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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.

The purpose of this study is to explore the sustainability of innovations introduced during the coronavirus disease 2019 (Covid-19) pandemic in remote and rural primary care advanced clinical practice.

The methodology includes an exploratory qualitative study of eight key stakeholders from Scottish remote and rural primary care advanced practice (three policymakers and five advanced practitioners). Data were collected using semi-structured interviews during 2022 and analysed thematically.

Advanced practice in remote and rural primary care is characterised by a shortage of doctors, close-knit communities and a broad scope of practice. Covid-19 catalysed changes in the delivery of healthcare. Innovations which participants wanted to sustain include hybrid working, triage, online training and development, and increased inter-professional support networks.

Findings provide valuable insights into how best to support remote and rural advanced practice which may have implications for retaining healthcare professionals. They also identified useful innovations which could benefit from further investment.

Given current healthcare workforce pressures, identifying and sustaining innovations which will support and retain staff are imperative. Hybrid consultations and online access to training, development and support should be sustained to support the remote and rural advanced practice workforce. Further research should explore the sustainability of innovations introduced during the Covid-19 pandemic in other care contexts.

Psychosocial problems, including social isolation and loneliness, are prevalent in rural communities and can impact the use of health services and health outcomes. Current approaches to managing patients with predominantly psychosocial issues may not be the most appropriate. Social prescribing (SP) is a relatively new way of linking patients with sources of non-medical support within the community. Emerging literature suggests that community-based, non-medical activities are an effective and preferred approach to managing psychosocial problems. However, there is little evidence describing the attitudes of general practitioners (GPs) towards formal SP pathways.

This research will occur in a general practice in a rural area of Tasmania, Australia. The project will deliver an education module to rural GPs to highlight the benefits of SP and provide a streamlined pathway for referring patients to community support hubs. Existing community organisations will act as “link workers” to connect patients with suitable community activities. GPs will complete a baseline and follow-up survey to measure their perception of SP and the acceptability, feasibility and appropriateness of such an intervention.

The acceptability, feasibility and appropriateness of the pathway will be assessed using published measures. Free-text responses to open-ended questions will be used to complement the quantitative data. A hybrid effectiveness-implementation method will be used to gather information about the rate of uptake and quality of the SP referral process and identify barriers and facilitators of the process in a real-world setting.

While qualitative data for SP programmes is predominantly positive, quantitative data is lacking. Although the planned project is relatively short, it will provide a basis for future SP programme implementation and guide the approach to data collection and implementation assessment.

The barriers to and facilitators of introducing a SP programme in a rural general practice setting may be used to guide the development and implementation of future large-scale SP interventions. This research is both timely and relevant as the problem of social isolation and loneliness, especially in rural areas of Australia, is becoming more well-recognised as a driver of poor health and unnecessary health service usage.

Using SP to address psychosocial risks may reduce healthcare burden and costs. Few SP programmes have been delivered and formally assessed in Australia, and the best way to implement SP locally remains unclear. By delivering a SP intervention in a rural setting and assessing GPs’ responses, future SP projects will be better able to design and integrate social and medical care services.

The COVID-19 pandemic has had a disruptive effect on the health system. Health facility leaders were at the forefront of maintaining service delivery and were exposed to varied stressors in the early phase of the pandemic. This study aims to explore the leadership experiences of health facility leaders during the early phase of the COVID-19 pandemic in Nigeria’s epicentre.

This study conducted an exploratory descriptive qualitative study. To achieve this, 33 health facility leaders of different cadres across primary, secondary, and tertiary levels of the public health care system in Lagos, Nigeria, were remotely interviewed. The key informant interviews were transcribed verbatim and were analysed by using thematic analysis.

The health facility leaders experienced heightened levels of fear, anxiety and stressors during the early phase of the pandemic. They also had genuine concerns about exposing their family members to the virus and had to manage some health-care workers who were afraid for their lives and reluctant. Coping mechanisms included psychological and social support, innovative hygiene measures at health facility and at home, training and staff welfare in more ways than usual. They were motivated to continue rendering services during the crisis because of their passion, their calling, the Hippocratic oath and support from the State government.

The experiences of health facility leaders from different parts of the world have been documented. However, to the best of the authors’ knowledge, this is one of the first studies that specifically report multi-layer leadership experiences of health facility leaders during the early phase of the COVID-19 pandemic in sub-Saharan Africa.

The dermatology service on the islands of Orkney, with a population of approximately 22,500, was taken over by National Health Service (NHS) Tayside in August 2018. This paper aims to provide an overview of the planning and review of a highly efficient and effective dermatology service for a rural island population.

The service includes visiting dermatology consultants, enhanced electronic referral vetting, skin surgery services, a General Practice (GP) with extended role (GPwER) in dermatology, specialist virtual clinics, urgent advice for inpatients at the local district general hospital and remote systemic therapy monitoring. A new phototherapy service has been set up in an island GP practice.

Local GPs and consultant dermatologists find the enhanced vetting service useable, efficient and educational. Between August 2018 and November 2022, there have been 1,749 referrals. Of these referrals, 60% were seen in clinic or a GPwER surgery, with 40% managed remotely by providing advice back to the referring GP. The number of consultations performed by the GPwER has grown over the past 3 years, and in the last year, it accounted for more than 50% of patient appointments. The waiting time has been significantly reduced using this model.

This remote service uses an integrated approach of teledermatology (TD) whilst offering continual in-person services using local capabilities including a GPwER and island general surgeons. New treatment facilities are provided to the island population. Continual educational feedback to the primary care referrer is provided, and it enhances relationships that greatly aid the high-quality dermatology service provided.

Although healthcare and healthy living are integral to the Sustainable Development Goals (SDGs) for 2030, the coronavirus epidemic has dealt a devastating blow to these efforts. As governments and policymakers were compelled to shift their focus to lockdowns, sustenance, procurement, and distribution of vaccines, the momentum for health initiatives slowed, and the already fragile health systems of emerging markets were subjected to additional shocks. However, in many underserved regions of the globe, the introduction of technology has greatly facilitated the distribution and adoption of healthcare services.

This chapter highlights mini-cases from four emerging nations: Bangladesh, Nigeria, Vietnam, and the Philippines. Although the countries are emerging, each one of them are in a distinct stage of development and face a unique set of healthcare-related challenges. The chapter showcases how four different organizations based in these countries leveraged the use of technology to take healthcare services to underserved populations. In doing so, they addressed the key challenges of imparting healthcare: geographic accessibility, availability, financial accessibility, and acceptability.

This chapter concludes with a discussion of the implications of expanding healthcare industries leading to increased healthcare waste. To prevent mass population exposure to hazardous substances, the emergence of intelligent healthcare waste collection and disposal systems will be an absolute necessity. Hence, with the development of healthcare services, governments and policymakers need to mechanize smart waste management systems to safeguard humans, animals, and the environment.

Creative entrepreneurship is a vital concept that revolves around setting up a business that is novel, thoughtful, lucrative, and yet compassionate. The global pandemic has made people realise the significance and importance of creative entrepreneurship. Self-help groups (SHGs) play a pivotal role in boosting the rural economy and empowering people. Rural creative entrepreneurship has witnessed a significant transformation during the COVID-19 pandemic. The conventional concepts vanished due to the modern shift towards digitisation. Usage of the technology became the new normal and SHGs made all possible efforts to acclimatise promptly. Online virtual meetings, conference calls, and groups on WhatsApp made common people techno-savvy, facilitating work from home. The adoption of digitisation became a catalyst for the development of remote/rural areas. The present study is focused on the role of creative entrepreneurship in supporting and helping SHGs to function seamlessly during the COVID-19 pandemic. The authors aimed at analysing pandemic and post-pandemic creative entrepreneurship through SHGs in Himachal Pradesh (India). The authors identify that Creative Entrepreneurship initiatives have changed and supported the livelihood of rural people during the pandemic. This chapter also highlights challenges faced by the SHGs during the lockdown and their resilience strategies.

From the perspective of any nation, rural areas generally present a comparable set of problems, such as a lack of proper healthcare, education, living conditions, wages and market opportunities. Some nations have created and developed the concept of smart villages during the previous few decades, which effectively addresses these issues. The landscape of traditional agriculture has been radically altered by digital agriculture, which has also had a positive economic impact on farmers and those who live in rural regions by ensuring an increase in agricultural production. We explored current issues in rural areas, and the consequences of smart village applications, and then illustrate our concept of smart village from recent examples of how emerging digital agriculture trends contribute to improving agricultural production in this chapter.

The prevalence of pediatric anxiety disorders is on the rise but youth have challenges in accessing specialty evidence-based mental health care. As a result, families turn to their pediatric primary care provider (PCP) for assessment and management of anxiety. To increase PCPs’ abilities to manage anxiety, the Extension for Community Healthcare Outcomes (“Project ECHO”) was used. The purpose of this study is to explore the impact of Project ECHO on participating PCPs’ knowledge, self-efficacy and interventions surrounding the assessment and management of anxiety.

Data were collected pre- and post-course across five cohorts. Participants completed a clinical knowledge test, ratings of self-efficacy and self-reported frequencies of in-office interventions. Satisfaction was also measured.

Attendance remained strong, and participants rated high satisfaction. From pre- to post-course, participants demonstrated increased knowledge on almost all objective questions. Participants reported increased self-efficacy across all domains. Finally, participants endorsed increased use of several in-office interventions.

This study highlights the importance of Project ECHO as a continuing education model to enhance PCPs’ abilities and confidence in the assessment and management of anxiety. Future continuing education endeavors should consider Project ECHO as a means of increasing PCPs’ capacity to manage mental health conditions.

To the best of the authors’ knowledge, this is the first study that applied the Project ECHO model to pediatric anxiety as a mechanism of increasing knowledge, self-efficacy and in-office interventions with PCPs.