How to Cite this Paper: Abdullahi Bashir & Muhammad Arabi Umar (2024). Hausa in Hospitals: Exploring Healthcare Communications in Yariman Bakura Specialist Hospital Gusau, Zamfara State, Nigeria. Middle East Res J Linguist Lit, 4(2): 35-42. DOI: 10.36348/merjll.2024.v04i02.003.
Hausa in Hospitals: Exploring Healthcare Communications in Yariman Bakura Specialist Hospital Gusau, Zamfara State, Nigeria
From
Abdullahi
Bashir
Department
of Languages and Cultures
Federal
University Gusau, Zamfara State – Nigeria
Phone: 08036481158
Email:
abdullahi.bashir@fugusau.edu.ng
And
Muhammad
Arabi Umar
Department
of Languages and Cultures
Federal
University Gusau, Zamfara State – Nigeria
Phone: 07062052814
Email:
arabiumar@fugusau.edu.ng
Abstract
This study investigates healthcare
communication at Yariman Bakura Specialist Hospital (YBSH) Gusau in Zamfara
state, focusing on the use of the Hausa language. A quantitative approach was
employed through a self-administered survey questionnaire distributed to both patients
and staff (n=200) at YBSH. The survey explored language preferences, dialect
variations, challenges, and communication strategies. Purposive sampling
ensured a representative sample of staff (doctors, nurses, etc.) and patients
with diverse backgrounds. Data analysis focused on the prevalence of Hausa use,
dialect variations, and staff perspectives on communication strategies and
medical terminology. The study found Hausa as the dominant language (77% of
staff, 64% of patients). However, dialect variations within Hausa (particularly
Zamfarci) pose the challenges. The study identified a gap in using Hausa medical
terminology. While staff primarily rely on interpreters (50%) and simplified
explanations (45%), limited resources and knowledge restrict the use of medical
terms in Hausa (5%). To improve communication, the study recommends developing
a Hausa medical dictionary (focusing on Standard Hausa and Zamfarci dialects)
and staff training programs on medical terminology. Additionally, a
multi-pronged approach that includes interpreters, simplified explanations, and
Hausa medical terminology is recommended for effective communication.
Keywords: Hausa language, healthcare communication, dialect variation,
medical terminologies, patient care
Introduction
Effective communication is the foundation
of quality healthcare, yet language barriers can hinder this crucial exchange.
Studies by prominent Nigerian researchers like Adeduro (2017), who investigated
the social and linguistic factors affecting communication between healthcare
providers and patients in Nigerian hospitals, highlight the dangers of
miscommunication in healthcare settings, including misdiagnosis and incorrect
treatment plans. This is especially concerning in local communities where
residents may not speak the dominant language used in hospitals.
In Nigeria's Zamfara State, Hausa is the
primary language for the majority of residents. Recognizing this linguistic
reality, the Yariman Bakura Specialist Hospital, a key
healthcare provider since 2013, serves a significant Hausa-speaking population.
This study investigates the use of Hausa within the hospital to improve
communication and ultimately, healthcare outcomes for the local community. By
exploring the challenges faced by medical personnel in understanding Hausa
dialects, the potential benefits of utilizing Hausa for improved patient trust,
understanding, and treatment adherence will be examined. Additionally,
recommendations for enhancing communication in Hausa, such as staff language
training or translated materials, will be proposed. This research aims to
contribute to a more inclusive healthcare environment at the Yariman Bakura
Specialist Hospital, empowering them to deliver better healthcare through
improved patient-provider communication in Hausa.
Language Barriers in Healthcare Settings
Language barriers in healthcare settings
occur when a patient and a healthcare provider do not share a common language,
or when communication is hindered despite sharing a language (Flores, 2015). These
barriers can significantly impact the quality of care delivered.
Sociolinguists, who study the relationship between language and society, offer
valuable insights into the complexities of language barriers in healthcare. Thus, Language
barriers extend beyond simply not sharing a common language. Even when a
patient and provider share a language, limited proficiency in the medical
vocabulary or the dominant dialect can create a barrier (Olsen, 2012). Imagine
a patient unfamiliar with medical terms struggling to understand a diagnosis or
treatment options proposed by their doctor (Olsen, 2012).
Similarly, Significant differences in dialects or accents can lead to
misunderstandings (Lin & Erickson, 2010, p. 124). Words might have
different meanings in different regions, or strong accents could make speech
difficult to comprehend. Misinterpretations can also arise when healthcare providers use
figurative language or idioms that patients don't understand literally
(Scarcella, 2003, p. 87). Literacy disparities can create a barrier. Patients with limited
reading skills might struggle to understand written instructions or consent
forms (Flores, 2015, p. 229). Cultural differences in non-verbal communication like eye
contact or gestures can lead to misunderstandings (Lin & Erickson, 2010, p.
132).
Patient-provider communication
Patient-provider communication is a cornerstone of quality healthcare. However, from a sociolinguistic perspective, it's more than simply exchanging information. It's a complex social interaction shaped by language, power dynamics, and cultural backgrounds (Li et al., 2019). Sociolinguists emphasize the importance of considering various factors that can impact this interaction:
1. Linguistic register: The level of formality and technical vocabulary used can create barriers. Imagine a doctor using complex medical terms while a patient struggles to understand them. Sociolinguists advocate for finding a balance between clear communication and appropriate medical terminology (Li et al., 2019).
2. Turn-taking and interruption patterns: Communication can break down if patients feel rushed or unable to express themselves fully. Sociolinguists highlight the importance of active listening and respectful turn-taking patterns for effective patient-provider communication (Li et al., 2019).
3. Non-verbal communication: Facial expressions, gestures, and body language can convey unspoken emotions and influence the interaction. For example, a patient with crossed arms might appear closed off, while a hesitant tone could indicate fear or uncertainty. Sociolinguists encourage healthcare providers to be mindful of non-verbal cues to better understand patients' needs (Li et al., 2019).
4. Cultural beliefs and expectations: Cultural understanding of illness, communication styles, and expectations of HCP interaction all play a role. Sociolinguists emphasize the importance of cultural sensitivity in healthcare communication to bridge potential gaps and build trust with patients from diverse backgrounds (Li et al., 2019).
Literature Review
Effective communication between patients
and healthcare providers is a cornerstone of quality care. While factors such
as infrastructure and funding are crucial, clear communication transcends these
tangible elements. This review examines the existing literature on language and
communication in Nigerian healthcare, highlighting a significant gap in
research on specific language contexts within hospitals. We then propose a case
study approach to address this gap, focusing on the use of Hausa, a major
Nigerian language, at the Yariman Bakura Specialist Hospital.
Previous
studies, including those by Tsaure & Sani (2016), Sama & Sani (2018),
and Tsaure & Sani (2024), have emphasized the significance and influence of
communication in human social dynamics. On the other hand, several studies
underscore the importance of language in healthcare delivery. (Antia &
Bertin, 2004) Antia et al. (2003) and Yassin et al. (2003) demonstrate how
language barriers can impede effective communication and ultimately, hinder
quality care. The World Health Organization (WHO) framework for health system
performance further emphasizes this concept through "linguistic
responsiveness" (Tandon et al., 2000). This principle highlights respect
for patients and client orientation, both of which rely heavily on clear
communication. Nigeria's low ranking (187th out of 191) in the WHO assessment
suggests a need for improvement in linguistic responsiveness within its
healthcare system.
While existing research underlines the importance of language, a critical gap exists in examining specific language contexts within Nigerian hospitals. The vast linguistic landscape of Nigeria presents unique challenges and opportunities depending on the dominant language spoken in a particular region. This study approaches to bridge this gap by focusing on the use of Hausa, a major Nigerian language, at the Yariman Bakura Specialist Hospital Gusau, Zamfara. Research on this specific context is limited, and further investigation is needed to understand the specific challenges and opportunities surrounding Hausa within the hospital setting. Focusing on the Yariman Bakura Specialist Hospital, key areas for further research include:
1. Prevalence of Hausa-speaking patients: Understanding the proportion of patients who primarily speak Hausa is crucial for assessing the need for language-based interventions.
2. Language proficiency of healthcare staff: The ability of staff to communicate effectively in Hausa is essential for ensuring quality care for Hausa-speaking patients.
3. Existing strategies for addressing language/Dialect barriers: Investigating current approaches, such as the use of interpreters or translated materials, can reveal their effectiveness and identify areas for improvement.
4. Impact of language barriers on patient care: Understanding how language barriers affect patient experiences, including adherence to treatment plans and overall satisfaction, is vital for informing solutions.
By addressing these research gaps, a case
study focusing on Hausa at the Yariman Bakura Specialist Hospital can provide
valuable insights into the challenges and potential solutions for improving
communication and patient outcomes in this multilingual setting. This research
aligns with existing literature on language and healthcare delivery, offering a
more nuanced understanding of the specific challenges faced in a Nigerian
context. This ultimately contributes to the broader goal of enhancing linguistic
responsiveness within Nigerian healthcare systems, thereby improving the
overall quality of care delivered to patients.
Research Methodology
The study design employed a quantitative
approach to gain insights into healthcare communication practices within
Yariman Bakura Specialist Hospital. The primary data collection tool used was a
self-administered survey questionnaire. The questionnaire was carefully
developed and covered key aspects such as preferred languages for
communication, use of dialects, challenges encountered and recommendations,
frequency of language-related difficulties, and perceptions of communication
quality.
To ensure accessibility, the survey was
shared via both hard copies and a Google form sent through WhatsApp. This
allowed participants who might be on leave or off duty to still have the
opportunity to participate in the survey. To accurately gather information from
patients and their relatives, the patient questionnaire was translated into
Hausa. The research team also enlisted both male and female research assistants
who were familiar with the hospital environment and had an understanding of the
Zamfarci dialect. These assistants visited the hospital regularly over two
weeks to obtain accurate information. Additionally, the research team explored
the possibility of utilizing Hausa interpreters to assist patients who required
further support in communication.
Participant selection was done through
purposive sampling to ensure a sample that accurately reflected the hospital
population. Participants were selected from various departments and units,
including doctors, nurses, pharmacists, laboratory attendants, and
administrators for the staff group, and a diverse group with varying
backgrounds and medical conditions for the patient group. The target
sample size was 200 participants, with an even distribution between staff and
patients. This sample size was chosen to ensure statistically significant
results.
Data Presentation and
Analysis
This section delves deeper into the
findings of the survey conducted at Yariman Bakura Specialist Hospital (YBSH).
The survey specifically explored the role of the Hausa language in healthcare
communication, focusing on perspectives from both patients and staff.
Understanding
the Communication Landscape
In this section, we examine the
prevalence of Hausa among patients. We explore the extent to which Hausa is
utilized for communication and identify any variations within the spoken
dialects. Additionally, we investigate language-related barriers faced at YBSH.
Notably, we consider the potential need for a mini medical dictionary in Hausa,
with particular attention to the Zamfarci dialect.
Language Use in the Hospital
Table 1: Primary Languages Used for Patient
Communication at YBSH
|
Frequency |
Percent |
Valid Percent |
Cumulative
Percent |
English |
17 |
17.0 |
17.0 |
17.0 |
Hausa |
77 |
77.0 |
77.0 |
94.0 |
Other |
6 |
6.0 |
6.0 |
100.0 |
Total |
100 |
100.0 |
100.0 |
|
Figure 1:
Distribution of Languages Used for Patient Communication at YBSH
The data presented in Table 1 and the
corresponding bar chart in Figure 1 illustrate the primary languages used for patient communication at Yariman
Bakura Specialist Hospital (YBSH) among a diverse group of healthcare
providers. Doctors, nurses, lab attendants,
administrators, and others participated in the survey, reflecting the various
departments and units within the hospital. The data reveals a clear
dominance of Hausa, with 77.0% of respondents reporting it as their primary
language for communication with patients. This dominance is visually evident in
the bar chart (Figure 1), where the Hausa bar towers over the bars for English
(17.0%) and "Other" languages (6.0%).
The prevalence of Hausa as the primary
language of communication highlights a crucial aspect of patient care at YBSH.
This data underscores the importance of ensuring healthcare providers are
proficient in Hausa to effectively communicate with a significant portion of
the patient population. The relatively low usage of English suggests potential
language barriers for patients who primarily speak English.
Table 2: Patient Language
Preferences
|
Frequency |
Percent |
Valid Percent |
Cumulative
Percent |
Valid English |
13 |
13.0 |
13.0 |
13.0 |
Hausa |
64 |
64.0 |
64.0 |
77.0 |
Mix Hausa and
English |
15 |
15.0 |
15.0 |
92.0 |
Other |
8 |
8.0 |
8.0 |
100.0 |
Total |
100 |
100.0 |
100.0 |
|
Figure 2: Language Landscape for YBSH Patients
The information
from Table 2 and the corresponding bar chart in Figure
2 sheds light on patient language preferences at Yariman
Bakura Specialist Hospital (YBSH). The data highlights a significant
preference for Hausa, with 64.0% of patients selecting it as their
preferred language. Visually, this dominance is evident in Figure 2, where
the Hausa section of the bar chart occupies the largest
portion. Following Hausa, we
observe preferences for English (13.0%), a combination of Hausa and
English (15.0%), and other languages (8.0%)1. This insight underscores
the importance of accommodating diverse linguistic needs to ensure effective
communication with patients during their recovery journey.
Dominant Use of Hausa
Confirmed, the data reveals a clear alignment with the staff language
proficiency. Hausa remains the dominant language preference among patients,
with 64.0% selecting it for communication. This finding is visually reinforced
in Figure 2, where the Hausa section of the pie chart occupies the largest
portion. Importance of Multilingual Support While Hausa is preferred by the
majority, the data also highlights the need for a multilingual approach at
YBSH. English is the preferred language for 13.0% of patients, followed by a
mix of Hausa and English (15.0%) and other languages (8.0%). This aligns with
the presence of staff who reported using English and potentially other
languages besides Hausa (as indicated by the "Other" category in
Table 1).
Table 3: Preferred Varieties
of Hausa for Communication at YBSH
|
Frequency |
Percent |
Valid Percent |
Cumulative
Percent |
|
2 |
2.6 |
2.6 |
2.6 |
Valid Dialect |
34 |
44.2 |
44.2 |
46.8 |
Mix Hausa and English |
18 |
23.4 |
23.4 |
70.1 |
Standard Hausa |
23 |
29.9 |
29.9 |
100.0 |
Total |
77 |
100.0 |
100.0 |
|
This table reveals that while a significant portion (77.0%) of staff utilizes Hausa for communication, dialect variation exists within this group. Dialect emerges as the most prevalent variety (44.2%), followed by Standard Hausa (29.9%) and a mix of Hausa and English (23.4%). This highlights the importance of considering dialect variations and potential code-switching (using both Hausa and English) for effective communication within the hospital setting.
Table 4: Preferred Dialects
for Communication at YBSH
|
Frequency |
Percent |
Valid Percent |
Cumulative
Percent |
|
33 |
42.9 |
42.9 |
42.9 |
Valid
Sakkwatanci |
2 |
2.6 |
2.6 |
45.5 |
Zamfarci |
42 |
54.5 |
54.5 |
100.0 |
Total |
77 |
100.0 |
100.0 |
|
Table 4 delves deeper into the specific dialect used within the broader "Dialect" category from Table 3. It reveals that Zamfarci appears to be the dominant dialect among staff who use dialects. This finding aligns with the reported challenges in communication with patients from villages who primarily speak Zamfarci and lack English comprehension.
Table 5: Distribution of
Preferred Hausa Dialects Among YBSH Patients.
|
Frequency |
Percent |
Valid Percent |
Cumulative Percent |
Sakkwatanci |
4 |
6.2 |
6.2 |
6.2 |
Standard Hausa |
22 |
33.8 |
33.8 |
40.0 |
Zamfarci |
39 |
60.0 |
60.0 |
100.0 |
Total |
65 |
100.0 |
100.0 |
|
Figure 3: Hausa Dialect
Landscape Among YBSH Patients
Table 5 and Figure 3 reveal
valuable insights for communication strategies. Zamfarci emerges as the most
preferred dialect (36%) among Hausa-speaking patients. This likely reflects the
hospital's location in Zamfara State, where Zamfarci is the dominant dialect.
Staff familiar with Zamfarci can ensure clear communication and build trust
with a significant portion of the patient population.
Standard Hausa is chosen by 23% of
patients. This formal dialect, used in education and media, offers a widely
understood communication channel. Staff proficient in Standard Hausa can
effectively interact with patients accustomed to this broader dialect.
While some patients might prefer other
dialects like Sakkwatanci (5%), prioritizing Zamfarci and Standard Hausa caters
to a substantial majority (59%). This approach fosters better patient
understanding, improves trust, and ultimately leads to more effective
healthcare delivery at YBSH.
Thematic Analysis: Staff Responses on
Improving Hausa Use in YBSH
This analysis examines staff feedback
regarding improving the use of Hausa in a healthcare setting. A significant
portion (80%) of respondents expressed a desire for improved communication
strategies. Their suggestions reveal two key themes as follows:
Theme 1: Addressing Dialect Variations
with Qualified Interpreters
Staff emphasized the need for
professional interpreters who are fluent in English, Standard Hausa, and the
dominant local dialect, Zamfarci. This highlights the limitations of relying
solely on staff proficiency in Hausa dialects. The variety of spoken Hausa
dialects can create communication gaps if healthcare providers are not familiar
with the specific dialect used by a patient. Qualified interpreters can bridge
this gap, ensuring clear communication and addressing dialect variations for
more effective patient interactions.
Theme 2: Enhancing Communication with
Hausa Medical Terminology
Staff also identified the lack of readily
available medical terminology in Hausa as a significant barrier. They suggested
creating resources that translate medical terms into Hausa for staff reference.
This would enhance their ability to communicate effectively with patients using
the appropriate terminology in their preferred Hausa dialect. With access to
these resources, staff can explain complex medical concepts clearly and
accurately, even if they are not experts in all Hausa dialects.
Interpretation: A Commitment to Effective
Communication
The staff responses demonstrate a clear
recognition of the challenges associated with language barriers and dialect
variations in a Hausa-speaking healthcare setting. Their suggested solutions,
professional interpreters and Hausa medical terminology resources, directly
address these challenges by:
1. Ensuring Expertise in Both Medical
Terminology and Dialects: Professional interpreters can handle complex
medical explanations while navigating specific dialect variations used by
patients.
2. Empowering Staff to Communicate
Effectively: Staff with access to translated medical terminology can
communicate more effectively in the patient's preferred language, even if their
dialect knowledge has limitations.
Furthermore, this analysis reveals a commitment among staff at the healthcare
facility to improve communication with Hausa-speaking patients. The proposed
solutions aim to bridge language gaps, enhance understanding, and ultimately
deliver better healthcare services.
Medical Terminology in Hausa
Table 7: Strategies for Overcoming
Language Barriers at YBSH
|
Frequency |
Percent |
Valid Percent |
Cumulative Percent |
Valid Medical
Terminology |
5 |
5.0 |
5.0 |
5.0 |
Simplified
Explanation |
45 |
45.0 |
45.0 |
50.0 |
Use of
interpreters |
50 |
50.0 |
50.0 |
100.0 |
Total |
100 |
100.0 |
100.0 |
|
Table 7 sheds light on how healthcare providers at Yariman Bakura Specialist Hospital (YBSH) address language barriers. The data reveals a multi-pronged approach, with each strategy contributing significantly.
The most frequently reported strategy is
the use of interpreters (50%). This highlights their critical role in bridging
communication gaps, especially for complex medical discussions where accuracy
and nuance are essential. Interpreters ensure clear understanding and informed
decision-making for patients who may not be proficient in the language used by
healthcare providers.
A significant portion of staff (45%) also
utilizes simplified explanations. This demonstrates an awareness of the need
for clear and concise communication adapted to the patient's language
proficiency. By avoiding complex medical jargon and focusing on key concepts,
healthcare providers can improve patient understanding and ensure they are
actively involved in their care.
Interestingly, medical terminology in
Hausa is the least used strategy (5%). This could be due to several factors.
Standardized medical terminology resources in the specific Hausa dialects
spoken by the patient population might be limited. Additionally, healthcare
providers may not be fully familiar with the specific medical terminology in
these dialects. It's also possible that interpreters or simplified explanations
are perceived as more efficient or effective for certain situations.
The low use of Hausa medical terminology
warrants further investigation. YBSH could explore potential solutions to
address this. Developing resources with accurate medical terms in the most
common Hausa dialects spoken by patients, in collaboration with language
experts, could be a valuable initiative. Additionally, providing staff training
programs to enhance their knowledge and use of medical terminology in these
dialects could further strengthen communication strategies.
By implementing these suggestions, YBSH
can ensure clear understanding for a wider range of patients, ultimately
leading to better healthcare delivery and improved patient outcomes.
Thematic
Analysis: Staff Perspectives on Hausa Medical Terminology in Healthcare
This thematic analysis examines staff
responses regarding the use of Hausa medical terminology in a healthcare
setting. The findings reveal valuable insights into communication practices and
highlight a potential need for improved resources.
Theme 1: Limited Use of English Medical
Terminology
When asked if they use English medical
terminology with patients (Question C1), 70% of staff responded "No".
While 30% selected "Yes," the qualitative responses (Question C1,
Why?) suggest they primarily do so for "easy communication". This
might indicate a lack of readily available Hausa equivalents for some medical
terms, leading staff to use English as a fallback option.
Theme 2: Awareness of Hausa Medical
Terminology, But Limitations Exist
Question C2 (Do you know any Hausa
medical terms?) revealed that a majority of staff are aware of some Hausa
medical terms. However, the provided examples (Question C2, Examples) focused
on basic terms like "malaria," "fever," and "headache."
This suggests a potential gap in their knowledge of more complex medical
vocabulary.
Theme 3: Strong Support for Developing
Hausa Medical Terminology Resources
Question C3 (Dictionary of Hausa Medical
Terms?) received a majority "Yes" response. The justifications
provided in the "Why?" section centered on "bridging the
language gap" and "enhancing communication" at YBSH (Question
C3, Why Beneficial?). This strong support indicates a staff recognition of the
limitations in their current ability to communicate effectively using Hausa
medical terminology.
Theme 4: Additional Considerations from
Staff Comments
Section D (Additional Comments) might
reveal further insights into staff experiences and suggestions. These comments
could be analyzed to identify any additional challenges or potential solutions
related to Hausa medical terminology use.
Conclusion: A Need for Enhanced Resources
The staff responses highlight a potential
gap in the availability of Hausa medical terminology resources. While staff are
aware of some basic terms, the limited use of English terminology and the
strong support for a Hausa medical terminology dictionary suggest a need for
improvement. Developing such resources could empower staff to communicate more
effectively with Hausa-speaking patients using accurate medical language in
their preferred dialect.
Summary of Research Findings:
This study investigated the role of the
Hausa language in healthcare communication at Yariman Bakura Specialist
Hospital (YBSH) through a survey administered to both patients and staff.
Key Findings:
1. Hausa is the dominant language used for
communication at YBSH, with 77% of staff and 64% of patients preferring it.
2. Dialect variations exist within the
spoken Hausa, with Zamfarci being the most prevalent dialect among staff
(42.9%) and patients (60.0%).
3. Patients also showed a preference for
Standard Hausa (23.8%) and a mix of Hausa and English (15.0%).
4. Staff identified challenges associated
with language barriers and dialect variations.
5. The most common strategies to overcome
these barriers are the use of interpreters (50%) and simplified explanations
(45%).
6. Medical terminology in Hausa is the least
utilized strategy (5%), potentially due to limited resources or staff
knowledge.
7. Staff expressed a strong interest in
developing a Hausa medical terminology dictionary.
Recommendations:
1. Develop a mini medical dictionary in
Hausa, focusing particularly on Standard Hausa and Zamfarci.
2. Provide staff training programs to
enhance their knowledge and use of Hausa medical terminology.
3. Continue to utilize a multi-pronged
approach that includes interpreters, simplified explanations, and medical
terminology in Hausa (when appropriate) to ensure effective communication with
patients.
Conclusion
This study highlights the importance of
acknowledging language variations and preferences within the Hausa language for
effective communication in a healthcare setting. By implementing the suggested
recommendations, YBSH can bridge communication gaps, improve patient
understanding, and ultimately deliver better healthcare services.
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