Search results

The implementation of mobile health (mHealth) in developing countries seems to be stuck in a pattern of successive pilot studies that struggle for mainstream implementation. This study addresses the research question: what existing health-related structures, properties and practices are presented by rural areas of developing countries that might inhibit the implementation of mHealth initiatives?

This study was conducted using a socio-material approach, based on an exploratory case study in West Africa. Interviews and participant observation were used to gather data. A thematic analysis identified important social and material agencies, practices and imbrications which may limit the effectiveness of mHealth apps in the region.

Findings show that, while urban healthcare is highly structured, best practice-led, rural healthcare relies on peer-based knowledge sharing, and community support. This has implications for the enacted materiality of mobile technologies. While urban actors see mHealth as a tool for automation and the enforcement of responsible healthcare best practice, rural actors see mHealth as a tool for greater interconnectivity and independent, decentralised care.

This study has two significant limitations. First, the study focussed on a region where technology-enabled guideline-driven treatment is the main mHealth concern. Second, consistent with the exploratory nature of this study, the qualitative methodology and the single-case design, the study makes no claim to statistical generalisability.

To the authors' knowledge, this is the first study to adopt a socio-material view that considers existing structures and practices that may influence the widespread adoption and assimilation of a new mHealth app. This helps identify contextual challenges that are limiting the potential of mHealth to improve outcomes in rural areas of developing countries.

The COVID-19 pandemic has led to “forced innovation” in the health education industry. High-quality training of the future rural health workforce is crucial to ensure a pipeline of rural health practitioners to meet the needs of rural communities. This paper describes the implementation of an online multidisciplinary teaching program focusing on integrated care and the needs of rural communities.

A multidisciplinary teaching program was adapted to allow students from various disciplines and universities to learn together during the COVID-19 pandemic. Contemporary issues such as the National Aged Care Advocacy Program for Residential Aged Care COVID-19 Project were explored during the program.

This case study describes how the program was adopted, how learning needs were met, practical examples (e.g. the Hand Hygiene Advocacy within a Rural School Setting Project), the challenges faced and solutions developed to address these challenges. Guidelines are proposed for remote multidisciplinary learning among health professional students, including those in medical, nursing, pharmacy, dentistry, and allied health disciplines.

The originality of this program centers around students from multiple universities and disciplines and various year levels learning together in a rural area over an extended period of time. Collaboration among universities assists educators in rural areas to achieve critical mass to teach students. In addition it provides experiences and guidance for the work integrated learning sector, rural health workforce practitioners, rural clinical schools, universities, policy makers, and educators who wish to expand rural online multidisciplinary learning.

The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address the burden of chronic disease in a population-based approach.

A systematic literature review was conducted and identified 1,880 published records through PubMed using 26 search terms. After abstract and full-text review, 70 articles remained as potential models.

Although there is already a severe shortage of physicians in Texas, emerging practice patterns and choices among physicians are likely to erode access to primary care services in the state. Health-care leaders are encouraged to consider models such as complex adaptive systems for team-based care, pharmacist hypertension care management program and combined nurse-led care management with group visit structure.

As with any study, this research has its limitations; for example, models that might work in one state, or under a unique state-funded academic medical center, might not be “do-able” in another state within the nuances of a different funding mechanism.

Results of this research provide a model for implementing IPCM for the state of Texas first and will guide IPCM planning and implementation in other states.

This study is “land grant-centric” and focused on carrying out the mission of a major, top-tier research university with an emerging college of medicine at an academic medical center.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

This study determined factors that influenced patients' knowledge, attitudes and practices (KAP) regarding uncomplicated malaria in primary healthcare (PHC) facilities of Plateau state, Nigeria.

The data of 956 patients treated for uncomplicated malaria in PHC facilities of Plateau state were used for the study. Inferential statistical analyses were conducted to identify factors that influenced patients' KAP on the disease and its management.

The study revealed age (p < 0.001), level of education (p = 0.012), attitudes (p = 0.007) and practices (p < 0.001) as significant predictors of knowledge outcomes on uncomplicated malaria, while their attitudes towards the disease and its management was predicted by their gender (p = 0.011), occupation (p = 0.049), monthly income (p = 0.018), knowledge (p < 0.001) and practices (p < 0.001). Furthermore, their practices were significantly predicted by monthly incomes (p = 0.043), knowledge (p < 0.001), attitudes (p < 0.001) and number of anti-malarial and adjunct drugs administered to them (p = 0.041).

The study revealed a mixed influence of patients' characteristics on their KAP outcomes. This calls for appropriate intervention measures towards achieving the desired patients' therapeutic outcomes.

This study provides a systematic literature review and categorization of the costs reported in the literature for the introduction of new vaccines, focusing on sub-Saharan Africa within LMICs, where vaccines are highly needed, financial resources are scarce and data are lacking and scattered.

A systematic literature search of PubMed and Web of Science databases was conducted according to the PRISMA requirements. Searches also included the relevant grey literature. In total, 39 studies were selected and nine cost categories were investigated to build a comprehensive framework.

The paper considers nine cost categories that cover the whole life of the vaccine, from its initial study to its full implementation, including for each of them the relevant subcategories. The systematic review, besides providing specific quantitative data and allowing to assess their variability within each category, points out that delivery, program preparation, administration and procurement costs are the most frequently estimated categories, while the cost of the good sold, costs borne by households and costs associated to AEFI are usually overlooked. Data reported on R&D costs and investment in the production plant differ significantly among the selected contributions.

The literature contributions on cost estimation tend to focus on a precise vaccine, a specific geographic area, or to adopt a narrow approach that captures only a subset of the costs. This article presents a rich and inclusive set of the economic quantitative data on immunization costs in limited-resource countries.

The purpose of this paper is to examine the effect of the intensive lifestyle modification program on weight and metabolic syndrome risk reduction in rural obese women who have no underlying non-communicable diseases in Thailand.

A randomized controlled trial was conducted. In total, 60 healthy obese women aged 30-50 years were recruited and randomly assigned to either the intervention (n=30) or control (n=30) group after health screening. Tailored nutritional counseling, health education and exercise training were included in the lifestyle modification program. Behavioral modification techniques were also incorporated. The intervention was conducted weekly for the first eight weeks, then biweekly until week 16.

The student’s t-test was used to compare mean difference between groups. The total weight loss in the intervention group (n=29) was significantly higher, 7.6±2.9 kg, compared with the control group (n=30) who lost 0.7±1.4 kg (p<0.001). The intervention group lost weight 10.2 percent from baseline which was significantly higher than that in the control group (p<0.001). Systolic and diastolic blood pressures, fasting blood sugar, and waist circumference were significantly improved. Triglyceride levels slightly improved while high density lipoprotein cholesterol was slightly lowered. The intervention group showed a statistical reduction in abnormal components of metabolic syndrome compared with the control group, with the relative risk=0.24, 95% confidence interval=0.072-0.791, and p=0.018.

Compatibility of the program activities conducted by a health professional who had achieved healthy weight loss and accepted as a role model was a key to achieving effective weight loss and metabolic syndrome risk reduction in obese women in rural areas. The program should be integrated into the conventional practice of health care centers.

The differences in the distribution of factors associated with under-five mortality (UFM) can help explain the rural-urban inequities in UFM. The determinants contributing to UFM in rural and urban areas have not been previously explored in Bhutan. This study examined the factors associated with UFM in rural and urban Bhutan and the role of the factors in explaining UFM disparity.

The dataset of 6,398 single births (4,999 in rural and 1,399 in urban areas) from the 2012 Bhutan National Health Survey was analyzed. Logistic regression analysis accounting for the complex survey design was performed to investigate the determinants.

The UFM rate was 2.75 times higher in rural than in urban Bhutan. In rural communities, children of younger mothers, born in households without safe sanitation and electricity, and central and eastern regions had increased UFM odds. Whereas, children born to working mothers and educated fathers, and born in households with non-working household heads had lower UFM odds in urban areas. A higher number of births and smaller household size was associated with an increased UFM odds irrespective of rural-urban residence. Environmental factors were attributable for the largest portion of rural UFM disadvantage.

This study helps to understand the rural-urban differences in the factors influencing UFM in Bhutan. The findings suggest that policies aimed to improve environmental and socioeconomic conditions, women empowerment, and those aimed to enhance health utilization can help reduce the rural-urban child survival disparity and accelerate the achievement of the Sustainable Development Goal target.

The purpose of this study is to address the challenges faced by rural areas and promote their sustainable development. It emphasizes the importance of re-establishing connections and cultivating a sense of belonging within rural communities, while safeguarding their cultural heritage. The study explores the potential of digital and creative tools in enhancing learning, supporting food production and tourism, facilitating research and providing engaging experiences. It also examines the economic condition of rural areas and the potential for their contribution to the national economy. Additionally, the study highlights the significance of sustainable community development, the role of rural areas in resilience and climate change adaptation and the complexities surrounding rural migration. The aim is to provide insights and recommendations for policymakers and stakeholders involved in rural development initiatives, focusing on the Mediterranean region.

This study develops an understanding of the role of digital and creative strategies in rural communities, highlighting their significance in preserving food heritage, culture and community capital while driving economic development. It specifically focuses on the Unesco Intangible Mediterranean Diet (UIMD) as a potential catalyst for regeneration through the integration of creative and digital tools and three cases are presented. The first is the impact of the Future Food Institute (FFI) ecosystem in the Living Lab in Pollica (Salerno, Italy); the second focuses on the digital tools provided by the CKF to support rural areas; and the third is a new identity and promotion of territorial development, co-designed in the Val di Vara (VdV) a rural region of the Ligurian inland in Italy, through digital strategies, heritage preservation and slow tourism development. The three cases highlight different ways of enhancing environmental and cultural heritage and demonstrate how collaborative creativity and digital tools contribute to the co-construction of knowledge and addressing critical issues to promote sustainable growth in rural areas.

The findings of this study indicate that re-establishing connections and fostering a sense of belonging within rural communities is crucial for their sustainable development. The use of digital and creative tools presents significant opportunities in enhancing various aspects such as learning, food production, tourism and research in rural areas. The study also reveals the potential economic contributions of rural areas to the national economy. It emphasizes the importance of sustainable community development and highlights the role of rural areas in resilience and climate change adaptation. Additionally, the study addresses the complexities surrounding rural migration and emphasizes the need for comprehensive policies to ensure the well-being and rights of migrant workers. The insights and recommendations provided in this study aim to guide policymakers and stakeholders involved in rural development initiatives, particularly in the Mediterranean region.

Nonetheless, it is imperative to acknowledge certain limitations within the scope of this study, primarily associated with the specific sample selection, potentially influencing the broader applicability of the findings. There is potential to explore a wider geographic area in future research. Additionally, the research underscores the importance of conducting further inquiries into certain aspects that have received limited attention. Living labs are a relatively recent phenomenon, warranting further in-depth scientific research. Additionally, the existing literature on this subject is often limited in scope.

The study and project aim to illustrate the feasibility of initiating a transformative process, centered on a visionary approach with a core focus on creative knowledge and the Mediterranean diet as a way of life, to revitalize marginalized communities. Furthermore, it seeks to emphasize that these neglected regions possess untapped potential for innovative ideas and opportunities. Rural communities, in their role as farmers of primary goods, are the ones who nurture the environment, and the landscape, and are the true protagonists of every era. Rurality is the place that preserves the most resources and potential in terms of biodiversity and rural knowledge. Every territory, like every human being, has its own characteristics and vocations to pursue. The existing Genius Loci is already an existing value that requires policies and governance to rediscover roots, identity and worth. The stratification of existing collective intelligence must become central and must be individually assessed and enhanced, also taking advantage of new digital technologies.

The social implications of this study are significant. By emphasizing the importance of re-establishing connections and cultivating a sense of belonging within rural communities, the study recognizes the social value of strong community ties. This can lead to increased social cohesion, a sense of identity and improved overall well-being within rural areas. The study also highlights the potential of digital and creative tools in enhancing learning, which can contribute to the empowerment and educational opportunities of individuals in rural communities. Furthermore, by promoting sustainable community development and addressing the complexities surrounding rural migration, the study acknowledges the social impact of inclusive policies that protect the rights and well-being of both local populations and migrant workers. Overall, the study's recommendations have the potential to foster social resilience, equity and a more vibrant social fabric within rural areas.

This study can offer valuable insights and recommendations for policymakers and stakeholders involved in rural development initiatives, particularly those focused on preserving food and cultural heritage in rural areas. By analyzing real-life examples, it bridges the gap between theory and practice, illustrating how these ideas have been effectively applied in specific contexts. This paper emphasizes the potential of the Mediterranean Diet as a sustainable and nutritious model with sociocultural, health, economic and environmental benefits, highlighting the importance of bottom-up approaches that empower local communities as custodians of knowledge and culture. It also provides practical strategies, such as investments in educational programs, the establishment of international campuses and the use of multichannel platforms for immersive experiences, which can be adapted for broader rural development initiatives, promoting sustainability and community engagement.

The purpose of this article was to identify factors impacting burnout, resilience and quality of life in rural career firefighters. In addition, sources of stress and the impact of generational differences were explored.

An exploratory cross-sectional survey was conducted at a rural career fire department.

The findings of the project indicate that the firefighters had high levels of compassion satisfaction (CS) and relatively low levels of secondary traumatic stress and burnout; displayed moderate to high psychological resilience and the majority felt moderate to high organizational support, but there was a noticeable minority who did not feel supported by the department. Findings indicate that organizational support is significantly related to both burnout and resilience. The majority of the men (88.3%) reported moderate to high risk for alcohol-related problems and over three-quarters (78.6%) reported binge drinking behavior in the past year. Qualitative findings highlight generational differences and chain of command challenges as primary stressors.

This is a unique study in that it focuses on a rural career department. What was found were issues similar to those facing urban career fire departments.