Decolonising hospital policies – promoting equity through inclusive hospital policies
1
Indigenous Health Equity Unit, Onemda: Aboriginal and Torres Strait Islander Health and Wellbeing, University of Melbourne, Melbourne, Australia
2
Latrobe Regional Health, Traralgon, Australia
Popul. Med. 2026;8(Supplement Supplement 1):A695
ABSTRACT
INTRODUCTION:
Indigenous populations experience significant and persistent disparities in health and wellbeing outcomes linked to and reinforced by intergenerational trauma from colonisation and unequal health services access. Policies that are not culturally responsive or trauma-informed perpetuate mistrust, disengagement and create barriers to care. Embedding decolonising and trauma-informed approaches into organisational structures and processes is critical for improving inclusivity and achieving health equity.
METHODS:
Healing the Past by Nurturing the Future is an Indigenous-led community-based participatory action project aiming to strengthen support for Indigenous families. We reviewed a regional hospital’s policies related to perinatal care for alignment with principles supporting Indigenous empowerment, safety, sovereignty, respect and recognition. We mapped policies to a Decolonising Framework to assess inclusion of power-sharing, transparency, accountability, and responsiveness to Indigenous determinants of health and wellbeing. Policies were also scored on their capacity to support trauma-informed practice and alignment with organisational goals, integration with related policies and the adequacy of resourcing to achieve stated policy objectives.
RESULTS:
Most of the 51 policies achieved low adherence to decolonising domains of power-sharing; recognition of and/or response to Indigenous culture, history, knowledges and social determinants of health; policy integration; organisational processes supporting decolonisation; monitoring and evaluation; and responsiveness to evaluation and review findings. While over 70% of policies scoring high or medium adherence to accountability structures, policy basis, and logical coherence. Of 30 policies assessed for 12 trauma-informed principles, 6 addressed 6 or more principles, 13 addressed between 5 and 1principles, and the remaining 12 addressed none.
CONCLUSIONS:
The policy review highlighted poor integration of decolonising and trauma-informed principles in hospital policies and made actionable recommendations to improve policy inclusivity. It is likely these results are representative across the tertiary health service sector. Improved integration of these principles may help address health and wellbeing disparities and improve access to healthcare.
Indigenous populations experience significant and persistent disparities in health and wellbeing outcomes linked to and reinforced by intergenerational trauma from colonisation and unequal health services access. Policies that are not culturally responsive or trauma-informed perpetuate mistrust, disengagement and create barriers to care. Embedding decolonising and trauma-informed approaches into organisational structures and processes is critical for improving inclusivity and achieving health equity.
METHODS:
Healing the Past by Nurturing the Future is an Indigenous-led community-based participatory action project aiming to strengthen support for Indigenous families. We reviewed a regional hospital’s policies related to perinatal care for alignment with principles supporting Indigenous empowerment, safety, sovereignty, respect and recognition. We mapped policies to a Decolonising Framework to assess inclusion of power-sharing, transparency, accountability, and responsiveness to Indigenous determinants of health and wellbeing. Policies were also scored on their capacity to support trauma-informed practice and alignment with organisational goals, integration with related policies and the adequacy of resourcing to achieve stated policy objectives.
RESULTS:
Most of the 51 policies achieved low adherence to decolonising domains of power-sharing; recognition of and/or response to Indigenous culture, history, knowledges and social determinants of health; policy integration; organisational processes supporting decolonisation; monitoring and evaluation; and responsiveness to evaluation and review findings. While over 70% of policies scoring high or medium adherence to accountability structures, policy basis, and logical coherence. Of 30 policies assessed for 12 trauma-informed principles, 6 addressed 6 or more principles, 13 addressed between 5 and 1principles, and the remaining 12 addressed none.
CONCLUSIONS:
The policy review highlighted poor integration of decolonising and trauma-informed principles in hospital policies and made actionable recommendations to improve policy inclusivity. It is likely these results are representative across the tertiary health service sector. Improved integration of these principles may help address health and wellbeing disparities and improve access to healthcare.
| eISSN: | 2654-1459 |
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