The aim of the article is to identify the main obstacles related to the language barriers that arise between migrants/refugee patients and healthcare personnel in the field of gynecology and obstetrics. To identify these obstacles a qualitative research was conducted from May 2017 to June 2018 among migrant/refugees and healthcare workers in Slovenia. The results show that first, linguistic obstacles are often the consequence of the lack of available professional healthcare interpreters/intercultural mediators; second, the absence of training of medical personnel on linguistic dimensions of healthcare causes inadequate awareness of interpreter's/intercultural mediator's role; and third, the linguistic obstacles that migrant/refugee women face hinder their access to basic health rights, entitlements and limitations, including reproductive rights. These obstacles significantly impair the ability of Slovene healthcare system to establish quality communication with migrant/refugee women and may cause inequalities among foreign-speaking healthcare users in their access to healthcare.

This paper seeks to contribute to critical reflection on the importance, dilemmas and problems that arise in educating health professionals about the socio-cultural dimensions of health and healthcare. In the first part of the paper the authors show that although educational programmes in the field of cultural competences have experienced a remarkable upswing, they are accompanied by many ambiguities and shortcomings. Based on numerous anthropological criticisms, the authors highlight the major conceptual and methodological problems that accompany many cultural competence efforts. The second part of the article focuses on an analysis of the multi-year process of introducing a training course in cultural competence in Slovenia, in which over 500 health professionals have been trained since 2016. Based on the results of the participants’ quantitative evaluation and educators’ self-evaluation, the authors critically analyse the contributions of this training course, while highlighting some of the key dilemmas and difficulties that have accompanied this process.

Based on the research conducted within the framework of the project "Together for Health-Skupaj za zdravje" led by National Institute of Public Health (2014-2016), the first part of the chapter presents several obstacles-legal and administrative barriers in formal access to Slovene public healthcare system as well as language and cultural barriers-that migrants/refugees face in the healthcare system in Slovenia. In the second part of our contribution, the authors discuss some approaches aimed at overcoming these obstacles that were implemented as part of the same project. Namely, a proposal for systemic changes on the level of legislation, an introduction of an intercultural mediator for women from the Albanian-speaking community in two Slovene healthcare institutions, a training course on cultural competence for healthcare workers and a selfevaluation tool for the measurement of the level of equity in the healthcare institutions. Through a critical analysis of these approaches, the authors try to show their advantages and limitations and to conclude this chapter with some considerations for future developments in this field.

Résumé En Slovénie, les « effacés » sont d’anciens concitoyens qui, à la suite de l’indépendance du pays, se sont retrouvés sans aucuns droits politiques, économiques ou sociaux, ni droits relatifs à la santé. L’article, fondé sur une enquête ethnographique, analyse les représentations et les réactions face à cette exclusion sociale.

The article seeks to stimulate dialogue about the evaluation of cultural competence in healthcare. The first part of the paper presents the different attempts to measure cultural competence in the field of healthcare and critically analyses the problems that arise concerning the use of instruments that measure the cultural competence of health providers. The second part of the article focuses on the evaluation process of the first cultural competence educational programme for healthcare workers in Slovenia, serving as an example to demonstrate the importance of complementing quantitative methods with qualitative ones and to emphasize the need to shift the focus from measuring the cultural competence of individual healthcare workers to the evaluation of educator performances, patient perspectives, and the cultural competence of healthcare institutions as a whole.