The dichotomy of commissioning Indigenous health and wellbeing program evaluations: What the funder wants vs what the community needs

There are multiple systemic structural barriers that result in health and wellbeing inequities experienced by Aboriginal and Torres Strait Islander peoples (hereafter referred to as Indigenous). The recent Overcoming Indigenous Disadvantage 2020 report highlights some of these barriers, emphasising the importance of addressing the social determinants and cultural determinants of health by delivering evidence-based and culturally responsive health programs and initiatives.1 While is it estimated that $5.9 billion (AUS) is spent annually on Indigenous health programs and services in Australia, there is scant evidence to illustrate what works (or does not work), for who and why.2, 3 A mapping exercise of Indigenous-specific programs in Australia reported that of 1082 programs delivered, over 90% were not evaluated to assess whether programs achieved their goals and objectives.3 Also, it is reported that only a few evaluations used culturally appropriate methods for assessing program effectiveness.3 Recently, there have been a growing number of robust evaluations that are culturally responsive, from which we can learn. These have important implications that can guide the commissioning of future evaluations.