Navigating taboos: A Gricean examination of communicating men’s reproductive health challenges in Kenya

Abstract

Effective communication between doctors and patients is a crucial aspect of medicine. This article uses Grice’s cooperative principles as a framework to explore doctor-patient communication in a male reproductive health clinic. This qualitative study was done in Kenya at a Nakuru County public health facility. Observation was the data collection method, with the doctor and patient conversation audio recorded. Discourse analysis was the analytical framework. Flouting and violating the Gricean maxims is part of the doctor-patient interaction due to the need to discuss reproductive health without violating societal norms. It is a way of addressing reproductive health indirectly and covering up behaviour considered socially and culturally unacceptable. In this context, it is a communication strategy that allows patients to meet their health care needs while respecting social expectations. Cultural norms and taboos can influence doctor-patient interaction, hence the need to adopt cultural competence in Kenya’s health care system. The study contributes to understanding conversational implicature in a medical setting by demonstrating that deviations from the Gricean maxims serve as communication strategies to navigate sensitive topics and adhere to cultural norms. Male reproductive health clinics should actively work to reduce shame around discussions of reproductive health by creating a supportive, non-judgemental environment.