Decolonising global health through implementation science: defining the path to equity and structural transformation.

Abstract

Decolonising global health requires rethinking how evidence is generated, valued and applied to address colonial legacies and power imbalances in systems, practices and research. This analysis draws on findings from a scoping review and synthesises existing literature to examine how decolonisation principles can be integrated into implementation science. We propose three conceptual shifts: (1) Embedding contextually and locally driven intervention approaches, (2) Centring participatory, equity-focused methodologies that redistribute authority and (3) Expanding metrics to capture power, authorship equity, adaptability and legitimacy. These shifts reposition implementation science as a transformative practice supporting structural change. Operationalising these shifts through policy-aligned, locally led research, equitable mentorship and technologies co-designed with communities provides a practical framework for researchers, funders and policymakers to embed decolonisation into implementation science, ensuring interventions are contextually relevant, equitable and socially just.