Conceptualizing Cultural Safety: Definitions and Applications of Safety in Health Care for Indigenous Mothers in Canada

The importance of delivering culturally-appropriate health care to meet the unique health needs of Indigenous peoples in Canada has resulted in the emergence of various concepts to describe how care should be provided. However, there is lack of clarity regarding how these terms differ from one another and what they look like in practice. An extended literature search was performed to conceptualize terminology used to describe culturallyappropriate care, emphasizing the concepts of ‘cultural safety’ and ‘cultural competence’. Maternal and child health programs that utilize these concepts were then surveyed to explore how they are being applied in practice. Relevant literature was identified through major databases (Ovid Medline, CIANHL, and the CHR Collection) with key terms “cultural competency”, “cultural safety”, and “Indigenous health care”, along with forward citation and grey literature searches. This literature review demonstrates that the theoretical definitions of cultural safety and cultural competence are distinct, but lack strict delineations, much like the variable and dynamic nature of their application. By comparing the conceptual bases of culturally-appropriate care with their actual application, gaps in current provision of culturally-appropriate health care for Indigenous peoples are identified and recommendations generated for enhanced development of care.