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

BACKGROUND: Decolonising global health requires rethinking how evidence is generated, valued and applied to address colonial legacies and power imbalances in systems, practices and research. METHODS: This analysis draws on findings from a scoping review and synthesises existing literature to examine how decolonisation principles can be integrated into implementation science. RESULTS: 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. CONCLUSION: 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.