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.

Despite the increased understanding of Canadian rural and remote nursing in the past two decades, no nursing frameworks to guide rural and remote practice have been in place. Working with the Canadian Association for Rural & Remote Nursing (CARRN), a process was planned to develop a rural and remote nursing framework. This Project Report describes the process, the framework developed, implications of the framework and lessons learned from the development process.

In Bhutan, a small, mountainous country in South Asia situated between India and China, noncommunicable disease (NCD)-related morbidity and mortality have been rising. In 2019, Bhutan’s Ministry of Health introduced a set of interventions associated with the World Health Organization’s Package of Essential Noncommunicable Disease Interventions for Primary Health Care in Low-Income Settings (PEN HEARTS). This initiative encompassed six components: healthy lifestyle intervention; evidence-based protocols; access to medicines and technology; risk-based management; team-based care; and systems monitoring. Evaluations of PEN interventions in other countries documented barriers to implementation. This report provides the results of a 2019–2020 evaluation assessing implementation of PEN HEARTS in Bhutan and initial impacts on provision of care for NCDs and patient outcomes.

While vaccination is a key strategy in reducing morbidity and mortality from COVID-19, vaccination rates vary widely. This study examined the influence of political affiliation, religious identity, and rurality on vaccine hesitancy in the US state of Oregon. In multivariate analysis, White Christian identity and political affiliation with Trump in the 2020 election explained 84.1% of the variability in COVID-19 vaccination status in Oregon counties, with population density also found to be a significant influence. The author recommends public health agencies partner with religious leaders to address vaccine hesitancy in rural, conservative, religious communities in Oregon.

Motor vehicle collisions (MVCs) are the leading cause of death for children and young adults globally. Rural areas have particularly high rates of MVC fatalities because of faster speeds, longer distances, lower quality road conditions, overstretched and low-resource health services that can be long distances away and more difficult access for emergency vehicles. The World Health Organization has predicted that without higher investment and evidence-based interventions, the sustainable development goal to ‘halve road traffic deaths by 2030’ will not be achieved. This scoping review examines the epidemiology, risk factors, prevention strategies and future research needs related to rural road fatalities in Australia and Canada.