Global Politics and Multinational Health-care Encounters: Assessing the Role of Transnational Competence

This planet’s most likely political/population scenario for the 21st century anticipates more people, more spatial movement, and more transnational interactions. Global health increasingly will be shaped by encounters among clinicians and patients who meet in health-care settings where cultural, ethnic, and national-origin match is not an available option. In multinational clinical consultations, bicultural competence and lists of culture characteristics will not suffice. The article adapts the generic Koehn/Rosenau framework of transnational competence (TC), which encompasses analytic, emotional, creative, communicative, and functional skills, to the global challenge of providing migrant-health care. The focus is on the patient/clinician encounter, where interpersonal interactions carry the potential to reduce or reproduce existing inequities in health care. A structured literature review provides the basis for the adaptation to transnational health encounters presented for the first time here by incorporating recent research findings from more than 80 published studies regarding patient–provider consultations and cultural competence in the medical interview into the TC framework’s empirical foundation in cross-cultural psychology, development studies, intercultural communication, and international management. The application elaborated in this article will enhance the ability of researchers to explore and to assess the role of encounter participants’ TC capabilities and deficiencies in transnational health-care outcomes—including migrant satisfaction/dissatisfaction with provider care, the incorporation of complementary biomedical and ethnocultural health-promotion practices, effective/ineffective migrant-health-promotion behavior in the new environment, and agreement on mental-health needs. The results of conceptually grounded TC research promise to enhance practitioner training and patient education in both North and South.