Preliminary Matter and Introduction
Culture encompasses all spheres of life. It constitutes the building blocks of what a society subscribes to in terms of norms, morals, values, customs, attitudes and beliefs. All these social and cultural factors shape our worldviews and form our belief systems as individuals which, in turn, motivate our behavior. Culture affects our perception of health as much as our biological make up does. This means that it influences what we believe causes illness and disease, who should cure illness and disease and what should be done to cure illnesses and diseases among other health beliefs; for example, before sick individual visits a health facility, he/she takes into consideration the sociocultural worldviews of his/her community regarding health and healing. Due to the diversity of the cultures that exist across the world, there are multiple ways of understanding health that vary from society to society (medical pluralism). This, in turn, means that there are multiple healing options such as faith healers, traditional medicine, self-medication and doctors among others that are categorized into the popular, folk and professional healthcare sectors.
Culture is a crucial component in the provision of healthcare services. This is evinced by the failure of multiple practices that did not comply to the cultural expectations of people they were meant to serve. It plays a major role in the health seeking behavior of individuals as well as their willingness to comply with various healing techniques. For example, a pregnant woman may forego delivery with the assistance of a male doctor at a well-equipped hospital because her culture does not allow the involvement of men in the birth process and opt for a traditional female midwife who may be inadequately prepared for any complications that may arise. In the past, health professionals have disregarded culture as a non-factor in healthcare delivery compared to other aspects such as medicines and health technologies, which has negatively affected the quality of healthcare they provide.
Relationship between Equity, Culture, Diversity, and Cultural Competence
As a result of the cultural diversity that exists between the health beliefs of different individuals, it is necessary for health specialists to understand health equity, which refers to the variances that may exist between the standards of health and healthcare across different populations. A good grasp of the concept of health equity means that a healthcare provider is capable of dealing with his/her patients despite any differences in cultural background (Edber & Edberg, 2012). For example, a health practitioner that has studied health equity will treat a Chinese patient with a mental illness differently from an American patient with the same illness. This is because the Chinese patient comes from a cultural background that views mental illnesses as shameful thus may require more counseling and psychiatric care. The American will be a bit more open minded about the diagnosis and treatment of the mental illness. A health professional’s ability to discern what type of healing and how best to introduce the healing to a patient arises out of cultural competence. It involves profound comprehension of what culture entails as well as how to deal with the different cultures he/she might encounter in his/her field of work (Spector, 2012).
The Elements and Principles of Cultural Competency
Cultural competency, within the context of healthcare, refers to the ability to provide tailor-made care solutions, that cater to the varying socio-cultural needs of patients . It is a strategy through which the quality of healthcare provided by health facilities can be improved and also the number of patients utilizing healthcare services can be increased. Cultural competence equips one with the skills needed to deal with the different cultural contexts of patients. It is cultural competency that enables an Indian doctor to deal with a Russian patient who comes from a background characterized by paternalistic healthcare rather than autonomous decision making in one’s own health matters. It exists to address the cultural factors that contribute to discrepancies in healthcare delivery.
Cultural competency in health practices is barred by an inadequate understanding of cultural diversity in health and well-being, poorly designed systems that do not meet the diverse cultural needs of patients and poor communication channels between health practitioners and their patients. It involves the knowledge of the cultural beliefs and health policies of diverse populations, as well as the application of said knowledge at every level of healthcare, at the system level or at the individual level. This means that health practices and providers should respect cultural differences, diversity and dynamism by treating all patients equally in a dignified and objective manner . They should recognize the language and dialect diversity of patients, developing and supporting custom-made services that cater to the culturally unique needs of patients and training practitioners to suit the patient’s needs (not just to satisfy the minimum requirements of healthcare provision).
Policy and Guidelines Related To Cultural Competence in Health Services
The office of minority health in the United States department of health and human services has established Culturally and Linguistically Appropriate Standards (CLAS) whose application goes a long way in making healthcare amenities and providers culturally competent. There are a total of 12 standards organized into themes. Standards 1-3 focus on culturally competent healthcare delivery; they are: Healthcare practitioners should receive and assist patients or clients in an effective understanding manner that is compliant with their cultural belief, practices and preferred language. Health practices should implement policies to employ employees at all organizational levels that represent the demographics of the area the practices service and health facilities should ensure that their employees are educated on cultural competency (with periodical retraining) for culturally appropriate service delivery (Dana & Allen, 2008).
Identification of Culturally Safe’ Professional Practice
In order to identify what is needed to ensure that health practices are culturally competent, health providers need to assess their systems in terms of structure and content. This will enable them to recognize the culturally inappropriate processes that compromise the quality and efficiency of healthcare services . For example, a clinic found in a Hispanic community that attaches a lot of importance on the purpose of religion in health matters may only focus on the professional healthcare instead of incorporating local folk healers (curandero) and home remedies as part of its treatment therapies. Only an organization-wide assessment by a cultural competency specialist or consultant who is well versed in the cultural matters of the area being served by the health facility can point out such gaps as well as what can be done to rectify these discrepancies.
Health practices can provide culturally appropriate services by introducing cultural competency education to its employees. The curriculum of this education should revolve around cross-cultural training delving into what culture is diverse, and how to manage the diversity and society-oriented healthcare. The employees should be regularly instructed on how to deal with current issues related to cultural competence such as the application of traditional medicine in the professional healthcare sector. Health providers should also undertake training in interpersonal skills. People skills allow them to be able to accommodate the different types of behaviors that are exhibited by different patients. These are important life skills that are often overlooked in the provision of healthcare despite the fact that it is an industry that based on service to others (Patti, 2010).
Health providers working in areas that use different languages form the ones they are competent in should make an effort to pick up the bits of the language that are key in conversation so as to allow for better communication between them and their patients/clients. In cases where this may be hard to do for one reason or another, the professional should enlist the services of a trusted interpreter; this will ensure that no vital information is lost during his/her interactions with the locals (Dreachslin, Mabert, & Malone, 2012). Health professionals can also expand their relationships with the societies they serve. This is done by involving the community in the formulation and implementation of healthcare programs thus ensuring that various cultural factors are taken into consideration. This in turn, makes the acceptance of the programs by the locals easier and faster (Hark & Delisser, 2011). Finally, health facilities should put in place programs that will empower locals to be more proactive in health matters. This makes cultural competency easier on health practitioners as they get an opportunity to understand the local cultures better though first-hand information from the locals meaning that is will be easier for them to provide culturally appropriate healthcare .
Recommendations and Conclusion
The issues of culturally diverse, safe and competent skills have been of great importance in the global health sector. Although there have been major steps and policies that have been introduced, in the health sector to ensure culturally responsive health care services, there are various recommendations that can be made. Some recommendations that can be considered to ensure comprehensive culturally responsible health sector include.
- Incorporation and improvement of cultural education in medical practice training to ensure inclusion of diversity in delivery of health care.
- The involved professional institutions should be comprehensively involved in the process of ensuring the cultural diversity is taken into account in medical services providing institutions.
In conclusion, cultural competency by health practices is based on cultural relativism. This means that health practitioners understands and values the different health perspectives that every patient brings from their different cultural backgrounds. An understanding of how culture influences patient attitudes, roles and expectations on disease and illness diagnosis, medical care, information disclosure (on the side of the health provider and the patient), drugs, treatment and the consequences of choosing one healthcare sector over another goes a long way in improving the quality of healthcare services offered, and the degree to which it is embraced and utilized.
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