A seven-year research project has revealed how Aboriginal-led healthcare models could transform treatment outcomes for First Nations people, who are increasingly losing trust in dominant medical systems that fail to address their holistic health needs.

The comprehensive report, funded by the National Health and Medical Research Council, documents how traditional Indigenous approaches to wellbeing—which have sustained the world’s oldest continuous cultures—are being systematically undermined by colonial healthcare frameworks that continue to produce poor outcomes for Aboriginal and Torres Strait Islander communities.

“Because of the continuous poor health outcomes, First Peoples are losing trust in the dominant health system,” explains Senior Researcher and Malyangapa/Barkindji woman Dr Kim O’Donnell from the University of Adelaide, who led the research alongside teams from Adelaide Nursing School and Flinders University’s Aboriginal and Torres Strait Islander Public Health Research Team.

Cultural Disconnect at Heart of Health Crisis

The research identifies a fundamental disconnect between how Indigenous Australians conceptualise health and how mainstream medical systems operate.

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

This mismatch has contributed to persistent health disparities despite decades of government initiatives and funding programs aimed at closing the gap.

Decolonising Health Practice as Solution

The report presents “decolonising practice” as a transformative approach that could rebuild trust while delivering more effective healthcare by challenging existing power structures and centering Indigenous knowledge.

“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,” Dr O’Donnell says.

Such practices are characterised by being led by Aboriginal and Torres Strait Islander approaches, breaking down systemic racism, challenging power imbalances, addressing white privilege, and focusing on strengths rather than deficits.

The research team has identified four critical policy recommendations based on their findings:

• Protecting Aboriginal primary healthcare’s decolonising practices through supportive policy environments
• Creating flexible funding models that respond to local community needs and enable community participation
• Respecting Indigenous ways of knowing in all policies while promoting strengths-based approaches instead of deficit narratives
• Supporting the recruitment and development of Aboriginal healthcare practitioners, as “decolonising practice can only be founded on a strong Aboriginal workforce”

The study itself modeled decolonising practices through its methodology, partnering with five Aboriginal primary health care services across Australia and using Indigenous-led research techniques.

“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,” explains Dr Toby Freeman from the University of Adelaide.

The team also produced a short film with The Story Catchers collective to share key findings and highlight the importance of decolonising healthcare practice.

“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 concludes, adding that this research area merits further exploration with other Aboriginal health services to document and share their strengths and approaches.