Cultural competence of paediatric doctors: A qualitative study in a rural setting

Cultural competence is an important aspect of patient-centred care, particularly in paediatric settings, where doctors from diverse backgrounds interact with families from different cultural contexts. South Africa is a multi-cultural country, with doctors working with people whose concepts of health and healing include traditional beliefs and practices. While the importance of cultural competence is widely acknowledged, limited data exist on how doctors exercise cultural competence in a neonatal intensive care unit (NICU). This study addresses this gap by exploring doctors' perspectives on providing culturally responsive care in a rural NICU.

We conducted an exploratory qualitative study, situated within a constructivist paradigm, to explore how doctors understand and practise cultural competence. The constructivist lens guided the exploration of participants' socially constructed perspectives within their clinical contexts. Nine doctors working in the NICU of a public-sector regional hospital in KwaZulu-Natal Province, South Africa, were purposively sampled. Semi-structured interviews were conducted, and data were analysed thematically.

Five themes were generated: (1) understanding cultural competence, (2) learning cultural competence, (3) importance of clinical settings, (4) professional challenges in displaying cultural competence and (5) evaluating cultural competence. Collectively, these themes highlight the disconnect between the perceived value of cultural competence and the realities of insufficient training, inconsistent application and limited institutional support in high-pressure clinical settings.

While the doctors recognised cultural competence as integral to effective paediatric care, gaps remain in training, implementation and evaluation. Addressing these challenges through structured education may enhance culturally responsive health care delivery.

This study contributes to the growing discourse on cultural competence in health care by providing perspectives into its practical application and challenges in a South African paediatric setting.