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This viewpoint piece will highlight the contribution of trained lay community health workers to the integrated workforce in rural, remote and island settings, drawing on experience from a system strengthening project involving community health agents (CHAs) in four municipalities in Litoral Norte, a remote coastal and island region in the state of São Paulo, Brazil.

This viewpoint reflects on experiential learning from a unique north–south collaboration that spanned the period of a global pandemic. It adds to the international literature on the value of community health workers in public health and chronic disease management and highlights their potential pivotal role as integrators at point of care.

CHAs took forward actions that touched the lives of thousands of vulnerable families with low income and complex needs in communities with high levels of social and health inequalities. They acted as a bridge between patients and families at home, primary healthcare professionals and wider community partners and services. Their valuable insight into the healthcare issues and social challenges experienced by the community informed and supported family centred practice and population health goals. The CHAs rapidly pivoted to became an essential public health workforce during the Covid-19 pandemic.

As the authors establish integrated care systems and embrace proactive care and population health, the conditions are favourable for introducing a similar role in the UK. For psychological safety and avoidance of burnout people in such new roles will require training, supervision and full integration within community teams.

This viewpoint reflects experiential learning from a unique north–south collaboration that spanned the period of a global pandemic. It adds to the international literature on the value of community health workers in public health and chronic disease management and highlights their potential pivotal role as integrators at point of care.

This study investigated the role of community infrastructure planning in Sarawak, Malaysia, by concentrating on the obstacles that hinder effective governance of community infrastructure planning.

The qualitative approach via case study design was adopted in this study. The Song District, located in the State of Sarawak, Malaysia, was selected as the case study area. Semi-structured interview sessions were conducted with 21 respondents who belonged to the government agencies involved in rural community infrastructure planning and village community representatives to capture their views on community infrastructure development planning in the selected district. The gathered responses were analysed thematically and the outcomes are discussed.

The findings revealed that although the development of community infrastructure in Song District has progressed and has exerted transformative impacts on rural livelihood, several challenges were identified in the delivery of community infrastructure. The four main themes of challenges that emerged from the data were location factors, financial resources, cooperation and collaboration of stakeholders, as well as community involvement. The outcomes disclosed that, in terms of governance, the institutional roles of the community, stakeholders and government agencies must be integrated throughout the rural community infrastructure planning process to resolve the emerging challenges effectively so that the demands of the rural community are met meritoriously.

An effective and efficient community infrastructure planning approach ascertains that the community infrastructure development gaps in rural areas are bridged and brings fruition to the rural communities for their livelihood transformation.

This paper delineates a view on the governance aspect of community infrastructure planning in Sarawak, Malaysia, that is largely untapped. The study outcomes may facilitate practitioners and academics to move forward and recommend improvements in the approach to rural community infrastructure planning.

Discussions about progressive gender reform across Melanesia highlight the need for more gender-inclusive policies and improved conditions for women and girls throughout all sectors. However, for many of these countries, attempts to address the problems are marred by insufficient resources and low prioritization of the issue and traditional, cultural and religious perspectives about gender and gendered roles. This article discusses how police responses are coordinated to address domestic and family violence (DFV) and provides a critical reflection on both internal responses and the complexities of multi-partner operations beyond urban spaces.

This article draws on the findings from a stakeholder engagement focus group with 20 participants from four Melanesian countries – Fiji, Papua New Guinea, the Solomon Islands and Vanuatu – to provide insight into policing innovations in rural contexts.

There is a need for improved multisector partnerships, increased police presence and greater reliance on indigenous strategies to improve responses to DFV in resource-constrained contexts.

The article provides insight into an under-researched area and makes recommendations for improving responses to DFV in rural areas in small-island developing states.

We present the results of one of the only in-depth studies of a police agency’s internal and external response to the coronavirus pandemic of 2020 (COVID-19). This study emphasizes the importance of law enforcement agencies conducting comprehensive case studies and after-action assessments to prepare, prevent and respond to prolonged public health crises and showcases the profound (and lingering) effects of COVID-19 on police organizations.

This multi-method case study combines document analysis, a workforce survey, a community survey, interviews and analysis of administrative data to detail and assess the agency’s internal and operational responses to the pandemic and the reactions of employees and community members to those responses.

Despite agency strategies to mitigate the pandemic’s effects, employees cited very high stress levels one year after the pandemic and a third of sworn officers considered leaving the policing profession altogether during the first two years of the COVID-19 pandemic. Several policies intended by the agency to protect employee health and maintain staffing needs kept workforce levels steady but may have increased feelings of organizational injustice in both sworn and non-sworn individuals, with variation across racial and gender groups. A jurisdiction-wide community survey indicated general support for the police department’s responses but a preference for in-person rather than telephone-based responses to service calls. Officers, however, preferred continuing remote responses even after the pandemic subsided.

To the best of our knowledge, this is one of the only in-depth case studies that examine a police agency’s internal and external responses to COVID-19 and the sworn, non-sworn and community reactions to those responses.

Digital learning systems are crucial for education and data collected can analyse students learning performances to improve support. The purpose of this study is to design and build an asynchronous hardware and software system that can store data on a local device until able to share. It was developed for staff and students at university who are using the limited internet access in areas such as remote Northern Territory. This system can asynchronously link the users’ devices and the central server at the university using unstable internet.

A Learning Box has been build based on minicomputer and a web learning management system (LMS). This study presents different options to create such a system and discusses various approaches for data syncing. The structure of the final setup is a Moodle (Modular Object Oriented Developmental Learning Environment) LMS on a Raspberry Pi which provides a Wi-Fi hotspot. The authors worked with lecturers from X University who work in remote Northern Territory regions to test this and provide feedback. This study also considered suitable data collection and techniques that can be used to analyse the available data to support learning analysis by the staff. This research focuses on building an asynchronous hardware and software system that can store data on a local device until able to share. It was developed for staff and students at university who are using the limited internet access in areas such as remote Northern Territory. This system can asynchronously link the users’ devices and the central server at the university using unstable internet. Digital learning systems are crucial for education, and data collected can analyse students learning performances to improve support.

The resultant system has been tested in various scenarios to ensure it is robust when students’ submissions are collected. Furthermore, issues around student familiarity and ability to use online systems have been considered due to early feedback.

Monitoring asynchronous collaborative learning systems through analytics can assist students learning in their own time. Learning Hubs can be easily set up and maintained using micro-computers now easily available. A phone interface is sufficient for learning when video and audio submissions are supported in the LMS.

This study shows digital learning can be implemented in an offline environment by using a Raspberry Pi as LMS server. Offline collaborative learning in remote communities can be achieved by applying asynchronized data syncing techniques. Also asynchronized data syncing can be reliably achieved by using change logs and incremental syncing technique.

Focus on audio and video submission allows engagement in higher education by students with lower literacy but higher practice skills. Curriculum that clearly supports the level of learning required for a job needs to be developed, and the assumption that literacy is part of the skilled job in the workplace needs to be removed.

To the best of the authors’ knowledge, this is the first remote asynchronous collaborative LMS environment that has been implemented. This provides the hardware and software for opportunities to share learning remotely. Material to support low literacy students is also included.

This paper aims to provide new insights into and offer potential solutions to the challenges encountered by mental health services working with remote, rural or underserved communities in the UK.

In this paper, the authors reflect on the utility of integrating conventional clinical approaches, with preventive care and empowering work within the community, to provide culturally sensitive and accessible mental health services. The authors describe an example of community intervention from a mental health service in Ghana designed to enhance reach within remote and rural communities and identify potential lessons for practice in the UK.

The partnership between community mental health services and the rural communities, including families and existing social frameworks, applies collaborative care to overcome the lack of resources and facilitate the acceptability of mental health services to the local population. There are a series of important lessons from this experience including the importance of understanding the culture of a community to optimise reach and the importance of working IN the community and WITH the community.

This paper is novel because it provides learning from a model of care applied in the global south that has potential for implementation with underserved populations in the UK. The authors suggest a reframing of the notion of community care to encompass existing frameworks of community, not merely a biomedical conceptualisation.

This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors’ leadership skills in Aceh, Indonesia. In order to persevere in the face of inadequate resources and infrastructure, particularly in rural and remote settings of low- and middle‐income countries, physicians require strong leadership skills. However, there is a lack of information on leadership development in these settings.

This study applied an educational intervention consisting of a two-day workshop. The authors evaluated the impact of the workshop on participants’ knowledge and skill by combining quantitative pre- and post-intervention questionnaires (based on Levels 1 and 2 of Kirkpatrick’s model) with qualitative post-intervention in-depth interviews, using a phenomenological approach and thematic analysis.

The workshop yielded positive results, as evidenced by participants’ increased confidence to apply and use the information and skills acquired during the workshop. Critical success factors were as follows: participants were curiosity-driven; the use of multiple learning methodologies that attracted participants; and the use of authentic scenarios as a critical feature of the program.

The intervention may offer a preliminary model for improving physician leadership skills in rural and remote settings by incorporating multiple teaching approaches and considering local cultural norms.

This chapter provides a comprehensive examination of the diverse strategies employed in various Asian regions to address family planning. Beginning with an in-depth analysis of family planning programs in South Asia, this chapter offers a comparative overview that highlights the unique characteristics and outcomes within this dynamic context. Furthermore, this chapter employs case studies to explore the multifaceted influences of religious beliefs, legal frameworks, and sociocultural factors on family planning practices. By delving into these complexities, it offers a nuanced understanding of the challenges and successes in different Asian regions. This comparative exploration equips policymakers and practitioners with valuable insights to inform more effective and culturally sensitive family planning initiatives.

This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.

The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.

The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.

The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.

Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.

Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.

It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.

Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.