**8. Conclusion**

These differences manifest during interactions with different patients and within diverse settings and situations. A reasonable level of flexibility, perception, and judgment is therefore

When cultural and linguistic barriers in the clinical encounter negatively affect communication and trust, it leads to patient dissatisfaction, poor adherence (to both medications and

According to Kreuter et al. [4], "Cultural competence" in healthcare delivery demands three basic skills when quality healthcare delivery to varied patient populations is the focus:

• The ability to understand how sociocultural factors affect personal beliefs and behavior.

• An appreciation of how these factors influence decision-making at all levels of the health-

• Capacity to design, plan, and implement interventions that take these issues into account.

Dr. Teta Greene stood in front of a gathering of 120 members of the Freetown branch of the Sande society, a fraternity of Liberian women. Her mission in that community was to start a campaign against the dehumanizing practice of female genital mutilation which had caused untold hardship for many years. When it was time for her address them, Dr. Greene introduced herself and two men who had accompanied her. After a brief introduction, both men proceeded to address the women for the next 30 minutes. By the end of the talk, many women were in tears. Dr. Greene asked women who were willing to help stop the practice among their children, families, and community to raise their hands. More than half of the group raised their hands and gave their names as a sign of commitment. How did she get that kind

Dr. Greene knew that genital mutilation is a ritual for admission into the Sande fraternity so the entire audience had experienced it and were suffering from its various complications. The first speaker was an elderly public school headmaster who was well respected in the community and whose mother had been mutilated as a child. The second speaker was a Catholic priest who was well respected in the predominantly Catholic community. Both men spoke about the dangers of the practice and how the same women subjected to it were its strongest promoters. The message was right, the messengers were ideal, and therefore the required

The acceptance of family planning in Egypt had been very low for centuries, and as a result, contraceptive prevalence rates were poor and maternal mortality high. However, in the late 1930s, the Grand Mufti, considered the highest authority as far as the interpretation of the Quran was concerned, issued a document endorsing contraception. He stated that contraception was in no way against the tenets of Islam. This led to the establishment of family

health promotion/disease prevention interventions), and poorer health outcomes.

**7.5. Case study 3 (an observance of the cultural competence principle)**

required.

38 Current Issues in Global Health

care system.

of response?

change was achieved.

**7.6. Case 4 (an observance of the principle)**

In conclusion, the face of health care is changing. The concepts of cultural awareness, cultural competence, and cultural sensitivity are gradually becoming standard terminologies in quality healthcare delivery. It has therefore become more imperative that they are understood and practiced.

With constant changes in the composition of global populations, it becomes more likely that disconnections may exist at points where services are rendered, including healthcare services. It also becomes more important that these differences are managed in such a way that the management of each patient is devoid of bias. Regardless of whether the healthcare provider is a nurse, physician, therapist, admissions clerk, or other professional, there are opportunities each and every day to interact with patients and their families and to succeed or fail in the application of the concepts of cultural sensitivity.

There is compelling evidence that proves the connection between patients' satisfaction with their healthcare providers and various healthcare provider behaviors. This implies that ability to deliver quality health care in its true sense will depend more and more on how much the information and skill the health worker has is "colored" by cultural sensitivity.

Finally, there is a growing need for healthcare workers to be aware of the predominant cultural factors that influence how their clients think and behave. These individuals must be empowered with skills which enable them to attend to the various collections of people they serve. Several interventions have been recommended and include in-house training, case study reviews, live interactions with patients, role-playing, and the use of continuing education healthcare videos. Regular periodic assessments based on established standardized procedures are also important for objective measurements of progress made.

[10] Huerta E, Macario E. Communicating health risk to ethnic groups: Reaching Hispanics as a case study. Journal of the National Cancer Institute. Monographs. 1999;(25):23-26

Cultural Sensitivities and Health

41

http://dx.doi.org/10.5772/intechopen.79455

[11] Resnicow K, Baranowski T, Ahluwalia J, Braithwaite R. Cultural sensitivity in public

[12] World Health Organization. Trends in Maternal Mortality: 1990 to 2015. Estimates by WHO, UNICEF, UNFPA, World Bank and the United Nations Population Division. Geneva, Switzerland: World Health Organization; 2015. [Accessed: July 29, 2017]. Available from: http://www.who.int/reproductivehealth/publications/monitoring/maternal-mortality-

[13] Alkema L, Zhang S, Chou D, et al. A Bayesian approach to the global estimation of maternal mortality. ArXiv151103330 Stat. 2015. [Accessed: August 15, 2017]. webpage on the Internet. [cited August 15, 2016]. Available from: http://arxiv.org/abs/1511.03330

[14] Rogler LH, Malgady RG, Costantino G, Blumenthal R. What do culturally sensitive men-

[15] Eng E, Parker EA, Harlan C, editors. Lay health advisors: A critical link to community capacity building (special issue). Health Education & Behavior. 1997;**24**:407-510

[16] Thomas J, Eng E, Clark M, Robinson J, Blumenthal C. Lay health advisors: Sexually transmitted disease prevention through community involvement. AmJ Pub Health.

[17] Pasick RJ, D'Onofrio CN, Otero-Sabogal R. Similarities and differences across cultures: Questions to inform a third generation for health promotion research. Health Education

[18] Rimal R, Adkins D: Using Computers to Narrowcast Health Messages: The Role of Audience Segmentation, Targeting, and Tailoring in Health Promotion. Paper presented at the American Public Health Association annual meeting, Atlanta, GA; 2001. p. 100

[20] Kreuter M, Strecher V, Glassman B. One size does not fit all: The case for tailoring print

[21] Williams DR. Socioeconomic differentials in health: A review and redirection. Soc Psych.

[22] Pincus T, Esther R, DeWalt DA, Callahan LF. Social conditions and self management are more powerful determinants of health than access to care. Annals of Internal Medicine.

[23] Andrulis DP. Access to care is the centerpiece in the elimination of socioeconomic dis-

[24] Department of Health and Human Services (US) and Health Resources and Services Administration (US). Health care Rx: access for all: barriers to health care for racial and

parities in health. Annals of Internal Medicine. 1998;**129**:412-416

[19] Kreuter M, Skinner C. What's in a name? Health Education Research. 2000;**15**:1-4

materials. Annals of Behavioral Medicine. 1999;**21**:1-9

tal health services mean? The American Psychologist. 1987;**42**:565-570

health: Defined and demystified. Ethnicity and Disease. 1999;**9**:10-21

2015/en/

1998;**88**:1252-1253

1990;**53**:81-89

1998;**129**:406-401

Quarterly. 1996;**23**(suppl):S142-S161
