Shades of competence? A critical analysis of the cultural competencies of the regulated-health workforce in Aotearoa New Zealand

Abstract

Objective: To critically examine, within the New Zealand context, the regulated-health practitioners' cultural competencies, their readiness to deliver culturally responsive health services to Mori (Indigenous peoples) and identify areas for development. Design: A mixed methods critical analysis of the regulatory bodies' cultural competency standards for health practitioners from their websites. Setting: The New Zealand regulated-health workforce, legislated by the Health Practitioners' Competency Assurance Act 2003 and the Medical Practitioners Act 2007, requires practitioners to regularly demonstrate cultural competence. Participants: The information provided on the websites of the 16 professional bodies for regulated-health practitioners. Main Outcome Measure(s): These standards were analysed against indicators of the knowledge-action-integration (KAI) framework for culturally responsive practice, and scored according to these being explicit, not explicit, or not evident. Results: Competency standards aligned to the 'knowledge' component were more likely to be explicit requirements. This included indicators related to understanding personal cultural values, beliefs, practices, assumptions, stereotypes and biases and the influence these have on practice. However, the 'action' and 'integration' components were less likely to be explicit. Five regulatory bodies provided no definitions of cultural competence. There was mixed engagement with te Tiriti o Waitangi or the Treaty of Waitangi. Conclusions: Variation in clarity surrounding requirements for cultural competence/responsiveness exists across most health regulatory bodies. Notably, the measurability of many standards tended to lack precision. Universal cultural competence standards could support health practitioners to deliver an improved healthcare experience for Mori, emphasizing cultural competence as a quality and safety issue.