The dichotomy of commissioning Indigenous health and wellbeing program evaluations: What the Funder wants vs what the Community needs

Abstract

There are multiple systemic structural barriers that result in health and wellbeing inequities experienced by Aboriginal and Torres Strait Islander peoples (hereafter referred to as Indigenous). The recent Overcoming Indigenous Disadvantage 2020 report highlights some of these barriers, emphasising the importance of addressing the social determinants and cultural determinants of health by delivering evidence-based and culturally responsive health programs and initiatives. 1 While is it estimated that $5.9 billion (AUS) is spent annually on Indigenous health programs and services in Australia, there is scant evidence to illustrate what works (or does not work), for who and why. 2,3 A mapping exercise of Indigenous-specific programs in Australia reported that of 1082 programs delivered, over 90% were not evaluated to assess whether programs achieved their goals and objectives. 3 Also, it is reported that only a few evaluations used culturally appropriate methods for assessing program effectiveness. 3 Recently, there have been a growing number of robust evaluations that are culturally responsive, from which we can learn. These have important implications that can guide the commissioning of future evaluations.

A scoping review of commissioning practices used in the evaluation of Indigenous health and wellbeing programs: Protocol article

“…It also aligns with Articles 18-21 and 23 in the United Nations Declaration on the Rights of Indigenous Peoples (United Nations, 2009), which outline the right of Indigenous peoples to act as full and effective participants in the decision-making processes that affect their health, economic and social wellbeing. However, recent scholarship points to the dichotomous relationship between what funders want and what Indigenous communities need when evaluations are being commissioned (Finlay et al, 2021). Ultimately if robust evidence is generated from this project, that meets the needs of stakeholders, it may then be applied to further improve policy and practice.…”

“…The commissioning of program evaluations tends to be conceptualised as a series of activities or steps (Finlay et al, 2021). Typically, the process begins when a funding body initiates an evaluation and ends with the final reporting of the evaluation findings.…”

“…Typically, the process begins when a funding body initiates an evaluation and ends with the final reporting of the evaluation findings. From the moment the evaluation is initiated until its completion, the commissioner of evaluation is central to the way program evaluations are carried out and the quality of evidence that is generated (Finlay et al, 2021). The commissioning process often sets the budget, selects the evaluators, and places parameters around the evaluation aims, objectives and data collection methods.…”

“…The commissioning process often sets the budget, selects the evaluators, and places parameters around the evaluation aims, objectives and data collection methods. These pre-determined variables, set the stage for the cultural safety and power dynamics of the evaluation (Finlay et al, 2021), or lack thereof for participating individuals and communities. This process can be particularly problematic with Indigenous evaluations, which are typically considered a threat to Indigenous peoples.…”

Weaving Promising Practices to Transform Indigenous Population Health and Wellness Reporting by Indigenizing Indicators in First Nations Health

“…Indigenous communities have consistently stated, 'nothing about us without us!' (Finlay et al, 2021;Marsden et al, 2020). Due to the historical exclusion, marginalization, and undermining of Indigenous autonomy and self-determination, it is essential that Indigenous peoples lead and be involved at all stages, at equal levels, in co-producing reports regarding their own health.…”