Cultural considerations in health care capacity building: A qualitative study in Lesotho

Kulesa, John; Chua, Ian; Crawford, Lexi; Thahane, Lineo; Sanders, Jill; Ottolini, Mary; Ferrer, Kathy

doi:10.1080/17441692.2021.1955399

Cited by 2 publications

(5 citation statements)

References 30 publications

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“…These subdomains reflect groupings formulated during analysis of the transcripts and mirror the subdomains used in a prior study. 4…”

Section: Methodsmentioning

confidence: 99%

“…26,27 The first 10 questions of our interview guide are identical to those used in a prior study on cultural barriers to health care capacity building in Lesotho. 4 Building on this prior work, we supplemented the interview guide with further questions specific to patient and community education. To do this, we worked with the Children's National Hospital vice chair of medical education, the education lead of the Children's National Global Health Initiative who spent 4 years as a physician in Lesotho, and a Mosotho physician at Children's National Hospital.…”

Section: Instrument Developmentmentioning

confidence: 99%

“…1–3 This bidirectional educational process involves an intricate network of stakeholders, including foreign clinicians, community members, and host-country clinicians within the public and private sector, such as nurses, physicians, and nutritionists. 4 Information that flows throughout this network converges in the community, where patients and community leaders, such as village chiefs, traditional healers, and village health workers, play an instrumental role. 4…”

Section: Introductionmentioning

confidence: 99%

“…4 Information that flows throughout this network converges in the community, where patients and community leaders, such as village chiefs, traditional healers, and village health workers, play an instrumental role. 4…”

Section: Introductionmentioning

confidence: 99%

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Cultural Considerations for Patient and Community Education in Global Health: A Qualitative Study in Lesotho

Kulesa

Crawford

Ferrer

et al. 2022

Community Health Equity Research & Policy

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Background: In global health, international nongovernmental organizations (NGOs) frequently hire, train, and partner with host-country clinicians who manage public outreach and patient care. Purpose and Research Design: We conducted a general interpretivist study of Basotho clinicians hired by NGOs and academic affiliates in Lesotho to identify cultural barriers and facilitators to community and patient education. Data Collection and Analysis: We conducted 13 interviews involving 16 participants (one physician, one nutritionist, 14 nurses). Using an inductive and iterative approach, we analyzed interview transcripts through the lens of social cognitive theory and identified 15 themes. Results: Major findings highlighted: 1) patient and community learners may view Basotho clinicians as authority figures; 2) family and community power dynamics affect healthcare access for vulnerable patient groups; and 3) village leaders may refuse community education when excluded from problem-solving and early planning. Conclusions: Although local clinicians and community members may identify with the same cultural group, clinicians can encounter cultural barriers to patient and community education.

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“…These subdomains reflect groupings formulated during analysis of the transcripts and mirror the subdomains used in a prior study. 4…”

Section: Methodsmentioning

confidence: 99%

Section: Instrument Developmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cultural Considerations for Patient and Community Education in Global Health: A Qualitative Study in Lesotho

Kulesa

Crawford

Ferrer

et al. 2022

Community Health Equity Research & Policy

Self Cite

View full text Add to dashboard Cite

show abstract

“…As one example of this barrier, some international medical non-governmental organisations in Lesotho worked to decolonise their international relationships by hiring almost exclusively clinicians of the local Basotho culture. 29 However, Basotho clinicians reported cultural tensions that affected their ability to educate patients and community members. For instance, women from rural villages wearing traditional face paint expressed discomfort and fear of rejection when seeking information and interacting with nurses.…”

Section: Barriers To Decolonising Partnershipsmentioning

confidence: 99%

Barriers to decolonising educational partnerships in global health

Kulesa

Brantuo

2021

BMJ Glob Health

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Global health partnerships between high-income countries and low/middle-income countries can mirror colonial relationships. The growing call to advance global health equity therefore involves decolonising global health partnerships and outreach. Through decolonisation, local and international global health partners recognise non-western forms of knowledge and authority, acknowledge discrimination and disrupt colonial structures and legacies that influence access to healthcare.Despite these well-described aims, the ideal implementation process for decolonising global health remains ill-defined. This ambiguity exists, in part, because partners face barriers to adopting a decolonised perspective. Such barriers include overemphasis on intercountry relationships, implicit hierarchies perpetuated by educational interventions and ethical dilemmas in global health work.In this article, we explore the historical entanglement of education, health and colonialism. We then use this history as context to identify barriers that arise when decolonising contemporary educational global health partnerships. Finally, we offer global health partners strategies to address these challenges.

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Cultural considerations in health care capacity building: A qualitative study in Lesotho

Cited by 2 publications

References 30 publications

Cultural Considerations for Patient and Community Education in Global Health: A Qualitative Study in Lesotho

Cultural Considerations for Patient and Community Education in Global Health: A Qualitative Study in Lesotho

Barriers to decolonising educational partnerships in global health

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