Cultural Heritage and Its Impact on Health Care Delivery

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What is Culture?

Culture reflects the way people.
Thus, we have cultural diversity among various cultures.
We experience cultural diversity when different groups of people live in a similar social structure. These differences arise from various sources like:

- Ethnic;
- Gender;
- Racial;
- Socioeconomic;
- Language/Nationality;
- Religion;
- Handicap/Mobility;
- Education;
- Age;
- Educational qualifications.

What is Culture?

Other forms of manifesting Cultural Diversity

Culture in Healthcare

There are various healthcare belief systems which:

Classify and group health problems;
Define the role of doctors or traditional healers;
Identify causes of illnesses using specific models.

Culture in Healthcare

The Western Culture and Healthcare Beliefs

Drugs have power over nature;
Standardization of treatments for similar ailments;
Medicines are from scientific discoveries;
Find solutions to emerging illnesses;
Act fast;
Medicine comes from nature;
Time heals everything i.e. wait and see;
Every illness is unique;
Have beliefs in treatments;
Have diverse approaches to treatments such as consulting oracles, temples, and other shrines.

The Western Culture and Healthcare Beliefs

Cultural Competence for healthcare providers

Healthcare providers must be sensitive to ways in which cultures and beliefs influence healthcare provisions to patients.

Cultural competence refers to congruent practices, behaviors, and attitudes that professionals apply to work effectively in different cultures(Cross et al, 1989).

Cultural competence starts by:

Self-assessment;
Appreciating diversity;
Controlling difference;
Attaining the cultural knowledge of others;
Adapting to various cultures.

Cultural Competence for healthcare providers

Achieving Cultural Competence

Cultural competence is a learning process:

Cultural Destructiveness;
Cultural Incapacity;
Cultural Pre-Competence;
Cultural Proficiency.

Achieving Cultural Competence

Explanations for the model

Cultural destructiveness: this acknowledges only a single culture and outlaws others.
Cultural incapacity: it promotes separate ideologies (racism, prejudice, unfair practices etc).
Cultural blindness assumes that people are alike, and one culture can substitute other cultures. It only serves the dominant group.
Cultural pre-competence promotes learning and understanding, gaining new ideas, approaches, and considering needs of others.
Cultural competence shows active consultation, commitment and applies wider varieties of practices.
Cultural proficiency reflects a high-level of cultural differences appreciation, pro-active cultural engagement, and promotes learning of new cultures.

Explanations for the model

Where to start

Healthcare providers should let patients know that they want to improve their health statuses.
Healthcare providers must adopt the attitude of honesty and acceptance.
Healthcare providers must engage patients directly.
It is important for healthcare providers to have knowledge of the general culture.

Where to start

At the individual level

Identify one’s own culture;
Challenge one’s own culture, beliefs, and assumptions;
Develop empathy;
Recognize differences in cultural beliefs.

In order to achieve these, the healthcare facility must change its:

Policies;
Administrative practices;
Service delivery;
Involve all stakeholders and communities.

At the individual level

Communication and Interaction

Understand both verbal and non-verbal cues;
Avoid stereotyping;
Tolerate ambiguous situations;
Adapt behaviors within a given cultural context;
Encourage intercultural interactions;
Be modest.

Communication and Interaction

Behaviors to enhance Cultural Competence in healthcare delivery

Recognize roles of cultural beliefs, attitude, values, actions, and behaviors on health conditions and treatments.
Integrate cultural awareness into medical procedures and practices.
Incorporate culture into all areas of healthcare provisions and other professional practices.

Behaviors to enhance Cultural Competence in healthcare delivery

The need for an Interpreter

There are many immigrants in the US and some of them do not understand English. Hence, the need for caregivers to have interpreters.

Interpreter must meet some qualifications like ability to be:

Comfortable in care facilities;
Maintain confidentiality;
Know/understand multiple languages;
Understand conditions in the care facilities.

The need for an Interpreter

The Roles of the interpreter

The role of the interpreter to the patient must be clear. The interpreter should:

Translate communications to both parties;
Act as a culture broker;
Advocate for the patient.

The Roles of the interpreter

Advantages of Cultural Competence in Healthcare delivery

Enhances equity in healthcare provisions;
Eliminates cases of delay in gaining access to healthcare services;
Improves health literacy among patients;
Overcomes communication barriers and understanding between patients and care providers;
Enhances safety of the patient and quality of healthcare;
Improves the image of the healthcare facilities;
Promotes better practices in the healthcare sector;
On the other hand, cultural incompetent in healthcare provision has substantial risks to all stakeholders (Steele, 2010).

Advantages of Cultural Competence in Healthcare delivery