Abstract
Over the past decades, Indigenous communities around the world have become more vocal and mobilized to address the health inequities they experience. Many Indigenous communities we work with in Canada, Australia, Latin America, the USA, New Zealand and to a lesser extent Scandinavia have developed their own culturally-informed services, focusing on the needs of their own community members. This paper discusses Indigenous healthcare innovations from an international perspective, and showcases Indigenous health system innovations that emerged in Canada (the First Nation Health Authority) and Colombia (Anas Wayúu). These case studies serve as examples of Indigenous-led innovations that might serve as models to other communities. The analysis we present suggests that when opportunities arise, Indigenous communities can and will mobilize to develop Indigenous-led primary healthcare services that are well managed and effective at addressing health inequities. Sustainable funding and supportive policy frameworks that are harmonized across international, national and local levels are required for these organizations to achieve their full potential. In conclusion, this paper demonstrates the value of supporting Indigenous health system innovations.
Highlights
In 2006, The Lancet published a series of papers focused on Indigenous health [1,2,3,4], calling for international action to address Indigenous health inequities
Increased international attention to Indigenous rights, which are encoded in international covenants, may well be legitimizing pathways that Indigenous communities are already forging, in the pursuit of autonomy and better health
It is important that local and national governments work to harmonize their legislation and policy frameworks with existing international and constitutional parameters, but that they do so in an inclusive manner that is informed by Indigenous expertise
Summary
Canada’s Constitution includes explicit protections for ‘Aboriginal and Treaty rights’ as well as an affirmation of a ‘nation-to-nation’ relationship between Canada (or the Crown) and Indigenous nations, which has remained intact since first contact with European powers [see the Constitution Act 1982: Ss25, 35, 12] These measures are defined to some degree in local and provincial policies as well as modern treaties and self-government agreements. New Zealand does not have a written constitution: Maori have continuously argued that the Treaty of Waitangi, signed in 1840, serves as their Constitution, and guarantees a measure of sovereignty to iwi (tribes) Both Colombia and Norway have made recent constitutional amendments, recognizing the right to cultural autonomy. Tribal nations are characterized under U.S law as ‘domestic dependent nations’, which is understood as a guarantee of sovereignty
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