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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 paper aims to analyze the status of infrastructure, workforce and basic amenities at public health-care facilities in rural India and draw a comparison with its urban counterparts.

Rural Health Statistics data and National Sample Survey Office Report for the period 2019–10 were used to analyze lower-level public health facilities, namely, subcenters, primary health centers and community health centers (CHCs). Selected tracer indicators under World Health Organization’s (WHO) Service Availability and Readiness Assessment (SARA) mechanism such as health center density, core health workforce density and basic amenities were used to carry out the analysis. The extent of facility coverage was measured using the National Rural Health Mission (NRHM) guidelines and the proportion of facilities satisfying the Indian Public Health Standards (IPHS) was measured to assess the service provision quality in rural public health-care facilities.

Results indicated that the density of public health centers is higher in rural areas than in urban areas. Almost all public health-care facilities lack basic amenities in rural areas. Working positions for health specialists in CHCs barely meet the total requirement. Almost all of the public health facilities functioning in rural areas do not meet the IPHS norms.

To the best of the authors’ knowledge, the present paper is the first initiative to assess the status of rural public health-care facilities on the national level using WHO’s SARA indicators as well as NRHM and IPHS guidelines. The study is significant in terms of policy input for achieving universal health coverage in India.

This study examined the influence of income and health insurance on the health-seeking behaviour of rural residents, addressing the concerns of endogeneity and heterogeneity bias.

A two-stage residual inclusion was utilised to correct self-selection-based endogeneity problems arising from health insurance membership.

This study provides support for Andersen's behavioural model (ABM). Income and health insurance positively stimulate rural residents' use of modern healthcare services, but the effect of insurance risks a downward bias if treated as exogenous. Further, the effect of health insurance differs between males and females and between adults and the elderly.

This study advances the literature, arguing that, within the ABM framework, enabling (i.e. income and insurance) and predisposing factors (i.e. age and gender) complement each other in explaining rural residents' use of modern health services.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-03-2023-0223

This study explored the effects of the coronavirus pandemic on rural municipal police in Pennsylvania.

The authors surveyed rural police chiefs and sworn officers to inquire about their intra-department organizational capabilities, police-community relations, well-being practices, and how these strategies may have developed since March 2020.

The pandemic affected rural police officers and rural policing strategies in many ways. Moreover, existing challenges to limited rural police budgets were exacerbated suggesting a need for more flexible budgetary capacities, access to wellness resources were limited suggesting better access to these resources and preparation for responding to public health emergencies was limited suggesting more complete training is warranted.

This study draws attention to the unique experiences of rural municipal police across one state by capturing specific areas of concern throughout the coronavirus pandemic.

This paper aims to investigate research activity on barriers for minority and underserved groups to access and use mental health services.

Using Scopus, relevant articles published from 1993 to 2022 were collected. The final list included 122 articles.

Research hotspots included cultural and ethnic barriers, obstacles encountered by LGBTQ+ individuals, challenges faced by refugees and immigrants, limited access in rural areas and barriers affecting special populations. The top 10 cited articles focused on language barriers, cultural stigma, gender-specific challenges and systemic obstacles. New research avenues included the role of technology in overcoming barriers to access mental health services.

Policymakers and practitioners can use this knowledge to develop targeted interventions, enhance cultural competence, reduce stigma, improve rural access and provide LGBTQ+-affirming care, ultimately promoting equitable mental health care.

This research underscores the importance of addressing mental health service barriers for equity and social justice. Neglecting these disparities can worsen mental health, increase health-care costs, reduce productivity and lead to higher social welfare expenses, perpetuating disadvantages.

This paper's uniqueness lies in its comprehensive analysis of barriers and facilitators to mental health service utilization among minority and underserved groups. It serves as a basis for developing evidence-based strategies to improve service accessibility and enhance the well-being of marginalized communities.

This paper aims to evaluate Ghana's National Health Insurance Scheme (NHIS) on healthcare utilisation by exploring its heterogeneous effects based on residential status and wealth.

The study used the Ghana Socioeconomic Panel Survey (GSPS) datasets. An instrumental variable strategy, specifically the two-stage residual inclusion (2SRI), was employed to control endogenous NHIS membership.

Generally, the results show that NHIS improves healthcare utilisation (i.e. visits to a health facility and formal care). Concerning the heterogeneous effects of health insurance on healthcare utilisation, the results revealed that NHIS members are more likely to seek care, irrespective of their residence status. The results further indicate that the probability of visiting a health facility and utilising formal care increases for the poorest NHIS participants. Based on these, the authors conclude that NHIS provides equitable healthcare access and utilisation for its vulnerable populations, who are beneficiaries.

To the best of the authors' knowledge, this paper is the first to explore the heterogeneous effects of NHIS on healthcare utilisation across residential and income subpopulations. Splitting the dataset by residential status to examine healthcare utilisation inequality is worthwhile. In addition, analysing utilisation in terms of health care type would show whether Ghana's NHIS may be viewed as welfare-enhancing through increased formal health care utilisation.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-05-2023-0330

That social franchising programs induce favorable outcomes is readily taken for granted, albeit lacking robust empirical support. Addressing this situation, this paper takes a closer look at a fractional social franchising program in the public health-care sector in Vietnam to better understand how such programs work. This paper aims to expand the nascent body of empirical research that has examined the inner workings of social franchising programs from the perspective of clients by focusing on the health professionals who work there.

Using an exploratory qualitative research design, the authors conducted 25 semistructured interviews with health professionals of a fractional franchising program called Sisterhood, which introduced reproductive health and family planning services into existing health facilities in Vietnam. Interviews were triangulated with Sisterhood’s internal documents as well as with publicly available reports.

The analysis highlights two pathways through which the social franchising program brought about positive change. On the one hand, the analysis suggests that many of the positive outcomes reported by public health professionals were consistent with the stated goals and measures used by the Sisterhood program, providing evidence that improving the quality of health care for disadvantaged communities can be achieved through careful design and execution. On the other hand, the analysis revealed beneficial outcomes that were outside the scope of the Sisterhood program and, in this sense, “unexpected.” Specifically, the paper sheds light on unintended knowledge spillover effects in which nonfranchised health professionals began to adopt new practices and principles introduced by the social franchising program.

The paper taps into a largely under-researched phenomenon – fractional social franchising – from the perspective of health professionals. Unpacking how the social franchising program created favorable outcomes, some by design and others by accident, the paper opens new empirical and policy insights into how social franchising can improve public health in hard-to-reach communities in the global South. Based on the findings, the authors argue for the intentional promotion and institutionalization of knowledge transfers from franchised to nonfranchised health facilities to reinforce and scale up the positive impact of social franchising. The authors conclude by emphasizing the need for future research to adopt a complexity-sensitive approach that accounts for the dynamic, nonlinear adoption pathways social franchising can take. Such an approach is essential to uncover the beneficial outcomes that can result from social franchising programs but cannot be readily predicted by program design.

This study aims to measure the level of satisfaction among women with childbirth services provided at public health facilities. Further, to analyse the impact of their socio-economic and obstetric characteristics on their level of satisfaction.

To accomplish these objectives a cross-sectional survey was conducted in two districts of an Indian state, Bihar. Structured questionnaire was developed based on the scale proposed by Okumu and Oyugi (2018) both for vaginal and caesarean birth patients. For empirical analysis multiple linear regression model was employed.

Results suggest that majority of mothers are satisfied with the care they received during childbirth, regardless of whether they chose a caesarean (55%) or vaginal delivery (53%). Women report the lowest levels of satisfaction with postpartum care and the privacy that was preserved by healthcare personnel at health facility. Further the study also confirms the association between patient’s socio-economic characteristics and their satisfaction level.

This is the first study of its kind to highlight the situation of public healthcare system in Bihar, which is the third most populated state in India with poor social and health indicators.

Research has found a strong correlation between maternal healthcare and health insurance coverage. But, despite having one of the best health coverage systems in the developing world, Rwanda still faces formidable challenges in provision certain key maternal health services, leading to higher levels of maternal morbidity and mortality. To understand this paradox, this study will examine the association between maternal health services and insurance coverage, utilizing the latest data from the Rwanda Demographic Health Survey.

Using a sample of 6,167 childbearing women aged 15–49 years, a bivariate and multivariate analysis was conducted to examine the paradoxical relationship between health insurance and maternal health services, such as antenatal care, in Rwanda.

The results reveal significant differences in ANC4+ and the timing of the first ANC, which remain low in Rwanda. Despite significant improvements in delivery factors and skilled ANC providers, ANC4+ rates in the country remain the lowest. However, this study found a positive and significant association between ANC4+ and insurance coverage (AOR = 1.64, p < 0.001).

Rwanda has implemented an effective health insurance policy, but there has been minimal progress in the utilization of maternal health services. Therefore, there is a strong need for policy interventions to reduce barriers to healthcare utilization. Additionally, supply-side factors such as transportation, socio-cultural factors and other logistic barriers should be examined in greater detail. These factors may overshadow the impact of health insurance on the utilization of healthcare services in Rwanda.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-01-2023-0059