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Better health outcomes

Professor Te Kani Kingi is the Executive Director of Research and Innovation at Te Whare Wananga o Awanuiarangi. He also supports the Board on matters of cultural significance as they relate to the profession including providing cultural expertise to the accreditation and accreditation process.

In his Board role, his view of cultural competence is taken beyond how it’s applied to direct practice, to how it is taught, and how it is practiced in physiotherapy schools and their recruitment processes.

“I often consider the extent to which students are supported in their cultural understanding, the extent to which staff are able to explore cultural matters with them in relation the profession and their clients, and how they can better engage with patients.

“But I also look at how they facilitate and support students of different cultural and ethnic backgrounds, particularly their support mechanisms for Māori and Pacific students. Obviously these students are required to complete identical programmes, but often they’ll be the first from their families to go on to tertiary studies and as such they’re placed in a world that is significantly different to where they’ve come from.

“The point of doing this is to improve health outcomes. Cultural competence is a mechanism through which the broad health disparities between certain ethnic groups can be bridged. It provides a better opportunity for them to engage with their clients. For many ethnic groups access to care is a problem, and personal compliance is a problem – people are less likely to make changes to improve their health if they don’t engage with or see the value of the advice.

“At the end of the day we shouldn’t view the introduction of cultural into the health system as cultural enhancement only. Fundamentally it’s about facilitating better health outcomes through the considered integration of culture.”

And Te Kani thinks that in many ways New Zealand is leading the world in understanding and implementing this approach. “That’s not to say there’s not a lot more that can be done or shouldn’t be done, but in New Zealand there is a growing acceptance and desire that these inequalities need to be addressed which is driving real change.

“It’s a massive shift in attitude from twenty years ago when, for example, there were few Māori health providers and now they make-up a significant part of our existing health landscape. It highlights how far we’ve come, and I think that from time to time we should look back and celebrate what we’ve achieved and pat ourselves on the back. At least for five minute before going back to examining what challenges we currently face.

“That said, it’s natural for people to always push the envelope and that’s probably a good thing.”