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Cultural Competency in Health

Cultural Competency in Health . About cultural competency. What is it? Why do we need it? What does it do? Who is responsible?. What is cultural competency?.

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Cultural Competency in Health

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  1. Cultural Competency in Health

  2. About cultural competency What is it? Why do we need it? What does it do? Who is responsible?

  3. What is cultural competency? “ Behaviours, attitudes and policies that enable systems, organisations, professions and individuals to work effectively in cross-cultural situations ”

  4. What is cultural competency? • improves health and wellbeing by integrating culture into delivery of health services • focuses on capacity of health systems • more than awareness of difference • everyone’s responsibility - not “special interest” groups • it’s not new !!…good health policy & services meet consumers’ needs

  5. Why do we need cultural competency in health? • Everyone has a right to health care that meets their needs • Australia’s diversity is increasing • Health system not always responsive • Health inequalities experienced by many groups • Health services, managers and practitioners are accountable for meeting needs of all consumers • World-wide pressure to improve • Bangkok Charter 2005, WHO World Health Report 2006

  6. Benefits • Improves equity & access for all groups • Good business practice • More effective service for health consumers and carers • Better use of health resources

  7. A culturally competent health system • Acknowledges benefits of diversity • Achieves best, most appropriate care for each consumer • Ensures self-determination for consumers and communities • Holds governments, health organisations and managers accountable for meeting needs of the communities they serve

  8. Who’s responsible? Governments – all levels Policy decision-makers– all agencies / all levels of government (not just health!) Managers– CEOs, finance, operational managers of health & related services Professions – professional bodies and their members Workers& practitioners– in health & related organisations Individuals – Everyone can learn and contribute

  9. A guide to improving cultural competency New NHMRC guide Aim Target audience

  10. —NHMRC Guide — Cultural competency in health: a guide for policy, partnerships and participation • Nationalfocus • Complements existing work • Generic approach • Applies to wide range of groups – not specialised • Provides model – 4 domains for action • systemic, organisational, professional & individual • Focus on healthier living & environments, obesity & overweight • Recognises gaps, identifies next steps • Based on research, consultation & feedback • Prepared by experts /researchers in public health

  11. Aim of Guide • Support development of health care services that meet needs of culturally & linguistically diverse communities Target audience • High level policy & decision-makers • Impact on-the-ground health services • Anyone interested in health & related policy

  12. Outcomes • Stimulate broader discussion • Ownership of issues • Begin nationally supported, sustained change • Provide ideas for next steps

  13. Increasing cultural competency Principles Four Dimensional Model Developing Competency

  14. Systems, organisations, professions can Adopt principles – that underpin cultural competency in health Take action – on infrastructure & human resources that support cultural competency Set standards – establish specific competencies at system, organisation, professional and individual level

  15. Principles for cultural competency Engaging consumers & communities and sustaining reciprocal relationships Leadership and accountability for sustained change Building on strengths — know the community, know what works A shared responsibility — creating partnerships and sustainability

  16. Principle 1 Engaging consumers & communities and sustaining reciprocal relationships • Promotion of healthier living and environments is a reciprocal relationship • CALD background communities and health services engage, learn & exchange at all stages of health care research, development and delivery

  17. Principle 2 Leadership and accountability for sustained change • Begins at highest levels of systems, organisations and professions • Continues to individual development and practice

  18. Principle 3 Building on strengths — know the community, know what works • Population health approach • Use data, information on diverse communities • Acknowledge CALD experience – successful practice • Understand risk factors & protective behaviours

  19. Principle 4 A shared responsibility — creating partnerships and sustainability • Partnerships – between health and human services, education and research sectors • Find systematic and long-term approaches

  20. systemic organisational professional individual The Model Four dimensions for action … Source: Research and consultation report commissioned for NHMRC project

  21. systemic organisational professional individual Action at Systemic Level • Fosters culturally competent behaviour through: • Effective policies and procedures • Mechanisms for monitoring • Sufficient resources • Policies that support involvement of culturally diverse communities in health matters

  22. systemic organisational professional individual Action at Organisational Level • Cultural competency is valued, integral to core business, supported and evaluated • Skills and resources to support diverse clients are in place • Management committed to diversity management • e.g. training for staff, cultural and linguistic diversity in staffing

  23. systemic organisational professional individual Action at Professional Level • Makes cultural competency important part of education & professional development • Professions develop cultural competence standards • Guidance provided for working lives of individuals

  24. systemic organisational professional individual Action at Individual Level • Individuals develop optimum knowledge, attitudes, behaviours re cultural competence • Individual health professionals are supported to work with diverse communities • Individuals develop relevant, appropriate, sustainable health promotion programs

  25. Develop competencies • Competency = knowledge, conviction, capacity for action • Systems, organisations, professional groups & individuals can develop cultural competencies in specific areas…

  26. Specific competencies… • Policy / Evaluation • e.g. a policy framework that directs & supports cultural competency across health system • Budgeting & resources • e.g. high priority areas are specifically budgeted for – staff training, interpreter & language skills • Consumer participation • e.g. reps of diverse communities are included at all stages of service development & delivery

  27. Specific competencies… • Management • e.g. performance agreements hold managers accountable • Education/skills • e.g. professions consider cultural / linguistic diversity in communication & health practice • Self-reflection • e.g. individuals understand potential impact of cultural & linguistic diversity on clients, & adapt practice to meet cross-cultural requirements

  28. Competence = knowledge conviction capacity for action Organisation & profession support individual system organisation profession individual Individual applies knowledge, conviction, capacity for action to inform organisation, profession & system

  29. Practical approaches Case study scenarios Next steps Resources, contacts & more info

  30. Case Study Scenario 1: Media campaign Research shows poor nutrition and low fitness affect some CALD background groups more than others • How would cultural competency principles guide a media campaign to promote healthy eating and improve fitness?

  31. Culturally competent approaches … • Use research • identify issues & key groups • Partnerships • work with relevant community leaders, share knowledge • Community engagement • get communities involved – from planning onward • use consumer advisory group, focus groups • Methodology • select media outlets used by the CALD background group/s you want to reach • Evaluate • before & after data to assess impact

  32. Case Study 2: Community group fitness A Muslim community leader notices low physical activity / reduced fitness among Muslim women in her local area • What culturally competent strategies would help find a solution?

  33. Culturally competent strategies …. • Community involvement • Muslim women initiate action, identify solutions • Reciprocity • Culturally appropriate community consultation, informal discussion, discuss barriers within community & with local authorities • Sustainability • Identify culturally appropriate solutions that have ongoing support, e.g. women-only exercise classes, appropriate venues • Think about wider factors e.g. child care, transport etc. • Share success • Evaluate & document outcomes, share learning with other cultural groups

  34. Next Steps Suggestions for projects & action at all levels • Individual • Organisational • Professional • Systemic

  35. Next steps for individuals • Access toolkits or other material to develop self-awareness & competencies • Take part in cross-disciplinary forums to share information & skills, promote support & awareness • Look for opportunities to introduce or improve cultural competence – discuss with colleagues

  36. Next steps for organisations • Participate in partnership forums with govts to apply the Model locally • Budget strategies – mobilise resources, prioritise cultural competence • Management competencies and performance measures • HR strategies • recruitment, succession planning, education • Context-specific competencies for your organisation, its community & health workers

  37. Next steps: professional groups • Demonstrate leadership • raise profile of cultural competency, recommend strategies for professional practice • Participate in partnership forums with govts / other agencies on applying the model • Reflect principles of cultural competency in ethical & other professional conduct codes • Develop policies and context-specific competencies for specific health professional group • Promote information to members

  38. Next steps across systems • A specific resource for Aboriginal and Torres Strait Islander Peoples • National collaboration on framework for culturally competent health practice • Address gaps in research, information and evidence base • Promote best practice diversity organisations

  39. How to find out more • Institute for Health and Diversity www.vu.edu.au/diversity • Cultural Competency for Healthy Living: a guide for policy, partnerships and participation - www.nhmrc.gov.au • Multicultural Mental Health Australia www.mmha.org.au • Centre for Culture, Ethnicity and Health www.ceh.org.au

  40. Cultural Competency in Health Care…. Who’s responsible? Everybody

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