Health competence from a transcultural perspective. Knowing how to approach transcultural care

Intercultural health, including intercultural competence, is a field of study which is generating a great deal of interest in the scientific community, indeed the focus on cultural competence in the curriculum, is becoming a priority. The importance of establishing political relationships with other countries, and more especially development cooperation agreements - redefined by the current recession - together with the global movement of populations, pose new challenges for health providers. This study aims to understand the social and cultural dynamics at work, essential for the acceptance and adoption of the cultural competence programmes, which are being proposed. The fieldwork was carried out in the Ecuadorian Amazon, among the Achuar people, researching an applied health promotion programme, based on the principles of development cooperation and western biomedicine. The main data collection methods were participative observation and in-depth interviews. The main findings reveal a lack of continuity in healthcare where use of indigenous methods of diagnosis and therapeutic resources coexist alongside the biomedical model, and where development agencies and healthcare professionals need to acquire cultural skills combined with specific local knowledge in order to be able to work with greater efficacy within their clients' cultural context. There is a clear necessity to reinforce relationships, communications, and dialogue between governments and cooperation agencies, with specific regard to the health of indigenous peoples and perceptions thereof. (C) 2017 The Authors. Published by Elsevier Ltd.