Yet, comprehensive MCOD is undermined because the unique features of human services agencies (that is, altruistic missions, multiple and ambiguous goals, democratic impulses, moral rationales for work, personalized worksites, and multiple stakeholders) make long-term planning difficult (Gutierrez & Nagda, 1996).
This qualitative exploratory study identified the daily realities of multicultural practice, the challenges to MCOD in human services, and some solutions.
Most of the practitioners had experience initiating or overseeing MCOD efforts.
Informants were provided with a definition of MCOD (Gutierrez & Nagda, 1996; Jackson & Holvino, 1988) and asked to compare their practices with that model.
Analytical categories regarding MCOD processes were developed.
Respondents identified numerous challenges to fully conceptualizing and implementing MCOD efforts.
Recent experience in particular cases of the MCOD has underlined that it is impossible for agencies, at thousands of miles' distance from the host church, to determine the local stipend rate satisfactorily, particularly if figures such as those provided by United Nations guidelines are challenged by the expatriate staff.
In most circumstances this is something the MCOD would probably discourage.
For cases coded as being due to an accidental cause, two-thirds of cases had an external cause as the UCOD with the remaining one-third having an external cause as a MCOD code.
In examining the specificity of codes across UCOD and MCOD positions, 11.
There were significantly higher odds of a death certificate being assigned an undefined external cause code if the external cause was coded as an accident (compared with intentional self-harm), was a MCOD (compared to an UCOD), where the deceased was not Indigenous, where the death was certified by a doctor instead of a coroner, where the deceased was female and where the death was of an older individual.
Specificity was particularly problematic for causes assigned as MCOD rather than UCOD.