication field. Purposive and convenience sampling techniques were employed by researchers in selecting key informants which comprised health communicators (15), health care givers (10), and nurses and doctors (10). Researchers further employed transactional observations in some of live presentations that were done by health educators to fully understand the implications of NVC in health communication.

Communication is central to the very existence and functioning of humans, “to live is to communicate” [15]. The impact of non-verbal cues in the business environment has been widely discussed and some scholars have augmented that using their various books, articles and journals. This increase in the prominence of the field, externally, is happening contemporaneously with important developments taking place, internally, one of which is the focus on the study of environmental, social and psychological influences on behavior and health. Given the global challenges posed by major threats, health communication scholars and practitioners recognize the importance of prevention and, with it, the need to understand human behavior through the prism of theory. Carey recognized that communication serves an instrumental role (e.g. it helps one acquire knowledge) but it also fulfills a ritualistic function, one that reflects humans as members of a social community. Thus, communication can be defined as the symbolic exchange of shared meaning, and all communicative acts have both a transmission and a ritualistic component. These considerations reflect the essential components of the communication process: channel, source, receiver and message, respectively. In the ritual view, however, target audiences are conceptualized as members of social networks who interact with one another, engage in social ceremony and derive meaning from the enactment of habitual behaviors. First is the realization that communication interventions do not fall into a social vacuum. Rather, information is received and processed through individual and social prisms that not only determine what people encounter (through processes of selective exposure), but also the meaning that they derive from the communication (known as selective perception), depending upon factors at both the individual (prior experience, efficacy beliefs, knowledge, etc.) and the macro-social (interpersonal relationships, cultural patterns Second, it is reasonable to expect discrepancies between messages disseminated and received. They arise not only due to differential exposure to the intervention but also because of the differences in interpretation in decoding information. A careful study of the correspondence between messages as they are sent and received is thus of great importance to avoid unintended (and worse, counterproductive) effects.10 Third, communication is a dynamic process in which sources and receivers of information continuously interchange their roles.

But there is absolutely no doubt that non-verbal cues are an integral part of communication in the marketing arena and even the business turf at large. Albert Mehrabian a pioneer of body language researchers found that 7% of the information is conveyed by the words, 38% by voice features and about 55% is conveyed by nonverbal language. The researchers Allan and Barbara Pease examined thousands of entrepreneurs and found out that about 60-80 percent of entrepreneurs are watching body language and form an opinion on the new one person as soon as possible within four minutes. This now clearly demonstrates that NVCs are key in the marketing field. To lure as many customers as possible, this should not be undermined at any cost. Navarro [16] emphasizes the importance of reading the body language signals arguing that.

The behaviors and messages can reveal the true human thoughts, feelings and intention. For this reason, it is sometimes referred to as an eloquent behavior. People are not always aware that they communicate without speaking and so often their body language is much more real because in order to achieve their goals people carefully think over the words. If you are observing the other person`s nonverbal behavior and understand what he feels, what is his plan and how he intends to do or figure out the meaning of the words –to decrypt his tacit language and took advantage.

This statement by Navarro clearly validates the significance of the NVCs in the business arena. For firms to launch successful marketing campaigns, they ought to make use of NVC considerably. Given the centrality of nonverbal communication in the business arena holistically, there is so much need to pay special attention to them because they have some deep underlying connotations as asserted by Goffman [17] when he noted that we are constantly “giving off signals” via nonverbal behavior that are interpreted by those around us as expressive of our underlying attributes. Since nonverbal communication can be used to promote social functioning, some researches denote that people are more likely to follow those who exhibit charisma, enthusiasm and capability and nonverbal behaviors can an effective tool communicating these elements in charismatic leaders that’s according to Bass [18]; Conger and Kanungo [19]. This denotes the significance of NVCs in business because once an organization possesses people with such traits; it will not be possible to flunk in the marketing field. Nonverbal communication can also augment a charismatic leader’s visionary message and strengthen the influence of verbal communication via a strong delivery characterized by eye contact, verbal fluency, facial and body expressions and many other NVCs. How a message is delivered, regardless of its content, has a positive impact on listener’s perceptions of charisma and subsequent attitudes according toAwamleh and Gardener [20]; De Groot et.al [21]; Howell and Frost [22]. The combination of a non-visionary message with a strong delivery is more effective than the combination of a visionary message with a weak delivery as propounded by Holladay and Coombs [23].

Effective communication is is very important and NVC can contribute to good communication as well as bad communication if not well handled. Many scholars who have researched on the effects of NVC in communication allude to the fact that it plays a powerful role in interactive and non-interactive settings if used to accompany verbal communication. Furthermore, they allege that NVC account to over 80% of all human interactions. When they are a mismatch between the verbal and non-verbal messages being conveyed (a phenomenon known as ‘social leakage’), it is likely that the non-verbal component is conveying the ‘truer message’. Silence can also be regarded as an NVC because it can send very strong message, for someone who is not speaking you are giving away volumes of information.

Some researchers have looked at micro (or discrete) nonverbal behaviors and attributions in the selection and assessment process. A firm, brief handshake, for example, can confer sociability, friendliness and confidence that are according to Chaplin et.al [24]. This assertion buttresses the significance of putting Haptics into a profound consideration whenever conducting a business venture. Emotional expressions are an important part of work interactions because they influence individual and organizational performance. For example, smiling and eye contact lead to positive outcomes for the actor as asserted by Raffaeli and Sutton [25]. However how emotional displays are perceived by others depends on the authenticity of this nonverbal behavior. Authenticity refers to the consistency between an emotion experienced and emotion displayed. Very subtle variations in the muscles associated with smiling can reveal (in) authenticity [26]. Consistent with these findings, results show that customers in service encounters can detect inauthentic (vs. authentic) emotional displays Grandey et.al 2005 [27]. Furthermore, as compared to inauthentic smiles, authentic smiles [28] lead to greater positive customer emotional reactions and perceptions of good customer-employee rapport, which influences customer satisfaction.

However, Adler [29] asserts that the most part to consider about non-verbal cues is that they do not cut across cultures easily and can lead to misunderstandings. Non-verbal communication is learnt in childhood from parents and the people whom you associate with. A few gestures seem to be universal for example in the Middle East and Britain looking in the speaker’s eyes show that you are listening and respecting but however, in Africa this may be interpreted as a sign of disrespect. According to Ekman [30] non-verbal cues in oral communication varies not by culture and context but by the degree of tension. This means that gestures seen as positive in one culture maybe seen as obscene in another culture. Furthermore, people have to be careful about the use of the body language and gesture as every culture uses nonverbal communication in a different way. Some cultures express themselves by using a lot of body language for instance, Southern Europe whereas it is most hidden by other cultures like China.

Responses from research participants show that there was a unanimous finding that NVC plays a vital and significant role in health communication. The NVCs were viewed by research participants as having the capacity and capability of making health communication interventions which were regarded as cost-effective in achieving behavior change in many HIV/AIDS affected contexts, they make their presentations more acceptable to the clients. A health communicator, who uses NVC for communication and performance, said that use of NVC in health communication helps affirm effective and efficient communication though he would like to see its use being emphasized on and expanded more in health institutions.

NVC, is inherently an assertive and potentially communication tool in health communication, and for someone to use NVC, it is powerful! One educator emphasized that eye contact contributes to the effectiveness of oral communication since this shows whether the receiver is understanding or is enticed by the message or not. This is the most effective when both parties (sender and receiver) feel its intensity is appropriate for the situation.Bovee and Thill [31] pointed out that, “your eyes are especially effective for indicating attention and interest, influencing others regulating others, regulating interaction and establishing dominance”.

Speaking in a clear, confident and assertive tone helps project your message and keep your audience engaged emphasizing specific points and varying your rate of delivery brings out key points in your presentation and attracts your audience. Use of this NVC can motivate to use condoms during sexually activities, invoke them to seek HIV/AIDS testing, promote them to seek medical treatment, seek home based care, and strengthen them to live with HIV/AIDS. This may help to reduce stigma associated with the diseases.

Verderber and Verderber [32]imply that non-verbal cues signal also provide feedback to other person, regulate the flow of communication, and convey information about their emotional state. Hence eye contact is very essential to have the attention of the audiences and for you to judge reception of the message being sent. The final element of intrapersonal communication, according to Burton and Dimbleby [33], involves the internal activity of monitoring the reactions of others to our communications. We constantly obtain and check reactions from others in order to see what effect we are having on them, and to adjust future behavior if appropriate. 

One research participant added that gestures are very important in health communication to explain in such a way that it will be easier for the audiences to understand your message and thus persuading them to change their behaviors. While delivering a presentation, the use of gestures which are part of non-verbal communication will make an audience pay attention to you. Gestures conveys emotions of the presenter through the head, hands and other body parts and they help to reflect or help stress out a point thus enhancing what the speaker is saying.

One of the marketers remarked that eye contact creates a bond of trust between the marketer and the audience and they trust in what one is telling them in such a way that can increase knowledge, shift attitudes and cultural/gender norms that can produce changes in a wide variety of HIV/AIDS related behaviors.

By maintaining eye contact the audiences are more likely to remain engaged because they will believe in you and trust in what you are saying. Hence, eye-contact with the audience boosts the audience’s trust in the marketer and it makes the presentation worth listening to. Eye contact is therefore a very important NVC when delivering an oral presentation since it enhances audience control and good delivery of the oral presentation. One lady health communicator emphasized that:

Looking down or avoiding eye contact during a presentation shows lack of confidence and uncertainty of what exactly one is talking about. People use eyes to show degree of interest and openness thereby making the message clear and easy to understand thus making one to pay maximum attention. Furthermore, through eye-contact it is easy to tell if a conversation can endure or not or if there is any interest in the conversation being discussed. In addition, eye contact increases the degree of perceived psychological closeness between the speaker and the listener. Another participant also added that constant eye contact signifies confidence during a conversation or presentation.

This is supported by Bayer et al [34] who postulate that public health communications typically solicit change either in behavior or belief. If one has to be a dependable source of information that can influence behavioral change, one has to consistently use various communication skills that will help the audiences to have confidence in you and to regard you as a dependable source. This will help the audiences to build confidence in you and hence automatically changing their behaviors. Therefore, it is imperative to consider NVC as the skills to help disseminate information about HIV/AIDS.

In this regard, most research participants concurred that being too serious without even smiling or using NVC that will present you as a jovial person will result in the audience losing interest in what is being presented and consequently losing a lot of health business. Therefore, in oral communication one should avoid facial expressions that can demotivate people being addressed for effective communication and clear understanding of the message. However, most research participants for this study felt that gestures should be limited so that they reflect what the speaker is presenting if they are overused the presentation becomes boring and the audience lose attention thus resulting in presentation failure. NVC provides warmth that will make affected individuals narrate their HIV/AIDS narratives. The stories may have a very strong impact on others such that they can invoke positive change, for example what it means to live with HIV/AIDS or otherwise unable to verbally articulate their points of view one can observe the silence. This shows the significance of the message being passed on and its relevance through portraying self confidence in the information being said. 

Most research participants concurred that haptics help in acquiring attention from the person you are talking to. For instance, touching one’s shoulders can effectively divert their attention to you, which helps in effective oral communication. However, it needs to be done in a professional manner without inducing any feelings of intimacy. If the body language is not used in a good way by the presenter it could be perceived as being self-defeating because it will derail all the marketing efforts and gains one wishes to achieve. They added that standing too close to a person during an oral communication process can be perceived as having little regard for that person. When a man or woman stands too close to another person who is not of the same sex, it may be taken as indicating intimacy. Therefore, communicators should first of all establish a respectful distance between them and their audience.

This is supported by Courtland and Thill [35] who says that time and spaces are non-verbal cues which can be used to assert authority or to imply intimacy. Therefore, non- verbal cues are important as they are used to the atmosphere or mood accompanied by verbal communication. An appropriate non–verbal cue can reflect confidence, interest and sincerity before the communicator speaks. Failure to establish a favorable NVC resembles may cost the speaker a favorable health outcome of the whole health communication presentation. If the HIV/AIDS health communication process is strategically designed, it can positively influence its reception thus creating positive attitudes toward all HIV/ AIDS related issues like testing, shifting stigma and perceptions about HIV/IDS infection, increasing confidence to accept the condition and to live with it, to encouraging friends and relatives to accept HIV/AIDS just like any other disease and to get tested.

Body postures may be used in health communication by helping the sender of the message to control the listening behavior of the audience. A good posture can be project a self- assurance authority and energy. Knapp and Hall [36] argues that postures convey both internationality about personality trait, intelligence, mental and physical health and social group membership for instance a speaker addressing people must communicate numerous messages by the way they talk walk and stand. Moreover, the use of posture is used to make help points raised to be more understood by the audience.

With paralinguistic one should avoid speaking in a low voice or a monotonous tone. According to Williams et al [37] the process of nonverbal communication or negotiation is to send or receive message in an attempt to gain someone’s approval or love. One research participant who watched the video clip presented for this study remarked that the tone of the voice complements and reinforces and emphasizes the message. This video also shows that the presenter’s tone might however lead to oral communication failure if the wrong tone is implemented and as such the tone of the voice must be treated with caution. The most important fact on tonnage is the way in which you speak rather than what you say. In other words, it is a question of how one articulates and not what one articulates. This type of non-verbal ques accentuates word of mouth. By accentuating one makes what he or she is saying more noticeable. This may motivate or persuade someone to think about HIV/AIDS in a beneficiary way, such as to appreciate the benefits such as home based care and male circumcision and be motivated to engage the processes.

One peer educator in the Ministry of health remarked thatNonverbal communication makes our work in health communication to be efficient as is required in business. Through the use of paralanguage one can increase the level of trust and interest in the subject matter by the audience it helps health communicators to see the level of engagement of the clients hence helps in decision making during the oral presentation. You can be able to observe that sexually active men and women, boys and girls are contemplating to reduce this risky sexual behavior and to seek medical testing or to seek male circumcision. Paralinguistics also improves the level of trustworthiness and accuracy of intentions. Poor use of paralanguage may indicate that the presenter is uncertain of their work and this may lead to boredom, hence will lose important business deals.

Furthermore, paralinguistics boosts confidence of both the speaker and listeners. DePaulo [38] says that confidence is a very important aspect in the communication process as it shows that the presenter has better knowledge in the subject one is presenting. Confidence in communication can help to create and sustain a positive, supportive environment within which behavior change may be promoted.

Other research participants reiterated that dress is a very strong and important NVC. Due to dress audiences may simultaneously marry the message being presented with one’s social status, level of education or character. Signals can be picked up very quickly from the way people dress, the way they walk and the way they stand”. Hence, specifically, people dress appropriately for the audience and the occasion. This reduces chances of diverted attention from the audiences as they are unlikely to comment about the speaker’s inappropriate dressing code. This is supported by Hindle [39] who reiterates that “first impressions are stronger and very hard to change”. Dressing for the occasion is an added advantage to making a positive first impression to others. On another note, appearance also boosts confidence of the speaker and improves his or her worthiness and credibility to the audiences. For example, when a lady wearing a mini-skirt is in front presenting something this can distract male people in the audience and people may start to focus on the dressing not the verbal message” This is reflective in the sense that when a presenter is dressed in casual that is not even close to being formal, the audiences will automatically lose faith and interest in the speaker. One lady said that, one’s appearance determines their impact on others and first impression is also important and they make the impression that that the presenter is worth his salt and this will be hard to erase from their memories. This will benefit HIV/ AIDS health communication in a great way, since the impression may persuade individuals to listen to message being conveyed and may end up seeking medical care once to ascertain their HIV/AIDS status, and to maintain contact with service providers once they test positive. This may enable them to be on ART initiatives.

However, another research participant argued that dress and appearance affect how a message is transmitted to a lesser extent, because the dress and appearance does not go hand in hand with the speaker’s message, the receiver will not have any problem getting the message because the message is not obstructed by what one is wearing. Some audiences may not be reluctant to listen to this person because their appearance does not show qualities of passing such an important message. There is no obligation what so ever to get a message from a welldressed person only. Thus, Wood [40] says that “non-verbal cues can help interactors determine others’ motivations with much more richness, depth and insights that cannot come from simply relying on spoken words”. The voice tonnage may be used by health communicators as a signal to sway opinions of the audience to their advantage. Through smiling a health practioner can make a significant difference to the life conditions of HIV/AIDS affected and infected people “health practitioners who attempted to form a warm and friendly relationship with their patients and reassured them that they would soon be better were found to be more effective” [41]. According to Segrin and Flora [42] the possession of good communication skills pays more dividend in people’s lives NVC will enable a sender of the message in observing answers given to questions asked, and to give a working framework in providing ways to respond even in challenging situations.

In conclusion a first impression is a lasting non-verbal communicator; the way a person portrays themselves on the first encounter is a nonverbal statement to the observer, and thus one’s nonverbal behavior gives away one’s inner personality and reflects one’s inner attitude. Nonverbal and verbal communication complements each other. Non-verbal cues can be used to explain on verbal to support the information when trying to achieve effective communication. Ideas have been shown to be remembered well when nonverbal signals are used. Although it is clearly visible that the use of non-verbal cues is important in health communication, they however impose some negative influence in oral communication. Different cultural backgrounds can result in communication barriers and misunderstandings. This then pose challenges as some gestures can produce a different feedback if the receiver does not understand the message or misinterprets the meaning of the message. However, there may be conflict of messages disseminated and received, because of misinterpretation and distortion because of differences in levels of abstraction of receivers of messages. Through NVC in health communication, one can be able to study the effects of messages as they are sent and received. NVC is thus of great importance to avoid unintended and counterproductive effect of the message sent [43-46].