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Cultural Competence

Cultural competence is defined as a set of values, behaviors, attitudes, and practices within a system, organization, program or among individuals and which enables them to work effectively cross culturally. Further, it refers to the ability to honor and respect the beliefs, language, interpersonal styles and behaviors of individuals and families receiving services, as well as staff who are providing such services. Striving to achieve cultural competence is a dynamic, ongoing, developmental process that requires a long-term commitment.

At a systems, organizational or program level, cultural competence requires a comprehensive and coordinated plan that includes interventions on levels of:

policy making;
infra-structure building;
program administration and evaluation;
the delivery of services and enabling supports; and
the individual.

This often requires the re-examination of mission statements; policies and procedures; administrative practices; staff recruitment, hiring and retention; professional development and in-service training; translation and interpretation processes; family/professional/community partnerships; health care practices and interventions including addressing racial/ethnic health disparities and access issues; health education and promotion practices/materials; and community and state needs assessment protocols.

At the individual level, this means an examination of one’s own attitude and values, and the acquisition of the values, knowledge, skills and attributes that will allow an individual to work appropriately in cross cultural situations.

Cultural competence mandates that organizations, programs and individuals must have the ability to:

value diversity and similarities among all peoples;
understand and effectively respond to cultural differences;
engage in cultural self-assessment at the individual and organizational levels;
make adaptations to the delivery of services and enabling supports; and
institutionalize cultural knowledge.

MCHB/DSCSHCN Guidance for competitive applications, maternal and child health improvement projects for children with special health care needs. US Department of Health and Human Services, Health Services and Resources Administration. 1993

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Ethnodevelopment builds on the positive qualities of indigenous culture and societies to promote local employment and growth. Such qualities includes these peoples’ strong sense of ethnic identity, close attachments to ancestral land, and capacity to mobilize labor, capital, and other resources to achieve shared goals. These dynamics are recognized as fundamental to the way in which indigenous peoples define their won processed of development and interactions with other segments of society.

Defining ethnodevelopment in operational terms:
lessons from the Ecuador Indigenous and Afro-Ecuadoran Peoples development project. World Bank. 2000

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Health Equity

Equity is about inequalities that are systematic, unjust and unfair but preventable by reasonable action. Silva F. Adapted from the quote below.

Where systematic differences in health are judged to be avoidable by reasonable action globally and within society they are, quite simply, unjust. It is this that we label health inequity.

Closing the gap in a generation: health equity through action on the social determinants of health. World Health Organization. 2007

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