Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
BMJ Glob Health. 2021 Feb;6(2). doi: 10.1136/bmjgh-2020-004052.
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.
殖民政策和实践给英联邦国家的土著居民带来了重大的健康挑战。卫生系统和护理模式是为占主导地位的社会塑造的，没有针对土著社区进行调整，也没有提供维护健康和健康的土著文化方法。支持土著健康成果的转变受到了关于确定应包括哪些系统和服务组件、实施方法的辩论的挑战，缺乏对实施模式的背景化评估以证明财务投资的合理性，但最重要的是，缺乏努力确保受影响社区的公平性和参与，以维护土著人民的健康权利。优先考虑土著社区和领导层的参与、合作和赋权对于成功转型土著社区的医疗保健至关重要。可以制定由地方确定的优先事项和解决方案，以满足社区和个人的需求，提高健康水平。本文分享了一些现有的成功和可持续的模式，这些模式展示了土著人民和社区在倡导、设计、提供和领导健康和健康支持方面的赋权。
