Towards attainment of Indigenous health through empowerment: resetting health systems, services and provider approaches

Abstract

Colonial policies and practices have introduced significant health challenges for Indigenous populations in commonwealth countries. Health systems and models of care were shaped for dominant society, and were not contextualised for Indigenous communities nor with provision of Indigenous cultural approaches to maintain health and wellness. Shifts to support Indigenous health outcomes have been challenged by debate on identifying which system and service components are to be included, implementation approaches, the lack of contextualised evaluation of implemented models to justify financial investments, but most importantly lack of effort in ensuring equity and participation by affected communities to uphold Indigenous rights to health. Prioritising the involvement, collaboration and empowerment of Indigenous communities and leadership are critical to successful transformation of healthcare in Indigenous communities. Locally determined priorities and solutions can be enacted to meet community and individual needs, and advance health attainment. In this paper, existing successful and sustainable models that demonstrate the empowerment of Indigenous peoples and communities in advocating for, designing, delivering and leading health and wellness supports are shared.

The stay strong app as a self-management tool for first nations people with chronic kidney disease: a qualitative study

“…The health disparities existing between First Nations peoples and non-First Nations populations require urgent attention. Health systems and models of care need to be contextualised for First Nations communities [ 3 ]. Supporting people to self-manage their own condition is key, along with promotion of cultural heritage and traditional knowledge and empowerment of First Nations communities and leadership.…”

“…The Plan highlights that health disparities exist between First Nations peoples and non-First Nations populations in incidence and common risk factors, and that these disparities are often linked to historical, economic and social factors. These factors include colonial policies and practices where health systems and models of care were shaped for dominant society, and were not contextualised for First Nations communities [ 3 ]. Most First Nations populations in colonised countries experience poor health outcomes relative to their non-First Nations counterparts [ 4 , 5 ].…”

Community participation in global surgery

“…Activities of community participation need to be of a 'higher order', where the communication between local populations and research teams are truly bilateral, and the decision making, and output of research projects are entirely community driven. 14 We suggest that the 12-activity Community Engagement in Research Index be a starting point for understanding community participation. 15 We also suggest an international consensus conference of key organisations in HIC and LMIC, and journal editors insist on accurate reporting of community participation in Global Surgery research.…”

Translating and Evaluating a Physical Activity Program for Aboriginal Elders on Noongar Boodjar (Country) — A Longitudinal Study

“…Indigenous peoples worldwide have suffered through invasion and the impacts of colonization (1,2). It has resulted in the loss of languages, customs, and the freedom to hunt and gather on their traditional lands leading to changes in dietary intake and a sedentary lifestyle (3,4).…”

“…These consequences of colonization have negatively impacted on the health status of Indigenous peoples (3), causing disparities between the Aboriginal and non-Aboriginal people and communities in Australia. This disparity must be addressed by hearing Indigenous voices and privileging Indigenous ways of working, rather than providing only Westernized health services (2,4).…”