some of these policies are paternalistic or integrationist and are based on policies of assimilation or integration that seek to resolve the problem of indigenous peoples in integrationist models the concept of health is defined from the top down privileging a biomedical paradigm over indigenous health models and indigenous cultures are treated as interesting folkloric elements without true value for health promotion similarly culturalistic approaches recognize cultural pluralism as intrinsically valuable but prioritize the didactic linguistic or folkloric aspects without delving into questions of participation or power in this approach there are minimal consultations conducted with indigenous peoples and projects programmes and policies are designed by actors external to indigenous communities who treat indigenous peoples as a target population there may be translation of educational materials into several languages for example but without a critical examination of the pedagogical or cultural implications