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 Tue, 21 Apr 26 11:57:05 +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/10304 https://www.rrh.org.au/journal/article/10304 Education, exercise prescription, targeted rehabilitation, and addressing risk factors form the cornerstone of prevention and treatment of many musculoskeletal and lifestyle-related health conditions. Although in-person health care at established facilities remains the gold standard of management, alternative options should be considered to assist with the prevention and treatment of musculoskeletal and lifestyle-related health conditions in rural communities in low- and middle-income countries (LMICs). This Scoping Review identifies and describes the use of digital and/or community-based health interventions for exercise and education in the management of musculoskeletal and/or lifestyle-related health conditions in rural communities in LMICs and explores the impact, feasibility, barriers, and facilitators of these interventions. Thu, 16 Apr 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10305 https://www.rrh.org.au/journal/article/10305 In rural and remote Australia, children and their families face many barriers to accessing dental care, contributing to poorer oral health-related quality of life and higher caries risk than those in metropolitan areas. This Systematic Review applies an ecological model to identify these barriers at system, policy, community and individual levels for rural and remote Australian children. The authors propose evidence-based solutions tailored to the unique challenges of these communities. Wed, 15 Apr 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10044 https://www.rrh.org.au/journal/article/10044 Effective management of open fractures focuses on restoring function, preventing complications and minimising long-term disability. This Original Research study evaluates and compares metropolitan primary presentations with rural and remote secondary presentations in the management of patients with open-fracture injuries in Western Australia, and identifies areas for improvement in the trauma care pathway, particularly for patients requiring aeromedical retrieval. Tue, 14 Apr 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10544 https://www.rrh.org.au/journal/article/10544 In Brazil, only 37% of people with type 2 diabetes are receiving treatment and, among this group, only 23% achieve adequate disease control. Therefore, lifestyle modifications (including regular physical activity and adopting a balanced diet) are an essential strategy in combating the type 2 diabetes epidemic. This Original Research study examines the barriers and facilitators to physical activity adherence in a vulnerable population with type 2 diabetes in the Brazilian Amazon setting. Mon, 13 Apr 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10468 https://www.rrh.org.au/journal/article/10468 Indigenous communities and isolated rural populations face a range of health challenges shaped by longstanding social, environmental, and structural conditions. Both groups experience a considerable burden of chronic diseases, infectious illnesses, undernutrition, and mental health conditions. Additionally, the continuing effects of colonisation, land dispossession, cultural disruption, and experiences of discrimination within health systems contribute to longstanding inequities in health and wellbeing for Indigenous peoples. These combined circumstances have important implications for maternal health. This Systematic Review evaluates the current evidence on the economic effectiveness of maternal healthcare services and offers recommendations for future research and policy development in maternal health services tailored to these communities. Fri, 10 Apr 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10433 https://www.rrh.org.au/journal/article/10433 Although cervical cancer is largely preventable and curable if detected early, in Nigeria, most cases present at advanced stages and nearly half of women diagnosed with cervical cancer are likely to die within 3 years. While inadequate access to appropriate treatment facilities plays a role, late presentation has also been consistently linked to misconceptions, poor awareness, negative attitudes towards preventive practices, and suboptimal utilization of available screening and treatment options. This Original Research study assesses cervical cancer knowledge, attitudes and screening uptake among rural women in North Central Nigeria. Tue, 07 Apr 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9311 https://www.rrh.org.au/journal/article/9311 Narratives on the experiences of the COVID-19 pandemic from African Indigenous communities are inadequately represented in the literature, even though historic and structural inequities create vulnerabilities that are best understood by the communities that live and exist within these contexts. This Original Research article explores the pandemic experiences of the Indigenous Xhosa people of Thamarha, in the Eastern Cape Province of South Africa: how they understand health and wellbeing and what actions they took to protect their health and wellbeing in the face of the pandemic. Tue, 07 Apr 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9844 https://www.rrh.org.au/journal/article/9844 The probability that healthcare workers choose to practice in rural areas is increased by multiple factors, including having a rural background and having sufficient exposure to rural practice during healthcare training. Given the importance of rural background, encouraging rural young people to consider a career in health care seems like a natural strategy to increase the number of rural healthcare workers. However, rural young people often face barriers to entering healthcare fields, including distances to access schooling, having few personal connections to healthcare 'role models', and a lack of confidence in their ability to succeed in the profession. This Original Research study examines the effectiveness of an Alberta-based program that promotes rural healthcare careers in rural areas to local students in grade 8 (aged approximately 14 years). Thu, 02 Apr 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9712 https://www.rrh.org.au/journal/article/9712 In Aotearoa New Zealand, rural communities experience poorer health outcomes than urban populations, partly due to shortages of rural health professionals. Since students from rural backgrounds are more likely to return to rural areas after graduating, clear pathways that include 'rural' New Zealand are essential for growing the rural health workforce. However, inconsistent definitions of 'rural' can limit access to education for rural and Indigenous students and contribute to workforce inequities. This Original Research study created a framework to identify the most appropriate definitions of rurality in New Zealand, aiming to improve the rural admissions scheme at the University of Auckland and strengthen rural health workforce development. Thu, 26 Mar 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9622 https://www.rrh.org.au/journal/article/9622 Children who live in rural Australia experience poorer health, development and education outcomes than those living in metropolitan areas. Recognition of the key role that schools can play in supporting children's health and wellbeing has led to the implementation of school-integrated healthcare models, including the School-Based Primary Health Care Service (SB-PHCS), a nurse-led model of care developed in Far West New South Wales. This Original Research study reviews the electronic medical records of primary school clients of the SB-PHCS and describes the use of assessment, treatment and therapy services of clients who received primary health care registered nurse support to access other healthcare services. Thu, 26 Mar 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10621 https://www.rrh.org.au/journal/article/10621 In many rural communities, the scarcity of healthcare professionals, geographic isolation, transportation challenges, and limited access to specialty care means that the work of family and informal caregivers, including relatives, friends, and community members who provide unpaid support, is indispensable. Yet, despite the growing recognition of caregivers' essential role in rural care, evidence on what families and informal caregivers do, how they interact with rural providers and systems, and where specific supports and policy interventions are most needed remains fragmented. This Scoping Review systematically maps the roles, activities, facilitators, barriers, and outcomes associated with family and informal caregivers in rural health delivery across diverse clinical contexts and geographic regions. Tue, 24 Mar 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9913 https://www.rrh.org.au/journal/article/9913 Rural and remote regions across Australia continue to experience chronic shortages in medical workforce capacity. Although various government programs and university-led initiatives have attempted to address this issue, long-term rural retention of medical graduates remains an unresolved challenge. This Commentary draws on national experience and emerging models to reflect on opportunities for improving the retention of medical graduates in rural practice. Mon, 23 Mar 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9911 https://www.rrh.org.au/journal/article/9911 Delivering health care in remote emergency contexts is inherently complex and demands timely, effective, and well-coordinated responses to ensure access to appropriate care. In such settings, healthcare professionals' perceptions of context-specific risks and operational challenges are critical to preventing adverse events and ensuring patient safety. They must be prepared to navigate unpredictable scenarios and take proactive measures to safeguard both patient outcomes and their own wellbeing. This Scoping Review identifies risks, and reports on management and mitigation of risks, to patients, themselves and service delivery among healthcare professionals in remote emergency care. Tue, 17 Mar 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10672 https://www.rrh.org.au/journal/article/10672 Pesticide exposure has been associated with a broad range of adverse health outcomes, including malignant, neurodegenerative, reproductive, developmental, respiratory, and metabolic diseases. Targeted strategies to mitigate pesticide exposure, particularly among frontline users such as farmers, therefore remain a public health priority. Several studies have demonstrated that the recommendations provided by pesticide sellers directly influence farmers' decisions regarding product selection, application methods, and safety practices. This Original Research study assesses occupational health and safety awareness among pesticide retailers in Mersin Province, Türkiye, and examines factors associated with their provision of safety information to buyers during pesticide sales. Mon, 16 Mar 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9583 https://www.rrh.org.au/journal/article/9583 Like other countries, Aotearoa New Zealand struggles to train and retain sufficient numbers of GPs. Compounding this, structural inequities affect healthcare access for Māori, other Pacific Islander Peoples and those in rural and socioeconomically deprived communities. While national health strategies acknowledge these disparities, tertiary training remains urban-centric, hospital-based, and misaligned with the healthcare needs of many communities. This Short Communication describes a proposed new graduate-entry, 4-year medical program in Aotearoa New Zealand that emphasises rural and provincial community-based training. The authors argue that this model is both urgently needed and potentially generalisable to other nations grappling with similar workforce inequities.   Tue, 10 Mar 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9264 https://www.rrh.org.au/journal/article/9264 The provision of eye health care in regional Australia is challenging due to a longstanding medical workforce shortage in regional communities. The Goldfields region of Western Australia does not have a resident ophthalmologist and is serviced by visiting outreach clinics. Lions Outback Vision provides specialist ophthalmology services throughout regional WA by a mobile Vision Van, a permanent tertiary eye clinic in Broome (in the Kimberley region) and scheduled outreach and telehealth, with no out-of-pocket costs for patients. This Project Report describes the trends in the provision of specialist eye care in the Goldfields region for three common causes of vision loss: cataracts, diabetic retinopathy, and neovascular age-related macular degeneration. Fri, 06 Mar 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9883 https://www.rrh.org.au/journal/article/9883 Motor skill development through physical play is an essential part of child development. Motor skill impairment poses significant functional, social and educational challenges. While advances in interventions for children with motor skills challenges are encouraging, there has been little research about effective interventions for children in low-resource and rural settings. This Original Research article reports on the feasibility of implementing the Hopscotch program, an intervention delivered by teachers with the support and guidance of motor skill experts, as a small-scale pilot study in a rural area in South Africa.  Wed, 04 Mar 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9519 https://www.rrh.org.au/journal/article/9519 Despite the success of many harm-reduction programs for people who inject drugs, they are not always designed to meet the diverse needs of Aboriginal and Torres Strait Islander Peoples. The 'Enhancing harm reduction services (BBV and STI) for Aboriginal and Torres Strait Islander people who inject drugs through improved engagement' project worked in partnership with local stakeholders and Aboriginal and Torres Strait Islander people with lived and living experience of injecting drug use to identify culturally safe approaches and local priorities. Using the CONSIDER statement as a reflexive tool, this Project Report critically assesses the project's research partnerships and processes. Tue, 03 Mar 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10113 https://www.rrh.org.au/journal/article/10113 Introducing the National Health Insurance Act in 1963 in South Korea substantially improved healthcare access and costs and has contributed to reduced mortality and morbidity. However, evaluations of health equity among rural-urban populations remains an underexplored area. Using 7 years of data, this Original Research study compares health status, health services accessibility, household finances, and financial burdens (including catastrophic health expenditure) between urban and rural individuals with end-stage kidney disease (ESKD), one of the most costly chronic conditions. Mon, 02 Mar 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10258 https://www.rrh.org.au/journal/article/10258 LGBTQ individuals face higher risk for adverse health conditions compared with their cisgender and heterosexual peers as a result of sexual and/or gender minority stress and insufficient social safety, including state-level and interpersonal-level discrimination, internalized stigma, and community disconnection. A large proportion of the LGBTQ population resides in rural areas but the rural LGBTQ population is often overlooked in health research and program initiatives. This Scoping Review maps population, methodological, content, and publishing characteristics of rural LGBTQ health research published since 2000. Identifying trends and gaps in rural LGBTQ health research could guide future research, program, and funding directions for this overlooked yet highly intersectional population. Fri, 20 Feb 26 00:00:00 +0000