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improves health and wellbeing by integrating culture into delivery of health services focuses on capacity of health systems more than awareness of difference everyones responsibility - not special interest groups
its not new !! good health policy & services meet consumers needs
Everyone has a right to health care that meets their needs Australias diversity is increasing
Benefits
Improves equity & access for all groups Good business practice
More effective service for health consumers and carers Better use of health resources
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
Whos 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
NHMRC Guide Cultural competency in health: a guide for policy, partnerships and participation
National focus Complements existing work Generic approach
Applies to wide range of groups not specialised
Focus on healthier living & environments, obesity & overweight Recognises gaps, identifies next steps Based on research, consultation & feedback Prepared by experts /researchers in public health
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
Stimulate broader discussion Ownership of issues Begin nationally supported, sustained change Provide ideas for next steps
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
2.
3.
4.
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
Principle 2
Leadership and accountability for sustained change Begins at highest levels of systems, organisations and professions Continues to individual development and practice
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
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
The Model
Four dimensions for action
Effective policies and procedures Mechanisms for monitoring Sufficient resources Policies that support involvement of culturally diverse communities in health matters
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
Makes cultural competency important part of education & professional development Professions develop cultural competence standards Guidance provided for working lives of individuals
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
Develop competencies
Competency = knowledge, conviction, capacity for action Systems, organisations, professional groups & individuals can develop cultural competencies in specific areas
Specific competencies
Policy / Evaluation
e.g. a policy framework that directs & supports cultural competency across health system e.g. high priority areas are specifically budgeted for staff training, interpreter & language skills e.g. reps of diverse communities are included at all stages of service development & delivery
Consumer participation
Specific competencies
Management
e.g. performance agreements hold managers accountable e.g. professions consider cultural / linguistic diversity in communication & health practice e.g. individuals understand potential impact of cultural & linguistic diversity on clients, & adapt practice to meet cross-cultural requirements
Education/skills
Self-reflection
How would cultural competency principles guide a media campaign to promote healthy eating and improve fitness?
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
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
Next Steps
Suggestions for projects & action at all levels
Individual
Organisational
Professional
Systemic
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
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
Context-specific competencies for your organisation, its community & health workers
Demonstrate leadership
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
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
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