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Decolonization and Health Systems: A Scoping Review
Karen Wright1, Nikita-Moana Turoa1
1Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, Waipapa Taumata Rau, University of Auckland, Auckland, New Zealand.
Health Equity
|July 31, 2026
Summary
Decolonization in health systems is an emerging area, focusing on addressing coloniality and promoting Indigenous health equity. More research and implementation are needed to transform health systems and support Indigenous well-being.
Area of Science:
- Public Health
- Indigenous Studies
- Health Systems Research
Background:
- Coloniality significantly impacts Indigenous peoples' health outcomes and access to care.
- Health systems are shaped by colonial structures, necessitating transformation.
- Decolonization offers a theoretical framework for health system reform.
Purpose of the Study:
- To explore decolonization, Indigenous health, and equity in publicly funded health systems.
- To identify gaps in the literature regarding decolonization in healthcare.
- To synthesize current knowledge on decolonization approaches in health systems.
Main Methods:
- A scoping review was conducted using Joanna Briggs Institute and PRISMA-ScR guidelines.
- An Indigenous methodology and Kaupapa Māori framework were employed.
- Searches included four databases and Aotearoa New Zealand gray literature.
Main Results:
- Sixteen texts were included, mostly published between 2019-2021.
- Decolonization approaches were mainly system or health professional-level and exploratory.
- Key characteristics identified: Addressing Coloniality, Transformation, Relationships, and Indigeneity.
Conclusions:
- Decolonization in health systems is an emergent research area with a gap between theory and practice.
- It offers a rights-based framework to address power imbalances and drive structural transformation.
- Further research, implementation, and evaluation are crucial for health system transformation and Indigenous well-being.
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