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Advancing Health Services and Systems for Vulnerable Populations Including People in Rural, Regional and Remote Areas

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: 31 October 2026 | Viewed by 1637

Editors


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Guest Editor
School of Health, University of the Sunshine Coast, Petrie, QLD 4502, Australia
Interests: cardiac; clinical research; diabetes; self-efficacy; self-management; telehealth; synthesis of literature review
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Broken Hill University Department of Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2880, Australia
Interests: social epidemiology; behavioral epidemiology; health system research; health program evaluation; Indigenous health; emergency medicine; paramedicine; mental health
Special Issues, Collections and Topics in MDPI journals
School of Public Health, Southeast University, Nanjing 210009, China
Interests: social epidemiology; health policy; health economics; chronic diseases management; chronic diseases epidemiology; health programs/policy evaluation; healthcare services and management; healthcare for vulnerable populations; healthy aging research
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

People living in rural, regional and remote areas often face greater barriers to access healthcare, particularly those with chronic conditions. To address this major challenge for healthcare systems, this Special Issue of IJERPH is dedicated to celebrating the achievements and progress in this significant area by sharing international research findings, including (but not limited to) findings in the fields of risk factors, self-management and support, adherence to medications/treatment, family/carer and community support, participation in prevention services, access to primary/secondary/tertiary care, clinical information systems, case management, life expectancy and deaths, models of care, coordination of care, patient-centred care, transitional care, cultural safety/competency for vulnerable populations, health system design/re-design, rehabilitation services, surveillance system, telehealth, and policy in the health system.

It is our intention that this Special Issue will provide the most up-to-date and high-quality evidence to guide practice worldwide to benefit rural people, particularly including those with chronic conditions, their families, communities, and society in general.

Dr. Chiung-Jung (Jo) Wu
Dr. Xiang-Yu Hou
Dr. Lijun Fan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health system
  • health policy
  • health services
  • health programmes
  • rural, regional and remote health
  • patient-centred care
  • primary healthcare
  • hospital care
  • tertiary healthcare
  • transitional healthcare
  • chronic diseases
  • cancer
  • cardiovascular diseases
  • mental health
  • diabetes
  • dementia
  • overweight and obesity

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Published Papers (1 paper)

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Research

18 pages, 1676 KB  
Article
Community Mental Health Services in Andean Peru: Mapping Supply and Demand
by Milagros Alvarado, Daniel Mäusezahl, Stella Hartinger, Andrea Fernandez-Rodriguez, Maria Melero-Dominguez, Francisco Diez-Canseco, Günther Fink, Ricardo Peña-Sánchez and Irene Falgas-Bague
Int. J. Environ. Res. Public Health 2026, 23(4), 512; https://doi.org/10.3390/ijerph23040512 - 16 Apr 2026
Viewed by 1107
Abstract
Peru’s recent national mental health (MH) reforms aim to decentralise care and expand access to MH services for rural populations by integrating services into primary healthcare through the expansion of Community Mental Health Centres (CMHCs). Evidence on the implementation of these reforms at [...] Read more.
Peru’s recent national mental health (MH) reforms aim to decentralise care and expand access to MH services for rural populations by integrating services into primary healthcare through the expansion of Community Mental Health Centres (CMHCs). Evidence on the implementation of these reforms at the local level remains limited. This qualitative study aimed to (i) describe the structure and implementation framework of MH services, (ii) analyse local understandings of MH; and (iii) examine pathways to care and identify barriers and facilitators to MH service implementation from both the supply (service providers) and demand (users and community members) perspectives. MH services were mapped across three provinces of northern Peru using a review of national MH policies, 2 focus group discussions, and 31 semi-structured interviews. Data were analysed thematically to explore local understandings of MH, pathways to care, and health system barriers. Local understandings of MH are shaped by cultural beliefs, social norms, and economic conditions, with many individuals experiencing distress initially relying on family networks or traditional healers. Stigma and expectations of a quick recovery hinder engagement with formal services. While the expansion of CMHCs has improved geographical access to specialised care in rural areas through proximity and being patient-centred, the implementation of respectful provider interactions remains uneven. Weak referral pathways and limited coordination between primary care centres and CMHCs frequently shift the responsibility for navigating care onto users and their families. Family involvement and culturally sensitive practices foster trust and support continued engagement. Persistent challenges include the limited capacity of service providers, high staff turnover, and the follow-up mechanisms, stigma, and tensions between cultural and biomedical understandings of MH. Peru’s expansion of CMHCs represents a significant health system reform to improve equitable access for rural populations. To sustain these gains, it will be necessary to strengthen workforce stability, clarify referral processes, and integrate culturally responsive approaches within primary care systems, offering lessons for similar resource-constrained contexts. Full article
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