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使口腔卫生保健非殖民化:呼吁采用基于权利的问责框架方法。

Decolonise oral health care: calling for a rights-based, accountability framework approach.

作者信息

Foláyan Moréniké Oluwátóyìn, Cachagee Madison, Poirier Brianna, Booth Joelle, Neville Patricia, Naresh Arish, Fleming Eleanor

机构信息

Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.

The Africa Oral Health Network (AFRONE), Alexandria University, Alexandria, Egypt.

出版信息

Front Oral Health. 2025 Feb 28;6:1539846. doi: 10.3389/froh.2025.1539846. eCollection 2025.

Abstract

This paper explores how colonisation has shaped oral healthcare and oral health inequities across Indigenous populations globally. It highlights how colonial healthcare models, which prioritise Western medical paradigms, often marginalise Indigenous knowledge and practices. For Indigenous communities, such as Aboriginal Australians, Māori, and those in the Global South, oral health disparities stem from historical and ongoing structural violence, socioeconomic barriers, and limited access to culturally appropriate care. The authors argue for a decolonisation framework in global oral health that shifts power, accountability, and respect toward Indigenous and marginalised communities. A rights-based, accountability-informed decolonisation framework seeks to address historical and ongoing oral health inequities, integrating a view that oral health is a human right and demands that governments and health systems rectify the disparities. It emphasises culturally relevant care and inclusive policymaking, fostering solidarity and systemic change to create equitable and effective oral healthcare for all populations. We propose that deliberate actions need to be taken to centre power redistribution, accountability, and respect in global oral health, moving away from Euro-American-centric frameworks to create an equitable, culturally responsive oral healthcare system. Our calls to action include the need for self-reflection within the field to dismantle entrenched colonial ideologies and prioritise Indigenous leadership and knowledge. Effective allyship should involve collaboration driven by the needs of communities, with institutions accountable for reducing exclusionary practices. By "learning to unlearn" traditional frameworks, the oral health community can build a system that genuinely addresses health disparities and supports justice and equity worldwide.

摘要

本文探讨了殖民化如何塑造了全球原住民群体的口腔保健及口腔健康不平等状况。它强调了以西方医学范式为优先的殖民医疗模式如何常常将原住民的知识和实践边缘化。对于澳大利亚原住民、毛利人以及全球南方的原住民社区等而言,口腔健康差距源于历史上及持续存在的结构性暴力、社会经济障碍以及获得符合文化习惯的护理的机会有限。作者主张在全球口腔健康领域建立一个去殖民化框架,将权力、问责制和尊重转向原住民及边缘化社区。一个基于权利、以问责制为导向的去殖民化框架旨在解决历史上及持续存在的口腔健康不平等问题,融入口腔健康是一项人权的观点,并要求政府和卫生系统纠正这些差距。它强调与文化相关的护理和包容性政策制定,促进团结和系统性变革,以为所有人群创造公平且有效的口腔保健。我们建议需要采取深思熟虑的行动,将权力重新分配、问责制和尊重置于全球口腔健康的核心位置,摆脱以欧美为中心的框架,以创建一个公平、对文化有回应的口腔保健系统。我们的行动呼吁包括该领域进行自我反思,以拆除根深蒂固的殖民意识形态,并将原住民领导和知识置于优先地位。有效的盟友关系应包括由社区需求驱动的合作,各机构应对减少排他性做法负责。通过“学会忘却”传统框架,口腔健康界可以建立一个真正解决健康差距并支持全球正义与公平的系统。

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