Implementing healthcare decolonisation for Indigenous people: a systematic review

Area of Science:

• Global Health
• Indigenous Health Studies
• Health Equity Research

Background:

• Western biomedical system's colonial roots perpetuate health inequities for Indigenous communities.
• Decolonising healthcare is recognized as necessary but lacks clear practical application.
• This study systematically reviews global literature on practical decolonisation in healthcare.

Purpose of the Study:

• To systematically review global literature and explore the practical meaning of decolonising healthcare.
• To identify key elements, barriers, facilitators, and outcomes of decolonising healthcare practices.

Main Methods:

• Systematic search of published and grey literature across multiple databases and sources.
• Independent screening and data extraction by two reviewers.
• Qualitative data analysis using an inductive thematic approach with Indigenous community member input.

Main Results:

• Fifteen qualitative studies from diverse global locations met inclusion criteria.
• Key elements include community governance, holistic care, relationality, storytelling, reflexive practice, and colonisation-informed care.
• Outcomes reported include increased patient satisfaction, empowerment, and trust, underpinned by equity and shared power.

Conclusions:

• Decolonising healthcare necessitates acknowledging colonialism and fostering equity between Western and Indigenous knowledge systems.
• Genuine community partnerships and Indigenous leadership are crucial for developing culturally aligned health services.
• Implementing decolonised healthcare aligns with Indigenous paradigms of health, well-being, and healing.