Cultural Competence for Health Policy Development

Abstract

This article addresses conditions for inclusive policy making in multicultural societies. It focuses on and compares development of health policies in Australia and Canada, asking whether paying greater attention to cultural competence could enhance deliberative health policy development by improving inclusion of people from culturally and linguistically diverse (CALD) backgrounds. Answering this question brings together insights suggested by critical multiculturalism, deliberative democracy, and public administration. Reviewing policy frameworks and interviewing health policy officers in both countries underpinned a critical examination of national and sub-national governments to understand barriers to and enablers of inclusive citizen engagement. Defining culture as relational and changeable, it became apparent that many Australian and Canadian health agencies perceive multicultural policy as a means of managing and controlling diversity rather than a mechanism to improve democratic participation. A critical multicultural perspective promotes consideration of context, challenging individual and organizational histories and assumptions, organisational processes and procedures, to understand how current modes of operating and thinking impact on CALD citizens. The article suggests shifting focus from "cultural competence" towards contextual sensitivity, the promise of which lies in encouraging awareness of citizens as individuals, for whom culture is just one of many influences shaping their position in society. Show more