"Cultures may affect the ways clients understand health system and illness, and how they access health services, and respond to health providers and their interventions".

Health workforce and systems of service must acknowledge different cultures come with varying perspectives. A more holistic and culturally responsive approach to accommodate the diversity of the population we serve is needed.

• How do you know you are responding effectively to migrant and refugee clients?
  
• Do they respond as you expect?
  
• Does your practice accommodate varying beliefs?
  
• Do you feel uneasy when working with your migrant /refugee clients?
  

Not being culturally responsive may have a detrimental impact on service delivery, access and quality care.

Below are some guidelines and framework on cultural competency and responsiveness:

• Cultural Competency Definition from Medical Council of NZ
  
• General Cultural Competency Standards (Medical Council of NZ
  

The Health Practitioners Competency Assurance Act (HPCA Act) requires registration bodies to develop standards of cultural competence and to ensure that practitioners meet those standards. New Zealand Medical Council, Public Health Physicians and the Nursing Council of New Zealand have developed cultural competence frameworks related to the culturally and linguistically diverse (CALD) groups in New Zealand.

Development of CALD cultural competencies in Auckland region DHBs includes:

• The recognition of culture as a determinant of health status;
• Poor health status in some ethnic groups;
• Health inequalities between the dominant cultural group and Māori  or other minorities;
• The recognition of the need for a culturally competent health workforce for CALD populations to address both issues of equity and health disparities.

To be effective, members of the primary and secondary health sector need to practice in a way that is culturally competent and that meets the requirements of the HPCA Act.