Cultural Competence In Health And Social Care Essay

‘Culture’ is a term that is defined by characteristics such as ideas, customs, values, race, ethnicity, beliefs and social behaviour of a particular group of people or society (Crisp and Perry 2013). Dreamchslin, Gilbert and Malone (2013) define cultural competence as the ability to acquire and respond to specific behaviours by delivering care effectively that meets the social, cultural and linguistic needs of people, therefore, promoting equality and equity in healthcare. Also, Garneau and Pepin (2014) view cultural competent as a way of appreciating patients cultural contexts as well as understanding the way healthcare can respond to the needs of a diverse population. Papadopoulos (2006) transcultural model is a renowned framework for developing
culturally competent nursing which consists of four components; awareness, knowledge, sensitivity and competence.
Cultural competence is a person-centred holistic approach, therefore, promoting positive health and wellbeing outcomes. This concept aims to allow practitioners to reflect on their own culture and to identify, respect and act with consideration and sensitivity when relating to people from other cultures (Jongen et al. 2018). The Nursing and Midwifery Council (2015) code states that nurses must treat every patient as an individual and not to discriminate irrespective of their age, ethnicity or cultural background while upholding their dignity at all times. Quickfall (2014) views cultural awareness as a foundation for establishing a nurse-client relationship by becoming aware of our own cultural values and beliefs to provide person-centred care for people across languages and cultures. Therefore, Cerezo (cited in Martínez, Martínez and Calzado 2014) suggest that to be culturally competent, healthcare practitioners need to acquire the right knowledge, attitude and skills which makes it possible to work effectively in an intercultural context.
Jongen et al. (2018) identify that there are two primary drivers of cultural competence which are the socio-cultural differences and health care disparities and that from these primary drivers we can clearly identify if cultural competence strategies are being achieved by focusing on reducing health inequalities and improving healthcare outcomes. Nolfo (2012) further explains that medical services and behavioural health services can help reduce health disparities if they do everything that they can in a culturally competent manner. Additionally, Ihara (2004) points out that if providers and systems are not working together to provide culturally competent care, patients are at a higher risk of having negative health consequences and receiving poor quality care. So training healthcare workers to be culturally competent will help reduce health inequality among diverse communities. Chen (cited in Ahn 2018) further observes that due to a lack of cultural understanding the wellness and healing of patients with diverse cultures can be negatively impacted on. Communicating effectively by understanding the meaning of the illness to the patient can contribute to educating patents how to self-care and manage their illness to promote a healthier lifestyle (Truong, Paradies and Priest 2014).

Global Healthcare challenge and the impact of relevant factors on health and well being.
Malaria is one of the most challenging global healthcare issues in today’s society occurring in nearly 100 countries worldwide.
Malaria Is caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes and is responsible for most deaths globally (World Health Organisation 2018). Malaria has been around for more than a hundred years and their recent resistance to the artemisinin presents major global healthcare challenges. Malaria is the leading cause of mortality and morbidity worldwide, according to Walker, Nadjm and Whitty (2018), the majority of deaths from malaria are in children under five years old as they are the most vulnerable to the
disease.
Ashley, Pyae Phyo and Woodrow (2018) points out that the disease is dependent on both the human and physical factors such as temperatures above 15C, natural disasters, war, vegetation, poor sanitation and poverty which all contribute to the worldwide distribution of malaria.
Ashley, Pyae Phyo and Woodrow further add that as a result of climate change, larger population are at risk of an increase in malaria, particularly in tropical highland areas. Dasgupta (cited in World Health Organisation 2018) findings show that an estimated death of 445,000 and 216 million malaria cases occurred worldwide in 2016, while 70% of the deaths occurred in children under the age of five causing heartbreak amongst communities. Hence, Malaria No More (2017) notes that as a result of the high number of malaria cases adults with malaria are too weak which leads to a loss of productivity meaning they cannot provide enough food for their family, therefore they remain poor and do not have enough food to eat which makes them more vulnerable to the disease and continues to keep them in a circle of poverty. Prothero (2001) explains that as the population continues to increase more people move across boundaries which have led to reinfection into areas cleared of malaria as well as exposing the non-immune people to the risk of an infection, therefore, they complicate the control measures of malaria. Also, Malaria No More emphasises that malaria can create a huge economic burden for countries as tourist
are less likely to come to a country with malaria, therefore, malaria affects the socio-economic wellbeing of people in affected areas.
Ricci (2012) observes that because of healthcare inequalities and health equity among nations, those in poorer communities cannot afford the cost of antimalarial drugs and have less access to medical treatment, Ricci suggests that educating people about the disease and how to prevent it by increasing local awareness of the disease will help to minimise risk. There are several campaigns that help raise awareness of malaria such as the Bill and Melinda Gate Foundation, Malaria No More, Africa Fighting Malaria along with the World Malaria Day which is an international observance commemorated every year on 25 April and recognises global efforts to control malaria.

An international organisation and it's current policy/strategy that might help address these needs.
The World Health Organisation is a governmental organisation that is concerned with international public health. Malaria has continued to remain as one of the most challenging global health problems. In 2015 the World Health Assembly adopted the Global Technical Strategy for Malaria 2016-2030 which is a framework to guide countries in their effort towards eradicating malaria. This strategy aims to reduce global morbidity and mortality rates by at least 90% by 2030. It highlights the need for fundamental malaria interventions for all population at risk and the importance of using high-quality data for decision making. The World Health Organisation strategy aim complements with the Roll Back Malaria (RBM) Partnership who launched its Action and Investment to defeat Malaria 2016-2030 – for a malaria-free world (Roll Back Malaria 2016).
To address these needs there are four main key goals identified; Reduce malaria mortality rates globally compared with 2015 by 2030, Reduce malaria case incidence globally compared with 2015 by 2030, Eliminate malaria from at least 35 countries by 2030 in which malaria was transmitted in 2015 and Prevent re-establishment of malaria in all countries that are malaria free. In addressing these goals, the World Health Organisation recommends an urgent need to adopt and implement its strategies so as to increase the effectiveness of responses and end preventable malaria deaths. One challenge, therefore, relates to providing high quality assured treatment to all patients across the globe. This might pose difficult and as a result, training and distribution of community health workers and volunteers can help extend the reach of public health services in remote and rural areas. The use of community and volunteer health workers will help bridge the health gap and provide care for most disadvantaged populations.
Another challenge relates to improving the ability to diagnose malaria as those undiagnosed remain invisible to the healthcare system. Also, they highlight the importance to provide treatment to prevent the disease to the most vulnerable groups of infants, children under the age of five and pregnant women. It is also important for non-immune travellers and migrants to be administered chemoprophylaxis as they are at a high risk of coming in contact with malaria especially when travelling from malaria-free areas to high malaria risk areas. Linking this to the sustainable development goal 3 which ensure healthy lives and promote well-being for all at all ages (United Nations 2017). This goal aims to end the epidemics of AIDS, tuberculosis, malaria, tropical disease, airborne diseases and other communicable diseases by 2030. In addition to reducing premature mortality by one-third from non-communicable diseases through prevention and treatment and promote mental health and well being by 2030. In all the International Council of Nursing (2012 p.1) states that “Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore health and to alleviate suffering”. Nurses play a crucial role in promoting health and well being as they have the multi-disciplinary knowledge and experience in their nursing practice. Furthermore, nurses complement the role of other healthcare practitioners and work towards the health gain of reducing inequality and equity in health by providing person and family centred care and population needs (Kemppainen, Tossavainen and Turunen 2012).