Decolonising Global Health: a scoping review

Though much has been written about the importance of decolonising global health, there is a lack of consensus around how it should be defined, conceptualised and actioned, and who has responsibility to do so. In accordance with PRISMA guidelines, we undertook a scoping review of the decolonising global health literature to explore the meaning of decolonising global health, to identify examples of best practice, and to find out how those writing about the issue see the future of the movement. We searched databases for peer-reviewed and grey literature with titles and abstracts, and then full texts double-screened by authors to identify papers for inclusion. Our search strategy focussed on opinions and discourse using terms broadly linked to decolonising global health. Papers published in either the peer reviewed and grey literature were eligible for inclusion. Data, including conclusions and recommendations, were extracted and results presented as a narrative synthesis of included papers to provide a contemporary account of the decolonising global health agenda. Included papers (n=129) were predominantly commentary or opinion pieces (n=95). Authors of the included papers were affiliated with institutions predominantly from high income countries including the USA (n=53) and UK (n=30). Included papers presented a broad range of definitions for decolonising global health, describe the historical, colonial influence on global health, explore power imbalances in current global health structures, and make a number of suggestions as to how to address these imbalances. Despite the clear imperative in the literature to take action, there is no clear consensus on where to start. Drawing from the findings of our review, we conclude with a set of recommended approaches and next steps for decolonising global health, focussing on epistemic injustice, partnership working, the structure of global health, and individual duty.