Cultural Competency Program for Health Workforce

1. Cultural Competency Program for Health Workforce Virasakdi Chongsuvivatwong Epidemiology Unit Faculty of Medicine Prince of Songkla University

2. HR for cross-border health for Greater Mekong Subregion(GMS) • In 2004-5, Rockefeller Foundation supported a collaborative study on human resource for cross-border health within GMS • to identify potential problems and solutions for Cross-border HRH

3. Collaborating centers • Thailand: Prince of Songkla, Chiangmai and Khon Kaen Universities • Vietnam: Hanoi Institute of Public Health • China: Kunming Medical College • Lao PDR: University of Medical Sciences • Cambodia: National Institute of Public Health

4. Methods of study • Situation review of the existing courses and curricula • International conferences • Site visits to the border areas and immigrant workers • China - Myanmar, China - Laos • Loas - Thai, Laos - Vietnam • Cambodia - Thai • Final brainstorming

5. Findings from HRH-GMS • Boder areas are often filled up with young doctors graduated from large cities • Common difficulties encountered by most doctors are cultural gaps between them and the local people. These include problems of • language • value systems • life styles

6. Health among migrant workers • GMS has high flow rate of immigrant workers who are at risk for various health problems, especially reproductive health and poor access to health care due often due to illegal status and culture barriers. • Routine health services are not ready to cope with this transnational problems.

7. Another cultural problem:deep south Thailand

8. HRH in ethnic unrest area in southern Thailand • 80% of the 1.8 million population are Malayu speaking Muslim annexed to Thailand over 100 years ago. • Neglected socio-cultural barriers. Most local people take mainly religion eduction, not enough to compete with the modern system run by Buddhist majority of the country • Insurgency fared up since 2003, wasting over 2,000 lives, mostly civilians.

9. Current HRH situations in deep southern Thailand • Good integration between the two cultures of providers as well as with the target population. • High and acceptable performance as indicated by increasing coverage of medical services despite the insurgency • Certain attacks by insurgency but still much less than the teachers. • High rate of emigration of workforce due to safety reasons.

10. Lessons learned and further attemps • Culture competency should be a core competency among HRH in the border areas • Development of basic education for local population in order to get a job as HRH at various levels is mandatory. • Special affirmative action to assist development of HRH is the priority.

11. Current Actions • Rockefeller Foundation is supporting countries in GMS to improve curriculum with increase of cultural competency. Experiences will be exchanged. • Ministry of Public Health of Thailand and local university are working out several affirmative action plans to improve HRH in the deep south of Thailand.

12. Definition of cultural competency • A set of cognitive functions and skills in dealing with cultural barriers between health providers and the clients. • Levels of learning experience • Cultural awareness & sensitivity • Cross-cultural exposure • Positive attitudes toward the different • Cultural skills

13. Education for new generation is the long-lasting solution