This project has two objectives: i) to develop a conceptual framework in improving climate-resilient health among Indigenous communities and ii) to identify transformative pathways in safely adopting climate-resilient health systems for Indigenous communities. To achieve the first objective, a systematic review of 137 articles was conducted. The second objective was carried out through key informant interviews with Indigenous Peoples Observatory Network partners. Data analysis was performed using manual coding and NVivo software. The resulting framework and transformative pathways will significantly contribute to Indigenous health governance by guiding researchers, policymakers, and health workers to develop Indigenous inclusive health systems.