Culturally responsive health initiatives for Māori and Pacific communities in Australia: A systematic review

OBJECTIVE: To synthesise evidence on culturally responsive health initiatives for Māori and Pacific communities living in Australia and examine how these initiatives contribute to improved health outcomes and health-equity. METHODS: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Peer-reviewed and grey literature published between 2001 and 2025 were searched across six databases. Studies were included if they described culturally responsive, community-led or Indigenous-informed health initiatives involving Māori and/or Pacific peoples in Australia. Data were analysed using a culturally grounded framework informed by decolonising research principles. RESULTS: Seventeen studies met the inclusion criteria. Four inter-related themes were identified: (1) power-sharing through community-led governance; (2) culturally safe dialogue grounded in relational practice; (3) the use of Māori and Pacific frameworks; and (4) partnerships shaped by differentiated funding models. Most initiatives demonstrated strong cultural process outcomes, while fewer reported sustained clinical outcomes. CONCLUSIONS: Culturally responsive health initiatives for Māori and Pacific communities in Australia are most effective when grounded in relational practice, Māori and Pacific leadership and explicit power-sharing arrangements. IMPLICATIONS FOR PUBLIC HEALTH: Health systems must move beyond cultural participation towards sustained cultural authority, fit-for-purpose funding and evaluation approaches that capture equity-relevant processes.