Volume twenty-two, Issue 3

Health professional leaders are key informants working at senior levels in various health facilities in the areas of policies and planning processes, and human resources. On the basis of a focus group discussion in three randomly selected hospitals, this study explores the factors affecting the nursing shortage in Vanuatu and recommends measures and interventions to resolve the shortage.

Like many countries around the world, Scotland faces a shortage of general practitioners (GPs) due to increased workload and recruitment and retention issues. Such workforce shortages are of particular concern in rural areas.To maximise the effectiveness of strategies to improve GP retention, it is vital to understand what affects the job satisfaction of Scottish GPs. This study compared the job satisfaction, job stressors, job attributes and intentions to reduce work participation of rural and non-rural Scottish GPs.

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.

This review of Larry Krotz's book "Nothing Ordinary" highlights the contribution the book makes to the literature on rural medical education. The reviewer characterizes the book as an "enjoyable and informative" read that "comes alive with descriptions of places and accounts of the people closely involved" in creating "a successful socially accountable rural-focused medical school".

Rural and Remote Health, the Australian Journal of Rural Health and the Canadian Journal of Rural Medicine have committed to the editorial requirement that research published about Indigenous Peoples must genuinely engage Indigenous Peoples in all stages of the research process, including authoring manuscripts. This Commentary, published in all three journals, takes the next step. The authors propose the development of an Indigenous Cultural Identity of Research Authors Standard (ICIRAS) for health research publications. This would signpost the rights of Indigenous Peoples into academic publishing governance. It also aligns with the movement for integrating human rights into research with Indigenous and Tribal peoples. The ICIRAS is a call to action for research journals and institutions to rigorously improve research governance and leadership to amplify the cultural identity of Indigenous Peoples in rural health research and work towards genuine truth-telling and reconciliation.

Lesbian, gay, bisexual, transgender, intersex, queer and people with a diversity of sexual and gender identities (LGBTIQ+) residing in rural contexts may face additional challenges to attaining wellbeing, yet a comprehensive understanding of these experiences is lacking. This systematic review examines the wellbeing, healthcare access and experience and barriers and facilitators to health care for rural LGBTIQ+ communities.

Coronavirus disease-19 (COVID-19), caused by the severe acute respiratory syndrome SARS-CoV-2, has become a global pandemic, giving rise to a serious global health threat. In Greece, early measures kept the first pandemic wave at a relatively small scale, but the reported morbidity and mortality caused by the second wave were among the highest in Europe, with many deaths and regions with increased incidence of COVID-19. This study evaluated the prevalence of SARS-CoV-2 infection based on diagnosis of IgG antibodies from blood serum in an observational descriptive cohort study in a semi-closed rural area of Greece after the second wave.

Informed consent is the foundation for research participation. This Commentary explores how we inform patients, and challenges the Eurocentric model of an extensive written consent form. The author reflects on her experience seeking study participants in another country, culture and language, and how this shaped her perspective. She addresses the need for researchers to protect vulnerable individuals, recognizing that vulnerability comes in many forms.