Language and cultural competency training in South Africa: Effects on quality of care and Health Care Worker satisfaction

Michael Eliad Levin


Most research into medical communication has been in a Western setting. Communication between non language concordant Health Care Workers (HCWs and patients adversely effects patient and staff satisfaction. To the best of our knowledge, no intervention studies have been conducted in Africa.
To determine whether teaching Xhosa language skills and cultural understanding to HCWs effects patient satisfaction, HCWs ability to communicate effectively with Xhosa-speaking patients and HCWs job satisfaction levels.
Design and setting
A before and after interventional study was performed at two Community Health Centers and a district hospital in the Western Cape Province of South Africa.
Fifty four randomly selected patients (27 pre and 27 post intervention) assessed communication with HCWs and rated their satisfaction. Six non-Xhosa-speaking HCW participants completed pre- and post-intervention questionnaires.
HCWs completed a ten week basic language course comprising ten 120 minute interactive contact sessions developing basic Xhosa speaking and listening skills and cultural competence.
Outcome measures
Questionnaires used a Likert scale to rate degrees of agreement or disagreement with statements. Patients assessed communication with HCWs, quality of care and rated their satisfaction. HCW questions were grouped according to themes, including ability to communicate, job satisfaction and staff interpersonal relationships.
Patient satisfaction showed significant improvements. Patients perceived HCWs to be more understanding, respectful and concerned, and to show better listening skills, after the intervention. Patients were better able to understand HCWs and their instructions.
HCWs ability to communicate improved and HCWs experienced decreased frustration levels.
Teaching language skills and cultural sensitivity to non Xhosa-speaking HCWs in South Africa improves ability to communicate, increases patient satisfaction and decreases misunderstandings and frustration.

Author's affiliations

Michael Eliad Levin, University of Cape Town

Full Text



Education; communication barriers; Patient satisfaction; quality of health care; culture

Cite this article

African Journal of Health Professions Education 2011;3(1):11-14.

Article History

Date submitted: 2011-02-02
Date published: 2011-06-17

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