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MCH Leadership Competencies

Competency 7: Cultural Competency


Cultural competence is a developmental process that occurs along a continuum and evolves over an extended period. It broadly represents knowledge and skills necessary to communicate and interact effectively with people regardless of differences, helping to ensure that the needs of all people and communities are met in a respectful and responsive way in an effort to decrease health disparities and lead to health equity. Becoming culturally competent is an ongoing and fluid process.

Health equity exists when challenges and barriers have been removed for those groups who experience greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; sexual orientation or gender identity; age; mental health; cognitive, sensory, or physical disability; geographic location; or other characteristics historically linked to discrimination or exclusion.

Cultural competence is “a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or amongst professionals and enables that system, agency, or those professionals to work effectively in cross-cultural situations."3

  • Culture refers to integrated patterns of human behavior that include the actions, beliefs, communication, customs, institutions, language and literacy (including health literacy and language proficiency), thoughts, and values held by groups while recognizing that individuals are often part of more than one cultural group.
  • Competence requires having the capacity to function effectively and communicate clearly and in a linguistically appropriate manner as a professional and an organization within the context of the cultural beliefs, behaviors, and needs presented by individuals and communities.4

MCH professionals exhibit cultural (including linguistic) competence through interpersonal interactions and through the design of interventions, programs, and research studies that recognize, respect, and address differences. These differences can include experiences and perspectives related to abilities (physical and mental), age, culture, education, ethnicity, gender identity, geography, historical experiences, language and literacy, profession, race, religious affiliation, sexual orientation, socioeconomic status, and values.


MCH leaders will demonstrate a working knowledge of:

  • The influence of conscious and unconscious (implicit) bias and assumptions on
    individuals and organizations.
  • How linguistic competence requires organizational and provider capacity to respond
    effectively to the health literacy needs of populations served.
  • How ability, age, class, race, sex, gender identity, and sexual orientation impact health.
  • How multiple social and cultural disparities influence health and access to health
    care services.
  • The impact of culturally competent health care practices on individuals’ access to health services, participation in health promotion and prevention programs, adherence to treatment plans, and overall health outcomes.


Foundational. At a foundational level, MCH leaders will:

  1. Conduct personal and/or organizational self-assessments regarding cultural competence.
  2. Assess, without making assumptions, the strengths and needs of individuals and communities based on sensitivity to, and respect for, their diverse backgrounds, and respond appropriately.
  3. Incorporate an understanding and appreciation of differences in experiences and perspectives into professional behaviors and attitudes while maintaining an awareness of the potential for implicit bias.
  4. Advanced. Building on the foundational skills, MCH leaders will:
  5. Modify systems to meet the specific needs of a group, family, community, or population.
  6. Employ strategies to ensure culturally sensitive public health and health service delivery systems.
  7. Integrate cultural competency into programs, research, scholarship, and policies.
  8. Use data-driven tools to guide efforts toward health equity.


(3) Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards A Culturally Competent System of Care, Volume I. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center. Available at files.eric.ed.gov/fulltext/ED330171.pdf

(4) Adapted from National Center for Cultural Competence, Conceptual Frameworks. Available at nccc.georgetown.edu/foundations/framework.php

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