https://www.rrh.org.au Rural and Remote Health is an open-access international academic journal serving rural and remote communities and publishing articles by rural health practitioners, educators, researchers and policy makers. en-gb Wed, 21 Oct 26 04:53:33 +0000 Papir Journal Platform melissa.storey@rrh.org.au (Melissa Storey) webmaster@commonline.com.au (Webmaster) https://www.rrh.org.au/images/rrh_og_branding.jpg https://www.rrh.org.au https://www.rrh.org.au/journal/article/11012 https://www.rrh.org.au/journal/article/11012 Approximately 70% of Kenya's population resides in rural areas, where shortages of health personnel are severe. Rural healthcare workers face high workloads, stock-outs of essential medications, and inadequate infrastructure, and compromised wellbeing among healthcare workers further threatens service delivery and the continuity of care. This Original Research study explores the relationships among happiness, health status, and motivation for healthcare workers in rural Kenya. Wed, 21 Oct 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10851 https://www.rrh.org.au/journal/article/10851 Open defecation is common in areas where sanitation infrastructure remains a critical public health challenge in Sub-Saharan Africa. In Nigeria, despite national commitments to achieve open defecation-free status by 2030, progress remains slow, particularly in rural areas. This Original Research study explicitly examines the knowledge-practice gap in hygiene and defecation behaviours, household economic decision-making regarding sanitation investments, child faeces management practices, and environmental factors affecting latrine feasibility. Tue, 20 Oct 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10001 https://www.rrh.org.au/journal/article/10001 Although rural populations account for nearly half the world's population, many rural communities continue to face substantial barriers to accessing quality health care, largely due to shortages and maldistribution of qualified health professionals. One strategy that countries have invested in to improve the attraction and retention of qualified physicians in rural areas is exposure to rural practice during medical training. This Scoping Review identifies and synthesizes the literature on the educational, professional, and service-related effects of rural medical internships undertaken during undergraduate medical education, including their reported contribution to healthcare delivery in rural communities. Sun, 18 Oct 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10729 https://www.rrh.org.au/journal/article/10729 In Japan, health care and education are considered basic rights to which all individuals should have equitable access. However, while even small rural towns usually have schools and teachers, many rural areas have a shortage of physicians, resulting in substantial regional disparities in access to health care. This Original Research study examines the distribution of physicians and teachers in Japan and explores what this can tell us about providing essential services more equitably. Thu, 15 Oct 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/12098 https://www.rrh.org.au/journal/article/12098 RETRACTION NOTICE for 'Socioeconomic and lifestyle factors influencing non-communicable disease prevalence among rural Jamaican adults: a population-based study' Tue, 13 Oct 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10829 https://www.rrh.org.au/journal/article/10829 Because uncertainty is an unavoidable feature of rural and remote health planning, planners are frequently required to make infrastructure and service decisions based on partial information, proxy indicators or qualitative judgement rather than on comprehensive empirical evidence. To manage uncertainty, health planning reports commonly include sensitivity analyses, which may provide reassurance without fully clarifying the conditions that determine the preferred option. This Commentary argues that reporting reversal thresholds - the values at which a planning conclusion would no longer hold - offers a simple but powerful complement to existing practice. By making these thresholds explicit, analysts can improve the transparency, credibility and usefulness of planning analyses in remote settings. Mon, 12 Oct 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10203 https://www.rrh.org.au/journal/article/10203 Many rural Australian communities are facing ongoing critical health workforce shortages, exacerbating already low rates of healthcare access compared with metropolitan areas. Future shortages appear likely because many Australian healthcare workers intend to retire early due to burnout, psychological distress, long working hours, budget cuts, or workforce retention issues. Little is known about the latent capacity of healthcare workers already living in rural communities who are unemployed, working casually or part-time, or otherwise not participating in the workforce to the extent they may be willing or able to sustain. This Original Research study investigates the barriers and enablers to increasing the participation, recruitment, and retention of underemployed rural healthcare workers in Australia. Fri, 09 Oct 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10139 https://www.rrh.org.au/journal/article/10139 Globally, the needs of children with developmental disabilities have often been overlooked in health systems planning and policy provision. Parents and families of children with developmental disabilities navigate extremely complex health, education, and social systems to secure a safe and supportive environment for their children. In  Kenya, caregivers face barriers including long distances to healthcare facilities, perceived discrimination, lack of physiotherapist services, and inadequate scheduling of appointments, and all of these barriers are intensified for families in rural and remote areas. This Original Research article examines how primary caregivers of children with developmental disabilities navigate healthcare systems in rural Kenya. Thu, 08 Oct 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10907 https://www.rrh.org.au/journal/article/10907 Canada is facing a primary care crisis, with rural areas being disproportionately affected by physician shortages. Internationally trained physicians (ITPs) have become essential to addressing rural workforce shortages and constitute more than 80% of rural physicians in Saskatchewan. Given their central role in rural healthcare delivery, understanding ITPs' perceptions of workload sustainability is essential for informing workforce planning, physician wellbeing, and long-term rural retention. The Saskatchewan International Physician Practice Assessment (SIPPA) program offers a unique opportunity to explore ITP experiences. This Original Research study explores how specific workload demands influence self-reported sustainability among SIPPA-participating ITPs. Wed, 07 Oct 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10969 https://www.rrh.org.au/journal/article/10969 Type 2 diabetes is a key modifiable risk factor for cardiovascular disease, and the best outcomes are achieved with early diagnosis and management to prevent health complications. However, managing diabetes in remote areas is challenging. The six main communities in the Yolηu region of East Arnhem are, on average, 627 km from the nearest laboratory, making access to pathology results and follow-up of patients logistically challenging. The implementation of portable haemoglobin A1c point-of-care testing (POCT) in outreach, family-based services can reduce barriers related to transportation, waiting times and administrative procedures. This Short Communication reports on agreement analysis between a portable HbA1c POCT system and routine laboratory HbA1c testing in a very remote North East Arnhem Land community, Australia. Mon, 05 Oct 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10149 https://www.rrh.org.au/journal/article/10149 Although much has been written about how students develop professionalism and professional identity, less is known about the role and perspectives of clinical supervisors, the relationships that connect or disconnect them from the communities and cultures in which they work, and how these contexts influence students as they develop professionally. This qualitative Original Research study, undertaken in the Northern Territory, Australia, reports on the key challenges and benefits of clinical placements in unique settings, and factors that impact student development and professional identity. Fri, 18 Sep 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10701 https://www.rrh.org.au/journal/article/10701 Climate change is recognized as one of the most complex and persistent challenges for global public health, and drought, an extreme weather event that is increasing in frequency as a result of climate change, is one of the most geographically widespread natural hazards worldwide. Evidence remains limited on how rural communities experience the health consequences of prolonged drought and how they perceive the role of health care in responding to this crisis. Chile has experienced several major droughts, including a megadrought that has persisted in central Chile since 2010. This Original Research article describes the perceived consequences of drought and examines the role of health care from the perspectives of members of two rural communities in Chile. Mon, 14 Sep 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10850 https://www.rrh.org.au/journal/article/10850 Globally, more than 1.3 billion people experience significant disability, with the highest unmet rehabilitation needs found in rural and resource-constrained settings. In South Africa, disability prevalence remains underestimated, particularly in rural areas where under-reporting, limited access to services, and social stigma persist. This Rural Health History article examines the historical evolution of disability and rehabilitation in rural South Africa through a qualitative document review of archival materials, exploring policy development, service evolution, and system-level change over time. Mon, 07 Sep 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10648 https://www.rrh.org.au/journal/article/10648 In South Africa, individuals commonly seek care across both Indigenous and formal healthcare systems, reflecting a pluralistic approach to health-seeking, particularly in rural areas where access to formal medical services is limited. Many people with surgical conditions are reluctant to seek care in the formal sector due to barriers such as cost, transportation, language, and lack of trust. Since Indigenous knowledge healers are trusted members of the community, they could play a role in improving surgical care. This Original Research study identifies community-prioritized surgical conditions and explores Indigenous and formal health stakeholder buy-in to collaborative approaches to care. Fri, 04 Sep 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9949 https://www.rrh.org.au/journal/article/9949 Engaging consumers in research prioritisation ensures that emerging research questions remain grounded in real-world experience and are perceived as relevant to policy and practice. However, people from rural areas have often been left out of consumer and community involvement initiatives in health research. This Original Research study identifies consumer priorities for rural health research in Australia and describes the process and learnings of a novel approach to promoting involvement of rural consumers in health research. Tue, 01 Sep 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10911 https://www.rrh.org.au/journal/article/10911 Climate change is recognized as an increasing threat to health, particularly in rural communities. This Original Research article reports on the analysis of a provider survey distributed in the northwest United States designed to identify health care provider attitudes on climate change and integration of these beliefs in patient care. Although the majority agreed climate change poses a risk to community health and indicated they had observed associated adverse outcomes in their community, less than one-third felt comfortable counseling their patients on climate change related health impacts Fri, 28 Aug 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9970 https://www.rrh.org.au/journal/article/9970 Healthcare professionals practising in remote, rural, and island practices encounter significantly more clinical, professional, and social challenges than their urban counterparts, including limited access to continuing professional development and specialised training and increased professional isolation. Hybrid training, using both synchronous (face-to-face) and asynchronous (web-based) modalities for learning, has been identified as a potential solution. The Short Communication explores how hybrid training can promote changes in healthcare practices in remote, rural, and island settings in two programs in different geographic areas: the Pre-Hospital Emergency Care (PHEC) Program in Scotland and the Tele-Ed Program in Georgia, US. Tue, 25 Aug 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9978 https://www.rrh.org.au/journal/article/9978 Colorectal cancer is the third-most common cancer diagnosis and the second-most common cause of cancer death worldwide. As access to cancer investigations like colonoscopies are a significant barrier identified by rural primary healthcare providers, novel approaches like colon capsule endoscopy (CCE) - in which a camera is digested and travels through the gut transmitting images to a data recorder for review and diagnosis before elimination - are required to meet the needs of rural and remote populations. This Original Research study examines the experiences and perspectives of staff involved in an innovative CCE service in Scotland. Fri, 21 Aug 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10491 https://www.rrh.org.au/journal/article/10491 In Germany, the shortage of rural GPs and the aging population, with older people requiring increasing amounts of medical care, is creating considerable strain on the healthcare system. In addition, the average age of GPs in Germany is climbing steadily. To encourage young doctors into general practice, especially in rural areas, GPs in the rural region of the Bavarian Forest launched the 'Excellent Project', which provides medical students with a structured internship program in a rural general practice, combining intensive one-on-one supervision by experienced GPs with an accompanying teaching program. This Original Research study investigates the impact of The Excellent Project. Sun, 16 Aug 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10695 https://www.rrh.org.au/journal/article/10695 Cognitive impairment is linked with poor sleep health (eg sleep duration, sleep efficiency, daytime sleepiness) and is more prevalent in rural areas. However, despite independent associations of rurality and sleep with cognitive function in aging adults, their interactive association is unclear. This Original Research study examines whether rurality (non-rural v rural) moderates the associations between self-reported sleep and cognition (including working memory, executive functioning, spatial attentional orienting, and processing speed) in aging adults in the US. Wed, 12 Aug 26 00:00:00 +0000