Communicative Functions of Morpho-Phonological Adjustments in Kenyan Multilingual Clinical Discourse

Communication is one of the key pillars of quality healthcare and is essential in clinical communication especially when dealing with chronic diseases like diabetes. In multilingual contexts like Kenya, where English is a second language in clinical interactions, communication challenges can impact treatment adherence and satisfaction among patients. This article investigates the communicative functions of morpho-phonological (MP) adjustments in the Diabetes Clinic of Machakos Level 5 Hospital, Kenya. Data were collected from audio-recorded doctor-patient, doctor-nurse, and nurse-patient encounters and analysed thematically based on Eckert's Three Waves of Variation Theory (2012). Results indicate that the four communicative functions of systematic use of phonological simplification, morphological blending, and prosodic modulation are empathy, clarity and understanding, patient empowerment, and professional authority. These changes were not arbitrary or incorrect, but were moulded through interlocutor type, the stage of consultation, and clinical practice. The findings show that morpho-phonological variation functions as a communicative tool or strategy and has implications for healthcare communication training and health policy in multilingual healthcare settings in Africa.