A scoping review of cultural competence training gaps among healthcare professionals in low-and middle-income countries

Abstract

BACKGROUND: Cultural competence is an essential skill required of healthcare professionals to provide quality and inclusive healthcare, enhancing patients’ satisfaction and improving health outcomes. However, its integration in healthcare delivery remains limited, particularly in low- and middle-income countries (LMICs). Thus, this current scoping review aimed to investigate the gap in cultural competence training among healthcare professionals in LMICs. METHODS: The study was guided by the methodological framework recommended by Arksey and O’Malley. A comprehensive search was conducted across six databases (PubMed, Scopus, CINAHL, PsycInfo, JSTOR, and AJOL) and non-database website (Google Scholar) to identify studies that assessed cultural competence skills or implemented cultural competence training to healthcare professionals in LMICs since the adoption of the Sustainable Development Goals (SDGs) by the United Nations in 2015 to 2nd April 2025. The search process resulted in the inclusion of thirty-eight (38) for this review. RESULTS: Out of 2,702 studies retrieved during the literature search, 83 studies were selected for full-text review after screening, of which 38 studies were included in the final review for meeting the inclusion criteria. The included studies were conducted between 2015 and 2025 across 14 LMICs. Out of the 38 eligible studies, 27 employed quantitative method, three were conducted using qualitative method, four used a mixed-methods study approach, three employed quasi-experimental design, and one used a cluster randomised controlled trial. Cultural competence interventions were reported in only five of the 38 studies, although they were recommended across the studies reviewed. CONCLUSION: This scoping review highlights a critical gap between the recognition of cultural competence as a key component of quality healthcare and its integration in healthcare delivery in LMICs. Thus, there is a need to develop and implement more effective, inclusive, and contextually appropriate cultural competence training programmes for healthcare professionals in LMICs. This could significantly contribute to enhancing the cultural competence skills of these professionals, improving healthcare delivery, and enhancing patient satisfaction and health outcomes.