First Peoples’ cultural medicines: A review of Australian health policies using an Indigenous critical discourse analysis approach

Purpose

First Peoples in Australia tend to have shared holistic understandings of health and wellbeing that emphasise strong interconnections among family, community, culture and Country. Central to this holistic health framework is First Peoples’ cultural medicines, which most First Peoples use or want to use, and have been used for millennia to heal the bodies, minds and spirits of First Peoples. This review aimed to explore and document the inclusion and representation of cultural medicines across national level policies and practice guidelines for health professionals. These policies intend to support effective and appropriate healthcare for all Australians, including First Peoples.

Methods

Australian national health policies that guide the practice of Australian Health Practitioner Regulation Agency registered health professionals and Aboriginal and Torres Strait Islander health workers/Indigenous liaison officers were systematically reviewed to explore their representation of cultural medicines in these policies. The review was informed by Indigenous critical discourse analysis that was modified to suit the review context. National level health policies from March to June 2023 were mapped and 52 policies eligible for inclusion were identified. Policies were downloaded and imported into NVivo for analysis. NVivo text search queries were conducted and nine policies were found to include any content about cultural medicines.

Main findings

Three overarching themes were found: 1) Absence of national leadership; 2) Disproportionate onus placed on Aboriginal and/or Torres Strait Islander health practitioners; and 3) Lack of detail and actionable directives. There was a distinct lack of representation of cultural medicines in national health policies, with most of these policies not providing any clear guidance for health professionals. The responsibility was too heavily placed on First Peoples health professionals to lead the healthcare related to cultural medicines.

Principal conclusions

The significant lack of national leadership and actionable directives around cultural medicines is concerning. To uphold cultural safety and the rights of Australia’s First Peoples, it is critical to have clear policy guidance, resources and training that support all Australian health professionals to engage with cultural medicines and see it as part of their responsibility.