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The Role of Effective Communication on

Organization Performance: A Case study of
Ghana’s National Health Insurance Scheme
Owusu Esther Agyeiwaa1*, Francisca Arboh2
1,2
Management Science and Engineering, Jiangsu University
*
Corresponding Author: Owusu Esther Agyeiwaa
DOI: https://doi.org/10.5281/zenodo.7118461
Published Date: 28-September-2022

Abstract: This study investigates how effective communication affects organization performance at the Ghana's
National Health Insurance Scheme (NHIS). Most academics agree that effective good communication improves
organizational performance. However, the various working environments, cultures, and ethics make most studies'
results ambiguous findings. This research focuses on Ghana's NHIS to show how better communication might
increase performance. The research investigated communication networks and employee performance to identify
the most efficient communication channel and significant obstacles and breakdowns in the organization's
communication infrastructure. Face-to-face contact was shown to be the most successful means of communication
at NHIS, followed by telephone, email/internet, printed memos, and grapevines, nevertheless face-to-face interaction
was seen to be most effective method of communication. This research found that employee performance metrics
connect favorably with effective communication techniques. Distraction, communication overload, reasoning,
information distortion, and bias were identified as NHIS communication system malfunctions. The report proposes
instituting proper communication systems to boost performance across all levels of management in the firm.
Key words: Effective Communication; Organization Performance; NHIS; Ghana.

1. INTRODUCTION
Transmitting information from one person to another is the process of communication. Communication serves as a medium
channel, a means of performing a constitutive end that are essential, as the end (Banihashemi, 2011). Effective
communication is vital for encouraging and leading personnel to accomplish corporate goals, according to common
perception by (Stephen, 2011; Rita Anekwe el at., 2018). Communication is vital for team and organizational
effectiveness, likened to blood flow in the human body Mckinney et al (2004).
Communication helps improves cooperate performance. It's a company's growth engine. Changes are expected to occurs
via effective communication; management-employee interactions must be well understood at both ends. Through this, all
parties participating in the communication processor chain will perform better in their duties as that leads to increase in
corporate performance at large. Effective, unambiguous communication is essential between managers-employees to achieve
firm success, according to Williams (2007). Consequently, organization’s that have deeper insight in communication values
and its importance to the firms’ employments it internally fit it into the organization strategics’ systems. Any business that
values communication employs it internally. It enables synchronization of production components and the organization's
most essential material and human elements as a change and advancement network.
"The key to organizational excellence and efficiency" is communication Grunig, (2000), in the mixes of Covid 19 endemic
effective communication is essence to both all health stakeholders and the general public as one of the most important
activities of an organization Harris, T. E., and Nelson, M. D. (2008), Is it recognized to organizations, particularly in this
tough moment, that communication affects performance? Without intending to generalize, we feel not all firms have
completely realized the main function of communication, because managers are more focused on immediate profit than on
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other elements, such as communication's effect on performance Harris, T. E., and Nelson, M. D. (2008). Each company's
communication system depends on its culture, size, and profile. According to some experts, management communication
is part of managerial and organizational culture and aims to improve organization performance. As earlier writers noted,
large organizations are focused with building their own communication platforms, although this is not always a priority. As
described by the preceding writers, we feel that corporate communication must become a management priority.
According to Harris and Nelson (2008), employee interaction is vital to firms. They also said that excellent communication
among staff is key to an organization's sustainability and relationship building. Workplace culture, economic, and social
growth vary greatly. Some firms have complicated reporting lines that are problematic for employees to follow, such as;
contradictory authority and duties, appointing some subordinates to becoming more liable than a superior. Some
organizations disregard intra-communication’s tools like intercoms, and memoranda, depriving subordinates of the vision
and goals of the organizations. Considering the foregoing difficulties, the current research aims to aid firms by explaining
how good communication may boost employee performance. Studies demonstrate that good effective communication helps
workers to coordinate effectively and reaching corporate objectives goals. The activeness in decision-making, socializing,
change of management and problem-solving. Again, this guarantees that members of an organization or institution have a
same aim. Most firms face obstacles and search for efficient communication channels.
Organizational performance plays a very vital role in achieving of its vision and mission, objectives-goals. An organization's
relevance and sociability engage with society depends on its communication infrastructure and information flow.
Unfortunately, NHIS in Ghana lacks a cohesive and efficient communication policy. The clients of the Ghana NHIS have
launched sever dissatisfaction with regards to constant delays in processing their claims. Communication plays a vital role
in harmonizing all departments of an organization to enhance organizational performance. Therefore, the organizational
communication structure, channels of communication, communication policy, and communication system at NHIS needed
to be evaluated to determine how relevant and effective they are in this era of Information Technology and to determine the
effects of communication on organizational performance. This research has several benefits. The findings; Provide
information to NHIS stakeholders on communication needs, problems, possible solutions, and the effects of communication
on organizational performance; add to the general body of existing knowledge in communication; enable management to
provide a favorable communication atmosphere necessary for NHIS's vibrant growth and to foster understanding between
senior and junior staff.
The following research questions were considered to achieve the study objectives.
1. How do effective communication affect NHIS Koforidua Regional Office worker performance.
2. How does communication improve employee performance at NHIS Koforidua Regional Office?
3. What are some breakdowns and barriers in the communication system at NHIS Koforidua Regional Office?

2. LITERATURE REVIEW
2.1. System Theory
Ludwig von Bertalanffy, a biologist, proposed the general system theory in 1968, the theory; Foundations, Development,
Applications to describe the linkage between parts and the whole of living Weckowicz, T. E. (2000). This kind gives an
organizational analytical framework. Subsequently, psychology, history, and physiology employ the hypothesis.
Management theorists' findings show a departure from the traditional and human relations paradigm.
According to Booth (1986), systems theory is more valid and appropriate in internal communication. Because the systems
approach acknowledges the significance of communication in improving effective organization-wide functioning. In
corporate communication research, several important components of the systems theory define how effective
communication contributes to employee productivity: wholeness, hierarchy, and feedback. The whole dictates the character
and function of pieces in systems theory (Weckowicz, T. E. 2000). Wholeness refers to system interconnectedness.
Individual system elements contribute to the organization's existence.
According to Miller, K. (2009), an organizational structure systematizes an organism's connections using hierarchy
principles. In this respect, components of key systems are designed into subsystems, making up the overall system, which
functions in a broader context. Feedback allows decision-makers in a company to strategy and stay on top of challenges,
developing network ties (Miller, 2009). According to Salem (1999), systems theory is based on interrelatedness and
interdependence, and communication audit uses the same ideas.
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2.2. Effect of Communication on Employee Performance

Communication skill as a predictor of employee performance is very controversial as prior researcher expressed mixed results.
Growing research links communication with job productivity and an organization's capacity to impact its bottom line (Muda, et al,
2014). With excellent communication, a corporation may have strong coordination across its teams or units; without it, business
operations would suffer or relationships will be damaged. People participating in communication processes require fundamental skills
and talents, otherwise, information may not be understood properly. It also relies on the facilities provided in companies and the
actions of managers to see the acceptability of accurate information deliverance Chen, N. (2008).
Furthermore, managers have also been encouraged to study employee feedback, which influences their job motivation
(Muda, et al, 2014). This pertains to the workers' present conditions, including the proper timing to convey information, so
they may execute depending on the signals they get. Managers must create and provide chances for workers to acquire new
skills via communication to achieve such higher results. According to Beyerlein, M. M. (2003) it is management's obligation
to align support systems in the strategic design so workers may convey their needs and frustrations. This keeps a company
working efficiently and makes the most of its greatest resource, its people [48]. Dwyer, J. (2005). found a link between
open communication and employee performance (2005). A source of employee performance is also helpful communication
from peers (Ducharme, L. J. and Martin, J. K. 2000)
2.3. Empirical Review of Organizational Communication
Various academics and theorists have studied this issue and produced many conclusions that are employed in most
contemporary companies for efficient communication. Femi (Ph.D.) studied "The Effect of Communication on Workers'
Performance in Selected Organizations." In Lagos, Nigeria," he recognized communication as a important component of
organizational project. Because of this, most organizations petition to satisfy their requirements with less resource moral
via communication since the global globe is so extensive. His study examines the link between substantial communication
and worker performance in some designated organizations in Lagos, Nigeria. A questionnaire with 120 responses collected
the research's statistics. Effective communication was linked to worker performance, productivity, and commitment. The
research recommended that managers speak often with staff to promote commitment and performance. Wang, Y. (2005)
investigated the roles of socio-emotional communication and job-related communication in China. Questionnaire data was
analyzed statistically. Respondents number 69. The research found that social-emotional communication among workers
positively improves performance. In contrast, the study found no relationship between horizontal and social-emotional
communication.
Vertical and job-related communication helps Chinese government personnel concentrate on their companies' goals,
according to the researcher. Rajhans (2012) discussed staff motivation and performance. The research examined how
communication and motivation affect employee performance. Rajhans (2012) uses a study of organizational
communication and motivating practices at Pune-based Vanaz Engineers Ltd. to support the paper's premise. The studied
employee communication in the Lilongwe City Assembly. Her research examined Assembly communication. Lilongwe's
internal communication was measured. According to the findings, employee morale, motivation, and performance affect
an organization's communication with its members.
The methodologicalapproach assessed to measured, the ideal and current amounts of organizational information. Receiving
information from others, transmitting informative message to others, acting on such information, communications
relationships, communication channels, communication and job satisfactions, and timelines of information from important
foundations and sources of information. 186 assembly participants indicated a strong desire to communicate with
management more often than they presently do. Subordinates and coworkers communicate seems to be satisfactory. Most
of his responses, however, expressed strong need to engage assembly management to address personnel welfare, benefits,
and salaries.
The impacts of effective communication on worker productivity in civil engineering projects in Kampala Central division
were also researched by [34]. The researcher utilized multinomial logit (MNL) to estimate the interactions between the
effective communication and employee’s productivity. Other explanatory variables include employment term, educational
background, timely updates on workplace changes, teamwork, and the quality of training provided to workers. The study
findings indicate that enquiring for more clarity in communication, collaboration to fulfill cooperation tasks, and timely
information regarding changes affects work statistically in civil engineering labor productivity. To achieve the specified
productivity level, managers should give clear instructions, offer adequate training for their employees, incentivize
employee participation, and build a robust communication strategy to ensure timely information delivery, particularly on
job changes.
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2.4. Barriers and Breakdowns in Communication Systems

Communication is unsuccessful when there is poor listenership, no clarity in speech, inappropriate timing of providing
information, usage of jargons, making caustic statements or using sloppy words, connecting emotions to talks, adopting
poor non-verbal communication, and displaying false thinking. Ineffective communication hinders corporate performance
(Miller, K. 2009). Ineffective communication occurs when departmental managers don't engage much with their employees.
Clarity, thoughtfulness, civility, accuracy, completeness, concreteness, and conciseness contribute to communication
failures. Ineffective communication occurs in organization and NHIS for that matter, when departmental managers fail to
engage frequent interaction with their employees. Lack or absence of the 7 indicators afore-mentioned (Clarity,
consideration, courtesy, correctness, completion, concreteness, and conciseness) contribute to communication failures in
systems. Misperception may also hinder communication, since, employees may misinterpret the manager's message
differently, that might not be the manager’s intention. This implies encoding and decoding of messages may be problematic,
and a crowded organizational structure might cause communication failures (Cheryl, H. 2013). Complex organizational
structures and hierarchies increase the risk of communication loss or misunderstanding Richmond & McCroskey (2009). In
such an organization, grapevines grow as informal communication channels, hindering efficient communication.
Communication may be misconstrued without an open-door approach. Ineffective communication is also caused by poor
listening (when the receiver isn't focused on the speaker) leads to ineffective communication.
According to Miller, 2009, anger and stress may also contribute to communication breakdown since communications may
be misinterpreted in a wrongly manner when a person is angry, upset and irritated, compared to a relaxed person. Messages
aren't always well-planned (For example, the medium of transmission of the message and the time of message delivery are
not chosen rightfully). This hinders effectiveness of communication; language barriers hinder communication. Possibly due
to linguistic uncertainty. To achieve organizational performance, managers should eliminate communication disruptions.

3. RESEARCH METHODS
3.1. Research Design
The authors tested implicit and explicit hypotheses assumptions using a descriptive survey. Descriptive surveys, according
to Fraenkel, J.R., and Wallen, N.E. (1993) are intended to correctly depict the traits of certain features of situations,
particular individuals, or groups people, according to Fraenkel, J.R., and Wallen, N.E. (1993). It is utilized as a requirements
assessment technique to provide data on which to base wise decisions and to set the stage for a more beneficial programming
of educational research. A descriptive survey study evaluates attitudes and opinions in addition to determining and reporting
how things are, according to Opoku-Amankwa, K., (2009). This current research utilized a survey to analyze and describe
the communication process and how it influences NHIS organizational performance.
3.2. Sampling Technique
This research was conducted in Ghana, and targeted seventy (70) NHIS employees specifically NHIS eastern regional
headquarters. The seventy employees consist of eight (8) managers and sixty (62) subordinate staff who are not in
management. Due to funding and time, the researchers were not able to cover all 70 employees, this current survey selected
fifty (50) employees’ representing seventy-one percent (71%) of the total population were sampled. The sample
Respondents were chosen using stratified and random sampling. The managers were stratified according to departments
and to select the managers of the different departments, Purposive sampling was employed to choose the top executive
manager and a department head from each sector of the company. Each department's staff were chosen by simple random
selection.
3.3. Data Collection Instrument
Self-administered questionnaires were used for this investigation. This is because less time is required to respond. It's
cheaper and free from interviewer prejudice. Respondents may provide well-thought-out answers. C.R. (2004). Two types
of questionnaires Two questionnaires were developed; one for supervisors and one for workers were created. Part A
collected personal and institutional data, while Part B emphasized communication. The items in the questionnaire have been
clearly illustrated in Table 1.

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Table 1: Questionnaire Development

Questions Items Sources

Effective Communication
Q1 You think that people in this organization say what they meanand Fielding, M (2006)
mean what they say
Q2 People in top management say whatthey mean and mean what they say
Q3 People in this organization are encouraged to be open and can do with
each other
Q4 People in this organization freely exchange information and opinions
Q5 You are kept informed about how well organizational goals and
objectives are being met
Q6 Top management is providing youwith the kinds of information you
really want and need
Q7 Communication from another department is detailed and accurate
Q8 You receive information from the sources that you prefer
Q9 The information you receive from other department is consistently
reliable
Q10 The directives that come from top management and consistent
Q11 Most of the information you receive from your manager is detailed
and accurate
Q12 Your job is not delayed because you get the information you need.
Employee Performance
Q13 I am able to meet my target from time to time. Diamantidis, A. D., &
Q14 I am able to enforce on their rights and obligations Chatzoglou, P. (2018
Q15 I am able to provide best customer care.
Q16 I am able to serve clients to their satisfaction
Q17 I am able to work voluntary without any supervision
Barriers in Communication
Q18 Selective Listening Klimova, B. F., &
Q19 Distraction Semradova, I. (2012)
Q20 Time Pressure
Q21 Communication Overload
Q22 Information Distortion
Q23 Rationalization
Q24 Prejudice

To improve the questionnaire's validity, pilot research was undertaken with fifteen (15) respondents, including one-(1)
senior executive manager, four-(4) department heads, and ten-(10) subordinates from the NHIS headquarters randomly.
This evaluates the clarity of the instrument items so those that fails to measure the desired variables may be adjusted or
removed. Split-half correlation method was utilized. Even-numbered and odd-numbered test items were separated.
Spearman-Brown prophesy confirmed the full reliability instruments' accuracy. The study total respondents inclouds 8
supervisors and 42 subordinates. The 100% response rate was satisfactory in representing the target population validly and
reliably.
3.4. Data Collection Procedure
Data collection started through pilot administration survey as the printed questionnaires distributed to a group of respondents
who were not included in the main study. Personalizing questionnaires helped build connection with responders. The pilot
study familiarized the researcher with questionnaires and data gathering before the major investigation. After a week, the
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researcher self-administered the questions at the NHIS Koforidua office. Respondents received printed questionnaires. They
were given instructions and asked to fill out questionnaires promptly. This assured accuracy and minimized group influence.
Those who couldn't fill out the surveys immediately were asked to do so later.
3.5. Data Analysis
First analysis the data, data was edited and inspected for spelling errors and incorrectly answered questions. Using
descriptive and inferential statistics, we analysis the data. Study variables were explored using frequencies, percentages,
and means. Perceptions, opinions, and suggestions are reported in percentages per respondent category and variable and
analyzed using Statistical Package for Social Sciences (SPSS).

4. EMPIRICAL RESULTS
In presenting the findings, this chapter presents the results in the following sections: demographic information, current
communication channels; how communication process goes on in NHIS, Ghana; employee communication demands,
communication problems, and how to enhance employee and management communication. Research questions drove data
analysis of the current study.
4.1. Demographic Information of Participants
The current research sought to looked at respondents’ configuration of age, gender, level of management, employment
terms, job experience, and education level of respondents. In Table 2, represent the response frequency counts and
percentages.
Table 2: Demographic Information of the respondents

Variables Sub-scale Manager Subordinate

Gender Male 6 75 25 59.53
Female 2 25 17 40.47
Age 20 – 30 8 19.07
30-40 4 50 10 23.8
40-50 3 37.5 18 42.85
50-60 1 12.5 6 14.28
Level of Management Management 3 37.5 8 19.05
Supervisory 5 62.5 18 42.86
Subordinate 16 38.09
Terms of Employment Permanent 8 100 39 92.86
Probation - 3 7.14
Working Experience 1-5 2 25 11 26.20
6-10 4 50 25 59.5
11> 2 25 6 14.3
Educational background Primary - -
Secondary - 6 14.23
College - 12 28.60
University 6 75 24 57.17
Postgraduate 2 25 - -

4.2. Main Results

4.2.1. Effective Communication
The study investigated NHIS's communication strategy and methods after identifying key communication sources and their
usefulness. This research used a 5-percent significance on one-sample t-test. This investigation utilized a "4" test value
signifying successful communication as shown in Table 3.

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Table 3: Effective Communication at NHIS

N Mean Median Std. Dev Min Max t- test Sig (2- tailed)
Q1 50 2.78 2.00 1.217 1 5 -7.088 0.00
Q2 50 2.68 2.00 1.285 1 5 -7.265 0.00
Q3 50 4.02 4.00 1.116 1 5 .127 0.00
Q4 50 2.22 2.00 1.130 1 5 -11.137 0.00
Q5 50 1.90 2.00 0.995 1 4 -14.926 0.00
Q6 50 3.43 4.00 1.374 1 5 -2.676 0.00
Q7 50 3.14 3.50 1.525 1 5 -3.986 0.00
Q8 50 3.72 4.00 1.031 1 5 -1.920 0.00
Q9 50 2.44 2.00 1.280 1 5 -8.616 0.00
Q10 50 3.94 4.00 1.268 1 5 -.335 0.00
Q11 50 2.68 2.00 1.671 1 5 -5.585 0.00
Q12 50 3.98 4.00 1.040 2 5 -.136 0.00

As shown in Table 3, all the communication points are less than the expected mean of 4; People are kept informed about
how well organizational goals and objectives are met point (5) performed worse on the level of performance; followed by
People in this organization freely exchange information and opinions point (4), The information you receive from other
departments is consistently reliable point (9), Employees mean what they say and say what they mean point (1), and people
in top management say what they mean and mean what they say point (2), communication was high little in level
communication in the area of, people in this company are encouraged to be open and frank with each other point (3); Most
of the information you receive from your manager is detailed and accurate point (12); and top management directives are
clear and consistent point (10).
Neves, P., Eisenberger, R., and Puth, G. (2002) suggest that when workers don't mean what they say, accuracy and
dedication to communication may be absent. It also puts doubt on workers' loyalty to management choices, organizational
objectives, and other messages they responded to. Also, it raises problems regarding the efficacy of the communication
routes (i.e., downward or upward). Z. Anchor (2009) noted that effective management communication and dedication to
what is stated would assist unify managerial functions and promote employee commitment. The study results indicated
84%, 8%, 6% and 2% of the workers frequently use face-to- face, telephone, written (memos) and email/internet, as a
channel of communication, respectively. Cross-tabulation results shows that majority of the respondents prefer face-to-face
communication with bosses and coworkers in the office. Table 4 shows that workers prefer vocal or direct workplace
communication over nonverbal or indirect approaches.
Table 4: Communication Channels

Face-to-Face Telephone Written (Memo) E-mail/internet

80% 8% 12% -
82% 8% 6% 4%
92% 8% - -
254(84%) 24(8%) 18(6%) 4(2%)

Table 4 shows 84% of the employees interact face-to-face. Only 8%, 6%, and 2% of this group interact through phone,
memoranda, and email, respectively. Face-to-face contact with coworkers follows the scenario. The likely implication is
that such employees are able to receive accurate, clear, brief, correct, and comprehensive information from their immediate
supervisor. They may also be able to ask for explanations if they have questions, it is two-way communication channel.
This improves clarity and reduces mistakes (Anchor, Z. 2009; Rhoades, G. and Eisenberger, R, 2013). Face-to-face meetings
with direct management can help employees feel appreciated and enhance work satisfaction. Two-way communication
suggests workers are participating in decision-making, which assures commitment to attaining objectives (Anchor, Z.,
2009). The research explored which communication channel was most beneficial in NHIS. Analyses employ mean ranking.
Table 5 illustrates communication channels' mean rankings.

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Table 5: Usefulness of the communication Channels

N Mean Std. Dev Min Max Ranking
E-mail/Internet 50 1.32 0.713 1 5 4th
Telephone 50 2.48 0.931 1 5 2nd
Written/Memo 50 1.86 1.86 1 5 3rd
Face-to-Face 50 4.42 1.197 1 5 1st
Face-to-face communication is most effective, per Table 5. Mean rating was 5, indicating that workers like it as a helpful
medium. Next is phone (Mean = 2.48). Face-to-face, phone, memoranda, and email/Internet are the main forms of
communication contacts at Koforidua NHIS.
4.2.2. The relationship between Communication Effectiveness’ and Employee Performance
Table 6 shows that average performance level is below expectation. Point 3 (l am able to provide best customer service)
received a high-performance score of 3.86, whereas point 1 (I am able to reach my aim sometimes) received a mean score
of 3.32. Meanwhile, the mean scores for I am able to serve client to theirsatisfaction (point 4; mean = 1.96); I am able to
enforce my rights and obligation (point 2; mean =2.58); I am able to work voluntary without any supervision (Point 5, mean
= 2.56) were below the predicted average 4 value which implies average performance. The issue now is whether the low-
level communication might affect employee performance significantly. The researchers used correlation to address this
question.
Table 6: Level of performance
N Mean Median Std. Dev Min Max t-test Sig
Q13 50 3.32 4 1.377 1 5 -3.492 0.001
Q14 50 2.58 2 1.605 1 5 -6.257 0.00
Q15 50 3.86 4 0.808 2 5 -1.225 0.227
Q16 50 1.96 2 1.124 1 4 -12.832 0.00
Q17 50 2.56 2 1.248 1 5 -8.159 0.00

Table 7 represents the correlation relationship between effective communication and employees Performance, all items of
communication and performance were correlated to determine how best they impact one other.
Table 7: Relationship between Effective Communication and Employees performance

Q1Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Q11 Q12

Q13 .786.786 .846 .793 .828 .964 .931 .855 .833 .864 .852 .917

Q14 .934.904 .757 .817 .868 .825 .917 .668 .906 .749 .984 .851

Q15 .736.762 .863 .749 .744 .815 .778 .956 .790 .887 .661 .822

Q16 .859.867 .635 .907 .909 .766 .848 .659 .920 .628 .873 .715

Q17 .943.929 .827 .866 .819 .840 .912 .759 .928 .884 .939 .874
***. Correlation is statically significant at 0.01 level (2-tailed). P<0.00
Table 7 shows that all indicates has significant positive correlation between organizational performance and effective
communication. The findings on (I can meet my target from time to time) over (employees meant what they say and say
what they mean) (r= 0.786, p < 0.05%) also suggest that as workers' experience grows, so does their performance. This
demonstrates Ghana-NHIS support employees training and system assistance for all staff members. All communication
indicators reveal a favorable and substantial positive and significant association with workers performance. (I can work
voluntary without supervision) over (Most of the information received from your manager are detailed and accurate)
r=0.874, p< 0.05, (I am able to serve client to their satisfaction) over (This company's employees freely share ideas and
information) showed r=0.907, p0.05. (I can provide excellent customer service) over (workers get information from
preferred sources) demonstrated r=0.956, p<0.05. Effective communication and performance are positively correlated,
according to the evidence.

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4.2.3. Barrier and breakdowns in Communicating Systems

This section examines potential NHIS communication barriers and breakdowns. Staff responses imply selective listening,
distraction, time constraint, information distortion, rationalization, and bias hinder communication. Table 8 shows one-
sample t-test that, while all the means are near to the predicted weight of 1 for each barrier or breakdown, each barrier is
expressed as significant. The test score of 1 indicates the non-relevance or significance of the relevant barrier to
communication; it also shows how strongly respondents disagree with the aspect as a barrier to effective communication.
Consequently, distortion and distraction are the strongest limitation to effective communication in NHIS among the rest
barriers (see Table 8).
Table 8: Barriers and Breakdowns in Communication Systems
N Mean Median Std. Dev Min Max t-test = 1 Ranking
Q18 50 2.98 3.00 1.378 1 5 10.164 3rd
Q19 50 3.02 3.00 1.378 1 5 10.369 2nd
Q20 50 3.00 3.00 1.400 1 5 10.104 4th
Q21 50 2.94 3.00 1.449 1 5 9.470 5th
Q22 50 2.82 3.00 1.424 1 5 9.037 7th
Q23 50 2.90 4.00 1.474 1 5 9.113 6th
Q24 50 3.38 4.00 0.945 2 5 17.804 1st
***. T-test is significant at the 0.01 level (2-tailed).
Information distortion, rationalization, and communication overload were the least rated variables affecting effective
communication. Prejudice, distraction, and selective management must be vigilant when communicating with subordinates
via third parties.
4.3. Discussions
The study investigation found low level communication. Horizontal communication can coordinate work tasks, manage
issues, settle disagreements [26], and promote information flow and responsibility commitment if employees are open and
truthful. Reprimands and encouragements from coworkers boost worker performance and efficiency. Though, it meant have
negatively implication like "dampen spirits," discourage dedication, and reduce efficiency, productivity, and production.
Open and forthright expressions of thoughts and opinions are vital, but the must function as efficient communication
channels that boost production, instead of productivity-efficiency-and-output-reducing "woes." The implication is that
enhance horizontal communication is required. So, systems will operate properly and carry out the organization's aims. One
or more departments being more efficient and productive than others doesn't boost organization productivity. Information
flows must be free of distortions and omissions. Unnecessary contests and showmanship must be avoided within and
between departments. This does not mean well-performing departments should not be apprised while un-performing
department will not be cautioned, but rather that should be done for organizational advantage. Systems theory promotes
unit interdependence (Booth, A. 1986; Rhoades, G. and Eisenberger, R, 2013). Hierarchies are created by groups,
departments, and units [56]. Competition between groups and departments might inhibit a systems approach to
communication (Greenberg and Baron. 2008; Tubbs, S. and Moss. S. 2008).
To warrant systems operation, employees should freely share information and thoughts conceding the company’s growth.
Because trust and compatibility promote pleasant behaviors, efficient communication, and produce positive work results.
Adequacy and accuracy of information are key to efficient communication, which boosts efficiency, productivity, and
output growth (Rhoades, G. and Eisenberger, R, 2013; Anchor, Z. 2009). Completeness, conciseness, clarity, accuracy, and
concreteness are also needed for effective communication. Completeness, concreteness, and consistency impact worker
performance, according to the study. So, all essential and requested information must be sent downward. Knowing what to
do and how to execute it properly boosts performance.

5. CONCLUSION
Results show many communication mechanisms are used. Formal and informal routes were included. Face-to-face, phone,
written (memos), email/internet are used by respondents. They are able to accomplish their tasks without abstraction and
deliver excellent customer service. In addition, various employee performance metrics link with different measures of
successful effective communication, as the study data shows. Employees utilize face-to-face, telephone, written (memos),
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emails/internet, and they consider face-to-face the most helpful channel. The research highlighted selective listening,
distraction, time constraint, and communication overload as NHIS communication failures. Distortion, rationalization, and
bias are further impediments. Misinformation. Information discrimination is NHIS's biggest communication hurdle,
according to employees.
This research examined the impact of effective communication on NHIS's performance. It assessed the organization's
communication systems, measured employee performance, found the most helpful communication channel from the
workers' perspective, and identified impediments and breakdowns. It determined the linkage between corporate
communication and employee performance. Purposefully sampling 50 NHIS staff in Koforidua using primary data. Face-
to-face, telephone, printed memos, email/internet, and grapevines are regularly utilized communication techniques, with
face-to-face being the most effective. NHIS staff performed well largely. Selective learning, distraction, time pressure,
information distortion, reasoning, and bias are communication hurdles and breakdowns. Finally, employee performance
indicators have a linkage with corporate effective communication metrics.

6. RECOMMENDATIONS
The association between effective communication and employee performance suggests managers should give more
complete and intelligible information. Notice boards are another way to communicate. Improve email/internet
communication. Face-to-face contact is deemed more helpful, because managers may include the grassroots in policy and
decision-making. This will make staff feel appreciated also elicit commitment to the implementation and encourage them
to adopt choices to attain goals of the company. Communication barriers or bottlenecks in company’s communication
systems might reduce employee performance. Hence, both bosses and subordinates must handle omitted and exaggerated
facts. Reduce or eliminate selective learning by reducing communication distractions.
In addition, managements should avoid communication overloads as it diminishes clarity. Open and honest conversation is
welcomed, but it should be done with decency, without hatred or bias. Timely information distribution reduces employee
time pressure, which lowers efficiency, effectiveness, productivity, and output. Timely information allows for clarity to
guarantee concreteness and accuracy. Encourage feedback. Upward information flow is also necessary. This will lead to
understanding, compatibility, favorable behaviors, easy communication, positive results, positive nonverbal
communication, and employee adaptation to messages.

7. LIMITATIONS
The NHIS bureaucracy delayed the researcher's study permission. There was a financial constraint, being the sole financier
of the research. Traveling to libraries to obtain material and preparing research reports were costly. NHIS employee
documents, such as assessment forms, were difficult to obtain, caused issues regarding communication. It would have been
a good source of secondary data.
Conflict of Interest: The authors declare no conflicting interest.
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