At the interface: Indigenous health practitioners and evidence-based practice

February 2019

Indigenous health practitioners in Canada face unique challenges with respect to implementing evidence-informed practice (EIP) and decision-making, specifically when addressing the complex health needs of Indigenous patients. They must often walk in two worlds, simultaneously applying both Western and Indigenous knowledges and evidence in their practice in order to optimally support the health and well-being of their Indigenous patients. Currently, EIP is primarily conducted through a Western lens that adopts a biomedical perspective of health as simply the absence of disease without considering the broader social, historical, economic, political and environmental contexts. This differs from Indigenous understandings of health that are holistic and encompass mental, physical, emotional and spiritual dimensions. These different understandings of health can result in a health care system that is culturally unsafe for Indigenous peoples.

There has been increasing recognition of the importance of Indigenous knowledges for the health and well-being of Indigenous peoples, with corresponding increased efforts to integrate both Indigenous and Western knowledges into health care practice and policy. This paper adds to the limited research on the knowledge and evidence needs, barriers and supports of Indigenous health practitioners when working with Indigenous patients, and on how to blend Indigenous and Western knowledges in these health care settings. It seeks to understand what constitutes evidence, how evidence is accessed, and how Indigenous knowledge is currently being integrated into health practice by Indigenous health practitioners.