Careerforce chief executive RAY LIND outlines why cultural competency is significant when assessing the equivalency of international nursing qualifications.
A deep understanding of the unique bi-cultural setting of New Zealand’s health system must be demonstrated by care and support workers holding international nursing degrees who wish to gain equivalency to the New Zealand Certificate in Health and Wellbeing (Advanced Support) (Level 4) for pay equity purposes.
As the Government appointed body that sets skill standards, develops and facilitates achievement of NZQA qualifications across all our sectors, new legislation has tasked Careerforce as the agency deciding qualification equivalency.
Our role includes assessing those international nursing qualifications from India, the Philippines, Australia, South Africa and the United Kingdom against the specific qualifications outlined in the Pay Equity Act.
“As these international nursing qualifications were gained overseas, it’s understandable that their outcomes do not match the specific cultural outcomes required of the Level 4 Health and Wellbeing qualifications, namely, an understanding of Māori principles and values and how to apply these to a health or wellbeing setting,” says Careerforce Chief Executive Ray Lind.
“Instead, we have recognised that these international qualifications are equivalent to Level 3 for pay equity purposes. That’s because they lack the two additional cultural competency units that would otherwise bring them up to equivalent to the Level 4 Health and Wellbeing qualification.
“By requiring these two cultural competencies, we are ensuring New Zealand care and support workers have the appropriate skills needed for a care and support role within the unique bi-cultural setting of New Zealand’s health system.
“However, we do recognise that there are care and support workers holding international nursing degrees from the Philippines, India, South Africa, Australia and the United Kingdom who have been working in the aged care, disability, home and community support sectors for quite some time and who may already display those cultural competencies.
Those workers may apply for Recognition of Prior Learning (RPL) or Recognition of Current Competency (RCC) and may be assessed as having equivalent to the Level 4 Certificate, providing they meet the outcomes for two specific unit standards around cultural competency and biculturalism, or, they complete the assessments in the following unit standards to be deemed to have equivalency to that level qualification for pay equity purposes.
These unit standards are (28989) Apply strategies to support cultural diversity and (28543) Describe culturally safe Māori operating principles and values and their application in a health or wellbeing setting.
The 2017 Care and Support Worker (Pay Equity) Settlement Act sets out the new rates of pay for care and support workers, which are mapped against their qualifications and/or experience.
 
The Act specifies those qualifications must be a Level, 2, 3, or 4 New Zealand Certificate in Health and Wellbeing issued by the New Zealand Qualifications Authority (NZQA); or a qualification (from New Zealand or overseas) that is recognised by Careerforce (the relevant Industry Training Organisation) as being equivalent to the above qualifications.
 
Careerforce have been guided by the New Zealand Qualifications Authority (NZQA), who prior to the Care and Support Worker Act, had previously assessed and determined equivalency of some international nursing qualifications. They had determined that these were credible qualifications that were equivalent to at least Level 4 on the New Zealand Qualifications Framework (NZQF).
 
However, Careerforce has been tasked by the Act to assess these international nursing qualifications against the specific qualifications outlined in the Act, which are the New Zealand Certificates in Health and Wellbeing (Level 2, 3 & 4).
While NZQA has determined these international nursing qualifications to be equivalent to Level 4 of the NZQF, Careerforce is assessing against different criteria. This is because the Act requires Careerforce to assess against the qualification (the New Zealand Certificate in Health and Wellbeing), not the Framework. We must determine whether these international qualifications meet the outcomes of the Level 4 Certificate in Health and Wellbeing for pay equity purposes.
“So, once Careerforce was tasked with determining qualification equivalency, we looked at what was required by the Health and Wellbeing qualifications and noted that the Level 4 qualifications required the graduate to understand the history of Māori as tangata whenua and a commitment to bicultural principles.
“We cannot reasonably say that someone with an international qualification has knowledge and experience of these cultural competencies.
“Therefore, we cannot reasonably say that what a person with an international nursing qualification knows is equivalent to what the sector expects and requires a Level 4 Health and Wellbeing graduate to know. But we can say they’re equivalent to the Level 3 qualification, which does not have this requirement.
“These units focus on strategies to support cultural diversity, an understanding of Māori principles and values and how to apply these to a health or wellbeing setting.
“As the Industry Training Organisation (ITO) for the health and wellbeing sectors, these qualifications were developed in close consultation with the aged care, disability support, home and community sectors and reflect the skills and competencies they deemed necessary for the kaiawhina workforce.
“To not respect that and not require the cultural competency units would be doing a disservice to the sectors we service and the skills and knowledge they identified as necessary for their staff.
 
“New Zealand’s health and wellbeing setting incorporates three main principles of Te Tirito o Waitangi, which are partnership, participation and protection.
 
“Partnership is about working together with people, their family and whānau, hapu and iwi so that they are all involved in the person’s health and wellbeing support.
 
“For example, a culturally sensitive care and support worker will understand the importance of allowing time for people, their family and whanau to be part of the discussion and decision-making about their needs,” Mr Lind says.
 
“Statistics show us that non-Māori have better health outcomes and live longer than Māori. We can help address poor Māori health outcomes by ensuring our health and support workers are equipped with the necessary tools and understanding to support and protect people from inequality in health outcomes.”
 
“This involves ensuring they have access to services that meet their needs. It is also about recognising and protecting all things Māori, including taha Māori (culture) and te reo Māori (language).
 
“While someone may hold the necessary clinical skills and experience, without the correct practices and attitude they may be doing more harm than good, since a threat to someone’s cultural practices and values can be a threat to their wellbeing.”
 
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