Reclaiming Our Own Measures Pt 1: Indigenous Health Evaluation on Our Terms

Health evaluation has long been framed by Western scientific methods and priorities. However, for Indigenous Peoples, evaluation is not new. It has always been part of how we live, make decisions, and sustain wellbeing. What’s needed now is not simply more evaluation, but better evaluation: work that reflects our knowledge systems, honours our protocols, and is done with, by, and for Indigenous communities.

Indigenous evaluators are reclaiming the space of health evaluation and reasserting its rightful purpose: to support thriving Indigenous families, strengthen self-determination, and uphold collective wellbeing. This shift is grounded in protocols, bundles, and principles created by Indigenous communities, for Indigenous priorities.

Take, for example, the Three Ribbons consensus process in Ontario, Canada. Elders, Indigenous health leaders, and evaluators came together to develop a set of emergent principles for Indigenous health service evaluation, including concepts like minobimaatisiiwin (the good life), relational accountability, collective benefit, and the use of 'wise' (rather than 'best') practices that reflect lived experience and Indigenous logic.

In Manitoba, the “Gathering a Bundle” guide reframes evaluation not as a linear, external measurement tool but as a personal and communal process of reflection, ceremony, and storytelling. This work critiques how dominant evaluation methods “fail to measure what is meaningful” (p.5) and advocates for indigenising evaluation by privileging Indigenous languages, ethics, and ways of knowing.

The Indigenous Evaluation 101 Guidebook from Minnesota extends this further by offering practical strategies to funders and evaluators, from building good relations agreements and securing Tribal IRB approval, to adopting culturally grounded logic models and community-led methods such as talking circles. Crucially, it insists that Indigenous values shape the evaluation from start to finish, not just as a token add-on.

These approaches are not merely aspirational, they are already being used successfully in Indigenous health initiative evaluations. For example, the Aloha Framework, developed in Hawaiʻi, integrates Indigenous values of aloha, kuleana, and pono to centre cultural integrity and community wellbeing in health evaluation design. Likewise, Indigenous wellness indicator projects with First Nations communities emphasize cultural identity, intergenerational strength, and land-based wellness over narrow metrics like hospital readmission rates

What do these examples have in common? They are driven by Indigenous people. They reflect a commitment to sovereignty over data, stories, and outcomes. They challenge the field to move beyond cultural adaptation toward Indigenous self-determination in evaluation.

This commitment is also captured in the Wolastoq Declaration on Indigenous Evaluation, endorsed at the 2023 Global Gathering of Indigenous Evaluators. The declaration affirms Indigenous evaluation as a sovereign practice rooted in ancestral knowledge, collective accountability, and the sacred duty to future generations. It challenges funders, institutions, and states to recognise Indigenous Peoples as the rightful authorities over the evaluation of their own lives, lands, and futures.

For funders and commissioners, this means rethinking what counts as credible evidence, resourcing Indigenous evaluators, and ceding control to Indigenous governance processes. It also means understanding that good evaluation is not just a technical task: it is a relational, ethical, and political act.

If you’re funding an evaluation of an Indigenous health initiative, inquire about the outcomes but also ask “whose knowledge guides the evaluation and who does it serve?”