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.

This article reports on a study conducted in partnership with a remote First Nation in northern Canada. The study utilised concept mapping to develop a framework for identifying gaps in oral health care for Indigneous youth. Findings of the concept mapping and framework development process can provide information on strategies to improve preventive oral health services for Indigenous youth living in rural and remote communities.

Aboriginal Community-Controlled Health Organisations (ACCHOs), like other primary care organisations in Australia and internationally, were required to respond rapidly to physical distancing requirements during the COVID-19 pandemic. A key component of the response was the adoption of telehealth to continue meeting the healthcare needs of Aboriginal and Torres Strait Islander Peoples. This study evaluates the uptake, acceptability and requirements for delivery of telehealth primary healthcare services for Aboriginal and/or Torres Strait Islander Peoples by a rural ACCHO, Budja Budja Aboriginal Cooperative, in Halls Gap, Victoria, during the pandemic.

Xingu Indigenous Park (XIP), the largest Indigenous territory in Brazil, protects the environment and the traditional way of life for the 16 Indigenous groups that live there. Access to XIP by non-Indigenous people is limited but, in recent decades, new roads and more people living in the vicinity of the park has increased exposure to different infectious agents. The Indigenous population is constantly dealing with shortages in medical care. This study evaluated the frequency and potential impact of chlamydia, gonorrhea and high-risk human papillomavirus on the Indigenous women of XIP.

El Parque Indigena Xingu (XIP), el mas grande territorio indígena en Brasil, protege el medio ambiente y la forma de vida tradicional de los 16 grupos indígenas que ahi viven. El acceso al XIP por personas no indígenas es limitado, pero en las décadas recientes, nuevos caminos y el aumento de personas viviendo en la proximidad del parque, han incrementado la exposición a diferentes agentes infecciosos. La población indígena esta constantemente lidiando con la escasez de cuidados médicos. Este estudio evalúa la frecuencia y el potencial impacto de agentes como clamidia, gonorrea y papilomavirus humano de alto riesgo en las mujeres indígenas del XIP.

O Parque Indígena do Xingu (PIX), o maior território indígena do Brasil, protege o meio ambiente e o modo de vida tradicional dos 16 grupos indígenas que ali vivem. O acesso ao PIX por não indígenas é limitado, mas, nas últimas décadas, novas estradas e mais pessoas morando no entorno do parque aumentaram a exposição a diferentes agentes infecciosos. A população indígena lida constantemente com a escassez de atendimento médico. Este estudo avaliou a frequência e o potencial impacto da Clamídia, Gonorreia e Papilomavírus Humano de alto risco nas mulheres indígenas do PIX.

Water is scarce for more than 40% of people globally, and among those with access to water, approximately 23% (1.8 billion) rely on a fecally contaminated water source. Diarrheal disease, which is prevalent in areas with limited access to water, sanitation, and hygiene (WASH), causes chronic consequences in children, including decreased growth, undernutrition, and impaired cognitive development. In Latin America, diarrheal disease kills more than 75,000 children annually, while in the Peruvian Amazon, the prevalence is as high as 50% for Indigenous children. This study reports on the prevalence of childhood diarrhea, access to WASH, and the association of childhood diarrhea with WASH indicators in Shawi communities along the Armanayacu River, Peru.

El agua es escasa para mas del 40% de las personas globalmente, y entre aquellos con acceso al agua, aproximadamente un 23% (1,8 billones) depende de una fuente de agua contaminada fecalmente. La enfermedad diarreica, que es prevalente en zonas con acceso limitado al agua, saneamiento e higiene (WASH), causa consecuencias crónicas en los niños tales como retraso del crecimiento, desnutrición y deficit en desarrollo cognitivo. En Latinoamérica, la enfermedad diarreica causa mas de 75 mil muertes en niños anualmente, mientras que en la Amazonia Peruana, la prevalencia es tan alta como el 50% de los niños indígenas. Este estudio muestra la prevalencia de diarrea en niños y su asociación con indicadores de acceso a WASH, en las comunidades SHAWI a lo largo del Rio Armanayacu en Perú.

A água é escassa para mais de 40% das pessoas em todo o mundo. Entre aquelas com acesso à água, aproximadamente 23% (1,8 bilhão) dependem de uma fonte de água contaminada por fezes. A doença diarreica, que é prevalente em áreas com acesso limitado à água, saneamento e higiene (WASH), causa consequências crônicas em crianças, incluindo crescimento reduzido, desnutrição e desenvolvimento cognitivo prejudicado. Na América Latina, a doença diarreica mata mais de 75.000 crianças anualmente, enquanto na Amazônia peruana a prevalência chega a 50% para crianças indígenas. Este estudo relata a prevalência de diarreia infantil, acesso a WASH e a associação de diarreia infantil com indicadores de WASH em comunidades Shawi ao longo do rio Armanayacu, Peru.

There is an increasing number of undergraduate health professions students being trained along a continuum of care from central academic hospitals to remote distributed training sites. This is an essential healthcare education reform for contextually relevant training. With the progressive expansion of distributed training in South Africa academic coordination at these sites is crucial. This study explored the experiences of university employed rural academic coordinators responsible for student learning and community engagement on distributed platforms in South Africa.

The rising prevalence of obesity (which is higher in rural than urban areas) is one of the most serious public health challenges. Over the past decade, several national guidelines have been established for the Norwegian health sector to meet the challenges of childhood overweight and obesity and ensure professionalism and standardization of health services. This study determined the extent to which public health nurses in rural Norway feel equipped to address overweight and obesity within these guidelines.

Rural areas worldwide face a continued shortage of suitably trained workforce to deliver healthcare services. In Papua New Guinea, workforce shortages are a continuous stressor on the delivery of healthcare services, including in the allied health professions, which are in their infancy in terms of provision of university-qualified practitioners. This study used a survey and focus group of University of Papua New Guinea Bachelor in Medical Imaging Science (BMIS) students to explore factors influencing choice to pursue rural radiography careers.

In the remote Kimberley region of Western Australia, the prevalence of dental disease is significantly higher than other regional centres. Access to timely dental care for remote Aboriginal communities remains a challenge and is both a state and national priority, but establishing permanent full-time dental services is generally not considered viable nor sustainable because of the vast, remote and sparsely populated  area. As a result, the Kimberley Dental Team, a non-government, volunteer-led organisation, was established by community invitation to ‘fill the gaps’ and extend dental care to areas of unmet need. This paper describes the development, resources, operational factors and organisational characteristics of the Kimberley Dental Team.

Adolescent pregnancies are a major public health concern in low- and middle-income countries, affecting more than 20 million girls under 19 years of age globally every year and potentially causing poor health outcomes for mothers and infants. In Turkey, due to the country’s cultural structure, social norms and traditions, minor marriages and adolescent pregnancies continue to be widely seen in some regions. This study determined changes in anxiety, depression and perceived social support in pregnant adolescents after provision of a Psychosocial Support-Based program in rural eastern Turkey.

In Indonesia, traditional medicine is well-known and practiced from generation to generation. The 2013 and 2018 results of the Indonesian Basic Health Survey indicated that, despite a lack of coverage by the National Health Insurance scheme, the use of traditional health services is increasing and it seems they are even expected to fill the gap in health coverage caused by a lack of modern health facilities in rural areas. This article reports on the use of traditional health services in rural Indonesia and how this relates to socioeconomic factors.

Providing culturally and linguistically appropriate rehabilitation services to older Indigenous adults is challenging, particularly within rural and remote settings. This article describes the community participatory action research process used to develop and evaluate a Community Rehabilitation Worker program to serve First Nation elders in Treaties 5 and 9, Canada. The resulting curriculum, which incorporates culture, spirituality, traditions, local language, and reintegration of elders into the community, is now being implemented. The authors reflect on the importance of a participatory approach when developing programs and services for Indigenous peoples.

Severe mental disorders (eg major depressive disorder, bipolar mood disorder, schizophrenia and other psychotic disorders) affect 4% of the adult population globally and account for 26.1% of reported mental disorders in South Africa. Informal caregivers are the backbone of recovery for persons with severe mental disorders, particularly in rural areas where access to mental health services is limited. This article reports on the extent of subjective and objective burdens among informal caregivers of persons with severe mental disorders in rural South Africa.

Maldistribution and retention of health professionals in underserved areas are global problems, and burnout is one reason that health professionals leave rural areas. Nurses are the frontline health workforce and are critical in a health service facility. National Indonesian regulations have a target of 180 nurses per 100,000 people, but several rural provinces do not meet this target. Chronic burnout is linked to depression, and nurses have a higher risk of depression than the general population. This article reports on resilience and depression in Indonesian nurses and finds that the resilience profiles of Indonesian nurses differ from those of doctors, so tailored approaches are required to support nurses, improve resilience and improve workforce retention.

China has the heaviest burden of stroke in the world, and this burden has increased in the past 30 years. Stroke outcomes are worse in rural areas than in urban areas as a result of poorer living conditions but also because of the time it takes to access time-sensitive treatment. Rural and regional clinics and hospitals often lack the necessary imaging equipment and there is often a long travel distance to access appropriate care. Using data available in patient records, this Original Research article reports on the time lags from the onset of stroke symptoms to arrival at a stroke center for two archipelagic regions in China: main island (urbanized) and outer islets (rural).

This unique study sought to explore the impact of wage differentials among urban, rural and remote healthcare settings as a potential factor in recruitment and retention of allied health professionals (AHPs). While the impact of wage was not demonstrated as an incentive for rural practice, additional factors such as gender, specific type of AHP and remoteness are illuminated. This paper adds considerably to the rural healthcare literature by focusing on AHPs, a valuable asset to the healthcare team.

Although sex work is not criminalized in Brazil, female sex workers experience prejudice and discrimination. In rural areas, which tend to be poorer regions, female sex workers experience inequities in gender, race, class and, above all, bear marks of struggle and survival. This study reports on the meanings that women in the experience of paid sexual work living in rural areas attribute to the quality of life, according to Sartre's phenomenological perspective.

Aunque el trabajo sexual no esta criminalizado en Brasil, las trabajadoras sexuales femeninas experimentan prejuicios y discriminación. En zonas rurales, que tienden a ser mas pobres, estas trabajadoras sufren inequidades de genero, raciales, socioeconómicas y por sobre todo están marcadas por la lucha y la sobrevivencia. Este estudio describe los significados que le atribuyen a la experiencia de vivir del trabajo sexual pagado en zonas rurales, respecto de la calidad de vida de acuerdo a la perspectiva fenomenológica de Sartre.

Embora o trabalho sexual não seja criminalizado no Brasil, as trabalhadoras do sexo sofrem preconceito e discriminação. Nas áreas rurais, que costumam ser regiões mais pobres, as trabalhadoras do sexo vivenciam desigualdades de gênero, raça, classe e, sobretudo, carregam marcas de luta e sobrevivência. Este estudo relata os significados que as mulheres na experiência do trabalho sexual remunerado residentes no meio rural atribuem à qualidade de vida, segundo a perspectiva fenomenológica de Sartre.