Rural and remote health最新文献

{"title":"Awareness of cervical cancer prevention among rural dwellers in Enugu State, Nigeria: findings from Ituku outreach.","authors":"Polycarp Uchenna Agu, Cyril Chukwudi Dim, Johnpaul Ejikeme Nnagbo, Godwin Ugonna Odoh, Matthew Ikechukwu Eze, Onyemaechi Silas Okoro, Peter Onubiwe Nkwo","doi":"10.22605/RRH10083","DOIUrl":"https://doi.org/10.22605/RRH10083","url":null,"abstract":"<p><strong>Introduction: </strong>WHO's global target of eliminating cervical cancer is just 5 years away, and women living in low-resource settings like Nigeria may be left behind, because a significant proportion may not be aware of cervical cancer and its preventive measures. Thus, there is an urgent need to review and possibly scale up awareness of cervical cancer prevention among women residing in rural communities in Nigeria through free medical outreach programs. The aim of this study was to assess the level of awareness and perceptions of cervical cancer prevention among participants of a community health outreach program in Ituku, Enugu State, Nigeria.</p><p><strong>Methods: </strong>This mixed-methods study was a quantitative survey of 352 participants and qualitative interviews of 10 purposively selected women attendees at the 2024 free medical outreach at the community of Ituku, Awgu local government area, Enugu State. A pre-tested and validated questionnaire was used to collect data from participants. Quantitative data analysis was done using the Statistical Package for the Social Sciences, while thematic analysis was done for qualitative components.</p><p><strong>Results: </strong>Out of 525 eligible women who attended the health outreach, 352 (67.0%) were recruited into the study. Awareness of cervical cancer was reported by 27.8% (n=98) of respondents, while 27.3% (n=96) were aware of cervical cancer screening methods. Only 9.1% (n=32) had heard of HPV vaccination as a preventive measure, and 4.5% (n=16) were aware that HPV infection is a causative factor for cervical cancer. Only 4.5% (n=16) of respondents had ever undergone cervical cancer screening. Awareness of screening methods was associated with age of 40 years or less and being Roman Catholic, while willingness to vaccinate children was associated with having formal education.</p><p><strong>Conclusion: </strong>In a rural community in Enugu State, Nigeria, only 3 out of every 10 women were aware of cervical cancer and its preventive measures. Although 1 in every 10 knew that HPV vaccination prevents against cervical cancer, over 9 of 10 of them were willing to vaccinate their children. To join the global community in eliminating cervical cancer by 2030, there is an urgent need to intensify awareness campaigns through outreach programs targeting rural dwellers in low- and middle-income countries about cervical cancer, its etiology and prevention.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"26 2","pages":"10083"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving patterns of child malnutrition in northern Nigeria: trends in stunting, wasting, and underweight from 2013 to 2018.","authors":"Felix Olaniyi Sanni, Abike Elizabeth Sanni, Oluwadare Peter Akeju, Tukwasi Ahamuefula, Onyeagwaibe Collins Isioma","doi":"10.22605/RRH9803","DOIUrl":"https://doi.org/10.22605/RRH9803","url":null,"abstract":"<p><strong>Introduction: </strong>Child malnutrition remains a critical public health challenge in low- and middle-income countries, significantly contributing to morbidity and mortality among children less than age 5 years. In Northern Nigeria, persistent nutritional deficiencies, compounded by socioeconomic disparities and regional variations, demand urgent attention. This study examines trends and determinants of stunting, wasting, and underweight from 2013 to 2018.</p><p><strong>Methods: </strong>A cross-sectional research design was used for this study. Household and anthropometric secondary data were extracted from the 2013 and 2018 Nigeria Demographic and Health Surveys, focusing on 39,720 mother-child pairs in Northern Nigeria. Anthropometric measurements were converted into Z-scores, with stunting, wasting, and underweight defined as scores less than &minus;2 standard deviations. Chi-squared analyses were used to assess associations between malnutrition and various factors. Analyses were performed using IBM Statistical Package for the Social Sciences (v28.0), with statistical significance set at p<0.05.</p><p><strong>Results: </strong>Findings reveal that stunting increased from 39.4% to 44.7% (p<0.001) over the study period, whereas wasting declined markedly from 17.0% to 8.1% (p<0.001) and underweight decreased from 30.0% to 27.5% (p<0.001). Significant disparities emerged across regions, with the North-West exhibiting the highest malnutrition rates, and rural areas showing greater vulnerability than urban settings. Rural children had higher malnutrition rates than urban children. Higher maternal education and greater household wealth were strongly associated with a reduced risk of malnutrition.</p><p><strong>Conclusion: </strong>This study contributes to the literature by showing that regional disparities and conflict-related instability exacerbate child malnutrition in Northern Nigeria. The findings revealed subnational variations that mirrored patterns in other crisis-affected regions, yet with distinct local drivers. The divergent trends in wasting (improved) and stunting (worsened) challenge the assumption that short-term interventions alone can address malnutrition in fragile settings. For practitioners in rural and remote health, these results emphasize the need for localized, multisectoral approaches. Such strategies must combine immediate nutritional support with long-term investments in maternal education, economic empowerment, and health systems adapted to the unique challenges of rural contexts, such as limited infrastructure and access to care.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"26 2","pages":"9803"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When eggs in the same basket are apples and oranges: length of stay for public sector allied health professionals in regional, rural and remote southern Queensland, 2010-2021.","authors":"Anthony Bruce Fallon, Clara Walker, Anna Coghlan, Priya Martin, Ansmarie Van Erp, Jessica Elliott, Lee O'Malley, Bahram Sangelaji, Hwee Sin Chong","doi":"10.22605/RRH9871","DOIUrl":"https://doi.org/10.22605/RRH9871","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Low retention of allied health professionals remains a major issue in regional, rural and remote areas of Australia. Professions in this catch-all label differ markedly in often fundamental ways. In most workforce research, however, low sample sizes often result in the combining of data from these diverse professions, potentially obscuring differences in employee retention. This study sought to assess employment retention patterns of public sector allied health professionals in regional, rural and remote regions of Southern Queensland, Australia, to determine retention time in location for various allied health professions, the impact of geographic location and other available demographic and employment covariates on risk of leaving location, and key exit times.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective quantitative longitudinal design used de-identified allied health employee records from two public health services from a 12-year observation period (January 2010 to December 2021). The critical time-based variable for survival analysis and Cox regression of employee retention was years employed in location, with profession and geographic remoteness of work location being primary covariates of interest.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Analysis of records from 1454 allied health employees revealed a median retention time of 1.27 years (95%CI 1.15-1.46). Those working as anaesthetic technicians (hazard ratio (HR) 0.45, 95%CI 0.26-0.77), in radiography/sonography/medical imaging (HR 0.59, 95%CI 0.45-0.77), pharmacy (HR 0.61, 95%CI 0.48-0.78), social work (HR 0.66, 95%CI 0.52-0.83), psychology/mental health (HR 0.68, 95%CI 0.55-0.86) and other allied health positions (HR 0.81, 95%CI 0.62-1.07) were less at risk of leaving location than the physiotherapist reference group. Speech pathologists (HR 0.86, 95%CI 0.66-1.11), occupational therapists (HR 0.83, 95%CI 0.68-1.03) and dieticians (HR 0.81, 95%CI 0.62-1.07) were at no greater risk. Those working in rural (HR 1.61, 95%CI 1.41-1.84) and remote (HR 2.16, 95%CI 1.80-2.61) communities exhibited higher risk of leaving their location than those working in the regional cities, with these risks emerging within 3-6 months after starting a position. Type of employment, age when starting employment, and starting pay grade also had small but significant influences on risk of leaving location.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Despite lower overall median retention time, possibly partly due to using a location-based, time-dependent variable, patterns observed in this study are largely consistent with previous research. Use of a location-based, time-dependent variable is advocated for future research - it most closely aligns with costs associated with replacing location-based positions, continuity of care and ultimately patient outcomes. The findings suggest prioritisation of interventions targeted towards allied health professions at highest risk of leaving location, and ","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"26 2","pages":"9871"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing the phenomenon of medical deserts by identifying the career plans of future doctors in Poland. Quo vadis?","authors":"Magdalena Łoś, Michał Henzler, Paweł Żuk, Alicja Domagała, Iwona Kowalska-Bobko, Monika Kaczoruk, Aneta Nitsch-Osuch","doi":"10.22605/RRH9879","DOIUrl":"https://doi.org/10.22605/RRH9879","url":null,"abstract":"<p><strong>Introduction: </strong>Provision of equal access to medical services for all citizens is a challenge for the public healthcare systems of many European countries. In many of them, rural areas and other peripheral regions are gradually turning into so-called 'medical deserts', whose inhabitants' access to healthcare is obstructed, which, in turn, leads to deterioration of the quality of life and worse healthcare characteristics of the population. This problem, also experienced in Poland, is not only caused by the shortage of doctors but also by the suboptimal dislocation of the medical workforce. Currently, it is also believed that the emergence of medical deserts can be triggered by factors connected both with the demand and supply of healthcare. The aim of the study is determine the preferences of medicine students towards planned specialization and workplace (understood both as a type of institution and a geographical location) as well as to isolate the determinants of choice of the medical profession, in order to explore how these factors may indirectly contribute to the development and persistence of medical desertsMethods: A computer-assisted web interviewing questionnaire study was conducted anonymously with students in their first, third and sixth year of medicine at the Medical University of Warsaw. The research was of a pilot and exploratory nature. Students took part in the research conducted online via the Lime Survey Professional online survey service in January and February 2024. The authored research questionnaire comprised 18 questions concerning motivations for the choice of the medical profession, preferred specialization and workplace. The questionnaire was completed by 434 participants.</p><p><strong>Results: </strong>Motivations for the selection of the medical profession of young people can be divided into those related to the profession and those connected with private life, expected salaries or time management. For some respondents, the most significant incentive was the prospect of work in the area of science (research motivations); for others it was the chance to help others (altruistic motivations). The most important factors influencing career plans were job stability (mean score: 4.5/5), the desire to have a socially meaningful profession (4.3/5), and opportunities for professional self-development (4.2/5).</p><p><strong>Conclusion: </strong>By identifying factors shaping future physicians' career plans, the study contributes to a better understanding of workforce-related mechanisms underlying the development of medical deserts in Poland. These findings may inform future workforce planning and educational strategies aimed at improving the distribution of medical professionals, particularly in underserved areas. However, given the pilot nature of the study and its single-university design, the results should be interpreted with caution, particularly with regard to their generalizability.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"26 2","pages":"9879"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employment status and healthcare utilization in Indonesia: a multilevel analysis across developed and underdeveloped districts.","authors":"Mardiana Dwi Puspitasari, Beni Teguh Gunawan, El Bram Apriyanto","doi":"10.22605/RRH10494","DOIUrl":"https://doi.org/10.22605/RRH10494","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Informal workers are a priority for health equity. However, Indonesian employment laws provide limited legal social protection to informal workers, which may constrain access to health insurance. From the supply side, underdeveloped districts continue to face a shortage of higher-level health facilities that accept National Health Insurance (Jaminan Kesehatan Nasional, JKN). This study examines disparities in outpatient and inpatient treatment utilization between formal and informal workers in Indonesia, and explores how geographic context and health insurance coverage shape these utilization patterns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Separate analyses were conducted for developed and underdeveloped districts using two-level binary logistic regression models. Individual-level data were drawn from the 2024 National Socioeconomic Survey (SUSENAS) and integrated with district-level data from the 2024 Village Data Census (PODES). The study included 97,042 working-age individuals (aged &ge;15 years) with poor self-rated health status residing in 452 developed and 62 underdeveloped districts. Outpatient and inpatient treatment utilizations were specified as the outcome variables. Employment status was treated as the primary exposure, and interaction terms were included to assess the modifying role of health insurance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In underdeveloped districts, formal workers had higher outpatient utilization (adjusted odds ratio (aOR) 1.51, 95% confidence interval (CI) 1.43-1.60) and inpatient (aOR 1.08, 95%CI 0.92-1.28) utilization than informal workers. Between-district heterogeneity is large, with intraclass correlation coefficient values of 25.61% for outpatient utilization and 38.26% for inpatient utilization. For the outpatient model, the interaction between employment status and health insurance shows that the odds for insured formal workers increased by 2.05 times, uninsured formal workers increased by 1.51 times, and insured informal workers increased by 1.49 times more than uninsured informal workers. For the inpatient model, the interaction shows that the odds of insured formal workers increased by 5.81 times, uninsured formal workers increased by 1.08 times, and insured informal workers increased by 4.27 times more than uninsured informal workers. In developed districts, between-district heterogeneity shows intraclass correlation coefficient values of 10.18% for the outpatient model and 15.77% for the inpatient model. There was no statistically significant association between formal workers (aOR 1.00, 95%CI 0.99-1.00) and informal workers to outpatient utilization. For the outpatient model, the interaction shows that the odds for insured formal workers increased by 1.44 times and insured informal workers increased by 1.40 times compared to formal and informal uninsured workers. Formal workers (aOR 0.92, 95%CI 0.91-0.94) have slightly lower inpatient utilization than informal workers. For th","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"26 2","pages":"10494"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding physical activity adherence in vulnerable adults with type 2 diabetes in the rural Brazilian Amazon.","authors":"Tiago Assunção Dos Santos Farias, Thalyta Mariany Rêgo Lopes Ueno, Wagner Ferreira Monteiro, Camila Fabiana Rossi Squarcini, Roseanne Gomes Autran, Hércules Lázaro Lm Morais Campos, Elisa Brosina De Leon","doi":"10.22605/RRH10544","DOIUrl":"https://doi.org/10.22605/RRH10544","url":null,"abstract":"<p><strong>Introduction: </strong>Adopting healthy behaviors is challenging in any context, especially related to physical activity in individuals with chronic conditions. In socially vulnerable settings, challenges are even greater. This study aimed to understand the barriers and facilitators to physical activity adherence in a vulnerable population with type 2 diabetes mellitus in the Brazilian Amazon setting.</p><p><strong>Methods: </strong>We conducted an exploratory qualitative study using a phenomenological approach. We used semi-structured interviews with participants with type 2 diabetes and the World Caf&eacute; group technique with community health workers. The meetings were recorded. In the organization and processing of the data, the recordings of the semi-structured interviews, the content of the tablecloths, and the videos were transcribed using the Reshape website, coded, and organized using the ATLAS.ti24 software. We used thematic analysis to identify the main facilitators and barriers. The ecological model was employed to guide data collection, analysis, and message development.</p><p><strong>Results: </strong>The main barriers identified were physical limitations, financial difficulties, lack of knowledge, lack of trained and qualified professionals, distance from physical activity locations, and lack of motivation. The major facilitators included an appropriate location within the coverage area of the primary healthcare units, professional guidance, trained and qualified professionals, personal motivation, family support, and adequate financial conditions.</p><p><strong>Conclusion: </strong>Environmental factors, personal motivation, and qualified professional guidance were crucial for adherence to physical activity. Our findings underscore the need for public policies and health interventions tailored to vulnerable populations.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"26 2","pages":"10544"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pae Ora - Healthy Futures: lessons learned from the first New Zealand Rural Health Strategy.","authors":"Liam Glynn, Sarah Clarke, Helen MacGregor, Julia Cronin, Grant Davidson, Garry Nixon, Rachel Pearce, Joseph Scott-Jones, Neta Smith, Jenni Vernon, Nicky Welch, Peter Hayes, Monica Casey, Veronika Rasic, Theadora Swift Koller","doi":"10.22605/RRH9922","DOIUrl":"https://doi.org/10.22605/RRH9922","url":null,"abstract":"<p><strong>Context: </strong>New Zealand began reform of its health system in 2018 with the commissioning of the Health and Disability System Review. The emergence of a specific rural health strategy was contributed to significantly by: the restructuring of the healthcare system with a focus on equity; the increased awareness of geographic inequities for rural communities with the emergence of high-quality research data demonstrating clear rural/urban health disparities; and the emergence of the Hauora Taiwhenua Rural Health Network as a single strong collective membership-led and driven, advocacy voice for health care in rural communities. The Rural Health Strategy was developed by the Ministry of Health and approved by government, with input from the M&#257;ori Health Authority (disestablished in 2024), Health New Zealand, other government agencies, and engagement with the health sector, stakeholders and the general public.</p><p><strong>Issues: </strong>Historically, rural areas in New Zealand have faced many challenges in health service coverage and health outcomes compared with urban areas. Generic rural classifications have underestimated rural health needs and failed to highlight health inequities in rural communities. The new Geographic Classification for Health has now addressed this issue in New Zealand. The Rural Health Strategy identifies five priorities over the next 10 years: considering rural communities as a priority group; prevention; services are available closer to home for rural communities; rural communities are supported to access services at a distance; and a valued and flexible workforce (including integrated, broader and different workforce models). Over time, monitoring of the implementation of the priorities of the strategy, and monitoring of overall health outcomes for rural communities, will assess the progress made towards the vision set out in the Rural Health Strategy.</p><p><strong>Lessons learned: </strong>The emergence of better information on rural health outcomes, together with effective advocacy for rural health, contributed to rural communities becoming a priority group for the New Zealand Government, thus mandating the development of a Rural Health Strategy. The resulting Rural Health Strategy is a key first step towards rural health equity and improving rural health outcomes in New Zealand. Lessons learnt through this process include, but are not limited to: the value of strong collaboration among, and advocacy by, rural health stakeholders; the role of the Office for Rural Communities in assessing rural community impacts and rural proofing policy changes across government; the importance of evidence-based policies and interventions in rural areas; the potential for fostering learning/solution showcasing across local levels; the central role of community engagement and empowerment; and the importance of emphasising Indigenous rights and cultural responsiveness in health care.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"26 2","pages":"9922"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encouraging youth towards rural health care through Young Medical Minds.","authors":"Chad Nichol, Clark Banack","doi":"10.22605/RRH9844","DOIUrl":"https://doi.org/10.22605/RRH9844","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Young Medical Minds (YMM) is a community-level program designed to address the challenges associated with attracting and retaining healthcare workers in rural areas by showcasing a variety of healthcare careers in rural areas to local grade 8 students. The objectives of this study were to determine if there is, after participating in the YMM program, an increase in participant interest and desire to go into the healthcare field and/or practice in rural communities, a desire to stay or return to rural areas for work or living, and an interest and desire to go to rural post-secondary institutions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective cross-sectional study of past YMM participants using an email survey enquiring about their life choices and reflections on the program. Survey validity was established using Kirkpatrick's four-level evaluation model using a combination of multiple-choice questions, Likert questions, and matrix questions, which was then reviewed by the YMM administrative team for clarity and precision. With an n=64, we used the package 'binom' to calculate Jeffreys confidence interval for standalone 95% confidence intervals. Similarly, the non-parametric Fisher's exact test, exact binomial test, and exact McNemar test were used to compare proportions to pre-existing values, demographic data, and before and after measurements, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The majority of participants reported that YMM played a role in who or where they were today and that it impacted the career they had or intended to pursue (88.71% and 74.55%, respectively). After taking YMM, there was a significant increase in the proportion of participants who changed their minds towards the healthcare field (39.22%, χ2=19.42, p&lt;0.001), careers in rural environments (24.00%, χ2=9.84, p=0.002), attending rural post-secondary institutions (19.15%, χ2=6.51, p=0.01), and attending the University of Alberta's rural-based Augustana Campus (19.64%, χ2=12.16, p&lt;0.001). While the proportion of participants who went into or were training for a career in health care was significantly greater than the provincial average (33.87%, p&lt;0.001), there was no difference in the proportion of participants who chose to or were planning to enter rural health care compared to the provincial average (47.62%, p=0.08). The proportion of YMM participants who chose or planned to live or work in rural environments was significantly greater than the provincial average (47.62%, p&lt;0.001 and 39.68%, p&lt;0.001, respectively). Additionally, the proportion of YMM participants who attended or planned to attend post-secondary institutions was significantly greater than for other rural students (90.00% and 95.65%, respectively, p=0.005) with less than half choosing to study in rural institutions (41.67% and 18.18%, respectively).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study demonstrates that YMM participants had an increased interest i","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"26 2","pages":"9844"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression in mothers and early childhood development: rural-urban disparities.","authors":"Nur Handayani Utami, Dwi Sisca Kumala Putri, Rofingatul Mubasyiroh, Kencana Sari, Donny Kristanto Mulyantoro, Elisa Diana Julianti, Nazarina Nazarina, Sudikno Sudikno","doi":"10.22605/RRH10419","DOIUrl":"https://doi.org/10.22605/RRH10419","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal mental health is essential for early childhood development but is often neglected in public policy, especially in low- and middle-income countries. This study investigates the relationship between maternal depression and early childhood developmental outcomes in Indonesia, with attention to rural-urban differences.</p><p><strong>Methods: </strong>Using data from 36,146 children aged 36-59 months from the 2018 Indonesian Basic Health Research (RISKESDAS), maternal depression was assessed with the Mini International Neuropsychiatric Interview, while child development was measured using the Early Child Development Index. Multivariate logistic regression was used to analyze the association between maternal depression and child developmental delays, stratified by urban and rural residence.</p><p><strong>Results: </strong>The results revealed developmental delays in 10.2% of urban children and 13.1% of rural children. Children of mothers with depression had significantly higher odds of overall developmental delay (OR=1.9; 95%CI: 1.6-2.2; p<0.001). Stratified analysis showed that the odds of delay were higher in urban areas (OR=2.1; 95%CI: 1.7-2.6) than in rural areas (OR=1.7; 95%CI: 1.4-2.0).</p><p><strong>Conclusion: </strong>These findings indicate that maternal depression is significantly associated with overall child development delays, with domain-specific associations observed particularly in the physical and literacy-numeracy domains, emphasizing the need for targeted mental health and child development interventions in both urban and rural settings.</p>","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"26 2","pages":"10419"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital and community-based health interventions for exercise and education in the management of musculoskeletal- and lifestyle-related health conditions in rural communities in low- and middle-income countries: a scoping review.","authors":"Alda Grethe Geldenhuys, Megan Dutton, Theresa Burgess","doi":"10.22605/RRH10304","DOIUrl":"https://doi.org/10.22605/RRH10304","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Musculoskeletal and lifestyle-related health conditions often co-occur, which presents a major physical and psychological burden on individuals and may have socioeconomic implications in society. Rural communities in low- and middle-income countries often have limited access to regular, in-person health and healthy lifestyle supportive services and facilities. As an alternative, digital and community-based interventions should be considered. A scoping review was conducted to investigate digital and community-based health interventions for exercise and education in the management of musculoskeletal and lifestyle-related health conditions in rural communities in low- and middle-income countries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The JBI methodology for scoping reviews was utilised. A three-step search strategy was implemented to identify articles. Following an initial exploratory search, the strategy was adapted. The full search was conducted using PubMed, Scopus, Web of Science, and EBSCOhost. Reference lists of included articles and grey literature searches were also performed. Titles and abstracts were screened followed by full-text evaluations against the eligibility criteria by two independent reviewers. Studies in the past 20 years involving digital or community-based health interventions aimed at the management of musculoskeletal and/or lifestyle-related health conditions through exercise or education for participants aged over 18 years and conducted in rural settings in low- or middle-income countries were included in the review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The search identified 1323 articles (following removal of duplicates). Nineteen studies meeting the eligibility criteria were included. Most studies (n=16) focused on community-based interventions with (n=8) or without (n=8) digital components, with one study involving a digital intervention only for lifestyle-related health conditions. Only two studies focused on musculoskeletal conditions. All interventions included a health education component and some studies included screening, monitoring, and exercise components. Digital health components included mobile health messages and apps, videos, and websites to assist health practitioners and patients. Many studies relied on community health workers for the implementation of interventions. Improvements in various health parameters were reported following the interventions. Barriers related to the digital components such as technical faults and concerns related to message content were reported. Community engagement during development and implementation of interventions and finding cost-saving strategies may be important to assist with the feasibility of interventions in rural under-resourced settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The findings of the review demonstrate that community-based health interventions with and without digital components for the management of lifestyle-related health conditio","PeriodicalId":21460,"journal":{"name":"Rural and remote health","volume":"26 2","pages":"10304"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}