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, 30 Jun 26 14:33:14 +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/10380 https://www.rrh.org.au/journal/article/10380 Non-communicable diseases (NCDs) are the leading causes of morbidity and premature mortality in Jamaica. NCD risk in the Caribbean is shaped by the interaction of socioeconomic constraints, environmental exposures, and health system limitations, some of which disproportionately affect rural residents, who face barriers to healthcare access that include limited diagnostic infrastructure and fragmented continuity of care. This Original Research study examined the prevalence and determinants of hypertension, diabetes, and obesity among rural adults in Jamaica using data from the Jamaica Health and Lifestyle Survey III. Mon, 29 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10085 https://www.rrh.org.au/journal/article/10085 Rural Australians continue to experience significant mental health challenges, including higher suicide rates and poorer mental health outcomes, compared with their urban counterparts. Accessibility barriers, specifically relating to service availability, have been well documented in rural areas, but further research is required to better understand the unique internal barriers - such as high rates of stigma, lower mental health literacy, and stoicism - faced by rural people across Australia. This Original Research study investigates the differences between rural and urban populations in internal barriers to help seeking and mental health outcomes, and identifies the unique challenges of rural mental health. Sat, 27 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10095 https://www.rrh.org.au/journal/article/10095 Nearly 21,000 deaths and 7.6% of the Australian disease and injury burden are attributable to tobacco use each year, with harms disproportionately impacting groups experiencing disadvantage and marginalisation. In Australia and globally, tobacco retailers are disproportionately concentrated in areas with greater disadvantage, and high tobacco retailer density is associated with higher smoking prevalence and lower smoking cessation success. This Original Research study maps the locations of tobacco retail licences in the Northern Territory, which has the highest smoking prevalence in Australia, and investigates associations between tobacco retailers, area remoteness and area-level socio-economic status. Thu, 25 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10301 https://www.rrh.org.au/journal/article/10301 Traditional healthcare delivery models have proven inadequate in addressing the multifaceted challenges faced by rural communities (geographical isolation, inadequate health infrastructure, and a shortage of qualified healthcare professionals), necessitating innovative approaches that leverage technological advancements. The emergence of telehealth and artificial intelligence (AI) presents unprecedented opportunities to revolutionize healthcare delivery in underserved rural communities, but the integration of these technologies introduces complex legal, ethical, and regulatory considerations that must be carefully addressed. This Review provides novel insights by synthesizing multidisciplinary perspectives on technology integration, regulatory requirements, and implementation strategies across diverse global contexts. Wed, 24 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9926 https://www.rrh.org.au/journal/article/9926 In Australia, as globally, rural regions consistently struggle with severe health workforce shortages, exposing rural health professionals to the risk of professional isolation, increased stress and burnout. In addition, they have reduced access to continuing professional development, which is crucial for health professionals because it helps maintain and enhance professional knowledge, expertise and competence, and serves as an essential pathway to develop required personal and professional qualities. This Original Research study investigates rural health professionals' usage patterns and experiences with a digital support platform that offers news, resources, discussions, jobs and training. Mon, 22 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9893 https://www.rrh.org.au/journal/article/9893 Substantial international evidence supports the role of the arts in promoting health and wellbeing. This Original Research article reports on the health, behavioural and economic outcomes associated with participation in the Pinnaroo Project, which aimed to improve the health and wellbeing of Pinnaroo, South Australia, residents through sustained, community-led engagement in a diverse range of arts and creative activities. Fri, 19 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10046 https://www.rrh.org.au/journal/article/10046 Breastfeeding has significant public health benefits for mothers and infants, and one of the determinants of successful breastfeeding to the recommended 2 years and beyond is support. The initial crucial period for breastfeeding support is the first 2 weeks but access to services can be limited in rural and remote settings. Evidence suggests that providing breastfeeding education and support by telehealth can increase exclusive breastfeeding and extend breastfeeding duration. This Original Research study investigates consumer and clinician perspectives of using telehealth to access or provide perinatal education and/or clinical service delivery in rural Western Australia.  Wed, 10 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10393 https://www.rrh.org.au/journal/article/10393 For decades, medical schools have debated appropriate ways to select the future workforce. Empirical research and reviews on selection of medical students mostly originate from high-income countries, which might not lead to training the health workforce to meet the needs and priorities of communities in low- and middle-income countries (LMICs). This Review explores approaches that medical schools in LMICs in the Asia-Pacific region could utilize in their selection strategies. Mon, 08 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/11298 https://www.rrh.org.au/journal/article/11298 This Letter to the Editor calls for more research into the factors that improve cervical screening uptake among rural women in low-resource settings. Fri, 05 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10792 https://www.rrh.org.au/journal/article/10792 The low recruitment and retention of doctors in rural areas is a significant barrier to achieving equitable health services globally. Various cross-country studies have shown that long-term clinical placements in rural areas through decentralised clinical training (DCT) - in which the location and model of clinical education is restructured into networks of health service facilities outside the primary teaching hospital - increase the probability of graduates practising in rural locations. This Original Research study investigates the influence of DCT duration on rural doctor recruitment and retention in East Nusa Tenggara, Indonesia. Sat, 09 May 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9803 https://www.rrh.org.au/journal/article/9803 Child malnutrition is a critical global health challenge, disproportionately affecting low- and middle-income countries, where it contributes significantly to morbidity and mortality among children under 5 years of age. Northern Nigeria presents a unique case of child malnutrition due to its complex socioeconomic and geopolitical challenges. This Review article explores the trends and determinants of child malnutrition in Northern Nigeria, particularly the prevalence of stunting, wasting, and underweight among children aged under 5 years and the underlying factors contributing to these conditions. Thu, 07 May 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10454 https://www.rrh.org.au/journal/article/10454 The incidence of chronic wounds (eg diabetic foot ulcers, venous ulcers, pressure ulcers, surgical wound dehiscence, and skin tears), is expected to rise alongside the increase in non-communicable chronic diseases (NCDs). Mexico faces significant healthcare challenges due to high rates of NCDs, a situation that is exacerbated in rural populations, which experience high rates of malnutrition, marginalization, discrimination, lack of access to specialized services, and a shortage of trained personnel. This Project Report examines the success of a co-constructed educational strategy for the prevention and basic care of wounds in Maya-Yucatecan Indigenous communities in the municipality of Chankom, Mexico. Thu, 07 May 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9871 https://www.rrh.org.au/journal/article/9871 Despite recognition that the term 'allied health' encompasses disparate professions (differing markedly in their background, training, scope of practice and client populations), evidence related to retaining the allied health workforce in regional, rural and remote areas often treats these professions as a homogeneous group. Grouping allied health professions together risks missing professions and/or geographic differences that could be targeted for the development of specific retention strategies. This Original Research study assesses the retention patterns of different allied health professionals employed in regional, rural and remote regions of Southern Queensland. Wed, 06 May 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9879 https://www.rrh.org.au/journal/article/9879 Provision of equal access to medical services for all citizens is a challenge for public healthcare systems across many European countries. Medical deserts, where medical services are inadequate for the local population, are caused by insufficient local workforce distribution and service availability, and commonly occur in rural and peripheral regions. A recent audit in Poland highlighted a lack of target numbers for medical professionals and a lack of analytical instruments or data necessary for long-term workforce planning. This Original Research study examines the determinants of professional plans (planned specializations and geographic locations) for future doctors. Tue, 05 May 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10494 https://www.rrh.org.au/journal/article/10494 Informal workers have few formal legal protections and tend to have more exposure and susceptibility to health-threatening situations than formal workers; they also represent the predominant form of employment globally, making them a key population for improving health equity. In Indonesia, informal workers make up 57.95% of the working population. This Original Research study uses a multilevel modelling approach to monitor disparities in healthcare utilization between formal and informal workers in Indonesia and examines how geographic context and health insurance coverage shape these utilization patterns. Mon, 04 May 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10083 https://www.rrh.org.au/journal/article/10083 To eliminate cervical cancer as a public health threat, the World Health Organization has set a global strategy that includes achieving 90-70-90 targets by 2030: 90% of girls fully vaccinated against human papillomavirus by age 15 years, 70% of women screened by age 35 years and again by 45 years, and 90% of women identified with cervical disease receiving appropriate treatment. In Nigeria, this need is especially critical in rural populations, which often face disproportionately limited access to health education and preventive services. This Original Research study assesses the level of awareness and perceptions of cervical cancer prevention among participants of a community health outreach program in Ituku, Enugu State, Nigeria Fri, 01 May 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9777 https://www.rrh.org.au/journal/article/9777 Innovative models are being adopted worldwide to enhance access to essential health services in rural areas. Nevertheless, implementing these models can prove challenging, particularly in low-resource countries. In Papua New Guinea (PNG), there is limited information about the application of health policy frameworks and the challenges affecting their implementation in rural districts. This Original Research study uses qualitative interviews and group discussions with administrators, clinicians, and community members in rural areas of Madang Province, PNG, to examine the socio-ecological factors that influence implementation at all levels of the healthcare system. Wed, 29 Apr 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10419 https://www.rrh.org.au/journal/article/10419 Early childhood development is essential for long-term health, educational, and financial outcomes. Among many determinants of childhood development, the mental health of mothers has emerged as a critical, yet often under-addressed, factor, particularly in low- and middle-income countries. Despite this, few studies have explored the relationship between mothers' mental health and child development in rural Indonesia. Most analyses use aggregated data, obscuring important rural-urban differences. This Original Research study examines nationally representative data to inform equity-focused, context-specific interventions. Thu, 23 Apr 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9922 https://www.rrh.org.au/journal/article/9922 Health equity is a crucial aspect of public health, ensuring that all members of society have equal opportunities to achieve their full health potential. In recent years, Aotearoa New Zealand has increased its focus on rural health equity, leading to the development of, for the first time, a specific Rural Health Strategy. The importance of a specific strategy for rural health, particularly in countries with large rural populations and regions, has been well established. This Policy Report delves into the background and context of rural health in Aotearoa New Zealand and the specifics of the development and implementation of the first New Zealand Rural Health Strategy. Wed, 22 Apr 26 00:00:00 +0000 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