Barriers to culturally safe care for Indigenous Peoples: a key informant perspective
Abstract
Health inequity for Indigenous Peoples persists on a global scale, due to the ongoing
impacts of colonization. Racism, power dynamics, and health professionals with limited
understanding of the historical context and lived realities of Indigenous Peoples are among the
many factors which create unsafe spaces in health care environments (Turpel et al., 2020;
Browne, 2017; Jacklin et al., 2017; Goodman et al., 2017). These unsafe spaces foster unsafe
care which undermines the quality of care that Indigenous Peoples receive, with detrimental
outcomes. Cultural safety is a health concept originating in New Zealand (and adopted in many
other countries such as Australia and Canada) that emphasizes provider reflexivity, facilitates
care that is free from discrimination, racism and prejudice, and empowers Indigenous patients to
define the quality of the care they receive. There is a growing body of research which suggests
that culturally safe care could have a meaningful impact on health experiences of Indigenous
Peoples when embedded into practice (Churchill et al., 2020), and supports the idea of cultural
safety being incorporated into healthcare environments (Goodman et al., 2017; Wesche, 2013;
Schill & Caxaj, 2019). However, cultural safety has not been widely implemented at an
organizational or systemic level within the health sector, and remains absent from health policy,
despite calls for its implementation (Truth and Reconciliation Commission, 2015). [...]