EFFECTS OF INTERNAL COMMUNICATION METHODS

ON PERFOMANCE OF PUBLIC HOSPITALS IN NAIROBO

COUNTY

BY

AKINYI SHARON OKOKO

A RESEARCH PROJECT SUBMITTED IN PARTIAL

FULFILMENT FOR THE AWARD OF A POSTGRADUATE
DIPLOMA IN BUSINESS MANAGEMENT

KISUMU POLYTECHNIC

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 DECLARATION

This research project is my original work and has not been presented for award of post Graduate
Diploma in any other polytechnic.
NAME: AKINYI SHARON OPOKO
DATE:_____________________________
SIGNATURE:________________________
This research project has been submitted for examination with my approval as The Kisumu
Polytechnic Supervisor.
SUPERVISOR;S NAME: MR. MBOI
DATE:_____________________________
SIGNATURE:________________________

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 DEDICATION
I dedicated this research project to my beloved husband EzronOkoko and my lovely children
Brian and Valerie. I thank them for their patience and understsnding during the course of my
study you are cherished with much affection.

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iv
 ACKNOWLEDGEMENT
I wish to express my sincere gratitude to my supervisor Mboi who found time to attend to my
work. His exceptional academic persuations, patince, devotion and constant scholarly guidance
which facilitated the timely competion of this research work. I am grateful and proud be
associated with him.
I feel indebted to the entire staff and students of the Extra moral. Studies Department for their
cooperation and assistance during the course period .
I also wish to pass my sincere gratitude to all the respondents expecially the managers,
supervisors and other workers of NHIF for their genuine cooperation during the data collection
stage. Were it not for their responses. I would have no data collect and analyse.
I also express my sincere thanks to my lovely husband Ezron for his financial and moral support,
encourage and cooperation and my children Brian and Valerie who had to beer with my tight
schedule throughout the whole course.
Finally thanks to all who in one way or another contributed to the succeful production of this
research wor. To all who participated and showed interest in my work may bless you all.

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 ABSRACT
The study was carried out to assess effective communication and organizational performance at
NHIF Headquarters, Nairobi. The main object of the study was: To determine the indicators of
internal communication performance; To identify internal communication method; To establish
the relationship between internal communication; The research design used was descriptive
survey. The target population was managers and other workers of NHIF headquarter, Nairobi.
The sample size consisted of managers and 32 other employees (subordinate staff). To select the
managers of different department, purposive sampling was used so that there was a department
head in each section of the organization. To select the other employees random sampling was
used.
The research gathered data using two questionnaires, one for the managers and other for
employees. Questionnaires were self-administered by the researcher through individual visits to
the respondents. The instrument was validated using the statistical package for social science
(spss)
The research findings revealed that the main channel of communication at NHIF were letters
and memos. Thus, communication become more mechanistic and impersonal and hinders social
interaction which is a vital ingredient of effective communication. The other mentioned means of
communication were telephone, notice board conference, Face to face conferences and
committees. The study also revealed that the organization tried to ensure that the employees
receive clear, accurate and prompt information of what is expected of them.
The study also recommended the following to be done by NHIF; Amend its communication
policy on a continuous basis; Apply training and carry out impact assessment to ensure
communication take place; Reward and motivate workers to undertake training in
communication skills;
The study had the following conclusion: The study had was limited to NHIF headquater in
Nairobi. A similar research can be carrid out in other branches to elicit more accurate nation
outlook of the effectictive communication and organization performance.Astudy can also be
done to check whether improved communication at NHIF from a basis for career development;
A study can also be carried out to investigate whether the management style and employee
attitude affects effective communication at NHIF.

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Contents
DECLARATION.............................................................................................................................ii

DEDICATION...............................................................................................................................iii

ACKNOWLEDGEMENT...............................................................................................................v

ABSRACT......................................................................................................................................vi

CHAPTER ONE..............................................................................................................................1

1.0 Background of The Study..........................................................................................................1

1.1.1 Effects of Internal communication methods.....................................................................2

1.1.3 The place where the study will be carried out..................................................................3

1.1.4 Independent and dependent variable.................................................................................3

1.2 Statement of The problems........................................................................................................3

1.3Research Objectives....................................................................................................................3

1.5Signicance of The study..............................................................................................................4

1.6 Scope of The Study....................................................................................................................4

CHAPTER TWO.............................................................................................................................5

2.1 Literature Overview...................................................................................................................5

2.2 Theoretical Framework or Literature.........................................................................................5

2.3 Empirical Studies – BASED ON The Objective of The Study.................................................5

2.4 Research Gap.............................................................................................................................6

2.5 Conceptual Framework..............................................................................................................6

2.5 Conceptual Framework variables..............................................................................................7

CHAPTER 3....................................................................................................................................9

3.1 Research Design........................................................................................................................9

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3.2 Where the study will be carried out...........................................................................................9

3.3 Target population.......................................................................................................................9

3.4 Sample Design...........................................................................................................................9

3.5 Data collection.........................................................................................................................10

3.6 Instrumentation........................................................................................................................10

3.6.Date validity.............................................................................................................................11

3.6.2 Date Reliability.....................................................................................................................11

3.7 Data Analysis...........................................................................................................................11

CHAPTER 4..................................................................................................................................12

DATE PRESENTETION..............................................................................................................12

4.0 Introduction..............................................................................................................................12

4.1 Questionnaires Return Rate.....................................................................................................12

4.2 Demographic Information of the Respondents........................................................................12

4.2.1 Gender of The Respondents..................................................................................................12

4.2.2 Age of Respondents..............................................................................................................13

4.2.3 Job level of the Respondents................................................................................................14

4.2.5 Work experience of the respondents.....................................................................................15

4.2.6 Educational Background.......................................................................................................16

4.3 Data Analysis...........................................................................................................................16

4.3.1 Communication channels used at NHIF...............................................................................16

4.3.2 Communication Policy at NHIF...........................................................................................17

4.3.3 Communication Policy and Objective of NHIF...................................................................18

4.3.4. Managers responses on whether they were satisfied with the organizations communication
system............................................................................................................................................19

4.3.5 Communication needs of Employee at NHIF.......................................................................24

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4.3.7 Barriers to effective communication at NHIF......................................................................25

4.3.8 what can be done to improve the effectiveness of communication systems at NHIF.. . .25

CHAPTER FIVE...........................................................................................................................27

SUMMARY, CONCLUSIONS, RECOMMENDATIONS AND SUGGEDTION......................27

5.0 Introduction..............................................................................................................................27

5.1 summary of the findings..........................................................................................................27

5.2 Answer to Research Question..................................................................................................28

5.2.1 Research Question: How is communication carried out at NHIF?.......................................28

5.2.2 Researcher Question............................................................................................................29

5.3.3 Research Question................................................................................................................29

5.3.4 What can be done to improve the Employees and management communication?...............29

5.3 Conclusion...............................................................................................................................30

5.4 Recommendations....................................................................................................................30

5.5 Suggestion for further Research..............................................................................................30

BIBLIOGRAPHY..........................................................................................................................32

APPENDIX....................................................................................................................................35

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 CHAPTER ONE

1.0 Background of The Study

The National Hospital insurance fund was established under the National insurance fund act
1998.This Act stated that there shall be a fund known as the National Hospital insurance fund
which shall vest in and be operated and managed by the board. The Board of management shall
consist of chairman to be appointed by the president by virtual of has knowledge and experience
in matters relating to insurance financial management, economies, health or
businessadministration. Thepermanent secretary to in the ministry for the time being responsible
for matters relating to health or his representativepermanent secretary to the Treasury or his
representative; The permanent secretary/Director of personnel management or his representative;
the Director of medical services; one person nominated by Federation of Kenya Employers
[FKE] central organization of Trade union[COTU] ,Kenya National Union of Teachers
[KNUT] AND KENYA National union[KNFU].Other people included in the NHIF
MANAGEMENT Board are; two members appointed by the minister; one from the Association
of Kenya insurer and the other from non a charitable boss by religious organization &one
member representing Non governmental organizations involved in the provision of health care
services, nominated by the NonGovernmental Act 1990.The Board is allowed to appoint for the
proper discharge of the functions stated in this act or any other written law, upon such term&
condition of service as the Board may determine objects &the functions of the Bord according to
NHIF Act shall be;1To receive all contribution& other payments as required by this Act to be
made to the fund & to make payments out of the fund to declared hospitals in accordance with
the provision of this act. In consultation with the ministry it wasto set the criteria for the
declaration of hospitals& to declare such hospitals in accordance there to for the purposes of this
act; To regulate the contributions payments to the funds &the benefits & other payments to be
made out of the fund;Handson [1996] stated that for the employees in any organization to
perform their duties effectively, they need effective communication.NHIF being an organization,
in order for members of staff appointed by the Board to perform their duties effectively, there is
need for effective communication is transferred or transmitted from sender to the receiver with
the information being understood by receiver & acted upon appropriately.

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Mukai G. (2007) further stated that the internal banksman such as standard and Barclays REL
heavily on communication technology to enhance and sustain their efficiency .
Waweru (2002) says that commination is the process of interchanging thoughts,feeling and
information. Therefore, communication is the process by which information is exchanged
between individuals intentionally or unintentionally.

1.1.1 Effects of Internal communication methods.

Internal communication methods is sharing of information within an organization for business
purpose. They are as follows
1Face – to face communication
A variety of media is available to Todays professionals but fac – to face communication is still
most preferred type of communication when it comes to internal communication, There is no
doubt that real life communications is the king of all communications
(ii) Intranet, Email print ,Newsletters& others
Intranet Email are currently the most used communication channels but you know that your
company’s employees are busy. They do not have time to read intranet sites that offer a lot of
complicated information or check a load of company heavily tax -text base emails & find what is
relevant for them inside.
1.1.2 Hospital Performance
The mortality rate within 30 days of patients being admitted to hospital after an acute myocardial
infarction reflect processes of care such as timely transport of patient & effective medical
interntions.one of the hospital performance indicators is,
(i)Abstract
Admission rate &length of stay (LOS) are two hospital performance indicators that affect the
quality of care patient’s satisfaction, bed turnover & health cost expenditures.

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1.1.3 The place where the study will be carried out
This study will be carried out in Kisumu and it will target sixty (60) employees of NHIF
specifically from NHIF Headquarter. The sixty employees consist of twelve ((12) managers
&forty-eight (48) subordinate stasis who are not in management.

1.1.4 Independent and dependent variable

According to these variables, the management is normally in charge of communication in any
organization. The management uses different channels to get the employees & the way in which
the message is passed leads to either better or poor performance among the employee

1.2 Statement of The problems

Effective communication is the backbone of good organization performance because it plays
Avery important role in the attainment of its goals ?& objectives. An efficient communication
system & information flow in an organization is a prerequisite to make them relevant & relate
well with the society. Unfortunately, there seem to be lack of a coordinated and effective
communication policy at NHIF.The NHIF clients have been complaining of serious delays in
processing of their claims since communication plays a vital role in harmonizing all departments
of departments of an organizational so as to enhance organizational performance , there was
need to evaluate the organizational communication structure,channels of communication,
communication policy and communication system ofNHIF to find out how relevant & effective
they are in this era of information Technology so as to establish the effectiveness of
communication in NHIF and its effect on the organizational performance.

1.3Research Objectives
(i)To identify indicators on performance
(i)To determine internal communication method
(iii)To establish the relationship between internal communication
1.4Research Questions
(i)How is communication is carried out in NHIF?
(ii)What are the communication needs of NHIF employees?
(iii)What are the challenges faced by the employees of NHIF

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(iv)What can be done to improve the employees and management communication?

1.5Signicance of The study

There is potentially beneficial in a number of ways. The findings can
(i)Providing information to the stakeholders of NHIF on the communication needs, problems,
possible situations and the effects of communication on organizational performance
(ii)Add to the general body of existing knowledge in the area of communication
(iii)Providing information that would enable the management to provide favorable
communication atmosphere necessary for vibrant growth of NHIF.
(Iv)Help nature understanding between the senior and junior staff
(vi)Help control any situation through engaging in suitable communication.

1.6 Scope of The Study

This study sought to analyze the of effects of effective communication on the employee’s
efficiency & performance, communication process, channels of communication, challenges faced
by NHIF employees during communication & the effect of communication on organizational
efficiency &performance. At the end of the study the researcher recommended possible changes
necessary in the communication process for increased efficiency & good organizational
performance at NHIF.

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 CHAPTER TWO

2.1 Literature Overview

Imagine a world without communication . a world where man lives as an individual without
interaction, never sharing experience and knowledge. Such world is inconceivable & impossible
to image, communication has a position of such unquestionable primary in fair of mankind. It
makes organization possible and organizations then have enabled our present system of
organized lifestyle.

2.2 Theoretical Framework or Literature

Communication studies have come up with various theories and models explaining how
information flows in society. An examination of these modes would provide some answers on
the role of communication in dissemination, of information in an organization. Reviews of
pertinent literature in communication show that diverse theories converge to provide wider
meaning towards organizational communication and the relationship between structure &
available channels. Early researchers have shown that media have powerful effects, a
phenomenon that made media act as the hypodermic needle or “magic Bullet”(Lowery and Fleur
1988).certain communication and management theories & models such as: the two -step flow
theory, the gate keeping theory, the social learning theory, communication theory, open system
theory and Taylorism seek to describe how communication takes place in organization. As
communication itself is a process in which participants create and share information with one
another in order to reach a mutual understanding, these models assert that there is selective
influence based on social relationships and social categories. The models depict individuals as
psychological machines with own perceptions that affects their communication flows and
attempt to account for human behavior.

2.3 Empirical Studies – BASED ON The Objective of The Study

The Research on how information flows in society is to conducted by Carl Haviland and others
in Erie county, Ohio on the 1940 us pre4sidential elections (Lowery and De flour, 1988).Named
the Decatur study after the city in which it has to be conducted, the study sought to evaluate the
level and impact of interpersonal communication in the diffusion of campaign messages Another

5
study that instrumental in evaluating the diffusion find out how effective leaflets are in a
complain in 1945 leaflets had been effectively used to convince the Japanese that military
resistance was futile, The idea of using leaflets was mooted a way reaching diverse and
disparate communities who could not be reach through conventional media. The limited success
that leaflets achieve attests to the fact that printed media may not be relied upon as the only
medium to reach wide audience given its vulnerability to distortion and the logical nature of
application.(Lower De Fleur, 1988)7

2.4 Research Gap

A system is a set of units that has a degree of structure and is differentiated from the environment
by a boundary. The system boundary is defined by communication on organization of the units in
the system in that it continuously exchanges information with its environment.

2.5 Conceptual Framework

Most experts on organization , management and leadership assert that effective communication
is the foundation for effectiveness in any type of organization. Lack of effective communication
can result a variety of ailments such as low employee morale, highly absenteeism and rate of
turnover, low productively, and resistance to change and perhaps most frequently, labor
conflicts, .This leads to poor organizational performance where recognizable, the communication
(gap) is seen to be bridgeable leading to effective communication.Although recogzation the
emphasis here will be a direct communication between the management and the individual
employees and how their interaction can improve the organizational communication leading to
improved performance. The figure 4 below presents the conceptual framework showing the
relationship between communication process in NHIF and organizational performance.

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2.5 Conceptual Framework variables

General manager

Deputies

HOD 1
HOD 2
HOD 2
HOD 3
HOD 4
HOD 3

Head Section

Employees

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According to the above variables, the management is normally in charge of communication in
any organization. The management uses different channels to get to the employees and the way
in which the message is pass leads to either better or por performance among the employees. The
different methods of communication used will depend largely on the different channels of
communication & the urgency of the message for instance, the use of memorandum and notice
boards in the organization for urgent message is inappropriate .On the other hand use of
inappropriate channels & method of communication is likely to leads to ineffective
communication. This can result to a variety of ailments such as low employee morale, high
absenteeism and turnover rate, low productivity, resistance to change and labor conflicts.
Therefore,influence the organizational performance either positively or negatively.

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 CHAPTER 3

3.1 Research Design

A research design refers to a plan, blue print or guide for date collection and interpretation, a set
of rules that enable the investigator to conceptualize and observe the problem under study.
Adams and scheveneldt (1985) in this study, descriptive survey design will be employed.
Fraenkel & Wallen (1993) describe a descriptive study as a collection and analysis of date that
allows one to describe the current status of the subjects in the study. It enables one to describe
the characteristics of a population understand the given characteristics of that population & also
after’s ideals for further research. It is sometimes helpful in making some decisions. Descriptive
survey study also determines & reports the way things are commonly involves assessing attitudes
and opinions, Gay (1981). Survey design is selected because this study aims at exploring and
explaining the existing status of communication process and its effects of communication
process and its effects on organizational performance in NHIF.

3.2 Where the study will be carried out

This study will be carried out in Nairobi and it will target sixty(60) employees of NHIF
specifically from the NHIF headquarter . The sixty employees consist of twelves (12) manager
and forty-eight (48) subordinate staff who are not in management.

3.3 Target population

Target population is a group or category of human being, among and objects which have one or
more characteristics in common and been selected as a focus of the study ,Mulusa(1988). This
study will be carried in Nairobi and it will target sixty (60) employees of NHIF. If specifically,
from the NHIF headquarter. The sixty employees consist of twelve (12) managers and forty-eight
(48) subordinate staff who are not in management.

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3.4 Sample Design
Peter N(2004) defines a samole as a representative, part of a population. Thus, by studying the
sample can know the population without having to study the entire population. The selection
process of the sample is the sampling procedure or sampling technique. The researcher will not
be able to cover all the sixty (60) employees within the given time and with the available funds.
A total of forty (40) employees representing sixty six percent (66%) of the total population will
be sampled for this study. This is in line with Gay (1976) who indicated that for a large
population, a sample of ten percent (10%) will be adequate and for small population, a sample of
twenty percent (20%) will be sufficient. The study proposes to use a total of forty(40)
respondents consisting of one (1) top executive manager, seven(7) managers headlining different
departments and thirty-two (32) subordinate staff. The sample respondents will be selected using
stratified sampling in combination with simple random sampling. The managers will be straffied
according to department head in each section of the organization. To select the departments,
purposive sampling will be used so as to include the top executive manager & a department head
in each section of the organization.
To select the employees, simple random sampling technique will be used to select four
employees from each department.

3.5 Data collection

Data collection started with a pilot administration of the printed questionnaires to a group of
respondents who were not included in the main study, Questionnaires were distributed and
administered personally to individual respondent in order to create report. The pilot study
enables the researcher to familiarize with the administration of questionnaires and collection of
data in preparation for the main study .
After one week the researcher revisit the NHIF headquarters to self _administer the
questionnaires .printed questionnaires were hand delivered to the respondents, instructions were
given to them before filling the questionnaires and then requested to fill immediately. This
ensured a high degree of accuracy were requested to so at their own convenience and the filled in
questionnaires were collected later.

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3.6 Instrumentation
The main research instrument for this study will be self- administered questionnaire. This is
because less time is required to respond, it is also less expensive and it is one of the best tools
that are free from the interviewer bias. Respondents have more time to give well thought out
responses, Kothari [1994 .two questionnaires will be developed ,one for the managers and the
other for the employees ,the questionnaires will have two parts. Part one will collect information
on personal and institutional data and part two focus on communication.

3.6.Date validity
Kothari (2004) state that validity indicates the degree to which an instrument measures what it is
supposed to measure that is the extent to which differences found with a measuring instrument
reflects true different among those being tested. To enhance the validity of the questionnaire, a
pilot study will be conducted on ten (10) respondents consisting of one (1) top executive
manager & two (2) heads of departments & seven (7) subordinate staff randomly selected from
the target population at the NHIF headquarters. This is geared from towards assessing the clarity
of the instrument items so that those that fail to measure the variables they are intended the
measure, can be modified.

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3.6.2 Date Reliability
A measuring instrument is reliable if it provides consistent results (Mugenda 2004). Reliable
instruments are consistent and stable hence can be depended upon to yield similar results under
similar circumstances (Borg and Gall 1989), The researcher will use split – half correlation
method. The test items will be split into two subjects; one with even numbered items and the
other with odd numbered items. Spearman- Brown prophecy will be used to establish full
reliability of the instrument’s spearman – Brown prophecy formula is given by ;
Re = 2r l l – r ;where Re rep Reliability co- efficient , r rep correlation co-
efficient between halves
Source; Best and Kahn, Research in Education 1998; 378

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3.7 Data Analysis
Analysis of data started with editing and inspecting of data pieces in order to identify spelling
mistakes and wrongly answered or responded items. The data gathered has been analyzed using
descriptive and inferential statistics. Specifically, the frequencies percentages and means were
utilized to explore the variables under study. Qualitative data arising out of perceptions, opinions
and suggestion is expressed in percentages as per the categories of respondents against their
variables and analyzed using statistical package for social sciences (spss)

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 CHAPTER 4

DATE PRESENTETION

4.0 Introduction
This chapter is devoted to the presentation of the research findings of the study and their
interpretation. The findings from each other of the research objectives were summarized in
tabular form, and then the summery results were analyzed using frequencies and percentages. In
presenting the findings, this chapter is organized into the following sections;
Demographic information, the existing channels of communication; how communication is
carried out in NHIF, communication needs of the employees of NHIF, challenges faced by the
employees during communication and what can be done to improve employees and management
communication. The data analysis was guided by the research questions.

4.1 Questionnaires Return Rate

The research targeted a total of 40 respondents who comprised of 8 managers and 32 subordinate
staff. The response rate achieved was 100 percent and it is considered adequate in providing a
relatively valid and reliable representation of the target population.

4.2 Demographic Information of the Respondents

Demographic information of the respondents was found important because they play an
important role in the day to day running of the organization.

4.2.1 Gender of The Respondents

The study sought out to find out the composition of respondents in terms of age and gender. The
frequency counts of the responses were done and their percentages calculated . table 1 present
data on the gender of the respondents.

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Table 1: Gender of the respondents
Gender Ma Subo
nagers rdinate
Frequency Percentage Frequency Percentage
Male 6 75% 15 46.9%
Female 2 25% 17 53.1%
Total 8 100% 32 100%

Table 1 shows that out of the 8 respondent managers, there were 6 (75%) female managers.
This indicates that there is a lack of gender equality n the distribution of the managerial posts
at NHIF headquarters in Nairobi. The table also indicates that out of the 32 respondent
subordinates, 15(46.9%) were male and 17(53.1%) were female. This also indicated a
presence of gender inequality.

4.2.2 Age of Respondents

The study sought to find the age of the respondents. The frequencies were computed and
percentages calculated. The results are presented in table 2
Table 2: Age of the respondents
Age Managers subordinate
frequency Percentage frequency Percentage
20 – 28 - - 7 21.9%
28 - 35 6 75 10 31.2%
36 – 43 2 25 11 34.4%
44 – 51 - - 4 12.5%
TOTAL 8 100% 32% 100%

From Table 2, it can be observed that among the managers, the youngest was 28 years while the
oldest was aged 43 years of age. 6(75%) of the managers were aged between 28 and 35 years of
age while 2(25%) of them were aged between 36 and 43 years of age. Among the subordinates,
the youngest was aged 20 years and the oldest was aged 51 years; 7(21.9%) of them were aged

15
between 20and 28 years; 10(31.2%) were aged between 36 and 43 years while 4(12.5%) were
aged between 44 and 51 years of age.
The data indicated that most of the managers and subordinates are middle-aged with a lot of
energy if well and fully utilized in the organization there will be effective achievement of
organizational goals and objectives.

4.2.3 Job level of the Respondents

The research also sought out to find out the job levels of the managers and other subordinates.
The data was obtained from the respondents, then tabulated using frequencies and percentages as
shown in table 3.
Table 3; Job level of the Respondents
Job Level Managers Subordinates
Frequency Percentage Frequency Percentage
Management 5 62.5 10 31.2
Supervisory 3 37.5 8 25
Subordinate - - 14 43.8
Total 8 100 32 100

Table 3 shows that 5 ( 62.5%) of the managers were in charge of the management level and
3(37.5%) were in the supervisory level. From the subordinates responses, 10(31.3%) were in the
management level, 8(25%) in the supervisory level and 14(43.8%) were in the subordinate level.
This shows that majority of the NHIF employees are either in the management or supervisory
level.
4.2.4 Terms of Employment
The research also sought out the information on terms of employment. Table 4 presents the data
gathered on terms of employment.

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 Table 4; Terms of Employment
Terms of Managers Subordinates
Employment Frequency Percentage Frequency Percentage
Permanent 8 100 31 46.1
Probation - - 1 3.1
Total 8 100 32 100

Table 4 shows that all the managers 8(100%) who participated in the study were employed on
permanent terms. 3(96.9%) of the subordinates were also on permanent terms and only 1(3.1.%)
were on probation awaiting confirmation.

4.2.5 Work experience of the respondents

Data on the work experience of the respondents was gathered . frequencies were computed and
percentages calculated. The results were as presented in table 5
Table 5; Work Experience of the Respondents
Manager Manager Subordinates
Work Frequency Percentage Frequency Percentage
Experience
1 – 5 years 1 12.5 5 15.6
6 – 10 years 4 50.0 18 56.2
11 years 3 37.5 9 28.2
Total 8 100 32 100

The analysis in table 5 shows that 7(87.5%) of the managers and 27(84.4%) of the subordinates.
This shows that a considerable number of the staff at NHIF have worked with the organization
for more five years. Only 1(12.5%) of the managers and 5(15.6%) of the subordinates have
worked for less that five years.

17
4.2.6 Educational Background
The research also sought out information on the educational background of the NHIF employees.
The information gathered was computed using frequencies and percentages as shown in table 6.

Table 6; Educational Background

Educational Managers Subordinates
Level Frequency Percentage Frequency Percentage
Primary - - - -
Secondary - - 2 6.2
College 1 12.5 15 46.9
University 6 75.0 6 18.8
Post Graduate 1 12.5 9 28.1
Total 8 100 32 100

Table 6 shows that majority of the respondents had acquired college level education and above.
The graduates and post graduates accounted for 7(87.5%) of the managers and 15(46..9%) of the
subordinates. It was however found that there were no respondents with primary education.

4.3 Data Analysis

Data analysis was done by the researcher answering the following research questions.;
Research question 1: how is communication carried out in NHIF.

4.3.1 Communication channels used at NHIF

The managers and subordinates were asked to mention the main channels of communication
used in NHIF. The frequencies were computed and percentages calculated. The results are
presented in table 7.

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Table 7: Communication channels used in NHIF
Communication Managers Subordinates
channels Frequency Percentage Frequency Percentage
Letters and 5 62.5 27 84.4
memoranda
Telephone/ email 2 25.0 2 6.3
Poster and 1 12.5 1 3.1
Notification board
Face to face - - 1 3.1
Communication - - - -
Meeting - - 1 3.1
Total 8 100 32 100

Data obtained in table 7 indicates that letters and memoranda are the used channels of
communication at NHIF. This was because 5(62.5%) of the managers reported that they used
letters and memoranda most of the time which was supported by 27(84.4%) of the subordinates
who also indicated that the management used letters and memoranda to communicate with them
most of the time. The other mentioned channels of communication at NHIF were the telephone,
email, face-to-face oral communication, meetings posters and notice boards.

4.3.2 Communication Policy at NHIF

The researcher was also interested in the communication policy at NHIF. The researcher
collected data on the communication policy at NHIF and analyzed it in form of frequencies and
percentages as shown in table 8.

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Table 8: Awareness of Communication Policies
Awareness of Managers Subordinates
communication Frequency Percentage Frequency Percentage
policy
YES 8 100 13 40.6
NO - - 19 59.4
Total 8 100 32 100.0

Table 8 shows that all the managers 8(100%) reported that there was an existing communication
policy at NHIF. On the contrary, 13(40.6%) of the subordinates did indicate that there was a
communication policy at NHIF while another 19(59.4%) stated that they were not aware of any
existing communication policy at NHIF. This provides a clear indication that half of the
subordinates were not aware of their communication policy.

4.3.3 Communication Policy and Objective of NHIF

Managers were further questioned on whether communication policy did fit NHIF objectives.
The data gathered was analyzed in frequencies and percentages as shown in table 9 below.
Table 9: Communication policy and objectives of NHIF
Communication policy Managers
and objectives of Frequency Percentage
NHIF
YES 6 75.0
NO 2 25.0
Total 8 100
It was reported by 6(75%) of the managers that the NHIF communication policy fitted into their
objectives while only 2(19.9%) of the managers reported that the NHIF communication policy
did not fit into the NHIF objectives.

20
4.3.4. Managers responses on whether they were satisfied with the organizations
communication system.
Managers were asked whether they wee satisfied with the organizations communication system
and their responses were recorded in table 10.
Table 10: Managers Responses on Organization’s Communication System.
Managers’ Responses Frequency Percentage
Yes 3 37.5
No 5 62.5
Total 8 100.0

When asked if they were satisfied with the organization’s communication system, 3(37.5%) of
them reported that they were satisfied with the organizations communication system while
5(62.5%) indicated that they were not satisfied with the organization’s communications system.
A question was also asked as to whether the employees received clear, accurate and prompt
information on what the organization expects from them. The data collected was analyzed in
form of frequencies and percentages as shown in table 11.
Table 11: Responses on whether employees received clear, accurate and prompt
information on what the organization expects from them
Responses Manager Subordinates
Percentage Frequency Frequency Percentage
Strongly agree - - 1 3.1
Agree 6 75 18 36.3
Disagree 2 25 12 37.5
Strongly - - 1 3.1
disagree
Total 8 100 32 100.0

From table 11 6(75%) of the managers agree with the statement that the organization ensures that
the employees receive clear, accurate and prompt information. The other 2(25%) of the managers
disagreed with the statement. From the subordinate’s responses, 1(3.19%) strongly agreed that
the organization ensures that the employees received clear, accurate and prompt information on

21
what the organization expects from them. 18(56.3%) agreed with the statement, 12(37.5%)
disagreed and only 1(3.1%) of the subordinates strongly disagreed with the statement that the
organization ensured that the employees receive clear, accurate and prompt information on what
the organization expects from them.
The employees were asked whether they are kept informed on matters that affected their work
and the working
conditions. Their responses were analyzed in form of frequencies and percentages as shown in
table 12.
The 12: Responses on whether employees are kept informed on matters that affect their work and
the working conditions, 2(25%) of the managers indicated that employees are not kept informed
on mattersthat affect managers and 12(37.5%) of the subordinates agreed that employees are kept
informed on matters that affect their work and working conditions. None of the managers
disagreed with the statement , but 18(56.3%) of the subordinates disagreed with the statement
that employees are kept informed on matters that affect their work and the working conditions.
The researcher also raised a question on whether the employees were given an opportunity to
voice their suggestion. The response are analyzed in Table 13 below
Table13: Responses on whether the employees were given opportunity to voice their suggestion
and fear.

22
 Response Managers Subordinate
Frequency Percentage Frequency Percentage
Strong Agree - - 1 3.1
Agree 6 75 10 31.3
Disagree 2 25 18 56.3
Strongly - - 1 3.1
Disagree - - 2 6.2
Undecided 8 100 32 100

From table 13, 6(75%) of the managers and 10(31.3%) of the subordinates agreed that the
employees were given an opportunity to voice their suggestions and fears. On the other
hand, most of the works 19(59.4%) indicated that employees and fears. The other
information which the researcher gathered was on whether the organization implemented the
opinions and the views of the employees, the data gathered is shown in table 14
Table14: Responses on whether the organization implements the opinion and views of the
employees at NHIF.
Responses Manager Subordinates
Frequency percentage Frequency percentage
Strong Agree - - 1 3.1
Agree 4 50 8 25.0
Disagree 4 50 1 3.1
Strongly - - 20 62.5
Disagree
Undecided - - 2 6.3
Total 8 100 32 100

Majority of the responses indicated that NHIF does not implemented the view and opinions
of the employees. This was supported that the organization does not implement 22(68.8%) of
the subordinates who reported that the organization does not implement the view of the

23
employees. However,4(50%) of the managers and 9(28.19%) of the subordinates reported
that the organization does not implement the opinion and the views undecided on whether the
organization implements the opinion and the views of the workers at NHIF. Responses on
whether the organization provides prompt feedback to the employees were analyzed as
shown in Table.
Table15: Responses on whether the organization provides prompt Feedback to the
employees.

Responses Managers subordinates

Frequency Percentage Frequency percentage
Strong Agree - - 1 3.1
Agree 3 37.5 6 18.3
Disagree 5 62.5 2 63
Strong Disagree - - 21 65
Total 8 100 32 100

From table 15 we can observe that 3(37.5%) of the managers and subordinates reported that
the organization providesprompt feedback to the employees. It was also noted that a majority
of the of the managers 5(62.5%) and 22(71.9%) of the subordinates indicated that the
organization does not provide prompt feedback to the employees. 2(6.3%) of the
subordinates were undecided on whether the organization gives prompt feedback to the
employees.

24
Table 16: comments about the communication system at NHIF.

Response Managers Subordinates

Frequency percentage Frequency percentage
Very Good 1 12.5 4 12.5
Good 6 75.0 22 68.8
unfair 1 12.5 1 3.1
undecided - - 5 15.6
Total 8 100.0 32 100.0

Table 16 shows that when the respondents were asked to give comments about the
communication systems anthia, 1(12.5%) managers reported that it was unfair, system was
unfair or good to them. On the other hand. 4(12.5%) subordinate workers reported that the
system was good, 1(3.1%) reported that the system was very good while 5(15.6) were
undecided about the communication.
The17: Responses on communication and Good of NHIF

Response Manage
rs
Frequency percentage
Yes 4 50
No 4 50
Total 8 100

From the table 17, we can observe that half the managers reported that the communication
systems at NHIF were able to meet the goals of the organization. The other half on the
contrary indicated that the communication systems do not meet the goals of organization.
Organization would have been better with a different communization system. Finally, the
researcher was interested in getting responses on how employees at NHIF . From the

25
 managers responses, 2(25%) felt that good communication could improved the profitability
of NHIF growth: 4(50%) reported that good communication at NHIF could lead to fewer
customers complains and increase modernization while 2(25%) reported that among other
factors, good communication could lead to change in the organization image will change,
improved staff disciplinechange in the organization culture will changed, the staff will highly
motivate and it was also reported that good communication could lead to improved readiness
and improved teamwork among employees of NHIF.
The 18: Responses on how good communication can enhance the performance of the
employees
Response Managers
Frequency percentage
Probability of NHIF will 2 25
grow
Fewer customer complains 4 50
Other 2 25
Total 8 100

Research Question2: what are the communication needs of Employee at NHIF

4.3.5 Communication needs of Employee at NHIF

A Question was also put across to investigate on the respondents reported that there was need for
the organization to ensure that the employees were able to access information on the computers
especially via the e- mail services. The responses also indicated that there was need for the
organization to improve their notice board services and telephone services so that the workers
can be able to communicate on what is happening and the organization expects of them.
The employees also indicated that there was need for follow up programs to be put in place so as
ensure that the proper channels are followed. The above responses were supported by the
responses of the managers who on the other hand indicated that there was a need for the
introduction of the e- mail, telephone, fax facilities as means of communication at NHIF.
The management also reported that there was need for timely and, accurate feedback which
would in turn lead to a smooth supply of information to the employees. Finally in relation to the

26
communication needs the management also reported that there was need to implement the
concerns by the employees.
Research Question3: what are the challenges faced by the Employees of NHIF.

4.3.7 Barriers to effective communication at NHIF.

Data obtained from the managers and the subordinate’sresponse. Clearly indicated that the
bureaucracy of NHIF was the main barrier to effective communication in the organization.
According to 5 of the managers the organization suffered from lack of coordination between the
top management and the other staff which inturm implies that there is normally a delay in
communication between the staff and the management. The managers also reported that the staff
could not raised their fears freely without the fear of loosing their jobs. It was also reported that
some machines which can facilitate effective communication problems were bound to continue
existing. From the work responses bureaucracy was also named as the leading barrier to effective
communication at NHIF.Half the workers indicated that there were no regular meeting especially
on the junior staff to update them on what was happening in the organization another 28
subordinates reported that there was lack of interest and coordination between the different
departments and that there was no proper integration of ideas in the different departments. It was
clearly indicated that there were no proper communication skills in the organization and that in
most cases workers learnt about certain outformation through the grave vine system

4.3.8 what can be done to improve the effectiveness of communication systems at NHIF.
Different response were given by the management and employees on what can be done to
improve the effectiveness of communication systems at NHIF. According to the managers there
is need for the organization to hold on regular meeting so as solve problems facing the
employees. The employees. The employees also need to be allowed to communicate freely with
their bosses without fear of loosing their job. The managers also indicated that there was need to
allow feedback to the employees so as be able to implement the different issues relating to NHIF
it was advocated that there was need for certain control points of inquiry to be established where
workers can be able to raise their issues and complains freely without the interference of the
management he managers also indicated that the organization needed to purchase computers so
as to encourage the use of the e- mail services among other employees. From the employees

27
point of view there was need for NHIF to introduce both the horizontal and upward
communication among the employees of the organization. The subordinate reported that there
was need for junior staff to address the different issues affecting them and to have a systematic
feedback through the use of memos and E- mail services. 2 subordinates indicated that there was
need for NHIF to coordinates and to monitor the written communication for clarity among the
workers. Finally, the employees advocated for the improvement of the working conditions at
NHIF so that they can be able to raise their complains freely without fear of losing their job.

28
 CHAPTER FIVE

SUMMARY, CONCLUSIONS, RECOMMENDATIONS AND SUGGEDTION.

5.0 Introduction
In this chapter conclusion about the data obtained and analyzed are male. Specifically, frequency
table and descriptive statistics were used to analyze data. The findings presented in the findings
are discussed the second section comprise the conclusion of the findings and recommendations.

5.1 summary of the findings

After data analysis, it was found out that communication is a very important tool in any
organization. Including NHIF whenever an organization is concerned with customers
service.Communication has to play a major role towards the effectiveness of service offered. The
results of the study indicated that the general condition found out through the various factors that
affects communication that the researcher tackled in this research. These included.
To determine if lack of effective communication is a challenge to organizational performance
The study gathered that lack of proper communication is a challenge to organizational
performance. This is mainly seen in the issue of effective customer service. If information is not
transmitted by one person to the other exhaustively, the customer is not likely to get quality
service which is the gauge that measures employee’s efficiency and overall organizational
To Find out communication channels used at NHIF
Data obtained from the study indicates that letters and memos are the most used channels of
communication at NHIF. This was so because 6 of the managers did report that they use letters
and memos most of the time which was supported by another 27 workers who also indicated that
the management used letters and memos to communicate with them most of the time. The other
mentioned means of communication at NHIF were the use of telephone, face to face oral
communication, committees, meetings, posters and notice board. The implies that letters and
memos are the most channel of communication at NHIF.

29
5.2 Answer to Research Question
At the beginning of this study, the researcher had research questions whose answers were to be
found from the research work.

5.2.1 Research Question: How is communication carried out at NHIF?

According to the research findings, communication at NHIF was carried out through
letters ,]memos and telephone. They accounted for over 70%. Face to face came second while
letters and meetings were not commonly used. Face to face being the most effectively channel of
communication was least use: this likely to affect the efficiency and performance of staff. The
memos , letters and telephone mail do not give the communicator a chance to see the non- verbal
communication such as gesture and facial expressions.
The employees are not also aware of an existing communication policy at NHIF. 19 subordinates
clearly stated that they were not a were of existing communication poly at NHIF, this gives a
clear indication that half of the employees were not aware of their communication policy. 6 of
the managers, representing over half of the managers respondents reported that the NHIF policy
did fit into NHIF objectives. The researcher also found out that the majority of the employees
were not notified with the communication system existing in the clear, accurate and prompt
information on what the organization expected of them . All limitations are likely to affect
organizational perforformance negatively. Interesting results were obtained when a question was
across to check on the status of the employees 6 of the managers reported that employees are
given an opportunity which was supported by 12 workers who also reported that voice their
suggestions and fears. On the other side most of the workers 19 did indicate that employees were
given an opportunity to voice their suggestion and fears. Majority of the responses indicated that
employees were given an opportunity to voice suggestion and fears and the organization does not
implement the views and opinion of employees. This was supported by 4 managers and 22
subordinates. This may lead to development of negative attitude between the management and
the lower level employees. Thus, the response to any information either coming from the staff or
management will definitely be influence by the attitude. In this case there is like hood that
effective communication will not take place.

30
5.2.2 Researcher Question
2. What are the communication needs of the NHIF Employees?
The researcher carried out shows that all the respondents felt that there was need for the
organization to ensure that employees have access to information on the computers especially
via the e- mail services, organization should improve their notice boards and telephone service to
enable the employees to communicate what is happening and the organization to communicate
what it expects of them. The respondents also indicated that there was need for follow up
programs and timely and accurate feedback for smooth flow of information.

5.3.3 Research Question

3: What are the challenges faced by the employees of NHIF.
The study result revealed that there was lack of coordination between rather top management and
other staff. This normally causes a delay in communication between the management and staff.
Managers also reported that the other staffs are unable to raise their fears and opinion freely in
fear of loosing machines such up to data computer which can facilitate effective communication
are expensive for the organization for all the employees.

5.3.4 What can be done to improve the Employees and management communication?
The findings of the study pointed out that there is need for holding regular meeting to solve the
different problems facing the workers and to facilitate face to face communication among the
staff themselves and between the staff and the management. There is also need for freely
communication between the staff and the management so that the staff can express their opinion,
fears and views freely without fear of losing their job. Vertical and horizontal communication
need to be introduced to facilitate effective communication among the members of the
organization. Two-way communication as opposed to one-way communication, mainly from the
management should also be encouraged. This will create good relations between the
management and the staff, as well as among the employees themselves. This will facilitate
effective communication which in turn is likely to enhance organizational performance. The
organization also needs to develop the right attitude to work such as reliability and unity among
the employees of NHIF:, create interest and coordinate between the different departments and

31
ensure that there is proper integration of ideas in the different departments and ensure that there
is no laxity , incompetence and act of sabotage on the management.

5.3 Conclusion
The following conclusions were made after careful analysis of data and underrepresentation of
the findings; It is apparent that the communication situation in the NHIF is not up to standard.
The management have a list of suggestions as to facilitate effective communication. On the other
hand, the junior staffs blame the management for their woes as far as communication is
concerned, they feel that the communication channels used communication policy,
communication system styles of management and nature of feedback have all contributed to lack
of effective . The findings also revealed that effective communication could improve the
profitability at NHIF, fewer customer complains and increased modernization change in the
organizational image improved staff discipling change in the organization culture; the staff will
be highly motivated and it was also reported that effective communication could lead to
improved readiness and teamwork among the employees of NHIF.

5.4 Recommendations
To improve its communication program in this changing and turbulent business times the
researcher recommended the following to the NHIF community if effective communication is
going to be achieved:
1 Amend its communication policy on a continues basis
2Apply training and carry out impactassememt to ensure communication takes place
3 Reward and motivate workers to undertake training in communication skills

5.5 Suggestion for further Research

Human resources development recognizes the value of human expertise and the responsibility of
using that expertise. It assumes that the unleashing of human expertise is ultimately for the
purpose of improving performance at individual, group and organizational levels. Therefore,
taking into account the limitations, findings and conclusions of this study, the following areas for
further study are recommended:

32
1 The study was limited to NHIF headquarters in Nairobi. A similar research can be carried out
in other branches to elicit more accurate national outlook of the effective communication and
organizational performance.
2 A Study can also be done to check whether improved communication at NHIF form a basis for
career development.
3 Since this study was based on internal point of view of effective communication, there is room
for more research in broad terms that will include external communities such ad customers,
suppliers and other general public.
4 A comparative study could also be undertaken to establish the extent to which effective
communication affects organizational performance in other organizations and institution.
5 A study can also be carried out to investigate whether the management style and employee
attitude affective communication at NHIF.

33
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 APPENDIX

QUESTIONAIRE FOR THE EMPLOYEES

Thank you for accepting to fill questionnaire. Answer the following questions as honestly as

possible. The information you give will be treated with outmost confidentiality.

Instruction(s) please indicate your chosen option with a tick where no choices are provided.

Write your responses in the spaces provided.

PART A

Indicate your gender in the space provided.

Male( ) Female ( )

Indicate your age bracket.

20-28 years ( ) 28- 35 years ( ) 36- 43 years ( )

What is your job level

Management ( ) supervisory ( ) subordinate ( )

Any other specify………………………………………….

State your terms of employment

Permanent ( ) contract ( ) Temporary ()

Any other specify…………………………………………

How long have you been working in NHIF?

1-5 years ( ) 6-10 years ( ) 11-15 years ( ) 16-20 years ( ) over 20 years

Indicate your Education background

Primary ( ) secondary ( ) college ( ) university () post-graduation ( )

Which are the most commonly used channels of communication in NHIF

Memos ( ) Letters ( )

37
Telephone ( ) Face to face oral communication ( )

Meeting ( )

Other, specify ………………………………………………….

Do you have a policy on communication?

Yes ( ) No ( )

What is your organization’s communication system?

Indicate whether the following statement describe your organization’s current communication

system as you see and experience it.

Employees receive clear, accurate and prompt information on the what the organization expects

of them.

Strongly agree ( ) Age ( ) Disagree ( ) strongly disagree ( ) undecided ( )

Employees are kept informed on matters that affect their work and the working condition.

Strongly Agree ( ) Agree ( ) Disagree ( ) strongly Disagree ( ) undecided ( )

Employees are given opportunity to voice their suggestation and fears.

Strongly Agree ( ) Agree ( ) Disagree ( ) strongly disagree ( ) undecided

The organization provide prompt feedback to the employees?

Strongly Agree ( ) strongly Disagree ( )

Agree () undecided ()

Disagree ( )

List down the ways through which feedback is conveyed to the workers at NHIF.

………………………………………………………………………………………………………

……………………..

38
………………………………………………………………………………………………………

……………………..

List the common communication needs of workers at NHIF.

………………………………………………………………………………………………………

………………..

………………………………………………………………………………………………………

………………

How does communication with NHIF contribute to the anticipated organization goals?

………………………………………………………………………………………………………

…………………………………

………………………………………………………………………………………………………

………………………………….

What are the main barriers to effective communication at NHIF?

………………………………………………………………………………………………………

……………………………………..

………………………………………………………………………………………………………

………………………………………..

What would you recommend for NHIF to do to overcome these barriers and communication

problems?

………………………………………………………………………………………………………

……………………………………………………….

………………………………………………………………………………………………………

………………………………………………………

39
How would you describe communication system of NHIF?

Excellent ( ) Good ( ) Average ( ) poor ( ) Very poor ( )

In your opinion , what do you think should be done to improve communication in NHIF?

40