Commissioning stronger evaluations of Indigenous health and wellbeing programs: A scoping review of government and non-government Indigenous evaluation commissioning practices

Purpose: Calls for evidence-based Indigenous health and wellbeing policy and practice development have increased over the last few decades. Funded evaluations of health and wellbeing programs provide a vital contribution to generating the evidence required to support these aims. The utility of program evaluations in contributing to this evidence base is often adversely affected by the processes surrounding their commissioning. Despite the importance of commissioning processes to the efficacy of Indigenous health and wellbeing evaluations, to date there are no developed models to support and guide good practice.

Methods: This scoping review systematically searched literature from Australia, Canada, Aotearoa New Zealand and the USA to identify government and non-government agencies commissioning practices of Indigenous health and wellbeing program evaluations. Through this review, commissioning practices were characterised according to Indigenous good practice principles, and gaps in current knowledge in these practices were identified.

Main findings: This review identified three key themes in commissioning practice: power, cultural safety and reciprocity. Through consideration of these principles, five models of current commissioning practice were defined: Indigenous-led, delegatory, co-design, participatory, and top down. The models represent a spectrum of Indigenous engagement, involvement and decision-making in the commissioning process, with Indigenous-led, delegatory and co-design being considered as good practice models, with higher levels of self-determination, power, respect, reciprocity and cultural safety.

Principal conclusions: The defining of good practice models of evaluation commissioning provides a vital starting point to assist commissioners, evaluators and service providers in undertaking Indigenous health and wellbeing evaluations that both benefit Indigenous communities and provide much needed evidence to inform policy and commissioning practices. The defining of these models allows for further research into their practical application and opens possibilities for the development of guidelines to support better commissioning practice.