Joanna Andrews is a Senior Instructor of Midwifery at Fatima College of Health Science in UAE, and Oalmide Solanke is a Senior Lecturer in Midwifery at the University of Derby.<\/em> What is Cultural Competence?<\/strong><\/p>\n Culturally appropriate care is a crucial component in providing effective healthcare services to diverse populations (1). Culture encompasses shared patterns of behaviour, interactions, cognitive constructs, and affective understanding learned through socialisation. Competence, as defined by the World Health Organization (2), is \u201cthe combination of knowledge, psychomotor, communication, and decision-making skills that enable an individual to perform a specific task to a defined level of proficiency.\u201d The term “cultural competence” emerged in the early 1980s in social work, later entering counselling psychology and nursing literature in the 1990s (1). Leininger (3) describes cultural competence as \u201ccare that is meaningful and fits cultural beliefs and lifeways.\u201d<\/p>\n In midwifery, cultural competence involves \u201cknowledge of how to promote respectful and responsive midwifery care in cross-cultural settings that reflects the cultural and linguistic needs of the diverse population\u201d (4). Contemporary literature is shifting towards terms like cultural appropriateness or transcultural care, focusing on ongoing knowledge development rather than training as an endpoint.<\/p>\n The Need for Culturally Sensitive Care in Midwifery<\/strong><\/p>\n Culturally appropriate care is integrated into midwifery through various statutory and policy documents. The International Confederation of Midwives (5) highlights that midwifery promotes, protects, and supports women\u2019s human, reproductive, and sexual health, and rights, respecting ethnic and cultural diversity. The ICM\u2019s code of ethics, 2008 (6) mandates that midwives provide care respecting cultural diversity while working to eliminate harmful cultural practices.<\/p>\n The UK\u2019s Nursing and Midwifery Council (7) advises registrants to consider cultural sensitivities to better meet individuals’ personal and health needs. Midwives should integrate clinical knowledge with interpersonal and culturally appropriate care skills to ensure quality and safety in maternity care. They should demonstrate an understanding of cultural contexts, provide culturally sensitive care, and assess, plan, and deliver care that promotes cultural safety across the continuum of care.<\/p>\n How to Embed Culturally Sensitive Care in Midwifery Education?<\/strong><\/p>\n WHO (2) stresses that midwifery education should extend beyond task-specific training to include values like good communication, individualised care, and cultural understanding. The ICM (8) asserts that midwives should support women in making individual care choices, understanding cultural norms and practices related to sexuality, reproductive health, marriage, the childbearing continuum, and parenting.<\/p>\n Addressing cultural diversity in healthcare education is crucial for improving care quality and eliminating disparities. However, implementing a culturally appropriate care curriculum is often fragmented, and educators may lack clarity on necessary content (9, 1). WHO (2) advocates for midwifery education that involves women and communities, ensuring the curriculum reflects women\u2019s rights and needs, and includes their voices. This approach involves collaborating with community care providers and promoting culturally appropriate, respectful care to empower women and avoid the over-medicalisation of birth.<\/p>\n A multifaceted approach involving educators, students, birthing people, and local communities can enhance cultural competence education. Researchers have argued that culturally appropriate care should be a continuous process rather than a set of educational goals (9). Reflective practice is crucial as it helps student midwives learn from their experiences. Specific training methods, such as role play, group discussions, case scenarios, mini-lectures, and sharing personal experiences, significantly improve healthcare providers\u2019 cultural awareness (10).<\/p>\n Currently, efforts to improve culturally appropriate care education in midwifery include novel programs like an eLearning ‘culturally appropriate care training’ introduced by King in a UK NHS Trust (11). In Turkey, a 28-hour ‘Transcultural Midwifery’ course was positively evaluated by final-year student midwives and suggested to be made compulsory (12). Key reports, such as the Black maternity experience surveys (13) and the NHS Race Observatory report on neonatal assessment (14), have been incorporated into the midwifery curriculum, offering first-hand insights into clinical experiences. Educators can use these insights to integrate culturally appropriate care aspects into the curriculum. For example, avatars are used in midwifery curricula to discuss the value of culturally appropriate care for women and birthing people (15).<\/p>\n In conclusion, fostering cultural competence in midwifery is essential for delivering safe and quality care that meets the diverse needs of women and their families. Integrating comprehensive cultural appropriate care training into midwifery education prepares future midwives to provide respectful, responsive, and effective care in diverse cultural settings. While there are ongoing efforts to improve understanding and implementation of culturally appropriate care, a more collaborative approach between institutions could yield better outcomes for students, educators, and birthing people.<\/p>\n @joanna.andrews@actvet.ac.uk<\/a>,<\/p>\n Linkedin: @Joanna Andrews\u00a0 @Ola Solanke<\/p>\n References<\/p>\n <\/p>\n To view other blogs in this series please see:<\/p>\n
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