Indigenous Health Care Research Articles

What it means to be an ally in Indigenous healthcare

Background: Strengths-based and culturally sensitive approaches to Indigenous healthcare are much needed within the Canadian healthcare system. This is where allyship comes in. Allyship is loosely defined as the actions of an individual who strives to advance the interests of marginalized groups in which they are not a member. This study investigated the concept of allyship with healthcare providers who were community-identified allies providing care for Indigenous patients. Methods: Qualitative description methodology was utilized, and data was generated through semi-structured interviews with allies in and around the Edmonton area, in Canada. The interviews were conducted online, transcribed verbatim and then coded using thematic analysis. Results: Interviews were conducted with 13 allies (eight physicians, four allied health professionals and one nurse). The results were captured into three main themes. The meaning of allyship demonstrated how allyship must be determined by the community, and encapsulates authentic action and advocacy, as well as working to create positive healthcare experiences. The experience of being an ally included commitment to the allyship journey, embracing emotions, and facing and disrupting systemic barriers. Finally, cultivating allyship in healthcare necessitated building and maintaining meaningful relationships with Indigenous people, and ongoing training and education. Conclusion: The study results enabled a better understanding of how allies interact with their Indigenous patients within the confines of the healthcare system and could inform learning opportunities for those who seek to practice in a culturally humble way. In particular, transcending passive education and training modalities to include opportunities for real life interactions and the development of reciprocal relationships with Indigenous patients.

Evaluation of a longitudinal Indigenous health elective in family medicine

Background: In response to the Truth and Reconciliation Commission of Canada Calls to Action 22 to 24 around health, the Department of Family Medicine at the University of Calgary piloted a novel Indigenous Health Longitudinal Elective (IHLE) to give first year residents longitudinal experiences in Indigenous healthcare environments. The purpose of this evaluation was to capture the successful qualities and identify areas for improvements to ensure feasibility of the IHLE pilot program. Methods: Between November 2022 and April 2023, semi-structured interviews were completed with seven participants of the IHLE and included a mix of residents, preceptors, and clinic staff members. Qualitative thematic analysis was used to gain an in-depth understanding of the IHLE program experiences of all participants. Results: Benefits of the IHLE program include a deeper understanding of the values and priorities critical to working in healthcare with Indigenous peoples in Southern Alberta. Areas for improvement include clarity around IHLE program structure; clearly defining roles and responsibilities for preceptors; increased opportunities for reciprocity and relationality; and a deeper self-reflection process. Conclusion: Recommendations for future iterations of the IHLE include ensuring preceptors are trained and engaged, while providing residents more opportunities for relationality and peer debriefing. Results from this study may also help inform future Indigenous health programming in family medicine.

Escalating Health Crisis: Dissecting Mortality Causes and Trends Among Indigenous Populations in Northeast Brazil.

In Northeast Brazil, the poorest region of the country, indigenous communities face critical health care challenges. Despite legal entitlements to the Unified Health System (SUS), systemic barriers persist, exacerbating health disparities and mortality. This ecological study analyzed mortality trends and causes of death within the Special Indigenous Sanitary District (DSEI) Alagoas-Sergipe over a decade. Data on deaths from 2012 to 2022 were obtained from the Indigenous Health Secretariat. Causes of death were classified into 13 categories. Mortality rates per 1,000 indigenous inhabitants were calculated, and trends were analyzed using the Mann-Kendall test. The study also compared causes of death by age group. Mortality rates ranged from 3.3 to 5.2 per 1,000, showing a moderate upward trend over time (τ = 0.5, p = 0.042). Predominant causes included heart and vascular disorders (24.3%), external causes (12.4%), respiratory issues (11.1%), and infections (10.9%). About one-third of pediatric deaths were associated with general neonatal complications. This study highlights increasing mortality in indigenous communities in Northeast Brazil. The predominant causes of death reflect broader public health concerns. These trends emphasize the urgency for more effective, culturally sensitive public health policies and improved health care access.

Folk Wisdom and Traditional Knowledge: A Study of Mother and Child Healthcare Practices of Maram Nagas in India

Indigenous knowledge and healthcare practices are deeply embedded in the cultural fabric of tribal communities, influencing every aspect of life and ensuring the well-being of individuals. This paper delves into the Indigenous knowledge systems of the Maram Naga community in Manipur, India, mainly focusing on practices related to mother and child healthcare. The study is based on qualitative data gathered from 225 households across 12 Maram Naga villages through in-depth personal interviews and focus group discussions. It explains the beliefs, rituals, and other traditional cultural practices integral to the Maram Nagas in promoting the health and wellness of the mother and child in pre-natal and post-natal care.

Truth to Action: Lived Experiences of Indigenous Healthcare Professionals Redressing Indigenous-Specific Racism.

The experience of discrimination through stereotyping, profiling, and bias-informed care not only leads to poor access to healthcare services, but low retention rates of Indigenous health professionals (IHP). As health systems transformation evolves, a significant gap remains in supporting IHP to safely address racism, to be supported culturally to bring their authentic selves and voices to work, and to attend to one's own intellectual, physical, relational, cultural and spiritual wellness within a westernized model of care. The aim of the study was to investigate the experiences of IHP working in mainstream healthcare in order to understand how their work environment impacts the delivery of cultural safe practices. What is reported in this manuscript, as an exercise in truth-telling, is findings about lived experiences of IHP working in one mainstream provincial healthcare region, and not the whole context and outcomes of the study. Using Indigenous research methodologies, we embodied our Indigeneity into every facet of the research process. We facilitated three talking circles with participants grounded in a distinct cultural and ceremonial context following Secwepemc protocols. The collective voices of IHP revealed the following common experiences: confronting genocide; addressing Indigenous-specific racism; uprooting toxicity and inequities; and upholding Indigenous human rights while enhancing accountability of systems transformation. The experience of IHP working in health systems goes beyond mere individual employment obligations, its often about a families and communities advocacy for Indigenous rights, culturally safe working environments and access to dignified and respectful healthcare service. This study highlights the need for IHP to be actively involved in health system transformation to ensure the redesigning and restructuring of healthcare service delivery by and for Indigenous Peoples remains centered on Indigenous health and human rights.

Advancing Indigenous primary health care research and education capacity: a qualitative study in Alberta, Canada

Background/Purpose The study explores the perspectives of family physicians in Alberta regarding Indigenous health research education within the framework of primary health care (PHC). Recognizing the key role of PHC in healthcare system, the research identified the preferences and needs of family physicians for relevant and accessible research skills education. To design effective research education, it is critical to understand the skills, content, and delivery methods desired by family physicians engaged in Indigenous health research. The Indigenous Primary Health Care and Policy Research (IPHCPR) Network is examined as a potential transformative platform aligned with Truth and Reconciliation Commission principles and Calls to Action. Methods Through purposive sampling, 12 family physicians practicing in Alberta were recruited to participate in semi-structured qualitative interviews . The study utilized a thematic content approach for data analysis. Results Four key themes emerged from the analysis: 1) Indigenous role modeling; 2) cohort-based learning; 3) relational learning; and 4) the epistemic importance of Indigenous perspectives on learning. Participants emphasized the need for mentorship, collaborative learning settings, and meaningful connections within a research network. Discussion The IPHCPR Network stands out as a pivotal platform for transformative change in healthcare research education, offering opportunities for family physicians, researchers, trainees, and communities to collaboratively improve Indigenous health outcomes. Through its inclusive practices, the network aligns with TRC principles to advance Indigenous health equity and addressing critical gaps in Indigenous primary health research and practice.

Integrating traditional practitioners within primary healthcare teams: Development of an accreditation framework.

While the work of Traditional Healing and its practice is centuries old, many mainstream healthcare providers do not recognize its value. A priority for the Indigenous Primary Health Care Council (IPHCC) is to support Indigenous people, communities, and partners in the work of reclaiming safe spaces for Traditional Healing within primary healthcare settings. The primary goal of this IPHCC-led initiative was to understand barriers for organizations to integrate Traditional Healing and cultural services and from this information design an accreditation model for Traditional Healing Practitioners. This included the protection and maintenance of the experiences and knowledge of our Traditional Healing Practitioners through promoting and delivering Traditional Healing training and mentorship opportunities for the next seven generations of practitioners; and the creation of curriculum that will embed the concept of Two-Eyed Seeing as it relates to integrated Traditional Healing within mainstream practice.

A novel framework for Indigenous eye health care in New Zealand: Ngā Mata o te Ariki

ABSTRACT Clinical relevance Development of an Indigenous eye health framework could offer the opportunity for eye health professionals to enhance engagement with Indigenous populations. Background Indigenous populations globally experience disproportionately poorer eye health outcomes than non-Indigenous peoples. Incorporating Māori perspectives of eye care and pre-existing Indigenous models of health offers potential to enhance Māori experience and engagement with eye health services. This study seeks to develop and refine a practical framework for eye health care that incorporates nine established Indigenous health principles. Methods Qualitative methodology, guided by Indigenous Māori research principles, was used to evaluate interviews with five leading senior Māori academics surrounding the ongoing development and refinement of a Kaupapa Māori (Māori worldview centric) framework for eye care in Aotearoa New Zealand, created following Māori health consumer consultation. Interviews were semi-structured and analysed using reflexive thematic analysis. Results Seven key themes arose in relation to the development of a Kaupapa Māori framework for eye care in Aotearoa New Zealand: 1) vision is critical to Māori well-being, 2) cultural safety is important, 3) Māori health beliefs must be upheld, 4) achieving pae ora (healthy futures) is important, 5) key concepts and focus of the framework must be clear, 6) pūrākau (traditional Indigenous stories) are valuable resources in developing health frameworks and 7) embedding Matariki (fundamental Māori) principles is valuable. Conclusions Using Kaupapa Māori principles allowed development and refinement of a framework that encourages clinicians to consider Indigenous health principles when engaging with Māori patients who seek eye care. Application of this framework may contribute to enhancing cultural safety and responsiveness of eye care for Māori.

Bridges between two medical realities: Perspectives of Indigenous medical and nursing students on snakebite care in the Brazilian Amazon.

In the Brazilian Amazon, snakebite envenomations (SBEs) disproportionately affect Indigenous populations, and have a significantly higher incidence and lethality than in non-Indigenous populations. This qualitative study describes the Indigenous and biomedical healthcare domains for SBE care from the perspective of the Indigenous medical and nursing students in Manaus, Western Brazilian Amazon. In-depth interviews were conducted with five Indigenous students from the Amazonas State University, between January and December 2021. The interviews were analyzed using inductive content analysis. We organized an explanatory model with five themes: (1) participants' identities; (2) causality levels in Indigenous and biomedical systems; (3) therapeutic itineraries in Indigenous and biomedical systems; (4) ideological implications of adding biomedical devices to Indigenous healing systems; and (5) therapeutic failure in and efficacy of Indigenous and biomedical systems. From a noncolonial perspective and seeking to increase the quality and acceptability of health care for the Indigenous populations of the Brazilian Amazon, the training of Indigenous health professionals presents itself as a promising strategy. For this goal, universities should serve as empowering settings for Indigenous health students that support them in their growth and development, raise their awareness of injustice, and catalyze change toward a culturally adapted and effective service for the users.

In-depth analysis of the medical supply for indigenous people in North-Eastern Colombia: a dominance of infectious diseases and only insufficient therapeutic options

BackgroundColombian indigenous Wiwas are exposed to a variety of partly complex medical conditions with a predominance of infectious diseases. The study provided here aims at verifying of falsifying previous suspicions on therapeutic shortcomings and neglect of disease categories.Material and methodsLocal diagnoses within various subpopulations of indigenous Wiwas obtained by a study physician and local health brigades and health points between 2017 and 2018 were coded following the ICD 10 classification from 2019. Proportions of diagnoses per ICD-10 sub-chapter were evaluated to find diseases and to rank the occurrence of diagnoses in the population of indigenous people. Thereafter, the available medication provided by the indigenous health care provider Dusakawi for the treatment of the indigenous patients was analyzed in regard of its sufficiency to cover the recorded diseases.ResultsThe majority of the diseases found in the communities cannot at all (32%) or only partially (56%) be treated according to available guidelines. Only few (12%), predominantly infectious diseases, were covered completely by the provided medication. Notably, there are some ICD chapters with diseases that do only rarely appear at all in the gained datasets, e.g., complications during birth, mental disorders or cancer.ConclusionsAn expansion and revision of the medical supply for the indigenous population of the Sierra Nevada de Santa Marta is needed. An emergency kit for medical brigades and health points should be provided and in place. Awareness for neglected diseases needs to be created.

Health Care Delays and Social Suffering Among Indigenous People with Diabetic Foot Complications in Mexico

ABSTRACT Diabetic foot (DF) is a leading cause of nontraumatic lower-extremity amputations, premature death, and a sign of social inequality in diabetes treatment. In Mexico, the incidence of DF is on the rise yet little is known about its impact among indigenous people, a disadvantaged group. Based on ethnographic research conducted in Oaxaca and analysis of institutional health-data, in this article we show the health care delays that rural indigenous people face when dealing with DF. Indigenous people’s uncertainty regarding their right to health and the structural barriers to medical care favor DF complications, a phenomenon that should be read as social suffering. Since health data concerning indigenous health care service users is patchy and imprecise, indigenous people's social suffering is invisibilized. This omission or partiality in the official records limits public health decision-making and undermines the human rights of the population.

Towards abundant intelligences: Considerations for Indigenous perspectives in adopting artificial intelligence technology.

Artificial Intelligence (AI) applications in healthcare are evolving rapidly. The integration of AI into the Canadian healthcare system has demonstrated significant potential for enhancing the efficiency of care and improving patient outcomes. However, as this transformative technology continues to advance, it is crucial to take into account the unique perspectives and requirements of Indigenous Peoples in Canada. This article delves into the political, ethical, and practical considerations associated with introducing AI into Indigenous healthcare, emphasizing the paramount importance of equity and inclusion, which are rooted in the Two-Eyed AI framework. It also underscores the significance of co-creating AI technology in collaboration with Indigenous communities and multidisciplinary development teams. To illustrate these principles, this article spotlights an international AI epistemology-focused working group example. Healthcare professionals who engage with AI, whether it be through research, management, development, or leadership are implicated with this contemporary paradigm shift in decolonizing novel AI technology.

The TransFORmation of IndiGEnous PrimAry HEAlthcare Delivery (FORGE AHEAD): economic analysis

BackgroundIndigenous populations have increased risk of developing diabetes and experience poorer treatment outcomes than the general population. The FORGE AHEAD program partnered with First Nations communities across Canada to improve access to resources by developing community-driven primary healthcare models.MethodsThis was an economic assessment of FORGE AHEAD using a payer perspective. Costs of diabetes management and complications during the 18-month intervention were compared to the costs prior to intervention implementation. Cost-effectiveness of the program assessed incremental differences in cost and number of resources utilization events (pre and post). Primary outcome was all-cause hospitalizations. Secondary outcomes were specialist visits, clinic visits and community resource use. Data were obtained from a diabetes registry and published literature. Costs are expressed in 2023 Can$.ResultsStudy population was ~ 60.5 years old; 57.2% female; median duration of diabetes of 8 years; 87.5% residing in non-isolated communities; 75% residing in communities < 5000 members. Total cost of implementation was $1,221,413.60 and cost/person $27.89. There was increase in the number and cost of hospitalizations visits from 8/$68,765.85 (pre period) to 243/$2,735,612.37. Specialist visits, clinic visits and community resource use followed this trend.ConclusionConsidering the low cost of intervention and increased care access, FORGE AHEAD represents a successful community-driven partnership resulting in improved access to resources.

Integrating Indigenous and Western Health Practices as Synergy for African Development in the Globalization Era: The Nigerian Example

The health policy of colonial rule precipitated structural and institutional changes in the healthcare system of the colonized Africans, as Western medicine was imposed across Africa as a better system of health management. This development fundamentally altered the professional and practical acceptability of indigenous medicine even beyond the colonial era. The much-acclaimed theoretical incompatibility of western and indigenous medical systems is one of the major causes of the strain in the levels of acceptance between indigenous medicine and western medicine in post-colonial Africa. In the case of Nigeria, a majority of the populace, especially in the rural areas, still consult the indigenous medical care providers. This consultation is arguably as a result of some factors, including the people’s thin financial resources,the mythical belief in the therapeutic efficacy of indigenous medicine, and closeness of the indigenous healthcare centres to the patients, among others. Given this, it becomes imperative to explore the historical development and value of Adepoju Adewale Toyin and Onagun Rasheed: Integrating Indigenous and… 415 indigenous healthcare practices in Nigeria and determine the possibility of its integration with western medicine. Towards accomplishing this, we explore historical-analytic method, using primary and secondary sources to examine the current state of indigenous traditional health practice in Nigeria, identify the factors that drive (mis)communication between patient and practitioner, and suggest solutions that can be implemented to address existing challenges. In addition, with illustrations drawn from successful examples of integration of indigenous and modern health practices in developing countries, the paper argues in the context of globalization that an advantageous synergy between indigenous and western health practices is feasible as a development strategy for Africa.

Drivers of access to cardiovascular health care for rural Indigenous Peoples: a scoping review.

M&#257;ori (the Indigenous Peoples of Aotearoa New Zealand) are disproportionately represented in cardiovascular disease (CVD) prevalence, morbidity and mortality rates, and are less likely to receive evidence-based CVD health care. Rural M&#257;ori experience additional barriers to treatment access, poorer health outcomes and a greater burden of CVD risk factors compared to Non-M&#257;ori and M&#257;ori living in urban areas. Importantly, these inequities are similarly experienced by Indigenous Peoples in other nations impacted by colonisation. Given the scarcity of available literature, a systematic scoping review was conducted on literature exploring barriers and facilitators in accessing CVD health care for rural M&#257;ori and other Indigenous Peoples in nations impacted by colonisation. The review was underpinned by Kaupapa M&#257;ori Research methodology and was conducted utilising Arksey and O'Malley's (2005) methodological framework. A database search of MEDLINE (OVID), PubMed, Embase, SCOPUS, CINAHL Plus, Australia/New Zealand Reference Centre and NZResearch.org was used to explore empirical research literature. A grey literature search was also conducted. Literature based in any healthcare setting providing care to adults for CVD was included. Rural or remote Indigenous Peoples from New Zealand, Australia, Canada, and the US were included. Literature was included if it addressed cardiovascular conditions and reported barriers and facilitators to healthcare access in any care setting. A total of 363 articles were identified from the database search. An additional 19 reports were identified in the grey literature search. Following screening, 16 articles were included from the database search and 5 articles from the grey literature search. The literature was summarised using the Te Tiriti o Waitangi (Treaty of Waitangi) Framework principles: tino rangatiratanga (self-determination), partnership, active protection, equity and options. Themes elucidated from the literature were described as key drivers of CVD healthcare access for rural Indigenous Peoples. Key driver themes included input from rural Indigenous Peoples on healthcare service design and delivery, adequate resourcing and support of indigenous and rural healthcare services, addressing systemic racism and historical trauma, providing culturally appropriate health care, rural Indigenous Peoples' access to family and wellbeing support, rural Indigenous Peoples' differential access to the wider social determinants of health, effective interservice linkages and communication, and equity-driven and congruent data systems. The findings are consistent with other literature exploring access to health care for rural Indigenous Peoples. This review offers a novel approach to summarising literature by situating the themes within the context of equity and rights for Indigenous Peoples. This review also highlighted the need for further research in this area to be conducted in the context of Aotearoa New Zealand.

Enablers and barriers to primary health care access for Indigenous adolescents: a systematic review and meta-aggregation of studies across Australia, Canada, New Zealand, and USA

BackgroundIndigenous adolescents access primary health care services at lower rates, despite their greater health needs and experience of disadvantage. This systematic review identifies the enablers and barriers to primary health care access for Indigenous adolescents to inform service and policy improvements.MethodsWe systematically searched databases for publications reporting enablers or barriers to primary health care access for Indigenous adolescents from the perspective of adolescents, their parents and health care providers, and included studies focused on Indigenous adolescents aged 10–24 years from Australia, Canada, New Zealand, and United States of America. Results were analyzed against the WHO Global standards for quality health-care services for adolescents. An additional ninth standard was added which focused on cultural safety.ResultsA total of 41 studies were included. More barriers were identified than enablers, and against the WHO Global standards most enablers and barriers related to supply factors – providers’ competencies, appropriate package of services, and cultural safety. Providers who built trust, respect, and relationships; appropriate package of service; and culturally safe environments and care were enablers to care reported by adolescents, and health care providers and parents. Embarrassment, shame, or fear; a lack of culturally appropriate services; and privacy and confidentiality were common barriers identified by both adolescent and health care providers and parents. Cultural safety was identified as a key issue among Indigenous adolescents. Enablers and barriers related to cultural safety included culturally appropriate services, culturally safe environment and care, traditional and cultural practices, cultural protocols, Indigenous health care providers, cultural training for health care providers, and colonization, intergenerational trauma, and racism. Nine recommendations were identified which aim to address the enablers and barriers associated with primary health care access for Indigenous adolescents.ConclusionThis review provides important evidence to inform how services, organizations and governments can create accessible primary health care services that specifically meet the needs of Indigenous adolescents. We identify nine recommendations for improving the accessibility of primary health care services for Indigenous adolescents.

Don’t be shame, be game! Responding to HIV and AIDS in Aboriginal and Torres Strait Islander communities

This article explores the under-examined history of how Aboriginal and Torres Strait Islander communities responded to HIV and AIDS in the 1980s and 1990s. When HIV emerged as a public health threat in Australia, Indigenous healthcare workers and community leaders developed and delivered health promotion programs that were highly successful in preventing the spread of the virus among their communities. These programs drew on the political principles of self-determination and community control, fought for by the Black activism of the preceding decades. This article follows the story of one healthcare worker, Aunty Gracelyn Smallwood, who was instrumental in advocating for and implementing the grassroots Indigenous response to the virus. A proud Birrigubba, Kalkadoon and South Sea Islander woman and registered nurse, Aunty Gracelyn’s outspoken advocacy took her from her hometown of Townsville all the way to the highest offices of Australia’s AIDS response, where she helped shape and implement a world-leading approach to HIV and AIDS prevention.

Progress towards cultural safety in Indigenous cardiovascular health care and research

Progress towards cultural safety in Indigenous cardiovascular health care and research

Examining Policy Shifts and Transformations in Indigenous Primary Health Care in Alberta, Canada

Primary health care (PHC) transformation continues to be identified as a key pathway to achieve health equity for Indigenous peoples. In Alberta, varying degrees of PHC services exist within First Nations, Métis, and urban contexts that are fragmented, under-resourced, and disconnected from each other, perpetuating existing health inequities. A retrospective policy analysis was conducted to a) analyze federal, provincial, and local policies to advance Indigenous PHC in Alberta; and b) examine the engagement of Indigenous peoples in PHC policy and decision-making. The review found that prior to and into the early 1960s, the federal government controlled Indigenous peoples’ rights to health. By the end of the decade, the federal government shifted their responsibilities to Indigenous peoples in an attempt to reduce their role in health care delivery. In the late 1970s, the federal government reaffirmed their responsibilities in providing PHC to Indigenous peoples by establishing Indigenous-specific policies. This led to the creation of many co-designed reforms and initiatives provincially to increase Indigenous participation in policy throughout the 2000s. Despite these advancements, more work is needed to ensure that health priorities important to Indigenous peoples are appropriately addressed. Future Indigenous PHC-focused policy reforms can enhance Indigenous health experiences by clarifying the roles of federal, provincial, and Indigenous governments in the coordination of PHC; by ensuring Indigenous representation at all relevant decision-making tables; and by actively working to decolonize the health care institution and promote health equity. La transformation des soins de santé primaires (SSP) continue d'être identifiée comme une voie clé pour atteindre l'équité en matière de santé pour les peuples autochtones. En Alberta, il existe divers degrés de SSP au sein des premières nations, des métis et des contextes urbains qui sont fragmentés, manquent de ressources et sont déconnectés les uns des autres, ce qui perpétue les iniquités dans la domaine de la santé. Une analyse rétrospective des politiques a été menée pour a) analyser les politiques fédérales, provinciales et locales visant à faire progresser les soins de santé primaires autochtones en Alberta et b) examiner l'engagement des peuples autochtones dans la politique et la prise de décision en ce qui concerne les SSP. Les résultats de l'analyse ont montré que, jusqu’au début des années 1960, le gouvernement fédéral gérait les droits des peuples autochtones en ce qui concerne la santé. À la fin de la décennie, le gouvernement fédéral a transféré ses responsabilités aux peuples autochtones dans le but de réduire son rôle dans la prestation des soins de santé. À la fin des années 1970, le gouvernement fédéral a réaffirmé ses responsabilités en fournissant des soins de santé primaires aux peuples autochtones, en établissant des politiques spécifiques aux peuples autochtones. Cela a mené à la création de nombreuses réformes et initiatives co-conçues au niveau provincial afin d'accroître la participation des autochtones à la politique tout au long des années 2000. Malgré tous ces progrès, il reste encore du travail à faire pour s'assurer que les priorités de santé importantes pour les peuples autochtones sont prises en compte de manière appropriée. Les futures réformes politiques axées sur les soins de santé primaires autochtones peuvent améliorer les expériences de santé des autochtones en clarifiant les rôles des gouvernements fédéral, provinciaux et autochtones dans la coordination des SSP, en garantissant la représentation des peuples autochtones à toutes les instances de décision pertinentes et en œuvrant activement à la décolonisation de l'institution des SSP pour promouvoir l'équité dans la santé.

Exploring the Concepts of Collection Practices of Bark - From Ancient to Modern

Indian indigenous health care tradition plays a vital role in the health sector as it forms the major resource base of the medicinal plants. Precisely, 90% of the plant constituents are yet to be explored while only 10% have been studied. The global popularity of ancient Ayurvedic medicine is creating the persistent increase in demand and supply of Ayurveda medicinal plants. Advantages of these medicinal herbs either in single or many combinations, one part or the whole plant are known in every Indian house hold from the time of our ancestors. Ayurvedic science, the Indian system of medicine is known for the uniqueness of utilising different parts of the medicinal plant such as roots, leaves, flowers, barks etc and even minerals to treat various disorders. Even Ayurveda Acharyas has stressed upon the medicinal values that each part of the plant possess and has described multiple benefits of these drugs. Dravyaguna is one among the branches of Ayurvedic science that deals with the studies related to Ayurvedic drugs that includes Analytical and physio-chemical studies. In association with the clinical studies, physicochemical and analytical studies are need of the hour to comprehend the beneficial properties of the different parts of the medicinal plants. In this regard, we find many studies but not on the collection of barks. This study is an attempt to explore in depth, the collection practices of barks mentioned in ancient period and modern period.