Annex
Table A.1. Case Study Plan Issue Approaches to culturally appropriate health services.
Statement for Testing Models for providing culturally-appropriate health services Indigenous communities are viable.
Opportunities provided by the articulation of traditional and conventional medical practices for indigenous health systems.
There is a good articulation of traditional and conventional medical practices.
Constraints faced in the articulation of traditional and conventional medical practices for indigenous health systems.
The articulation of traditional and conventional medical practices requires overcoming specific constraints both internally and externally.
Approaches in health services funding and management.
There are a variety of successful models for funding and managing culturally-appropriate health services.
Constraints in health services funding and management.
There are many constraints around funding culturallyappropriate health services that need to be overcome, along with limitations in management practices.
Health systems are enhanced by the articulation of traditional and conventional medical practices.
Indicators Evidence of cultural appropriateness of services. Health services at different sites incorporate cultural practices specific to the indigenous populations they serve. Evidence of effective use of intercultural health care services. Evidence of support for the model. Evidence of adequate communication among practitioners of conventional and traditional health care Evidence of proper physical settings that facilitate the articulation between conventional and traditional health care. Evidence of positive experience with both practices by indigenous populations when using health care services. Evidence of improved access to health care because of the articulation between both types of practice. Evidence of good quality of care across both types of practices. Evidence of good patient satisfaction with the combined practices. Evidence of broader obstacles to implement the articulation of traditional and conventional practices. Evidence of difficulties in combining both types of practices. Evidence of resistance to articulate both practices from health care workers. Evidence of structural barriers in national health systems. Evidence of professional resistance to intercultural practice. Funding formulas for culturally-appropriate health services are adequate and sufficient. Different management models of culturally-appropriate health services are congruent with multicultural approach. Flexibility in allocation of resources across programs Financial accountability frameworks. Funding of culturally-appropriate health services is resisted by other sectors. Funding of culturally-appropriate health services is resisted by the health care sector. Funding formulas are inadequate for multicultural approaches. Management models are inappropriate for multicultural approaches.
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