UN-Backed Framework Redefines Indigenous Health Beyond Traditional Metrics

The Indigenous Determinants of Health (IDH) Framework was introduced in 2023 to bridge the gap between recognition of Indigenous leadership and the understanding of health and environment. It reframed health beyond traditional indicators by establishing Indigeneity as a key determinant, incorporating 33 risk and protective factors specific to Indigenous Peoples' well-being. In 2023, the framework was first unveiled, offering a new lens for understanding Indigenous health. The following year, the UN Permanent Forum on Indigenous Issues recommended its adoption to member states and UN agencies. This call was repeated in 2024 and 2025, reinforcing the framework’s growing influence.

In 2024, the UN Convention on Biological Diversity referenced the IDH Framework in Decision 16/19, integrating it into the Global Plan of Action on Biodiversity and Health. That same year, a study expanded the framework, providing practical tools for institutions to implement Indigenous health determinants in policy and practice.

By 2025, the WHO Report on the Social Determinants of Health Equity officially recognised Indigeneity as a determinant of health. Another study that year introduced the IDH Evaluation Instrument, designed to assess how well institutions address Indigenous health risks, protective factors, and rights. The 2026 IDH study later demonstrated how Indigenous health serves as a systems integrator, reflecting outcomes across multiple sectors.

The framework highlights systems like Indigenous midwifery, which is rooted in relationships between people, land, knowledge, and spirituality. However, Indigenous midwives continue to face systemic barriers, including lack of recognition of their governance systems, dismissal of their knowledge, and criminalisation of their practices in some regions. The IDH Framework has gained international recognition and practical application. It is now embedded in global health and biodiversity policies, with tools available to support its implementation. Institutions and governments are increasingly urged to adopt its principles to address Indigenous health disparities.