How the Indigenous Determinants of Health Framework Is Reshaping Global Policy

The Indigenous Determinants of Health (IDH) Framework was first introduced in 2023. It aimed to bridge the gap between recognising Indigenous leadership and understanding the deep connections between health, environment, and cultural systems. The framework quickly gained international attention for its innovative approach to health assessment. In 2023, the framework was unveiled to address long-standing gaps in health policy. It reframed health beyond traditional indicators, establishing Indigeneity as a key determinant with 33 specific risk and protective factors affecting Indigenous Peoples’ well-being. The following year, the 2024 study expanded its foundation, offering structural and operational guidance for real-world application in policy and practice.

The UN Permanent Forum on Indigenous Issues repeatedly endorsed the framework. In 2023, 2024, and 2025, it urged member states and UN agencies to adopt the IDH Framework. Meanwhile, the UN Convention on Biological Diversity incorporated the framework into its 2024 Global Plan of Action on Biodiversity and Health through Decision 16/19.

By 2025, the framework’s influence grew further. The WHO Report on the Social Determinants of Health Equity officially recognised Indigeneity as a determinant of health. That same year, the IDH Evaluation Instrument was introduced to assess institutions’ efforts in addressing Indigenous health risks, protective factors, and rights. The 2026 study later demonstrated how Indigenous health serves as a systems integrator, reflecting the integrity of policies across multiple sectors. The IDH Framework has reshaped how health is understood and addressed for Indigenous communities. It highlights the importance of recognising and supporting autonomous, rights-based systems of care, such as Indigenous midwifery. Official endorsements from global bodies have cemented its role in future health and environmental policies.