In recent years, the concept of healthcare decolonisation has gained considerable traction within medical and social sciences, particularly concerning Indigenous populations worldwide. With a legacy marred by colonial disregard for Indigenous knowledge and health systems, many healthcare structures continue to perpetuate inequities and cultural insensitivity. A newly published systematic review by Santos, Hunter, Bennett-Brook, and colleagues, appearing in the International Journal for Equity in Health in 2025, sheds critical light on the implementation processes and outcomes of healthcare decolonisation initiatives targeting Indigenous communities. Their work provides a comprehensive synthesis of existing interventions, revealing both the complexity and necessity of transformative approaches grounded in Indigenous epistemologies.
Decolonisation in healthcare reframes the dominant biomedical model, which historically marginalized Indigenous healing systems, as an essential, not supplemental, element of care. The systematic review delves into numerous studies from diverse geographic settings, identifying strategies that challenge entrenched colonial power dynamics in health institutions. The authors emphasize that healthcare decolonisation is not a monolithic goal but a multi-dimensional process requiring structural, cultural, and epistemic shifts. This involves dismantling eurocentric norms and centering Indigenous voices in policy development, clinical practice, and research methodologies.
A key finding from the review is the critical role of Indigenous-led governance and leadership in healthcare settings. Programs that integrate Indigenous decision-makers from the outset report higher cultural safety and patient satisfaction. These leaders often act as mediators between Western health frameworks and Indigenous worldviews, ensuring care paradigms respect spiritual, relational, and communal dimensions of health. The paper discusses how Indigenous governance structures can transform service delivery by embedding cultural protocols and holistic wellness principles, leading to more accessible, relevant, and trusted care.
The review further highlights education and training interventions as pivotal in decolonising healthcare workforce attitudes. Many healthcare providers operate with implicit biases or lack cultural competency, perpetuating inequitable treatment. Training modules designed in collaboration with Indigenous educators, which incorporate storytelling, historical context, and critical self-reflection, have yielded promising outcomes. When clinicians develop awareness of colonial histories’ enduring impacts and gain skills to engage respectfully with Indigenous clients, systemic racism diminishes, and therapeutic alliances strengthen.
Additionally, the researchers explore the integration of Indigenous healing practices alongside Western medicine. The review details several instances where traditional healers, medicines, and ceremonies are formally included in health service protocols. These hybrid models not only validate Indigenous knowledge systems but also enhance clinical outcomes by addressing social and spiritual determinants of health often neglected by biomedicine. However, the authors caution that such integration must avoid tokenism and instead involve genuine partnership founded on mutual respect and shared authority.
Structural barriers to decolonisation are a recurring theme throughout the review. Institutional policies, funding streams, and accreditation processes frequently prioritize Western medical standards, constraining the scope for Indigenous approaches. The paper critiques how colonial legal frameworks limit Indigenous sovereignty over health resources, underscoring the need for policy reforms that recognize and protect Indigenous health rights unequivocally. Equity-focused funding that supports Indigenous-led health initiatives emerges as a crucial enabler of sustainable decolonisation.
The systematic review also scrutinizes research paradigms underpinning healthcare interventions. Conventional research methods, often extractive and non-participatory, have contributed to Indigenous mistrust and ethical violations. Conversely, community-based participatory research (CBPR) methodologies, which engage Indigenous communities as equal partners in study design and knowledge dissemination, foster empowerment and validity. Santos and colleagues advocate for widespread adoption of these ethical frameworks to redress power imbalances and produce culturally relevant evidence.
Among the reviewed literature, the authors identify several promising case studies illustrating successful healthcare decolonisation. One example includes a Canadian First Nations health authority that implemented culturally tailored mental health services integrating traditional practices with counseling. Evaluations showed significant improvements in engagement and mental well-being. Another case from Australia involved training Aboriginal health workers to lead chronic disease management programs, resulting in enhanced community trust and improved health metrics. These exemplars demonstrate that decolonisation efforts can yield measurable health equity gains when Indigenous agency and expertise are prioritized.
Nevertheless, the review acknowledges ongoing challenges to scaling decolonisation initiatives. Fragmented governance structures, insufficient resources, and resistance from entrenched biomedical establishments can impede progress. The authors argue for sustained political will and multi-sectoral collaboration to embed decolonisation within health systems fundamentally. They call for global policy forums to adopt Indigenous health sovereignty as a core principle, recognizing the interconnectedness of decolonisation with broader movements for Indigenous rights and social justice.
Furthermore, the analysis underscores the importance of interoperability between Western and Indigenous health data systems. Data sovereignty — the right of Indigenous peoples to control information about their health — is integral to decolonisation. The review reports that partnerships enabling Indigenous stewardship over health metrics can enhance service planning, accountability, and cultural safety while protecting against data misuse. This necessitates technological innovation coupled with governance reforms to ensure Indigenous communities maintain full custodianship.
A notable contribution of this systematic study is its comprehensive theoretical framing of healthcare decolonisation. The authors draw on postcolonial theory, Indigenous methodologies, and critical race theory to articulate the multifaceted nature of colonial legacies in healthcare. They illustrate how systemic racism is embedded in clinical guidelines, diagnostic criteria, and research agendas, making decolonisation synonymous with anti-racism efforts. This nuanced conceptualization offers a critical lens through which future health policies can be examined and restructured.
The review’s extensive evidence synthesis also calls attention to the psychosocial dimensions of decolonising health care. Health disparities among Indigenous populations are often rooted in historical trauma, social exclusion, and identity disruptions. Effective interventions must address these interrelated factors through culturally affirming trauma-informed care that promotes resilience and reconnection to cultural heritage. Thus, decolonisation extends beyond clinical procedures to holistic restoration of Indigenous health sovereignty.
Importantly, the systematic review stresses that healthcare decolonisation ultimately benefits broader society by fostering reconciliation and social cohesion. By confronting colonial injustices in health systems, these initiatives contribute to dismantling structural inequalities and promoting human rights for all. The authors emphasize that decolonised health care embodies respect for diversity, inclusivity, and shared humanity — values critical in an increasingly pluralistic world confronting global health challenges.
As the healthcare landscape evolves, this seminal review by Santos et al. provides a pivotal roadmap for academics, practitioners, and policymakers committed to equitable Indigenous health outcomes. It challenges stakeholders to move beyond performative changes towards transformative action underpinned by Indigenous leadership, ethical research, and systemic reform. Their findings advocate a paradigmatic shift in how health systems conceptualize, deliver, and evaluate care for Indigenous peoples, affirming that health decolonisation is an urgent moral and clinical imperative.
In conclusion, the systematic review underscores how healthcare decolonisation is both a reclamation of Indigenous knowledge and a radical restructuring of global health infrastructures. It calls for authentic partnerships, legal recognition of Indigenous sovereignty, and contextualized therapeutic approaches that honor cultural integrity. As more nations reckon with colonial histories, this research offers critical insights into pathways for healing and justice through decolonised healthcare paradigms. The momentum generated by such scholarship could catalyze a new era where Indigenous health equity is not merely aspirational but an achievable reality.
Subject of Research: Healthcare Decolonisation for Indigenous Peoples
Article Title: Implementing healthcare decolonisation for Indigenous people: a systematic review
Article References:
Santos, C.A.K., Hunter, K., Bennett-Brook, K. et al. Implementing healthcare decolonisation for Indigenous people: a systematic review. Int J Equity Health (2025). https://doi.org/10.1186/s12939-025-02705-x
Image Credits: AI Generated
