Introduction
The Caring for Asian Children: Culture and Health – A Resource for Health Providers is written for health providers caring for Asian children and young people and their families.
The Auckland region is super diverse with more than 200 ethnic groups settled in the region. Asian peoples are the second largest ethnic group (23 percent or 307,230 people) in the region (Statistics New Zealand (SNZ), 2013). For the Asian population the most represented level 2 ethnicities in Census 2013 were Chinese and Indian, each accounted for over a third of Asian ethnicity responses (Walker, 2014). Twenty-one percent of the Asian population in the Auckland region was born in New Zealand (Walker, 2014).
For Waitemata DHB, Asian births have increased by 50 percent over the past six years, and are projected to increase similarly, over the next 12 years. As a proportion, Asian births are expected to rise from 29% to 32% of all births in the Auckland region by 2025 (Auckland DHB & and Waitemata DHB, 2015). In 2013, 37 percent of the Asian population was under the age of 25 years (Walker, 2014). The younger age brackets have a much higher proportion born in New Zealand (Walker, 2014).
In Auckland, 1 in 3 people are likely to identify with an Asian ethnicity in 2038, up from about 1 in 4 in 2013 (SNZ, 2015). At the national level, by 2038 the Asian population will make up 21 percent of the population, compared with 12 percent in 2013 (SNZ, 2015).
Language, culture and unfamiliarity with New Zealand health and social services are major barriers for Asian families accessing services for their children and young people. In Census 2013, thirteen percent of the Asian population spoke no English.
Refugees to New Zealand from Asian backgrounds come from: Vietnam, Laos, Cambodia, Afghanistan, Sri Lanka, Burma, Bhutan and China. Paediatric refugees have complex medical and psychological needs (Rungan et al., 2013).
Culturally competent care for Asian children and their families is central to the provision of quality, equitable and responsive services. Cultural competence includes health practitioners developing cultural awareness, sensitivity, knowledge and skills
Being aware of the barriers to accessing health services for Asian families, and how to overcome these, is helpful in ensuring that families remain engaged with service providers and with the treatments and interventions prescribed. As well, being familiar with Asian family values, traditional health beliefs and practices, perceptions of health and illness and expectations of healthcare, will reduce cultural conflict between families and practitioners. Gaining skills in cultural assessment including: assessing cultural views, behaviours, practices and expectations; and the ability to negotiate a culturally and mutually acceptable outcome, will improve service uptake, treatment compliance, patient experience and reduce misunderstanding and disengagement.
What this resource aims to do
This resource aims to provide information and strategies to enable health providers caring for Asian children to respond more effectively when working with Asian families.
It will help health providers to:
- Gain an understanding of the knowledge, skills and attitudes needed for culturally competent practice when working with Asian children and their families.
- Be more aware and have more knowledge of the cultural practices and beliefs of Asian families in respect to birth, postnatal care, health and illness, child disability, child and adolescent mental health, grief and death and dying and the impact of these on providing healthcare services.
- Gain skills to work effectively and broach sensitive issues with CALD children and families.
- Apply cultural assessment tools in practice.
- Know how to find and use resources to work with CALD children and families.
Purpose
The purpose of this resource is to provide an overview and perspective on Asian children and their families including, their health status, health needs and the socio-cultural issues affecting Asian children’s health in New Zealand. The resource offers a general guide with strategies on how to be culturally effective and responsive to Asian families when caring for their children.
Who this resource is for
This resource is for health providers who are involved in caring for Asian children and their families in primary, community, mental health, and secondary care settings. The resource complements the CALD Cultural Competency Training Programme provided by WDHB eCALD® Services (for more information go to www.ecald.com). NB CALD in this resource refers to culturally and linguistically diverse groups from Asian backgrounds.
It is highly recommended that the viewers of this resource will have completed the CALD 1: Culture and Cultural Competency course available via www.eCALD.com.
It is expected that viewers of this resource will:
- Have completed CALD 1: Culture and Cultural Competence
- Additionally, it is highly recommended that the readers of this resource will:
- Have completed CALD 2: Working with migrants (Asian) patients [course].
- Have completed CALD 3: Working with refugee patients [course].
- Have completed CALD 4: Working with Interpreters [course].
- Have completed CALD 9: Working in a mental health context with CALD clients [course].
Additional valuable information on working in a culturally competent way with migrants, refugees and interpreters can be found in the following courses and supplementary resources all available via www.eCALD.com under Resources.
- CALD 5: Working with Asian mental health clients [course].
- CALD 7: Working with religious diversity [course].
- CALD 8: Working with CALD families - Disability Awareness [course].
- Supplementary resources with culture-specific information, case scenarios, tips, guidelines and approaches to supplement the above courses:
- Cross-Cultural Resource for Health Practitioners working with CALD clients-patients [pdf].
- Ayurvedic Medicine [video].
- Working with Religious Diversity [HTML object].
- Working with CALD families - Disability Awareness [HTML object].
- Working with Asian mental health clients [HTML object].
- Working with Middle Eastern and African mental health clients [HTML object].
- CALD Family Violence Resource for Health Practitioners: Working with Asian, Middle Eastern and African women [pdf, HTML object].
- Maternal Health for CALD Women: Resource for health providers working with Asian, Middle Eastern and African women [pdf, HTML object].
Topics discussed in this resource include:
- Current demography, health determinants, health service utilisation and key health status.
- The importance of providing culturally competent care for Asian families and what is involved.
- Concepts of culture and cultural competency.
- How to improve cross-cultural communication with Asian families, e.g. how to address parents and grandparents, language and cultural issues, and how to implement cultural awareness-assessment-negotiation techniques.
- Understanding Asian cultures including: the importance of family, religious traditions, duty, value, respect for authority, views of health and illness and traditional treatments.
- How to elicit information about cultural and ethnic identity, explanatory health beliefs, use of traditional medicines, traditional child rearing practices, views about disability and mental health etc.
- Guidelines and tools on how to improve communication and engagement with Asian families, as well as cultural assessment tools.
- Resources for health care providers and translated information for consumers.
