When Kweya James gave birth at a clinic in Tsiigehtchic, Northwest Territories, her family filled the room, songs rose in Gwich’in, and the placenta was wrapped in cloth to be buried under a spruce tree—just as her grandmother once did. This is not an exception in Canadian Indigenous birthing care; it’s becoming a model of what health systems can look like when they return power to the people they serve. A groundbreaking review led by The George Institute for Global Health’s Guunu-maana (Heal) team has identified six practical elements of decolonizing health care, drawing from 15 studies across Canada, Australia, Aotearoa New Zealand, the United States, Chile, and South Africa—and involving insights from 835 patients, providers, and community members. This is the first global analysis to map how decolonization works not in theory, but in clinics, hospitals, and healing circles.
For generations, Western medicine dismissed Indigenous knowledge as folklore, creating systems where racism and mistrust thrive. Today, Indigenous patients still face delayed diagnoses, inadequate pain treatment, and cultural erasure. But this review shows that change is possible when care is reimagined around equity—not just in access, but in knowledge, governance, and worldview. The six elements that emerged—community governance and ownership, holistic care, relationality and trust, storytelling, reflexive practice, and colonization-informed care—are not add-ons. They are foundational shifts. In one Australian program, integrating Indigenous-led mental health services led to an 680% increase in psychology consultations, with 82% of those patients identifying as Aboriginal or Torres Strait Islander. That’s not just better care; it’s care that reconnects people to their dignity.
Community governance means more than consultation—it means Indigenous nations deciding how clinics are run, who staffs them, and how funds are used. Holistic care treats illness as more than a biological event; it includes spirit, land, family, and history. Storytelling becomes a clinical tool, where a patient’s narrative is honored as truth. Reflexive practice asks doctors and nurses to confront their own biases daily. And colonization-informed care recognizes that trauma isn’t just personal—it’s woven into policies, institutions, and medical records.
"Colonial structures have not disappeared from health care, they have simply been reshaped," says Camila Kairuz Santos, Ph.D. Candidate & Research Associate with the Aboriginal and Torres Strait Islander Program. The message is clear: decolonization can’t be a checklist or a one-day training. It’s an ongoing act of justice. In Tāmaki Makaurau, Māori health providers now co-design services with iwi (tribes), while in British Columbia, the Heiltsuk Nation runs its own wellness centers grounded in ancestral knowledge. These are not isolated successes—they are blueprints. As health systems worldwide grapple with inequity, the path forward isn’t innovation for the sake of novelty, but restoration for the sake of healing.