A Cultural Competence Organizational Review for Community Health Services: Insights From a Participatory Approach.

Cultural competence is an important aspect of health service access and delivery in health promotion and community health. Although a number of frameworks and tools are available to assist health service organizations improve their services to diverse communities, there are few published studies describing organizational cultural competence assessments and the extent to which these tools facilitate cultural competence. This article addresses this gap by describing the development of a cultural competence assessment, intervention, and evaluation tool called the Cultural Competence Organizational Review (CORe) and its implementation in three community sector organizations. Baseline and follow-up staff surveys and document audits were conducted at each participating organization. Process data and organizational documentation were used to evaluate and monitor the experience of CORe within the organizations. Results at follow-up indicated an overall positive trend in organizational cultural competence at each organization in terms of both policy and practice. Organizations that are able to embed actions to improve organizational cultural competence within broader organizational plans increase the likelihood of sustainable changes to policies, procedures, and practice within the organization. The benefits and lessons learned from the implementation of CORe are discussed.

Coping with Drought in Rural Papua New Guinea: A Western Highlands Case Study.

The short- and long-term effects of climate change on Papua New Guinea's agricultural sector have generated significant debate in recent times. Current literature demonstrates that different population groups have differing levels of vulnerability and resilience to the flow-on effects of climate change, particularly drought. Yet different schools of thought on the country's food security and effects on livelihoods persist. This article draws on evidence from research conducted in the Western Highlands of Papua New Guinea as part of a bigger economic empowerment project to illustrate the vulnerabilities of one community of rural semisubsistence farmers to drought-induced food insecurity. It examines responses to drought, identifies modes of resilience, and discusses the implications for future actions.

"Living from day to day": food insecurity, complexity, and coping in muTare, Zimbabwe.

In Zimbabwe, unpredictable conditions associated with structural and institutional factors exacerbated the combined effects of structural violence, economic and political instability, and climate change in the mid 2000s, contributing to widespread food insecurity. Drought, food shortages, and government settlement policy affecting both rural and urban populations has yielded a national human rights crisis. Drawing on ethnographic research conducted in Mutare, southeast Zimbabwe, in 2005-2006, the authors illustrate the flow-on effects of drought and government policy on the livelihoods of households already suffering as a result of the social impacts of AIDS, and how people in a regional city responded to these factors, defining and meeting their basic food needs in diverse ways.