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The report shares research findings, about the effects and limitations of dominant health models on Aboriginal and Torres Strait Islander People. It establishes an evidence base for decolonising practice in primary health care and ensures cultural safety.

Funded by the National Health and Medical Research Council, the report presents key findings from a seven-year project which included researchers from the University of ���޲�Ʊ����’s Stretton Health Equity, ���޲�Ʊ���� Nursing School, and Flinders University’s Aboriginal and Torres Strait Islander Public Health Research Team.

“Decolonising health care practices are the ways of working that describe colonial approaches to health, so Aboriginal and Torres Strait Islander people will become the agents of change. This will mean, leading and transforming the policies, processes and practices that influenced health in the past, and which are still present today,” explains Senior Researcher and Malyangapa/Barkindji woman Dr Kim O'Donnell from the University of ���޲�Ʊ����.

Dr O’Donnell explains that the way many First Nations people view health — encompassing spiritual, social, emotional and physical wellbeing — differs significantly from dominant health models and treatment regimes.

“Aboriginal and Torres Strait Islander people ways of knowing, being and doing cultivated the oldest living cultural populations in the world predating all other societies,” she explains.

“Because of the continuous poor health outcomes, First Peoples are losing trust in the dominant health system.”

Dr O'Donnell outlines that decolonising practice is led by Aboriginal and Torres Strait Islander ways; breaks down systemic racism; challenges the power imbalances in all structures formed by the dominant society; acknowledges and addresses white privilege; and is strengths-based.

The policy recommendations identified based on the report findings are:

• Ensuring Aboriginal primary health care decolonising ways of working are protected and supported by the policy environment
• Ensuring funding models for Aboriginal primary health care are flexible enough to respond to local community needs, enable community participation in service delivery and decision-making, and support strategies beyond individual health care
• Fundamentally respecting Aboriginal ways of knowing, being and doing in all policies and funding models, and promoting strengths-based approaches rather than perpetuating a deficit narrative around Aboriginal and Torres Strait Islander health
• Supporting the recruitment, retention and professional development of Aboriginal primary health care practitioners and managers as decolonising practice can only be founded on a strong Aboriginal workforce — particularly in advocacy, interagency collaboration and community engagement

“Our report provides new, detailed understanding of decolonising practice in Australia, highlighting the strengths of Aboriginal primary health care services that have been under-reported in other research, and makes clear the rationale for their ways of working,” Dr O'Donnell says.

The research was a collaboration between Aboriginal and non-Indigenous researchers, in partnership with five Aboriginal primary health care services across Australia, including both community-controlled and state-managed services.

“We interviewed and ran workshops with service staff, board members, community members, peak bodies, and policy makers to understand in depth the context of each service partner and the broader policy environment,” Dr Toby Freeman from the University of ���޲�Ʊ���� says. “Aboriginal research team members led processes to embed decolonising methodology, informed by a relational worldview, Indigenous ways of knowing, being, and doing, and a holistic view of health.”

The research team also produced����in collaboration with�� collective��to share the key ideas and importance of decolonising practice in Aboriginal and Torres Strait Islander primary health care. They note that decolonising health care practice is a critical area for continued exploration.

“Future research could involve other Aboriginal primary health care services, document their implementation of decolonising practice and share their strengths and ways of working,” Dr O'Donnell says.