International Journal of Environmental Research and Public Health

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Closing the Health Gap for Rural and Remote Communities

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Prof. Dr. Fiona Doolan-Noble

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Guest Editor

Goldfields University Department of Rural Health, Curtin University, Kalgoorlie, WA 6430, Australia
Interests: rural and remote health and well-being; inequities; health workforce; interprofessional collaborative practice

Dr. Saliu Balogun

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Guest Editor

Goldfields University Department of Rural Health, Curtin University, Kalgoorlie, WA 6430, Australia
Interests: rural and remote health; musculoskeletal health; health inequality; sarcopenia and multimorbidity

Special Issue Information

Dear Colleagues,

The evidence base regarding rural and remote health requires substantial expansion, particularly through the lenses of intersectionality and system entanglement. Our current paradigm examining health determinants in isolation neglects the complex interplay of environmental, social, and economic factors that shape rural health outcomes. The rural context demands particular attention as environmental stressors escalate due to climate change, population dynamics, and economic transitions.

We invite researchers and practitioners to contribute to this vital discourse, recognizing that closing the health gap for rural and remote communities requires a fundamental reimagining of how we conceptualize, monitor, and address environmental determinants of health. Our hope is that this Special Issue will catalyze innovative approaches that recognize the inseparability of environmental quality, health outcomes, and social justice in rural settings.

Prof. Dr. Fiona Doolan-Noble
Dr. Saliu Balogun
Guest Editors

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16 pages, 1087 KB

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Looking Back to Move Forward: A Narrative Review of Indigenous Health Intervention Research by the University Departments of Rural Health Against a Contemporary National Framework

by Katrina Fyfe, Samantha Bay, Emma V. Taylor, Ha Hoang, Lisa Hall, Annette McVicar, Emma Walke, Carolyn Lethborg, Bahram Sangelaji and Sandra C. Thompson

Int. J. Environ. Res. Public Health 2026, 23(5), 600; https://doi.org/10.3390/ijerph23050600 - 1 May 2026

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Abstract

The Australian University Departments of Rural Health (UDRHs) promote the health and wellbeing of people in rural and remote Australia through health education, research, and advocacy. This narrative review evaluated the extent to which Indigenous health intervention research conducted by UDRHs over a 12-year period (2010–2021) aligned with the Principles and Priorities of the National Aboriginal and Torres Strait Islander Health Plan 2021–2031. The purpose was to reflect on past UDRH research contributions to identify existing strengths and areas for improvement in line with current policy. Thirty-three relevant UDRH publications were identified from a broader database of UDRH research outputs. Each paper was independently coded by at least two authors as demonstrating “yes”, “partial”, or “not evident” alignment with the twelve priorities of the Health Plan. UDRH intervention research demonstrated strengths in genuine shared decision making and partnerships with Indigenous communities, workforce development, health promotion, and identifying and addressing racism. However, gaps were evident in research addressing social and emotional wellbeing, mental health and suicide prevention, promotion of healthy environments, sustainability and preparedness, and transparency regarding shared access to data and information. UDRHs play a key role in building research capacity among staff and communities in rural settings and often maintain long-standing, respectful relationships with local Indigenous communities. While UDRH research aligns with many domains of the national Health Plan, future efforts should prioritise social and emotional wellbeing and mental health. Improved reporting of shared data access represents an immediate opportunity for enhancement. Full article

(This article belongs to the Special Issue Closing the Health Gap for Rural and Remote Communities)

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13 pages, 851 KB

Open AccessProject Report

Impact of Cash for Health Assistance on Healthcare Access and Health-Seeking Behaviors for Families of Pregnant Women in Sindh, Pakistan

by Faiza Rab, Ahmad Wehbi, Asma Hasnat, Chelvi Singeswaran, Mohamed Aliyar Ifftikar and Salim Sohani

Int. J. Environ. Res. Public Health 2025, 22(12), 1843; https://doi.org/10.3390/ijerph22121843 - 10 Dec 2025

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Abstract

Background: The 2022 Pakistan floods devastated healthcare access for pregnant women in already impoverished areas in Sindh province. This study examines how Cash for Health assistance (CH) of USD 112 alleviated financial burdens and improved maternal health outcomes and resilience, bridging a critical literature gap on cash effectiveness in humanitarian crises. Methodology: This study used a mixed-methods approach to assess the CH assistance intervention for families of pregnant/lactating women in flood-affected rural Sindh, Pakistan. A pre-post quantitative analysis of baseline (May–June 2024) and endline (August–November 2024) survey data in ~100 villages (Jamshoro/Sehwan) examined changes in healthcare access, expenditure, and preferences using t-tests, proportion tests, and multivariable regression. Concurrently, five qualitative case studies from key informant interviews provided thematic content analysis, triangulating findings on economic, health, and social impacts. Results: Respondents predominantly had low literacy rates and were from households of daily wage laborers in vulnerable, flood-affected areas. While income and education remained low, instances of forgone care due to financial barriers increased (68% to 97%, p < 0.001). CH significantly improved healthcare access (58% to 98%, p < 0.001). Access to regular physicians (20% to 69%) and private facilities (10% to 41%) notably expanded. Healthcare expenditure significantly increased from USD 9.3 to USD 25, with a shift in spending preference towards medication, consultations, and diagnostics. CH also significantly improved food security (21% to 97%), meal frequency, and overall household stability, including reducing domestic violence. Qualitative data emphasized pre-existing vulnerabilities and CH’s role in addressing health, nutrition, and psychosocial needs. Conclusions: CH significantly improved healthcare access and reduced financial burdens for vulnerable pregnant women post-disaster. However, a sustainable impact requires integrated “cash plus” models, combining financial aid with stronger health systems, psychosocial support, and literacy for long-term resilience. Full article

(This article belongs to the Special Issue Closing the Health Gap for Rural and Remote Communities)

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