Developing a cultural responsiveness framework in healthcare systems: an Australian example

Australia has had over five decades of permanent immigrant settlement programmes, and faces the challenge of negotiating approaches to health service delivery that meet the needs of a diverse population. This paper reports the findings of a major review of one Australian state health system’s cultural and linguistic diversity, cultural competence requirements, minimum standards and benchmarks. Drawing on the framework of the Australian Charter of Healthcare Rights, the review examined culture, cultural diversity and cultural competence in healthcare services for culturally and linguistically diverse (CALD) communities. Multiple sources of information were used, namely relevant literature, consultations with health service agencies, organisations working with CALD communities, and focus groups with consumer advisory bodies within health services. The findings identified the strategies adopted by healthcare services in delivering healthcare to CALD clients, and the barriers to accessing care and treatment. Cultural competence was not well defined, and caused confusion. The paper concludes by recommending a cultural responsiveness framework which can be more easily adapted by healthcare systems and staff.