WorldWideScience

Sample records for rural service area

  1. Utilization of Mental Health Services by Veterans Living in Rural Areas.

    Science.gov (United States)

    Teich, Judith; Ali, Mir M; Lynch, Sean; Mutter, Ryan

    2017-06-01

    There is concern that veterans living in rural areas may not be receiving the mental health (MH) treatment they need. This study uses recent national survey data to examine the utilization of MH treatment among military veterans with a MH condition living in rural areas, providing comparisons with estimates of veterans living in urban areas. Multivariable logistic regression is utilized to examine differences in MH service use by urban/rural residence, controlling for other factors. Rates of utilization of inpatient and outpatient treatment, psychotropic medication, any MH treatment, and perceived unmet need for MH care are examined. There were significant differences in MH treatment utilization among veterans by rural/urban residence. Multivariate estimates indicate that compared to veterans with a MH condition living in urban areas, veterans in rural areas had 70% lower odds of receiving any MH treatment. Veterans with a MH condition in rural areas have approximately 52% and 64% lower odds of receiving outpatient treatment and prescription medications, respectively, compared to those living in urban areas. Differences in perceived unmet need for mental health treatment were not statistically significant. While research indicates that recent efforts to improve MH service delivery have resulted in improved access to services, this study found that veterans' rates of MH treatment are lower in rural areas, compared to urban areas. Continued efforts to support the provision of behavioral health services to rural veterans are needed. Telemedicine, using rural providers to their maximum potential, and engagement with community stakeholder groups are promising approaches. © 2016 National Rural Health Association.

  2. 47 CFR 22.228 - Cellular rural service area licenses subject to competitive bidding.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Cellular rural service area licenses subject to... Procedures § 22.228 Cellular rural service area licenses subject to competitive bidding. Mutually exclusive initial applications for Cellular Rural Service Area licenses are subject to competitive bidding. The...

  3. Welfare service in rural areas

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    Many rural municipalities are challenged due to overall population decline and demographic changes and thus need to make adjustment to municipal services. Demographic profiles are central for assessing both needs, place bound resources and development potential of individual localities.Assessment......Many rural municipalities are challenged due to overall population decline and demographic changes and thus need to make adjustment to municipal services. Demographic profiles are central for assessing both needs, place bound resources and development potential of individual localities.......Assessment of development potential for individual localities using a place-based approach is in line with EU policies for rural development thereby setting a competitive framework for local development. This paper addresses place bound approaches in relation to service adjustment and discusses how local resources...... and place bound potentials are identified and how they are addressed in plans for future development. The paper draws on a study on service adjustments in rural municipalities in Denmark examining how service adjustments e.g. closing of local schools are decided, how they are managed by rural communities...

  4. Provision of oncology services in remote rural areas: a Scottish perspective.

    Science.gov (United States)

    Smith, S M; Campbell, N C

    2004-05-01

    There is a paucity of research into rural health care services. In particular little is known about the provision of specialist cancer services for patients who live in remote rural areas of the UK. This study set out to investigate current models of medical and clinical oncology care in Scotland. A national survey with key health professionals was conducted to identify rural oncology schemes currently in operation. Detailed quantitative data about the schemes together with qualitative data on how health professionals view current models of care were collected by a computer-assisted telephone survey. Schemes that currently provide outpatient and chemotherapy oncology services for remote rural patients fell into three categories: central clinics (5); shared care outreach clinics with chemotherapy provision (11); and shared care outreach clinics without chemotherapy provision (7). All radiotherapy was conducted at central clinics (5). Widely varying practices in delivery of cancer care were found across the country. The main issues for professionals about current models of care involved expertise, travelling and accessibility (for patients), communication and expansion of the rural service. Nation-wide consistency in cancer care has still to be achieved. Travelling for treatment was seen to take its toll on all patients but particularly for the very remote, elderly and poor. Most professionals believe that an expansion of rural services would be of benefit to these patients. It is clear, however, that the proper infrastructure needs to be in place in terms of local expertise, ensured quality of care, and good communication links with cancer centres before this could happen.

  5. Assessment of pharmacists' delivery of public health services in rural and urban areas in Iowa and North Dakota.

    Science.gov (United States)

    Scott, David M; Strand, Mark; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan

    2016-01-01

    The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists' delivery of public health services. To assess Iowa and North Dakota pharmacists' practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (PDakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking.

  6. Customer satisfaction with mobile operators’ services in Lithuanian rural areas

    OpenAIRE

    Pilelienė, Lina; Grigaliūnaitė, Viktorija

    2017-01-01

    In tough competitive conditions of Lithuanian mobile services market, customer satisfaction becomes one of the most important factors for customer retention and attraction. Lithuanian mobile market can be described as being in a maturity stage of its life-cycle: the prices and services of different mobile operators are quite similar. However, the network coverage and signal strength differs – main differences can be observed in rural areas of the country. Therefore, the scientific...

  7. Assessment of pharmacists’ delivery of public health services in rural and urban areas in Iowa and North Dakota

    Science.gov (United States)

    Scott, David M.; Strand, Mark; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan

    2016-01-01

    Background: The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services. Objective: To assess Iowa and North Dakota pharmacists’ practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. Methods: This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Results: Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (PDakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking. PMID:28042356

  8. Traveler information services in rural tourism areas : appendix A, tourist intercept surveys

    Science.gov (United States)

    2000-06-30

    This document presents documentation regarding tourist intercept surveys for traveler information services in rural areas. It documents data collection functions and information dissemination functions, and provides an interpretive description of tra...

  9. Traveler information services in rural tourism areas : appendix D, system/historical data analysis

    Science.gov (United States)

    2000-06-30

    This document presents information regarding data collection and dissemination functions for traveler information services in rural areas. It documents data collection functions and information dissemination functions, and provides an interpretive de...

  10. The Implementation of TTG Book Service Done By Community Library in Rural Area

    Directory of Open Access Journals (Sweden)

    Pawit Muhammad Yusup

    2016-06-01

    Full Text Available The problem of poverty in rural areas cannot be separated from the following aspects: poverty, lack of education facilities, low level of entrepreneurial skills, health, lack of learning facilities, population distribution, infrastructure and facilities are inadequate, access to information, and other aspects that are still limited. The Village Library and Community Library as part of the affordable infrastructure and learning facilities are, not yet available in every village. This study tried to introduce pilot models Appropriate Technology Implementation Services Book through Rural Libraries and the community library to a number of poor people in the village. The result could contribute in improving the skills of a number of rural poor in entrepreneurship-based reading. This service models can be applied in other similar villages.

  11. The Need and Use the Rural ICT Services in Iranian Rural Areas

    Directory of Open Access Journals (Sweden)

    Amir Mozafar Amini

    2015-11-01

    Full Text Available Nowadays, Internet access and use of information resources in all human societies are experiencing a rising trend, and different communities are used each with multiple infrastructures due to the benefits of ICT. The present study was based on applied research. In this research, a hybrid approach involving quantitative methods (survey and qualitative (observation, interviews was used. Statistical population of this study consists of two parts, the first part responsible for rural ICT offices, with a population of 125 people using Cochran Formula 80 subjects were selected as first sample, and the second part of the rural of first sample villages with a population of 84,836 people using Cochran formula and randomized-comparative method were studied as second sample. The questionnaire was subjected to reliability testing by using data collection in the pilot study with Cronbach’s Alpha value 0.73 to 0.95 for all variables. SPSS statistical software was used to analysis the data. The results of the study indicate that the overall performance of the agencies providing services to the rural was lower-middle in the offices in banking services has received first place, and the final ranking in the provision of health services. The results of study showed that rural employment, level education and family size effect on the rate of rural ICT offices.

  12. Free preconceptual screening examination service in rural areas of Hubei Province, China in 2012.

    Science.gov (United States)

    Li, Cui-ling; Zhao, Kai; Li, Hui; Farah, Omar Ibrahim; Wang, Jiao-jiao; Sun, Rong-ze; Zhang, Hui-ping

    2014-01-01

    This work aims to collect and summarize the outcomes on free preconceptual screening examination in rural areas of Hubei Province in 2012. Moreover, this review promotes further understanding of the status of this activity to provide the Family Planning Commission valid scientific data upon which to construct effective policies. Couples, who complied with the family planning policy and were the residents in agricultural areas or lived in a local rural area for more than six months, were encouraged to participate in the free preconceptual screening examination service provided by the Hubei Provincial Population and Family Planning Commission. This service included 19 screening tests. All the data, including forms, manuals, and test results, were collected from 1 January 2012 to 31 December 2012 in rural areas in Hubei Province. A total of 497,860 individuals participated in the free preconceptual screening examination service, with a coverage rate of 97.1%. 4.0% and 4.8% of the participants exhibited with abnormal blood levels of ALT and creatinine, respectively; 0.36% of the participants tested positive for syphilis; 0.44% and 3.6% of the female participants tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis, respectively; and 0.84% and 1.8% of the female participants tested positive for cytomegalovirus (IgM) and Toxoplasma gondii (IgM), respectively. After risk assessment, 59,935 participants might have high-risk of adverse pregnancy outcomes. In 2012, the prevalence of birth defects among the parturient who participated in the preconceptual screening examination service was 0.04%, while the prevalence was 0.08% among those who did not participate in the service. Preconceptual screening examination service may help to address the risk factors that can lead to adverse pregnancy outcome. More studies on the relationship between preconceptual screening examination service and prevalence of birth defect or other adverse pregnancy outcomes should be

  13. Assistive Technology Service Delivery in Rural School Districts

    Science.gov (United States)

    Ault, Melinda Jones; Bausch, Margaret E.; Mclaren, Elizabeth M.

    2013-01-01

    Little is known about the implementation of assistive technology (AT) services for students in rural areas. This study investigated the AT service delivery in 10 rural districts across six states. The results indicated that students use AT across functional areas, but considerably fewer number of devices than do those not living in rural areas. AT…

  14. Rural health service managers' perspectives on preparing rural health services for climate change.

    Science.gov (United States)

    Purcell, Rachael; McGirr, Joe

    2018-02-01

    To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

  15. Traveler information services in rural tourism areas : appendix C, observations at tourist interactions with kiosks

    Science.gov (United States)

    2000-06-30

    This report presents a series of observations of tourists' experiences with kiosks providing traveler information services at rural tourism areas. The kiosks were assessed in five areas: reliability visibility, usability, usefulness, and adaptability...

  16. Free preconceptual screening examination service in rural areas of Hubei Province, China in 2012.

    Directory of Open Access Journals (Sweden)

    Cui-ling Li

    Full Text Available OBJECTIVE: This work aims to collect and summarize the outcomes on free preconceptual screening examination in rural areas of Hubei Province in 2012. Moreover, this review promotes further understanding of the status of this activity to provide the Family Planning Commission valid scientific data upon which to construct effective policies. METHODS: Couples, who complied with the family planning policy and were the residents in agricultural areas or lived in a local rural area for more than six months, were encouraged to participate in the free preconceptual screening examination service provided by the Hubei Provincial Population and Family Planning Commission. This service included 19 screening tests. All the data, including forms, manuals, and test results, were collected from 1 January 2012 to 31 December 2012 in rural areas in Hubei Province. RESULTS: A total of 497,860 individuals participated in the free preconceptual screening examination service, with a coverage rate of 97.1%. 4.0% and 4.8% of the participants exhibited with abnormal blood levels of ALT and creatinine, respectively; 0.36% of the participants tested positive for syphilis; 0.44% and 3.6% of the female participants tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis, respectively; and 0.84% and 1.8% of the female participants tested positive for cytomegalovirus (IgM and Toxoplasma gondii (IgM, respectively. After risk assessment, 59,935 participants might have high-risk of adverse pregnancy outcomes. In 2012, the prevalence of birth defects among the parturient who participated in the preconceptual screening examination service was 0.04%, while the prevalence was 0.08% among those who did not participate in the service. CONCLUSION: Preconceptual screening examination service may help to address the risk factors that can lead to adverse pregnancy outcome. More studies on the relationship between preconceptual screening examination service and prevalence of

  17. Traveler information services in rural tourism areas : appendix B, qualitative interviews and focus groups

    Science.gov (United States)

    2000-06-30

    This report documents results from surveys which were conducted for qualitatively assessing the use of traveler information services in rural areas. The focus of the surveys was to identify those factors which influence travel planning and thus impro...

  18. 47 CFR 54.207 - Service areas.

    Science.gov (United States)

    2010-10-01

    ... company to be other than such company's study area, the Commission will consider that proposed definition... definition of a service area served by a rural telephone company. (2) The Commission shall issue a Public... to consider a definition of a service area served by a rural telephone company that is different from...

  19. Addressing service delivery in rural areas through deployment of information and communication technology platforms

    CSIR Research Space (South Africa)

    Foko, Thato E

    2017-05-01

    Full Text Available deployment of ICT Platforms in the rural areas. The contribution of ICT Platform adds to the important notion of access which enhances service delivery. This is seen through the Technology Acceptance Models used in this paper. The main research methodology...

  20. Measuring potential access to food stores and food-service places in rural areas in the U.S.

    Science.gov (United States)

    Sharkey, Joseph R

    2009-04-01

    Geographic access to healthy food resources remains a major focus of research that examines the contribution of the built environment to healthful eating. Methods used to define and measure spatial accessibility can significantly affect the results. Considering the implications for marketing, policy, and programs, adequate measurement of the food environment is important. Little of the published work on food access has focused on rural areas, where the burden of nutrition-related disease is greater. This article seeks to expand our understanding of the challenges to measurement of potential spatial access to food resources in rural areas in the U.S. Key challenges to the accurate measurement of the food environment in rural areas include: (1) defining the rural food environment while recognizing that market factors may be changing; (2) describing characteristics that may differentiate similar types of food stores and food-service places; and (3) determining location coordinates for food stores and food-service places. In order to enhance measurements in rural areas, "ground-truthed" methodology, which includes on-site observation and collection of GPS data, should become the standard for rural areas. Measurement must also recognize the emergence of new and changing store formats. Efforts should be made to determine accessibility, in terms of both proximity to a single location and variety of multiple locations within a specified buffer, from origins other than the home, and consider multipurpose trips and trip chaining. The measurement of food access will be critical for community-based approaches to meet dietary needs. Researchers must be willing to take the steps necessary for rigorous measurement of a dynamic food environment.

  1. Performance needs assessment of maternal and newborn health service delivery in urban and rural areas of Osun State, South-West, Nigeria.

    Science.gov (United States)

    Esan, Oluwaseun T; Fatusi, Adesegun O

    2014-06-01

    The study aimed to determine performance and compare gaps in maternal and newborn health (MNH) services in urban and rural areas of Osun State, Nigeria, to inform decisions for improved services. This study involved 14 urban and 10 rural-based randomly selected PHC facilities. Using a Performance Needs Assessment framework, desired performances were determined by key stakeholders and actual performances measured by conducting facility survey. Questionnaire interview of 143 health workers and 153 antenatal clients were done. Performance gaps were determined for the urban and rural areas and compared using Chi-square tests with SPSS version 17. PHC facilities and health workers in Osun State, Nigeria, were found to have significant gaps in MNH service performance and this was worse in the rural areas. Root cause of most of the performance gaps was poor political will of local government authorities. Improved government commitment to MNH is needful to address most of the gaps.

  2. [Psycho-oncology care in rural areas : Results from a cross-sectional survey on the utilisation of community-based psychosocial support services].

    Science.gov (United States)

    Haun, Markus W; Sklenarova, Halina; Zimmermann-Schlegel, Verena; Herzog, Wolfgang; Hartmann, Mechthild

    2018-01-01

    Clinically relevant distress and unmet psychosocial needs frequently occur in the course of cancer diseases. Particularly for thinly populated rural areas in Germany rates of distressed patients and uptake of community-based psycho-oncology services are unknown. Determination of a) the proportion of cancer patients with psychosocial distress and unmet needs and b) the utilisation of community-based psycho-oncology services in thinly populated rural areas. Prospective cross-sectional study of 229 cancer patients (colon, breast, prostate cancer) living in thinly populated rural areas. Indicators for clinically relevant distress and utilisation of psychosocial services were assessed by applying screening instruments. We conducted descriptive and multivariate analyses. More than one third of all cancer patients (39.3%) in thinly populated areas exhibited clinically relevant distress. However, only 15.6% of distressed patients consulted community-based psycho-oncology services. Most frequently, medical or psychological psychotherapists were contacted. Information deficits of patients and attending physicians alongside dispositional factors emerged as the main reasons for non-utilisation. This study presents first data on psycho-oncology care in rural areas in Germany stratifying the degree of urbanisation in line with the standards of the European Commission. Concerning limitations, we only accounted for structural service coverage, leaving aside other indicators for socio-spatial deprivation.

  3. Should Master's Level Training To Provide Rural Services Survive?

    Science.gov (United States)

    Keller, Peter A.

    Despite recent efforts to encourage federal funding of psychological services for underserved populations such as the elderly and residents of rural areas, ample evidence suggests that rural areas are underserved by psychologists. Drawing on data from rural and urban areas in Pennsylvania, this paper argues that master's level training can provide…

  4. Utilization of health care services in rural and urban areas: a determinant factor in planning and managing health care delivery systems.

    Science.gov (United States)

    Oladipo, Jimoh Ayanda

    2014-06-01

    Disparities in use of healthcare services between rural and urban areas have been empirically attributed to several factors. This study explores the existence of this disparity and its implication for planning and managing healthcare delivery systems. The objectives determine the relative importance of the various predisposing, enabling, need and health services factors on utilization of health services; similarity between rural and urban areas; and major explanatory variables for utilization. A four-stage model of service utilization was constructed with 31 variables under appropriate model components. Data is collected using cross-sectional sample survey of 1086 potential health services consumers in selected health facilities and resident milieu via questionnaire. Data is analyzed using factor analysis and cross tabulation. The 4-stage model is validated for the aggregate data and data for the rural areas with 3-stage model for urban areas. The order of importance of the factors is need, enabling, predisposing and health services. 11 variables are found to be powerful predictors of utilization. Planning of different categories of health care facilities in different locations should be based on utilization rates while proper management of established facilities should aim to improve health seeking behavior of people.

  5. Hybrid Terrestrial-Satellite DVB/IP Infrastructure in Overlay Constellations for Triple-Play Services Access in Rural Areas

    Directory of Open Access Journals (Sweden)

    E. Pallis

    2010-01-01

    Full Text Available This paper discusses the convergence of digital broadcasting and Internet technologies, by elaborating on the design, implementation, and performance evaluation of a hybrid terrestrial/satellite networking infrastructure, enabling triple-play services access in rural areas. At local/district level, the paper proposes the exploitation of DVB-T platforms in regenerative configurations for creating terrestrial DVB/IP backhaul between the core backbone (in urban areas and a number of intermediate communication nodes distributed within the DVB-T broadcasting footprint (in rural areas. In this way, triple play services that are available at the core backbone, are transferred via the regenerative DVB-T/IP backhaul to the entire district and can be accessed by rural users via the corresponding intermediate node. On the other hand, at regional/national level, the paper proposes the exploitation of a satellite interactive digital video broadcasting platform (DVB S2/RCS as an overlay network that interconnects the regenerative DVB-T/IP platforms, as well as individual users, and services providers, to each other. Performance of the proposed hybrid terrestrial/satellite networking environment is validated through experimental tests that were conducted under real transmission/reception conditions (for the terrestrial segment and via simulation experiments (for the satellite segment at a prototype network infrastructure.

  6. Scoping the context of programs and services for maintaining wellness of older people in rural areas of Indonesia.

    Science.gov (United States)

    Kadar, K S; McKenna, L; Francis, K

    2014-09-01

    Ageing and problems concerning the aged are an increasing and concerning reality in developing and underdeveloped countries such as Indonesia. Improving service quality is important to promote and maintain wellness of older persons, especially in rural areas. To explore programs and services offered to the elderly in a rural area of Indonesia to support them in promoting and maintaining their wellness. To describe roles and practices of health professionals and teams responsible for delivering services to older people. Action research was used with mixed method data collection (interview and survey). Results demonstrated that activities related to the elderly health programs were limited due to budget and facilities. Practices of health staff for elderly in the community focused on intervention tasks, rather than prevention. Lack of available information on the range of programs and services implemented in Indonesia for the elderly in community settings was a limitation of this study. Programs and services for older people have been implemented in Indonesia. However, these do not yet meet their needs, especially in rural areas. There is a need for greater focus on health promotion and illness prevention. Findings contribute to development of international knowledge in community health nursing, as these issues may not be only relevant to Indonesia. It is timely for governments, including in Indonesia, to evaluate health workforce needs in the community and appropriate educational qualifications for delivering optimal health services for older people. © 2014 International Council of Nurses.

  7. Multifunctional centers in rural areas

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase

    2009-01-01

    abandoned. One outcome has been closings of schools in remote rural areas. This evidently contributes to exacerbate depopulation in these areas. To stop this tendency, we need new models for high-quality, cost effective public services in rural areas as those as we find in Denmark. This chapter introduces...... ideological roots in history pointing at 19th c. national civic movements and an early 20th c. transnational Garden City movement within urban planning as crucial. Drawing on contemporary case studies of multifunctional centers in Holland and Denmark, I then suggest that public and private donors should...... invest in multifunctional centers in which the local public school is the dynamo. This in order to increase local levels of social as well as human capital. Ideally, such centers should contain both public services such as school, library and health care, private enterprises as hairdressers and banks...

  8. Evaluation of municipal solid waste management in egyptian rural areas.

    Science.gov (United States)

    El-Messery, Mamdouh A; Ismail, Gaber A; Arafa, Anwaar K

    2009-01-01

    A two years study was conducted to evaluate the solid waste management system in 143 villages representing the Egyptian rural areas. The study covers the legal responsibilities, service availability, environmental impacts, service providers, financial resources, private sector participation and the quality of collection services. According to UN reports more than 55% of Egyptian population lives in rural areas. A drastic change in the consumption pattern altered the quantity and quality of the generated solid wastes from these areas. Poor solid waste management systems are stigmata in most of the Egyptian rural areas. This causes several environmental and health problems. It has been found that solid waste collection services cover only 27% of the surveyed villages, while, the statistics show that 75% of the surveyed villages are formally covered. The service providers are local villager units, private contractors and civil community associations with a percentage share 71%, 24% and 5% respectively. The operated services among these sectors were 25%, 71% and 100% respectively. The share of private sector in solid waste management in rural areas is still very limited as a result of the poverty of these communities and the lack of recyclable materials in their solid waste. It has been found that direct throwing of solid waste on the banks of drains and canals as well as open dumping and uncontrolled burning of solid waste are the common practice in most of the Egyptian rural areas. The available land for landfill is not enough, pitiable designed, defectively constructed and unreliably operated. Although solid waste generated in rural areas has high organic contents, no composting plant was installed. Shortage in financial resources allocated for valorization of solid waste management in the Egyptian rural areas and lower collection fees are the main points of weakness which resulted in poor solid waste management systems. On the other hand, the farmer's participation

  9. Organization of public services in remote rural areas in developing countries: application to decentralized rural electrification

    International Nuclear Information System (INIS)

    Bui, D.N.

    2005-01-01

    The electrical sector has traditionally been organized as a natural monopoly. The intensity in capital of the grid and the public service obligation of electrical distribution led to the creation of electrical companies with exclusive territorial concessions. This approach has recently been challenged because of its failure to electrify remote rural villages in developing countries. A new set of solutions appeared under the umbrella of Decentralized Rural Electrification (DRE) thanks to technological innovations that replace collective infrastructures with individual systems. However, the widespread deployment of decentralized technologies remains impaired by numerous obstacles at various levels: institutional, legal, organizational, social, financial... New models that take into account the specificities of DRE must now be imagined. The study of two case studies in Morocco and India provide insightful examples of possible strategies to accelerate the deployment of DRE and therefore attain the objectives of rural electrification. Two major policies stand out: public service delegation and the approach of delivering equipment by the public market. Even though these models are too recent to conclude on their viability and permanence, they provide guidelines for the public and private players of the sector to generalize the access to electrical services to rural populations in developing countries, and contribute to their development. (author)

  10. Health-Related Quality of Life of Rural Clients Seeking Telepsychology Services

    Directory of Open Access Journals (Sweden)

    Kevin R. Tarlow

    2014-01-01

    Full Text Available Sixty million US residents live in rural areas, but health policies and interventions developed from an urban mindset often fail to address the significant barriers to health experienced by these local communities. Telepsychology, or psychological services delivered by distance via technology, is an emerging treatment modality with special implications for underserved rural areas. This study found that a sample of rural residents seeking telepsychology services (n=94 had low health-related quality of life (HRQOL, often due to cooccurring physical and mental health diagnoses including high rates of depression. However, a brief telepsychology treatment delivered to rural clients (n=40 was associated with an improvement in mental health-related quality of life (d = 0.70,  P<.001. These results indicate that despite the complex health needs of these underserved communities, telepsychology interventions may help offset the disparities in health service access in rural areas.

  11. Rural Tourism - Alternative to the Development of Rural Areas

    Directory of Open Access Journals (Sweden)

    Maria Cristina PAIU

    2017-06-01

    Full Text Available Rural tourism through its content and its features is a distinct component in the economy of a region, and the sustainable, efficient use of local tourism resources can be an extremely important activity by: adding added value, boosting productivity, employment and increasing the living standard of the population. Rural tourism is considered a lever to mitigate local imbalances and besides attracting touristic areas in the circuit, it also has consequences on territorial development: housing construction, road development, development of public services and the development of small and medium-sized enterprises. Consequently, rural tourism has an impact on a country's economic and social development strategy, but also on a branch level.

  12. INVESTMENTS AND SERVICES ON THE RURAL DEVELOPMENT IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Popa Ana

    2013-04-01

    Full Text Available The article started with the modern connection observed between sectors in EU -primary, secondary and tertiary- on rural areas, where agriculture becomes essential. First, this connection is manifested in Romania under the impact of the main directions of the Common Agricultural Policy (CAP during 2014-2020, namely: a more market-oriented production, but also related to the public, promoting food security, while considering environmental issues and, in addition, achieve cooperation and alignment to the European Economic Area, including equality in European funding. Secondly, there is a dedicated rural development policy, which is supported by a series of investments, but imposed a number of directions that will lead to the expansion of tertiary sector measures, marketing, tourism, ecology, and promoting social inclusion, poverty reduction and economic development in rural areas. Other influences are generated by foreign direct investments-FDI in rural areas. The conclusion is based on the fragility of the rural sector in Romania, compared to other European countries and highlights specific areas of interest of stakeholders for the following issues: improving policies and decisions, access to markets, infrastructure development, access to financial services, access to knowledge, services innovation and risk reduction.

  13. Development Strategy for Mobilecommunications Market in Chinese Rural Area

    Science.gov (United States)

    Zhang, Liwei; Zhang, Yanjun; Xu, Liying; Li, Daoliang

    Based on full analysis of rural mobile communication market, in order to explore mobile operators in rural areas of information services for sustainable development model, this paper presents three different aspects, including rural mobile communications market demand, the rural market for mobile communications business model and development strategies for rural mobile communications market research business. It supplies some valuable references for operators to develop rural users rapidly, develop the rural market effectively and to get access to develop a broad space.

  14. Reaching Rural Handicapped Children: The Transportation Situation in Rural Service Delivery. Making It Work in Rural Communities. A Rural Network Monograph.

    Science.gov (United States)

    Tucker, Jamie; And Others

    Almost everyone who responded to three transportation surveys of rural Handicapped Children's Early Education Program (HCEEP) projects identified transportation as a critical problem in the delivery of services to handicapped children in rural areas. Transportation problems encountered were attributed to environmental/geographic factors,…

  15. Urban-rural demarcation within a metropolitan area: a methodology for using small area disaggregation

    CSIR Research Space (South Africa)

    Green, Cheri A

    2008-04-01

    Full Text Available There is ongoing debate with regard to the levels of service provision in urban and rural areas. However, progress with respect to the delivery of planned services can only be efficiently and equitably measured once benchmarks for different areas...

  16. Leaching Functions from the Outer Metropolitan Zones (Trade, Services - Increasing Peripherality of Small Towns and Rural Areas

    Directory of Open Access Journals (Sweden)

    Krystian Heffner

    2015-01-01

    Full Text Available Intensive spatial processes taking place around metropolitan areas leads to many economic, structural and social changes in their surroundings. The small towns and rural areas located in the outer zone of metropolitan areas are most affected by this functional changes. In the outer zone of a big urban canters appears a lot of new competing possibilities on the labor market and a comprehensive commercial, service and cultural offer to smaller centres. One of the most competitive advantage of the metropolitan zones becomes modern shopping centres being established in the most accessible places, providing a comprehensive shopping-services and even cultural-recreational offer.

  17. Availability of health services vs. health condition of residents of rural areas in Poland – Analysis performed on the basis of EHIS 2009

    Directory of Open Access Journals (Sweden)

    Iwona Laskowska

    2015-12-01

    Full Text Available [b]Introduction. [/b]One of the aspects considered in a debate preceding the establishment of the new retirement age in Poland, was the health condition of the Polish population. A steady increase in the average life expectancy, observed for several years, is much higher in the cities than in the country. One of the reasons for this might be a limited availability of health services in rural areas. [b]Objective[/b]. The aim of the study is to assess the scale of income-related inequalities in the access to health services in rural areas, and subsequently to assess the impact of having to give up some medical services on the subjective perception of health condition by rural inhabitants. [b]Materials and methods.[/b] Individual data derived from the European Health Interview Survey (EHIS conducted in 2009 constituted the basis for the presented analysis. The concentration index was used to measure the income-related inequalities in the use of medical services. The ordered logit model was used to verify the hypothesis that the availability of health services has an impact on the health condition. [b]Results.[/b] Significant differences in the distribution of medical services utilization with regard to income, were found only in the case of hospital services. People with low income stay in hospital more often. The obtained inequality indices show a lack of income-related inequality in the use of outpatient services. The performed analyses confirm a negative impact of giving up this type of services on the health condition of residents of rural areas. [b]Conclusions.[/b] The availability of medical services is an important determinant of the health condition. Too few medical institutions and scarce medical personnel limits the use of these services, and not only for people with low income.

  18. Substance Abuse in Rural Areas

    Science.gov (United States)

    ... challenges for rural communities: Behavioral health and detoxification (detox) services are not as readily available in rural ... the supplemental services necessary for positive outcomes. Detoxification (detox) services, for example, provide the initial treatment for ...

  19. Aging in Rural Appalachia: Perspectives from Geriatric Social Service Professionals

    Directory of Open Access Journals (Sweden)

    Natalie D. Pope

    2014-09-01

    Full Text Available This paper uses qualitative methodology to explore the experience of growing old in rural Appalachia. Given the growing population of older adults seeking and utilizing services, it is important to understand the challenges and specific needs related to aging. Within the context of rural Appalachia, these challenges and needs may be different than those in urban areas or areas outside of the region itself. From interviews with 14 geriatric service providers in rural southeast Ohio, the authors were able to identity three prevalent themes associated with aging in rural North Central Appalachia: scarcity of resources, valuing neighbors and family, and the prevalence of drug use. These findings suggest that preparation and ongoing training of rural geriatric social workers should include attention to topics such as substance abuse and strengthening social support networks that often exist in these regions.

  20. An analysis of current and desirable situation of electronic government service provision in rural areas of the Hamedan province

    Directory of Open Access Journals (Sweden)

    Mousa Aazami

    2017-04-01

    Full Text Available The informative society is seen as the central element of rural development at the beginning of the third millennium and the development of information technology and communication in villages has always been considered in current summits across the world. Nowadays, information and communication technology service offices are the basis of electronic government. Therefore, recognition of these offices is necessary for sustainable rural development. The purpose of this research was a comparative analysis between the current situation and the desirable situation of e-government services in the rural districts of the Hamedan province as perceived by their directors (Hamedan, Bahar and Famenin Counties. The study population consists of 91 respondents who were chosen and studied through the census method. The findings of this research study consist of two sections. The items related to satisfaction with the activities in information and communication technology service offices were prioritized in the first section. Moreover, the current and the desirable conditions for electronic service provision were identified. The gap between these two were analyzed in the second section. The results indicate that there is a significant difference between these two conditions of electronic service provisions in rural areas. This significant difference was recognized through the paired T test at the 0.05 level with 6.33 value that illustrates the existence of a gap between these two situations. Electronic government, information technology and communication, information and communication technology service offices

  1. Utilization of photovoltaic for broadband satellite communications in rural area of Thailand

    Science.gov (United States)

    Jinayim, Theerawut; Mungkung, Narong; Kasayapanand, Nat

    2013-06-01

    Electricity, Information and Communication Technologies (ICTs) are very important not only in urban areas but also in rural areas. To provide ICTs service in rural areas, sources of electricity and communication infrastructures must be implemented. Electricity is a major condition due to the fact that all electronic devices needed it in order to power on, so that it is impossible to operate any forms of ICTs in areas where the main national grid line is unavailable. Almost rural areas of Thailand where the main national grid line is unavailable have very good sunlight intensity. Photovoltaic is the most effective renewable energy technologies in those areas for meeting electricity needed in areas that are not connected to the main national grid line. In this paper, the efficiency utilization of photovoltaic as source of electricity for broadband satellite communication systems as well as social and economic impact and quality of life of people in rural areas of Thailand are presented. The results show that most rural communities would be able to universally access to the basic telecommunications services such as internet access and public telephone via satellite communication systems. However, in some field case study, broadband internet access via satellite communication may be unnecessary for some rural communities and the most exactly rural communities needed are electricity for household usage and battery charger.

  2. Potential use of mobile phones in improving animal health service delivery in underserved rural areas: experience from Kilosa and Gairo districts in Tanzania.

    Science.gov (United States)

    Karimuribo, Esron D; Batamuzi, Emmanuel K; Massawe, Lucas B; Silayo, Richard S; Mgongo, Frederick O K; Kimbita, Elikira; Wambura, Raphael M

    2016-10-07

    Sub-optimal performance of the animal health delivery system in rural areas is common in developing countries including Tanzania. However, penetration of mobile phones and availability of good road network and public transport systems offer opportunities for improving the access of rural communities to diagnostic and advisory services from facilities and expertise located in urban areas. A questionnaire survey on possession and use of mobile phones by pastoral and agro-pastoral communities in Kilosa and Gairo districts was carried out between November and December 2015. A total number of 138 livestock keepers from three villages of Chakwale (54), Mvumi (41) and Parakuyo (43) participated in the study. An e-based system was designed and tested to link rural communities with urban diagnostic facilities. It was observed that the average number of phones possessed by individuals interviewed and household families was 1.1 ± 0.26 (1-2) and 3.5 ± 2.23 (1-10), respectively. It was further observed that out of 138 livestock keepers interviewed, 133 (96.4 %) had feature phones while 10 (7.2 %) of them possessed smartphones. Mobile phone is currently used to support livestock production by communicating on animal health in Parakuyo (18, 41.9 %), Mvumi (18, 43.9 %) and Chakwale (14, 25.9 %). Other contributions of mobile phones in livestock and crop agriculture observed in the study area include: exchange of livestock price information, crop price information, communicating on plant health/diseases, livestock extension and advisory services as well as crop farming extension and advisory services. We also designed and tested an e-based SUAVetDiag® system to support timely diagnosis of infectious disease conditions and prompt advice on case management in veterinary underserved areas. Availability of mobile phones in rural areas, in combination with supporting infrastructure and facilities in urban areas, has potential to stimulate local development and improving

  3. The walk out of the rural kitchen : towards planning energy services for sustainable rural livelihoods in Sudan

    NARCIS (Netherlands)

    Ahmed, Nouralla

    2008-01-01

    This thesis is about rural energy services, the problems with accessibility and the consequences of their inaccessibility on rural livelihoods in the traditional rural areas of Sudan. The thesis is organised in six chapters. Chapter 1 starts by providing a background to the political and economic

  4. Health care in rural areas.

    Science.gov (United States)

    Nath, L M

    1994-02-01

    In India, although the health care system infrastructure is extensive, the people often regard government facilities as family planning (FP) centers instead of primary health care centers. This problem has been compounded by the separation of health care and FP at all stages, even down to the storage of the same medication in two different locations depending upon whether it is to be used for "health" or for "FP." In rural areas where the government centers are particularly desolate, the community has chosen to erect its own health care system of private practitioners of all sorts and qualifications. Even in rural areas where a comprehensive health service is provided, with each household visited regularly by health workers, and where this service has resulted in a lowering of the crude death rate from 14.6 to 7 and the maternal mortality rate from 4.7 to 0.5/1000, people depend upon practitioners of various types. Upon analysis, it was discovered that the reason for using this multiplicity of practitioners had nothing to do with the level of satisfaction with the government service or with the accessibility of the services. Rather, when ill, the people make a diagnosis and then go to the proper place for treatment. If, for instance, they believe their malady was caused by the evil eye, they consult a magico-religious practitioner. These various types of practitioners flourish in areas with the best primary health care because they fulfill a need not met by the primary health care staff. If government agencies work with the local practitioners and afford them the proper respect, their skills can be upgraded in selected areas and the whole community will benefit.

  5. Service Level Decision-making in Rural Physiotherapy: Development of Conceptual Models.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2016-06-01

    Understanding decision-making about health service provision is increasingly important in an environment of increasing demand and constrained resources. Multiple factors are likely to influence decisions about which services will be provided, yet workforce is the most noted factor in the rural physiotherapy literature. This paper draws together results obtained from exploration of service level decision-making (SLDM) to propose 'conceptual' models of rural physiotherapy SLDM. A prioritized qualitative approach enabled exploration of participant perspectives about rural physiotherapy decision-making. Stakeholder perspectives were obtained through surveys and in-depth interviews. Interviews were transcribed verbatim and reviewed by participants. Participant confidentiality was maintained by coding both participants and sites. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of regional, rural and remote communities. Thirty-nine surveys were received from participants in 11 communities. Nineteen in-depth interviews were conducted with physiotherapists and key decision-makers. Results reveal the complexity of factors influencing rural physiotherapy service provision and the value of a systems approach when exploring decision-making about rural physiotherapy service provision. Six key features were identified that formed the rural physiotherapy SLDM system: capacity and capability; contextual influences; layered decision-making; access issues; value and beliefs; and tensions and conflict. Rural physiotherapy SLDM is not a one-dimensional process but results from the complex interaction of clusters of systems issues. Decision-making about physiotherapy service provision is influenced by both internal and external factors. Similarities in influencing factors and the iterative nature of decision-making emerged, which enabled linking physiotherapy SLDM with

  6. Towards understanding the availability of physiotherapy services in rural Australia.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2016-01-01

    A recent exploration of factors affecting rural physiotherapy service provision revealed considerable variation in services available between communities of the study. Multiple factors combined to influence local service provision, including macro level policy and funding decisions, service priorities and fiscal constraints of regional health services and capacity and capabilities at the physiotherapy service level. The aim of this article is to describe the variation in local service provision, the factors influencing service provision and the impact on availability of physiotherapy services. A priority-sequence mixed methods design structured the collection and integration of qualitative and quantitative data. The investigation area, a large part of one Australian state, was selected for the number of physiotherapy services and feasibility of conducting site visits. Stratified purposive sampling permitted exploration of rural physiotherapy with subgroups of interest, including physiotherapists, their colleagues, managers, and other key decision makers. Participant recruitment commenced with public sector physiotherapists and progressed to include private practitioners, team colleagues and managers. Surveys were mailed to key physiotherapy contacts in each public sector service in the area for distribution to physiotherapists, their colleagues and managers within their facility. Private physiotherapist principals working in the same communities were invited by the researcher to complete the physiotherapy survey. The survey collected demographic data, rural experience, work setting and number of colleagues, services provided, perspectives on factors influencing service provision and decisions about service provision. Semi-structured interviews were conducted with consenting physiotherapists and other key decision makers identified by local physiotherapists. Quantitative survey data were recorded in spreadsheets and analysed using descriptive statistics. Interviews

  7. HIV in Predominantly Rural Areas of the United States

    Science.gov (United States)

    Hall, H. Irene; Li, Jianmin; McKenna, Matthew T.

    2005-01-01

    Background: The burden of HIV/AIDS has not been described for certain rural areas of the United States (Appalachia, the Southeast Region, the Mississippi Delta, and the US-Mexico Border), where barriers to receiving HIV services include rural residence, poverty, unemployment, and lack of education. Methods: We used data from Centers for Disease…

  8. Identifying rural-urban differences in the predictors of emergency ambulance service demand and misuse.

    Science.gov (United States)

    Wong, Ho Ting; Lin, Teng-Kang; Lin, Jen-Jia

    2018-06-13

    This study aims to assess rural-urban differences in the predictors of emergency ambulance service (EAS) demand and misuse in New Taipei City. Identifying the predictors of EAS demand will help the EAS service managing authority in formulating focused policies to maintain service quality. Over 160,000 electronic EAS usage records were used with a negative binomial regression model to assess rural-urban differences in the predictors of EAS demand and misuse. The factors of 1) ln-transformed population density, 2) percentage of residents who completed up to junior high school education, 3) accessibility of hospitals without an emergency room, and 4) accessibility of EAS were found to be predictors of EAS demand in rural areas, whereas only the factor of percentage of people aged above 65 was found to predict EAS demand in urban areas. For EAS misuse, only the factor of percentage of low-income households was found to be a predictor in rural areas, whereas no predictor was found in the urban areas. Results showed that the factors predicting EAS demand and misuse in rural areas were more complicated compared to urban areas and, therefore, formulating EAS policies for rural areas based on the results of urban studies may not be appropriate. Copyright © 2018. Published by Elsevier B.V.

  9. Solar lighting system delivery models for rural areas in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Koirala, Binod Prasad; Ortiz, Brisa [Freiburg Univ. (DE). Center for Renewable Energy (ZEE); Fraunhofer-Institut fuer Solare Energiesysteme (ISE), Freiburg im Breisgau (Germany); Modi, Anish [KTH Royal Inst. of Technology, Stockholm (Sweden); Mathur, Jyotirmay [Malaviya National Institute of Technology, Jaipur (India); Kafle, Nashib [Alternative Energy Promotion Center (AEPC), Kathmandu (Nepal)

    2011-07-01

    Many rural areas in developing countries will not have electricity access from the central grid for several years to come. Autonomous Solar Lighting Systems (SLS) are attractive and enviromentally friendly options for replacing kerosene lamps and providing basic lighting services to such areas. In order to highlight the benefits of these technologies, analysis of reduction in indoor air pollution due to replacement of kerosene lamp by SLS has been carried out. Use of SLS in place of kerosene lamps saves an equivalent of 1341 kg CO{sub 2} emissions per annum from each household. If a suitable mechanism is created, this amount of GHG emissions saving could alone be sufficient to finance solar lighting system for rural households. However, these technologies have not reached most of the poor population. In order to guarantee the access of solar lighting to the people at the Base of the Pyramid (BOP), strengths of different organizations working in the rural areas should be combined together to form successful business models. This paper will discuss business models to disseminate such services to needy people. A comparative study of SLS delivery models based on cash, credit, leasing, subsidy and service is performed. In addition, SWOT analysis for each model is employed. Further, Case studies of few projects to elaborate different models are also presented. If suitable business models for its delivery to rural people are considered, solar lighting systems are viable for providing basic lighting needs of rural areas in developing countries. (orig.)

  10. Transition Management and Social Innovation in Rural Areas: Lessons from Social Farming

    Science.gov (United States)

    Di Iacovo, Francesco; Moruzzo, Roberta; Rossignoli, Cristiano; Scarpellini, Paola

    2014-01-01

    Purpose: The article reflects on transition management in rural areas and the possible implications for extension services able to support social innovation and rural change, starting from experiences on social farming in different areas of Italy. Design/methodology/approach: By presenting three case studies we investigate the role of social…

  11. Market opportunities in Canada for multimedia residential services in rural and small urban areas

    Science.gov (United States)

    Shariatmadar, Mehran; Narasimhan, Vasantha

    1995-01-01

    This paper reviews the studies which were undertaken jointly by Telesat and Industry Canada to provide an estimate of the market opportunities for residential multi-media services in the rural and small urban areas of Canada. This study is part of the Advanced Satcom program, a Ka-band satellite system proposal which is currently in the implementation proposal phase by the government and the Canadian space industry of which Telesat is an active member. Advanced Satcom extends the reach of terrestrial information highways to the remote and sparsely populated parts of the country in a cost-effective manner and thus provides a ubiquitous coverage of the information highways to all Canadians. Therefore, the rural and small urban markets are believed to be good opportunities for the Advanced Satcom. Although the results are primarily intended for fixed residential applications, they can also be used as input to market opportunity studies for wideband mobile applications.

  12. Women's maternity care needs and related service models in rural areas: A comprehensive systematic review of qualitative evidence.

    Science.gov (United States)

    Hoang, Ha; Le, Quynh; Ogden, Kathryn

    2014-12-01

    Understanding the needs of rural women in maternity care and service models available to them is significant for the development of effective policies and the sustainability of rural communities. Nevertheless, no systematic review of studies addressing these needs has been conducted. To synthesise the best available evidence on the experiences of women's needs in maternity care and existing service models in rural areas. Literature search of ten electronic databases, digital theses, and reference lists of relevant studies applying inclusion/exclusion criteria was conducted. Selected papers were assessed using standardised critical appraisal instruments from JBI-QARI. Data extracted from these studies were synthesised using thematic synthesis. 12 studies met the inclusion criteria. There were three main themes and several sub-themes identified. A comprehensive set of the maternity care expectations of rural women was reported in this review including safety (7), continuity of care (6) and quality of care (6), and informed choices needs (4). In addition, challenges in accessing maternity services also emerged from the literature such as access (6), risk of travelling (9) and associated cost of travel (9). Four models of maternity care examined in the literature were medically led care (5), GP-led care (4), midwifery-led care (7) and home birth (6). The systematic review demonstrates the importance of including well-conducted qualitative studies in informing the development of evidence-based policies to address women's maternity care needs and inform service models. Synthesising the findings from qualitative studies offers important insight for informing effective public health policy. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  13. Older family carers in rural areas: experiences from using caregiver support services based on Information and Communication Technology (ICT).

    Science.gov (United States)

    Blusi, Madeleine; Asplund, Kenneth; Jong, Mats

    2013-09-01

    The aim of this intervention study was to illuminate the meaning of ICT-based caregiver support as experienced by older family carers living in vast rural areas, caring for a spouse at home. In order to access, the support service participants were provided with a computer and high speed Internet in their homes. Semi structured webcam-interviews were carried out with 31 family carers. A strategy for webcam interviewing was developed to ensure quality and create a comfortable interview situation for the family carers. Interviews were analysed using content analyses, resulting in the themes: Adopting new technology with help from others and Regaining social inclusion . The results indicate that ICT-based support can be valuable for older family carers in rural areas as it contributes to improve quality in daily life in a number of ways. In order to fully experience the benefits, family carers need to be frequent users of the provided support. Adequate training and encouragement from others were essential in motivating family carers to use the support service. Access to Internet and webcamera contributed to reducing loneliness and isolation, strengthening relationships with relatives living far away and enabled access to services no longer available in the area. Use of the ICT-service had a positive influence on the relationship between the older carer and adult grandchildren. It also contributed to carer competence and promote feelings of regaining independence and a societal role.

  14. Rural Women, Money and Financial Service.

    Science.gov (United States)

    Jiggins, Janice

    1985-01-01

    The author points out the multifaceted aspects of the problems associated with rural women's need for money and financial services and outlines innovative schemes in this area such as the bank for the landless in Bangladesh, a savings and loan cooperative for market women in Nicaragua, and a savings development movement in Zimbabwe. (CT)

  15. Rural women's perspectives of maternity services in the Midland Region of New Zealand.

    Science.gov (United States)

    Gibbons, Veronique; Lancaster, Gytha; Gosman, Kim; Lawrenson, Ross

    2016-09-01

    INTRODUCTION Rural women face many challenges with regards to maternity services. Many rural primary birthing facilities in New Zealand have closed. The Lead Maternity Carer (LMC) model of maternity care, introduced in 1990, has moved provision of rural maternity care from doctors to independent midwifery services. Shortages of rural midwives in the Midland region led to rural maternity care being seen as a vulnerable service. AIM To understand the views and experiences of rural women concerning maternity care, to inform the future design and provision of rural maternity services. METHODS Participants were drawn from areas purposively selected to represent the five District Health Boards comprising the Midland health region. A demographic questionnaire, focus groups and individual interviews explored rural women's perspectives of antenatal care provision. These were analysed thematically. RESULTS Sixty-two women were recruited. Key themes emerging from focus groups and interviews included: access to services, the importance of safety and quality of care, the need for appropriate information at different stages, and the role of partners, family and friends in the birthing journey. While most women were happy with access to services, quality of care, provision of information, and the role of family in their care, for some women, this experience could be enhanced. CONCLUSION Midwives are the frontline service for women seeking antenatal services. Support for rural midwives and for local birthing units is needed to ensure rural women receive services equal to that of their urban counterparts.

  16. Working in rural areas – the experiences of Umthombo Youth Development Foundation graduates

    Directory of Open Access Journals (Sweden)

    Andrew J. Ross

    2014-12-01

    Full Text Available Background: Recruiting and retaining healthcare professionals (HCPs for rural areas is challenging throughout the world. Although rural origin HCPs have been identified as being the most likely to work in rural areas, only a small number of rural-origin South African scholars are trained as HCPs each year and many do not return to work in rural areas. Aim: The aim of this article was to present the experiences of rural-origin HCPs who returned to work in a rural area after graduation. Setting: Umthombo Youth Development Foundation has been running an innovating rurally-based scholarship scheme since 1999. By December 2013, 184 students supported by the scheme had graduated and all had returned to work in a rural area for a period of time. Methods: This was a qualitative study using a life history methodology to explore the educational experience of six rural-origin HCPs working in rural areas. Results: The four themes that emerged from the data were: (1 contribution to service delivery; (2 professional development (3 the challenges and frustrations of working in rural hospitals; and (4 the impact of working as an HCP. Conclusion: Rural-origin HCPs are willing to return and work in rural areas. However, context and content factors need to be addressed if a work-back scholarship scheme is to be along-term strategy for the recruitment and retention of HCPs.

  17. Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

    Science.gov (United States)

    Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

    2017-12-01

      Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

  18. Rationing is a reality in rural physiotherapy: a qualitative exploration of service level decision-making.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2015-03-27

    Deciding what health services are provided is a key consideration in delivering appropriate and accessible health care for rural and remote populations. Despite residents of rural communities experiencing poorer health outcomes and exhibiting higher health need, workforce shortages and maldistribution mean that rural communities do not have access to the range of services available in metropolitan centres. Where demand exceeds available resources, decisions about resource allocation are required. A qualitative approach enabled the researchers to explore participant perspectives about decisions informing rural physiotherapy service provision. Stakeholder perspectives were obtained through surveys and in-depth interviews. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of rural, regional and remote communities. Thirty-nine surveys were received from participants in eleven communities. Nineteen in-depth interviews were conducted with physiotherapist and key decision-makers. Increasing demand, organisational priorities, fiscal austerity measures and workforce challenges were identified as factors influencing both decision-making and service provision. Rationing of physiotherapy services was common to all sites of this study. Rationing of services, more commonly expressed as service prioritisation, was more evident in responses of public sector physiotherapy participants compared to private physiotherapists. However, private physiotherapists in rural areas reported capacity limits, including expertise, space and affordability that constrained service provision. The imbalance between increasing service demands and limited physiotherapy capacity meant making choices was inevitable. Decreased community access to local physiotherapy services and increased workforce stress, a key determinant of retention, are two results of such choices or decisions

  19. Kees: a Practical Ict Solution for Rural Areas

    Science.gov (United States)

    Dai, Xiaoye; Tabirca, Sabin; Lenihan, Eamon

    This paper introduces a practical e-learning system, identified as Knowledge Exchange E-learning System (abbr. KEES), for knowledge distribution in rural areas. Particularly, this paper is about providing a virtual teaching and learning environment for small holders in agriculture in those rural areas. E-learning is increasingly influencing the agricultural education (information and knowledge learning) in all forms and the current e-learning in agricultural education appears in informal and formal methods in many developed countries and some developing areas such as Asian Pacific regions. KEES is a solution to provide education services including other services of information distribution and knowledge sharing to local farmers, local institutes or local collection of farmers. The design of KEES is made to meet the needs of knowledge capacity building, experience sharing, skill upgrading, and information exchanging in agriculture for different conditions in rural areas. The system allows the online lecture/training materials to be distributed simultaneously with all multimedia resources through different file formats across different platforms. The teaching/training content can be contextless and broad, allowing for greater participation by more small holders, commercial farmers, extension workers, agriculturists, educators, and other agriculture-related experts. The relative inconsistency in content gives farmers more localised and useful knowledge. The framework of KEES has been designed to be a three-tier architecture logic workflow, which can configure the progressive approach for KEES to pass on and respond to different requests/communications between the client side and the server.

  20. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Science.gov (United States)

    2010-10-01

    ... Definitions § 440.20 Outpatient hospital services and rural health clinic services. (a) Outpatient hospital... services that are not generally furnished by most hospitals in the State. (b) Rural health clinic services... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital services and rural health...

  1. Information society and the countryside: can internet-based systems bring income alternatives to rural areas?

    OpenAIRE

    Heilig, Gerhard K.

    2003-01-01

    The paper reviews seven types of Internet-based technologies and services that may be especially suitable for rural areas. Its main focus is to analyze, which of these applications could promote rural development and prevent further economic and socio-demographic decline in peripheral rural areas. In particular, we will analyze whether these technologies have the potential to create income alternatives for the rural population. The paper also criticizes the current rural development policy of...

  2. Rural hospital ownership: medical service provision, market mix, and spillover effects.

    Science.gov (United States)

    Horwitz, Jill R; Nichols, Austin

    2011-10-01

    To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost Report Information System and Prospective Payment System Minimum Data File, and primary data collection for geographic coordinates. The sample includes all nonfederal, general medical, and surgical hospitals located outside of metropolitan statistical areas and within the continental United States from 1988 to 2005. We estimate multivariate regression models to examine the effects of (1) hospital ownership and (2) hospital ownership mix within rural hospital markets on profitable versus unprofitable medical service offerings. Rural nonprofit hospitals are more likely than for-profit hospitals to offer unprofitable services, many of which are underprovided services. Nonprofits respond less than for-profits to changes in service profitability. Nonprofits with more for-profit competitors offer more profitable services and fewer unprofitable services than those with fewer for-profit competitors. Rural hospital ownership affects medical service provision at the hospital and market levels. Nonprofit hospital regulation should reflect both the direct and spillover effects of ownership. © Health Research and Educational Trust.

  3. Maternity Care Services Provided by Family Physicians in Rural Hospitals.

    Science.gov (United States)

    Young, Richard A

    The purpose of this study was to describe how many rural family physicians (FPs) and other types of providers currently provide maternity care services, and the requirements to obtain privileges. Chief executive officers of rural hospitals were purposively sampled in 15 geographically diverse states with significant rural areas in 2013 to 2014. Questions were asked about the provision of maternity care services, the physicians who perform them, and qualifications required to obtain maternity care privileges. Analysis used descriptive statistics, with comparisons between the states, community rurality, and hospital size. The overall response rate was 51.2% (437/854). Among all identified hospitals, 44.9% provided maternity care services, which varied considerably by state (range, 17-83%; P maternity care, a mean of 271 babies were delivered per year, 27% by cesarean delivery. A mean of 7.0 FPs had privileges in these hospitals, of which 2.8 provided maternity care and 1.8 performed cesarean deliveries. The percentage of FPs who provide maternity care (mean, 48%; range, 10-69%; P maternity care who are FPs (mean, 63%; range, 10-88%; P maternity care services in US rural hospitals, including cesarean deliveries. Some family medicine residencies should continue to train their residents to provide these services to keep replenishing this valuable workforce. © Copyright 2017 by the American Board of Family Medicine.

  4. Are there any differences in medical emergency team interventions between rural and urban areas? A single-centre cohort study.

    Science.gov (United States)

    Aftyka, Anna; Rybojad, Beata; Rudnicka-Drozak, Ewa

    2014-10-01

    To compare interventions of medical emergency teams in urban and rural areas with particular emphasis on response time and on-site medical rescue activities. A retrospective analysis of ambulance call reports from two emergency medical service substations: one in the city and the other in a rural area. Two emergency medical service substations: one in the city and the other in a rural area. Medical emergency teams. Interventions in the city were associated with a substantially shorter response time in comparison to rural areas. In the city, the distances were generally less than 10 km. In the rural area, however, such short distances accounted for only 7.2% of events, while 33.8% were over 30 km. Medical emergency teams more often acted exclusively on-site or ceased any interventions in rural areas. Compared with the city, actions in the rural setting were associated with significantly increased use of cervical collars and decreased use of intravenous access. The presence of a physician in the team raised the probability of pharmacotherapy. The relationship between medical emergency teams activities and the location of intervention shows the real diversity of the functioning of emergency medical service within a city and rural areas. Further research should aim to improve the generalisability of these findings. © 2014 National Rural Health Alliance Inc.

  5. Expanded emergency medical services for the provision of primary care in remote rural areas.

    Science.gov (United States)

    Mccabe, S

    2000-05-01

    It is now widely recognised that a potential recruitment crisis is looming in the provision of primary care physicians for remote rural areas of the United Kingdom. Anecdotal evidence suggests that rural registrar, associate and principal vacancies are becoming increasingly difficult to fill and for many rural GPs locums are an impossible dream. Many practitioners are no longer prepared to work in areas where out-of-hours cooperatives are not available. We are now faced with the very real possibility that in some remote areas of the Scottish Highlands and Islands the recruitment of suitable GPs may no longer be possible. So what are the alternatives? In October 1999 I visited a community in the mountains of northern New Mexico which has had to deal with this very problem.

  6. Municipal service provision in rural communities

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    EU policies for rural development stress the importance of investments rather than subsidies and aim at integrating different sectoral policies in order to improve the coherence and effectiveness of public expenditure. Policies also emphasize a place-based approach for rural development and thereby...... hierarchies and considering local resources and place bound potentials.  This paper draws on a study of rural municipalities in Denmark examining how service adjustments e.g. closing of local schools are managed by rural municipalities and local communities. The paper further discusses whether rural...... municipalities can plan strategically, manage service provision and support place bound potential in rural communities in light of a competitive framework for local development....

  7. ROLE OF RURAL TOURISM FOR DEVELOPMENT OF RURAL AREAS

    Directory of Open Access Journals (Sweden)

    Andrej Udovč

    2001-09-01

    Full Text Available The paper analyse the role of rural tourism for the development of rural areas, on the comparison of two regions with different types of rural tourism. One area is of highly diversifi ed rural tourism with wide range of tourist products (rafting, hiking, cycling, farm tourism, skiing …. The tourism offer in the second area is much more uniform (mainly farm tourism and some spa. The study analysed how the two different types of tourist product diversifi cations influence the development possibilities of studied rural areas. We analysed how different systems are able to maintain its functions in the context of identifi ed perturbations (socio-economic and geophysical. We analysed the infl uence of different factors on systems stability, its resilience, robustness and integrity. The gained results show that only the higher level of diversifi cation is not a guarantee for systems higher stability, resilience, robustness and integrity, but there also other

  8. 47 CFR 54.316 - Rate comparability review and certification for areas served by non-rural carriers.

    Science.gov (United States)

    2010-10-01

    ... Rates, Price Indices, and Expenditures for Telephone Service published by the Wireline Competition... areas served by non-rural carriers. 54.316 Section 54.316 Telecommunication FEDERAL COMMUNICATIONS... High Cost Areas § 54.316 Rate comparability review and certification for areas served by non-rural...

  9. 8034 agriculture extension service delivery in a semi-arid rural area ...

    African Journals Online (AJOL)

    dela dovie

    2013-09-04

    Sep 4, 2013 ... RURAL AREA IN SOUTH AFRICA: THE CASE STUDY OF THORNDALE ... Social Network for Environment & Development, P. O. Box CT 3441, Cantonments,. Accra ... the Savannah biome of the Bushbuckridge region in the Limpopo Province, South ...... Oklahoma City, Oklahoma: World Neighbors: 1985.

  10. Community health worker in hard-to-reach rural areas of Myanmar: filling primary health care service gaps.

    Science.gov (United States)

    Sommanustweechai, Angkana; Putthasri, Weerasak; Nwe, Mya Lay; Aung, Saw Thetlya; Theint, Mya Min; Tangcharoensathien, Viroj; Wynn, San Shway

    2016-10-21

    Myanmar is classified as critical shortage of health workforce. In responses to limited number of trained health workforce in the hard-to-reach and remote areas, the MOH trained the Community Health Worker (CHW) as health volunteers serving these communities on a pro bono basis. This study aimed to assess the socio-economic profiles, contributions of CHW to primary health care services and their needs for supports to maintain their quality contributions in rural hard to reach areas in Myanmar. In 2013, cross-sectional census survey was conducted on all three groups of CHW classified by their training dates: (1) prior to 2000, (2) between 2000 and 2011, and (3) more recently trained in 2012, who are still working in 21 townships of 17 states and regions in Myanmar, using a self-administered questionnaire survey in the Burmese language. The total 715 CHWs from 21 townships had completely responded to the questionnaire. CHWs were trained to support the work of midwives in the sub-centres and health assistant and midwives in rural health centres (RHCs) such as community mobilization for immunization, advocates of safe water and sanitation, and general health education and health awareness for the citizens. CHWs were able to provide some of the services by themselves, such as treatment of simple illnesses, and they provided services to 62 patients in the last 6 months. Their contributions to primary health care services were well accepted by the communities as they are geographically and culturally accessible. However, supports from the RHC were inadequate in particular technical supervision, as well as replenishment of CHW kits and financial support for their work and transportation. In practice, 6 % of service provided by CHWs was funded by the community and 22 % by the patients. The CHW's confidence in providing health services was positively associated with their age, education, and more recent training. A majority of them intended to serve as a CHW for more than

  11. HIV Testing and HIV/AIDS Treatment Services in Rural Counties in 10 Southern States: Service Provider Perspectives

    Science.gov (United States)

    Sutton, Madeline; Anthony, Monique-Nicole; Vila, Christie; McLellan-Lemal, Eleanor; Weidle, Paul J.

    2010-01-01

    Context: Forty percent of AIDS cases are reported in the southern United States, the region with the largest proportion of HIV/AIDS cases from rural areas. Data are limited regarding provider perspectives of the accessibility and availability of HIV testing and treatment services in southern rural counties. Purpose: We surveyed providers in the…

  12. Opinions of South African optometry students about working in rural areas after graduation.

    Science.gov (United States)

    Mashige, Khathutshelo P; Oduntan, Olalekan A; Hansraj, Rekha

    2015-07-31

    Eye and vision problems have been reported to be more prevalent in rural than urban areas; and a large proportion of South Africans live in the rural areas. To investigate the opinions of South African optometry students about working in rural areas after completion of their training and to identify factors that may influence their decisions. This was a cross-sectional quantitative study using a survey instrument containing both closed and open-ended, semi-structured questions. Four hundred and thirty-eight students responded to the questionnaire (85.4% response rate). Overall, many of the respondents did not want to open their first (66%) or second practices (64.6%) in the rural areas. However, most respondents from rural backgrounds reported that they would open their first (77.2%) or second (79.4%) practice in the rural areas. The main reasons cited by the respondents for their unwillingness to work in the rural areas were financial concerns (81.2%), personal safety (80.1%) and poor living conditions (75.3%), with a significantly higher number (p < 0.05) being from urban respondents for the latter two issues only. Many students were not in favour of opening practices in rural areas, but were willing to work for the government or a non-governmental organisation after graduation. Efforts should be made to address financial incentives, safety and living conditions in the rural areas. The results of this study have implications for the future of availability and accessibility of eye care services to those living in the rural and remote areas of the country.

  13. SELECTED ASPECTS OF THE IMPLEMENTATION OF ACTIVE MARKETING CAMPAIGN TO RAISE AWARENESS AND PROMOTE PUBLIC TRANSPORT SERVICES IN RURAL AREAS

    Directory of Open Access Journals (Sweden)

    Katarzyna NOSAL

    2016-09-01

    Full Text Available The article presents selected aspects of the implementation of the EU’s SmartMove project, which aims to promote feeder public transport systems in rural areas through the implementation of an active marketing campaign (AMC. Campaigns of this type are connected with providing general and personalized information concerning the functioning of public transport services. In the article, characteristics of one of the implementation areas of the project are presented, namely, the Liszki district near Cracow. Transport services were also evaluated. In addition, selected results are presented from a survey that was conducted among residents of the area from the point of view of the implementation of the AMC. The results concerned data about the means of transport that were currently used for travelling, the knowledge of bus services, the reasons for their use and the factors that might encourage residents to use public transport

  14. Knowledge, awareness, and utilization pattern of services under Janani Suraksha Yojana among beneficiaries in rural area of Himachal Pradesh

    Directory of Open Access Journals (Sweden)

    Prem Lal Chauhan

    2015-01-01

    Full Text Available Introduction: Safe motherhood is perceived as a human right, and the health sector is always encouraged to provide quality services to ensure the same. Government of India launched a scheme called Janani Suraksha Yojana (JSY on April 11, 2005, under the flagship of National Rural Health Mission to reduce maternal and neonatal mortality, by promoting institutional deliveries for which financial incentives are provided to mothers delivering in the health facilities. Objective: To study the knowledge, awareness, and utilization pattern of services under JSY among the beneficiaries in rural area of Shimla, Himachal Pradesh, India. Materials and Methods: This cross-sectional study was conducted among the 78 JSY beneficiaries residing in the rural field practice area of Indira Gandhi Medical College Shimla, Himachal Pradesh, India. These beneficiaries were interviewed with pretested, predesigned, semi-structured close ended questionnaire by house-to-house visits, after obtaining informed consent. Results: Majority of the JSY beneficiaries (50; 64% were in the age group of 20–25 years and 43 (55.1% of them heard about the JSY scheme before the present pregnancy. Anganwadi workers 78 (100% and female health workers (62; 79.5% were the main sources of information. More than half of the study participants (44; 56% had good knowledge about the scheme and 42 (53.85% registered their name in health institution during thefirst trimester of last pregnancy. Forty-four (56.4% beneficiaries had undergone three antenatal checkups and only 11 (14.1% of them received three postnatal (PN visits. All the beneficiaries received the JSY incentives 1-week the following delivery. Conclusions: Awareness regarding the JSY scheme, early antenatal registration, minimum three antenatal care visits, and three PN visits is still low among rural women which needs strengthening through intensification of IEC activities.

  15. Prevalence of Internet addiction and risk of developing addiction as exemplified by a group of Polish adolescents from urban and rural areas

    Directory of Open Access Journals (Sweden)

    Beata Pawłowska

    2015-02-01

    The Internet addiction criteria were fulfilled by 0.45% of adolescents living in urban areas and 2.9% of those living in rural areas, whereas 35.55% of urban dwelling students and 30.18% of students living in rural areas showed a risk of developing this addiction. More adolescents living in urban areas, compared to those living in rural areas, use Internet pornography, play computer games, disclose their personal data to unknown individuals encountered on the Internet, use Instant Messaging (IM services, electronic mail and Facebook social networking service. Compared to their peers from urban areas, significantly more adolescents from rural areas use ‘Nasza Klasa’ (Our Classmates online social networking service.

  16. Attracting and retaining health workers in rural areas: investigating nurses’ views on rural posts and policy interventions

    Directory of Open Access Journals (Sweden)

    Goodman Catherine

    2010-07-01

    Full Text Available Abstract Background Kenya has bold plans for scaling up priority interventions nationwide, but faces major human resource challenges, with a lack of skilled workers especially in the most disadvantaged rural areas. Methods We investigated reasons for poor recruitment and retention in rural areas and potential policy interventions through quantitative and qualitative data collection with nursing trainees. We interviewed 345 trainees from four purposively selected Medical Training Colleges (MTCs (166 pre-service and 179 upgrading trainees with prior work experience. Each interviewee completed a self-administered questionnaire including likert scale responses to statements about rural areas and interventions, and focus group discussions (FGDs were conducted at each MTC. Results Likert scale responses indicated mixed perceptions of both living and working in rural areas, with a range of positive, negative and indifferent views expressed on average across different statements. The analysis showed that attitudes to working in rural areas were significantly positively affected by being older, but negatively affected by being an upgrading student. Attitudes to living in rural areas were significantly positively affected by being a student at the MTC furthest from Nairobi. During FGDs trainees raised both positive and negative aspects of rural life. Positive aspects included lower costs of living and more autonomy at work. Negative issues included poor infrastructure, inadequate education facilities and opportunities, higher workloads, and inadequate supplies and supervision. Particular concern was expressed about working in communities dominated by other tribes, reflecting Kenya’s recent election-related violence. Quantitative and qualitative data indicated that students believed several strategies could improve rural recruitment and retention, with particular emphasis on substantial rural allowances and the ability to choose their rural location

  17. Rural vs urban hospital performance in a 'competitive' public health service.

    Science.gov (United States)

    Garcia-Lacalle, Javier; Martin, Emilio

    2010-09-01

    In some western countries, market-driven reforms to improve efficiency and quality have harmed the performance of some hospitals, occasionally leading to their closure, mostly in rural areas. This paper seeks to explore whether these reforms affect urban and rural hospitals differently in a European health service. Rural and urban hospital performance is compared taking into account their efficiency and perceived quality. The study is focused on the Andalusian Health Service (SAS) in Spain, which has implemented a freedom of hospital choice policy and a reimbursement system based on hospital performance. Data Envelopment Analysis, the Mann-Whitney U test and Multidimensional Scaling techniques are conducted for two years, 2003 and 2006. The results show that rural and urban hospitals perform similarly in the efficiency dimension, whereas rural hospitals perform significantly better than urban hospitals in the patient satisfaction dimension. When the two dimensions are considered jointly, some rural hospitals are found to be the best performers. As such, market-driven reforms do not necessary result in a difference in the performance of rural and urban hospitals. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. The contribution of town functions to the development of rural areas: empirical analyses for Ethiopia

    NARCIS (Netherlands)

    Tadesse Woeldesenbet, T.

    2012-01-01

    Rural areas in many developing countries often lack infrastructure and institutions. However, rural towns and towns possess some of the major services that rural and town households can use to advance their economic activities. The study of the contribution that towns and their functions make to

  19. Rural Women Veterans' Use and Perception of Mental Health Services.

    Science.gov (United States)

    Ingelse, Kathy; Messecar, Deborah

    2016-04-01

    While the total number of veterans in the U.S. is decreasing overall, the number of women veterans is significantly increasing. There are numerous barriers which keep women veterans from accessing mental health care. One barrier which can impact receiving care is living in a rural area. Veterans in rural areas have access to fewer mental health services than do urban residing veterans, and women veterans in general have less access to mental health care than do their male colleagues. Little is known about rural women veterans and their mental health service needs. Women, who have served in the military, have unique problems related to their service compared to their male colleagues including higher rates of post-traumatic stress disorder (PTSD) and military sexual trauma (MST). This qualitative study investigated use of and barriers to receiving mental health care for rural women veterans. In-depth interviews were conducted with ten women veterans who have reported experiencing problems with either MST, PTSD, or combat trauma. All ten women had utilized mental health services during active-duty military service, and post service, in Veterans Administration (VA) community based-outpatient clinics. Several recurring themes in the women's experience were identified. For all of the women interviewed, a sentinel precipitating event led to seeking mental health services. These precipitating events included episodes of chronic sexual harassment and ridicule, traumatic sexual assaults, and difficult combat experiences. Efforts to report mistreatment were unsuccessful or met with punishment. All the women interviewed reported that they would not have sought services without the help of a supportive peer who encouraged seeking care. Barriers to seeking care included feeling like they were not really a combat veteran (in spite of serving in a combat unit in Iraq); feeling stigmatized by providers and other military personnel, being treated as crazy; and a lack of interest

  20. Utilisation of a direct access echocardiography service by general practitioners in a remote and rural area--distance and rurality are not barriers to referral.

    Science.gov (United States)

    Choo, Wai K; McGeary, Katie; Farman, Colin; Greyling, Andre; Cross, Stephen J; Leslie, Stephen J

    2014-01-01

    This study aimed to examine whether general practitioner (GP) practice locations in remote and rural areas affected the pattern of direct access echocardiography referral and to assess any variations in echocardiographic findings. All referrals made by all GP practices in the Scottish Highlands over a 36-month period were analysed. Referral patterns were examined according to distance and rurality based on the Scottish Government's Urban-Rural Classification. Reasons for referral and cardiac abnormality detection rates were also examined. In total, 1188 referrals were made from 49 different GP practices; range of referral rates was 0.3-20.1 per 1000 population with a mean of 6.5 referrals per 1000 population. Referral rates were not significantly different between urban and rural practices after correction for population size. There was no correlation between the referral rates and the distance from the centre (r2=0.004, p=0.65). The most common reason for referral was the presence of new murmur (46%). The most common presenting symptom was breathlessness (44%). Overall, 28% of studies had significant abnormal findings requiring direct input from a cardiologist. There was no clear relationship between referral rates and cardiac abnormality detection rates (r2=0.07, p=0.37). The average cardiac abnormality detection rate was 56%, (range 52-60%), with no variation based on rurality (p=0.891). In this cohort, rurality and distance were not barriers to an equitable direct access echocardiography service. Cardiac abnormality detection rates are consistent with that of other studies.

  1. Opinions of South African optometry students about working in rural areas after graduation

    Directory of Open Access Journals (Sweden)

    Khathutshelo P. Mashige

    2015-07-01

    Full Text Available Background: Eye and vision problems have been reported to be more prevalent in rural than urban areas; and a large proportion of South Africans live in the rural areas. Aim: To investigate the opinions of South African optometry students about working in rural areas after completion of their training and to identify factors that may influence theirdecisions. Method: This was a cross-sectional quantitative study using a survey instrument containing both closed and open-ended, semi-structured questions. Results: Four hundred and thirty-eight students responded to the questionnaire (85.4% response rate. Overall, many of the respondents did not want to open their first (66% or second practices (64.6% in the rural areas. However, most respondents from rural backgrounds reported that they would open their first (77.2% or second (79.4% practice in the rural areas. The main reasons cited by the respondents for their unwillingness to work in the rural areaswere financial concerns (81.2%, personal safety (80.1% and poor living conditions (75.3%, with a significantly higher number (p < 0.05 being from urban respondents for the latter twoissues only. Conclusion: Many students were not in favour of opening practices in rural areas, but were willing to work for the government or a non-governmental organisation after graduation. Efforts should be made to address financial incentives, safety and living conditions in the rural areas. The results of this study have implications for the future of availability and accessibility of eye care services to those living in the rural and remoteareas of the country.

  2. SOCIO-ECONOMIC DEVELOPMENT PROSPECTS OF RURAL AREAS IN THE CONTEXT OF APPLICATION OF LEADER PROGRAM IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Adrian TUREK RAHOVEANU

    2013-12-01

    Full Text Available Rural development policy is an important component of the Common Agricultural Policy. LEADER is an innovative approach to rural development policy in the European Union to improve the quality of life in rural areas. LEADER is a very effective way to support "smart" and to increase "sustainable" and "inclusive" rural areas, encouraging rural territories to explore new ways to become competitive, to capitalize at maximum their assets and overcome difficulties encountered, encouraging the socio-economic factors to collaborate in order to produce quality goods and services in their local area

  3. Characteristics of HIV-infected adults in the Deep South and their utilization of mental health services: A rural vs. urban comparison.

    Science.gov (United States)

    Reif, Susan; Whetten, Kathryn; Ostermann, Jan; Raper, James L

    2006-01-01

    Insufficient utilization of mental health services has been described among HIV-infected individuals in urban areas; however, little is known about utilization of mental health services among rural-living HIV-infected individuals. This article examines use of mental health services by HIV-infected adults in the Southern U.S., where approximately two-thirds of rural HIV cases reside, and compares mental health services use between those in rural and urban areas. Data were obtained from surveys of HIV-infected individuals receiving care at tertiary Infectious Diseases clinics in the Southern U.S. (n = 474). Study findings indicated that participants living in areas with a higher proportion of rural-living individuals were less likely to report seeing a mental health provider (p mental health visits in the previous month (p = .025). Furthermore, rural living was significantly associated with being African-American, heterosexual, less educated, and having minor children in the home. Due to differences in characteristics and mental health services use by degree of rurality, efforts are needed to assess and address the specific mental health and other needs of HIV-infected individuals in rural areas.

  4. Evidence to service gap: cardiac rehabilitation and secondary prevention in rural and remote Western Australia.

    Science.gov (United States)

    Hamilton, Sandra; Mills, Belynda; McRae, Shelley; Thompson, Sandra

    2018-01-30

    Cardiovascular disease (CVD), a leading cause of morbidity and mortality, has similar incidence in metropolitan and rural areas but poorer cardiovascular outcomes for residents living in rural and remote Australia. Cardiac Rehabilitation (CR) is an evidence-based intervention that helps reduce subsequent cardiovascular events and rehospitalisation. Unfortunately CR attendance rates are as low as 10-30% with rural/remote populations under-represented. This in-depth assessment investigated the provision of CR and secondary prevention services in Western Australia (WA) with a focus on rural and remote populations. CR and Aboriginal Community Controlled Health Services were identified through the Directory of Western Australian Cardiac Rehabilitation and Secondary Prevention Services 2012. Structured interviews with CR coordinators included questions specific to program delivery, content, referral and attendance. Of the 38 CR services identified, 23 (61%) were located in rural (n = 11, 29%) and remote (n = 12, 32%) regions. Interviews with coordinators from 34 CR services (10 rural, 12 remote, 12 metropolitan) found 77% of rural/remote services were hospital-based, with no service providing a comprehensive home-based or alternative method of program delivery. The majority of rural (60%) and remote (80%) services provided CR through chronic condition exercise programs compared with 17% of metropolitan services; only 27% of rural/remote programs provided education classes. Rural/remote coordinators were overwhelmingly physiotherapists, and only 50% of rural and 33% of remote programs had face-to-face access to multidisciplinary support. Patient referral and attendance rates differed greatly across WA and referrals to rural/remote services generally numbered less than 5 per month. Program evaluation was reported by 33% of rural/remote coordinators. Geography, population density and service availability limits patient access to CR services in rural/remote WA. Current

  5. Wireless multihop backhauls for rural areas: A preliminary study.

    Directory of Open Access Journals (Sweden)

    Zainab Zaidi

    Full Text Available Rural areas have very low revenue potential. The major issue in providing low-cost broadband to rural areas is to provide reliable backhaul connections that spread over tens or even hundreds of miles, connecting villages to the nearest service provider. Along with aerial networks of Google and Facebook, there has been a considerable amount of research toward long-distance terrestrial WiFi links. As a comparison, WiFi routers are easier to be deployed and maintained by non-technical people from the local communities, whereas the aerial networks require professional support to operate. Moreover, they are still in the experimentation phase. However, the long distance WiFi links require high-gain directional antennas and very expensive tall towers for high data rates. On the other hand, multihop paths with stronger links may provide better data rates without the need of tall towers. In this paper, we evaluated the concept of using such multihop WiFi links for long backhaul connections. Our simulation results show that these networks can possibly be a cost-effective and practical solution for rural connectivity. These initial results can serve as a first step to understand the comprehensive feasibility of using multihop WiFi networks for backhaul connections in rural area.

  6. Wireless multihop backhauls for rural areas: A preliminary study.

    Science.gov (United States)

    Zaidi, Zainab; Lan, Kun-Chan

    2017-01-01

    Rural areas have very low revenue potential. The major issue in providing low-cost broadband to rural areas is to provide reliable backhaul connections that spread over tens or even hundreds of miles, connecting villages to the nearest service provider. Along with aerial networks of Google and Facebook, there has been a considerable amount of research toward long-distance terrestrial WiFi links. As a comparison, WiFi routers are easier to be deployed and maintained by non-technical people from the local communities, whereas the aerial networks require professional support to operate. Moreover, they are still in the experimentation phase. However, the long distance WiFi links require high-gain directional antennas and very expensive tall towers for high data rates. On the other hand, multihop paths with stronger links may provide better data rates without the need of tall towers. In this paper, we evaluated the concept of using such multihop WiFi links for long backhaul connections. Our simulation results show that these networks can possibly be a cost-effective and practical solution for rural connectivity. These initial results can serve as a first step to understand the comprehensive feasibility of using multihop WiFi networks for backhaul connections in rural area.

  7. Wireless multihop backhauls for rural areas: A preliminary study

    Science.gov (United States)

    Zaidi, Zainab; Lan, Kun-chan

    2017-01-01

    Rural areas have very low revenue potential. The major issue in providing low-cost broadband to rural areas is to provide reliable backhaul connections that spread over tens or even hundreds of miles, connecting villages to the nearest service provider. Along with aerial networks of Google and Facebook, there has been a considerable amount of research toward long-distance terrestrial WiFi links. As a comparison, WiFi routers are easier to be deployed and maintained by non-technical people from the local communities, whereas the aerial networks require professional support to operate. Moreover, they are still in the experimentation phase. However, the long distance WiFi links require high-gain directional antennas and very expensive tall towers for high data rates. On the other hand, multihop paths with stronger links may provide better data rates without the need of tall towers. In this paper, we evaluated the concept of using such multihop WiFi links for long backhaul connections. Our simulation results show that these networks can possibly be a cost-effective and practical solution for rural connectivity. These initial results can serve as a first step to understand the comprehensive feasibility of using multihop WiFi networks for backhaul connections in rural area. PMID:28403167

  8. Public Library Extension Service for Rural Areas Kırsal Kesimlerde Halk Kütüphanesi Hizmetlerinin Yaygınlaştırılması

    Directory of Open Access Journals (Sweden)

    Peter Oldroyd

    1994-03-01

    Full Text Available This speech, given in Istanbul on 3 December 1993 during a visit to Turkey, starts with an overview of public library services in Britain Following information on services offered to rural areas; the author refers a report published in 1993. This report highlights the main topics under discussion in Britain currently: (1 it is recognized that a modern public library is a very complicated organization serving a large clientele aiming to meet their very many requirements; (2 volunteers, new technologies and modern management and marketing techniques should be utilized to improve the services to rural areas; (3 although services to rural areas pose specific problems, people who live in these areas have the right to demand equal services; (4 although only some services can be offered directly, in rural areas, everyone should have equal opportunities in reaching all library and information services; (5 cooperation with local people by library authorities can be a solution to some of the problems. Bu konferans, genel anlamda kütüphanelerin ve kütüphanecilerin karşı karşıya bulunduğu sorunlar üzerinde yoğunlaşmakla birlikte, ele alınan konular Büyük Britanya 'daki kütüphanelerle özellikle de halk kütüphaneleri ile sınırlı kalmaktadır. Ancak kütüphanecilik, evrensel bir kavram olduğundan Britanya'daki kütüphanelerin sorunları, az ya da çok tüm ülke kütüphaneleri tarafından paylaşılmaktadır. Göz önünde bulundurulması gereken en önemli konu, genel kütüphanecilik hizmetlerinin, küçük yerleşim birimleri itibariyle de yaygınlaştırılmasının gerektiğidir. Ve bu konuyla ilgili olarak, çağdaş iletişim araçlarının inkar edilemez bir rolü sözkonusu olmaktadır. Kütüphanecilik hizmetlerinden herkesin eşit oranda yararlanabilme hakkı vardır. Bu hizmetlerden yararlanabildiği ve kültür seviyesinin daha yüksek olduğu

  9. A Systematic Review of Services to DHH Children in Rural and Remote Regions

    Science.gov (United States)

    Barr, Megan; Duncan, Jill; Dally, Kerry

    2018-01-01

    Children in regional, rural and remote areas have less access to services than those living in urban areas. Practitioners serving children with a hearing loss have attempted to address this gap, however there are few studies investigating service access and experiences of non-metropolitan families and professionals. This systematic review…

  10. Transformation of the rural PV market through the National Rural Water Service Delivery Program

    International Nuclear Information System (INIS)

    2009-03-01

    The primary objective of the project is to reduce the country's energy-related Co2 emissions by substituting solar Pv to fossil fuels to provide basic water pumping services to the non-electrified rural communities in the Middle-South region. A secondary objective is to institutionalize the use of solar Pv for low-head irrigation and basic domestic (lighting, Tv) and community (health clinics, telecom, schools) uses in rural areas as a substitute for fossil fuel-based energy sources (paraffin, diesel and LPG). The activities proposed in the project are designed to: (I) remove barriers to the wide-scale utilization of solar Pv for solar pumping; (II) meet the basic energy needs of community based organizations; and (III) reinforce public-private partnerships in promoting solar Pv technology. This project will assist with the introduction of solar Pv in the Government rural water program - which is a unique opportunity to tap a sizable Pv market within the country - and will ensure sustain ability through the involvement of the private sector in the provision of water services

  11. Rural development NGOS and service delivery to the very poor: An empirical analysis of a training center in rural Cameroon

    OpenAIRE

    Balgah Roland Azibo; Emmanuel Yenshu Vubo; Innocent Ndoh Mbue; Jude Ndzifon Kimengsi

    2015-01-01

    The role of development nongovernmental organizations (DNGOs) in driving change, servicing the very poor and reducing poverty especially in rural areas in developing countries has been generally affirmed in the rural economics literature. This romantic image accounts to a large extent for the exponential numeric growth observed in the sector, and for burgeoning research on the subject by rural development economists. However, not enough empirical evidence exists on the extent to which such or...

  12. Social conflict in response to urban sprawl in rural areas: urban reconfiguration of the Mezquital valley as influence area of the megalopolis of Mexico City

    OpenAIRE

    Carrasco, Brisa; Cadena, Edel; Campos, Juan; Hinojosa, Raquel

    2016-01-01

    The urban sprawl of metropolitan areas involves complex processes of coexistence between urban and rural dynamics, the functional redefining of central urban areas and rural areas or urban-rural surrounding transition generates land conflicts. In this paper the context of Mexico City megalopolis and its expansion process, will be discussed in the new specialization of the central city to tertiary services and increasing the value of land, it has resulted in the expulsion of the industry and s...

  13. Tertiary Students and Social Development: An Area for Direct Action--Student Rural Service Activities in Malaysia.

    Science.gov (United States)

    Kong, Kee Poo

    The study is a survey of the different kinds of voluntary rural service (service-learning) corps of students from the institutions of higher education in Malaysia. The history, organization, and activities of the service corps are examined, and this type of student social action is viewed with reference to the role of higher education in the…

  14. ANALYSIS OF ECONOMIC GAPS BETWEEN URBAN AND RURAL ROMANIAN AREAS

    Directory of Open Access Journals (Sweden)

    Toader Valentin

    2011-07-01

    Full Text Available In this paper the authors will perform a comparative analysis of the impact that the population residential areas have on the economic and social activity from Romania. Our analysis will be carried out for a time span of 10 years, between 2000 and 2009. The main purposes are to emphasize the economic gaps between the residential areas (urban and rural and to identify the factors that determine these gaps. The economic differences between rural and urban areas and their impact on the peoples standard of living represent an important issue for international institutions like IFRC, UNICEF or OECD. Also, this topic represents a frequent subject in the economic literature from poor and developing countries. Studies conducted by Huong and Booth (2010, Alister, Alana and Ayele (2007, Chao, Zhidong and Mingxing (2008, Mateoc-Srb, Mateoc, Darva?i and Manescu (2008 or Sahn and Stifel (2002 are representative examples. Most of these papers focus on the living standards differences generated by the differences between income and expenditures between urban and rural areas. To achieve our goals, we will use the statistical methods to analyze the data released by the National Institute of Statistics. We will try to find some correlations between the economic indicators household incomes, value and structure of household expenditures, structure of household expenditures the social indicators residential area, education level, age and occupation. The highlight of the gaps between the rural and urban areas will be the main objective during this analysis. We conclude that in Romania there are substantial differences between rural and urban areas. The income differences are determining different consumption patterns between rural and urban persons. In rural areas, the population is spending less in all goods and services aspect that reduce their standard of living. Anyway, the results obtained are the subject of at least two possible limits. The fact that the data

  15. Strategies for gender-equitable HIV services in rural India

    Science.gov (United States)

    Sinha, Gita; Peters, David H; Bollinger, Robert C

    2009-01-01

    The emergence of HIV in rural India has the potential to heighten gender inequity in a context where women already suffer significant health disparities. Recent Indian health policies provide new opportunities to identify and implement gender-equitable rural HIV services. In this review, we adapt Mosley and Chen's conceptual framework of health to outline determinants for HIV health services utilization and outcomes. Examining the framework through a gender lens, we conduct a comprehensive literature review for gender-related gaps in HIV clinical services in rural India, focusing on patient access and outcomes, provider practices, and institutional partnerships. Contextualizing findings from rural India in the broader international literature, we describe potential strategies for gender-equitable HIV services in rural India, as responses to the following three questions: (1) What gender-specific patient needs should be addressed for gender-equitable HIV testing and care? (2) What do health care providers need to deliver HIV services with gender equity? (3) How should institutions enforce and sustain gender-equitable HIV services? Data at this early stage indicate substantial gender-related differences in HIV services in rural India, reflecting prevailing gender norms. Strategies including gender-specific HIV testing and care services would directly address current gender-specific patient needs. Rural care providers urgently need training in gender sensitivity and HIV-related communication and clinical skills. To enforce and sustain gender equity, multi-sectoral institutions must establish gender-equitable medical workplaces, interdisciplinary HIV services partnerships, and oversight methods, including analysis of gender-disaggregated data. A gender-equitable approach to rural India's rapidly evolving HIV services programmes could serve as a foundation for gender equity in the overall health care system. PMID:19244284

  16. Obesity awareness among elders living in rural area: a household survey

    OpenAIRE

    Maycon Sousa Pegorari; Alisson Fernandes Bolina; Darlene Mara dos Santos Tavares

    2017-01-01

    The acceptance of the disease is essential to health self-care, elder’s awareness regarding obesity is suggested to influence their search for health services, and consequently, in obesity’s treatment. This study aimed to verify obesity awareness of elders living in rural areas and associated socioeconomic and demographic factors. We conducted a cross-sectional household survey with 562 individuals, who were older than 60 years and were rural residents from a Brazil southeast city. The identi...

  17. Youth retention in rural areas, a prerequisite for sustainable rural entrepreneurship and employment

    Directory of Open Access Journals (Sweden)

    Ali Ghasemi Ardahaee

    2017-07-01

    Full Text Available Entrepreneurship and sustainable rural employment are the main concerns of rural planners. One of the most basic requirements for this is that young people remain in the rural areas. Accordingly, the aim of this paper is to identify individual and structural factors that are effective in keeping young people in rural areas. Statistical results of the bivariate and multilevel modeling (HLM shows that rural youth are not willing to stay in rural regions. One may cite the following individual factors contributing to this lack of interest in staying in rural areas: age, marital status, education, communication with relatives in the city, as well as employment status and job skills. People with higher human capital who have technical skills and building related non-agricultural skills are not interested in staying in rural areas. Moreover, the increased population in the villages and lack of social welfare facilities in village are highly effective in reducing the tendency of young people to stay in the villages.

  18. Empowering Rural Women through Mobile Services

    Science.gov (United States)

    Nagarajan, P.; Jiji, G. Wiselin

    2010-01-01

    This paper is intended as a gender issue to the rural finance practitioners. It highlights the questions that need to be asked and addressed to the gender mainstream. It will also be useful to gender experts to wish to increase their understanding on specific gender issues in rural finance through mobile services. It focuses on rural microfinance…

  19. Side Activities of Non-Farmers in Rural Areas in the Netherlands

    Directory of Open Access Journals (Sweden)

    Marianna Markantoni

    2012-01-01

    Full Text Available In many rural areas, not only in The Netherlands but also elsewhere in Europe, has been observed a variety of employment opportunities for rural populations, following the decline in traditional agricultural employment. This contributes to the fact that the countryside is changing and rural areas can be viewed as new spaces of work. As a result, rural economy is no longer dominated by agricultural activities, but by activities such as small scale industrial production, service provision, landscape management, and residential use. To a certain extent these activities have the form of side-activities next to primary income sources. Most attention in both scientific literature and policies is focused on side-activities by farmers, such as agro-tourism and direct marketing. However, according to empirical data from The Netherlands, most side-activities are developed by non-farmers. In this paper the focus is on this last group. The amounts and types of non-farmers’ and farmers side-activities will be deployed, together with their motives to start new entrepreneurship endeavors and the impact on the local community. It will be argued that this type of activities will stimulate rural economic development offering new job opportunities for income generation to the rural inhabitants and create new economic spaces in rural geographical contexts transforming the rural economy.

  20. The sustainability and efficient use of renewable energy sources in rural areas

    Science.gov (United States)

    Adetunji, Kayode E.; Akinlabi, Akindeji O.; Joseph, Meera K.

    2018-04-01

    The energy system in African countries is mostly dependent on coal, gas, and oil, which in turns leads to environmental challenges and an imbalance of energy usage in some area of the countries. Given that, a mostly rural area in Africa suffers from the unsustainable energy system, thus it necessary to integrate renewable energy into the rural area for social and economic development. A sustainable energy system built on a clean energy such as renewable energy based on the availability of the natural resource is the main focus of this paper. Renewable energy is a solution for service delivery and when deployed everyone would be able to access electricity power, particularly in the remote area (which can be a suburb or rural environment) where the absence of national power grids. Renewable energy opens new opportunities for an economic development and sustainable solution to employ for energy efficiency, energy delivery, and energy management by the people and upon that a platform to promote environmental friendliness. In this paper, we explored the reasons for switching to renewable energy, saving energy and the awareness of potential and use of renewable energy in the rural area. IBM's SPSS is used for the quantitative data analysis. The results showed that sustainability of the National utility grid to the rural area is low, with over 80 percent of participants agreeing to disruption of power supply. The Positivity of the rural peoples' awareness of renewable also brought about the conclusion and recommendations from this paper.

  1. Outcome of treatment seeking rural gamblers attending a nurse-led cognitive-behaviour therapy service: A pilot study

    Directory of Open Access Journals (Sweden)

    Barry Tolchard

    2016-03-01

    Full Text Available Objectives: Little is known about the differences between urban and rural gamblers in Australia, in terms of comorbidity and treatment outcome. Health disparities exist between urban and rural areas in terms of accessibility, availability, and acceptability of treatment programs for problem gamblers. However, evidence supporting cognitive-behaviour therapy as the main treatment for problem gamblers is strong. This pilot study aimed to assess the outcome of a Cognitive-Behavioural Therapy (CBT treatment program offered to urban and rural treatment-seeking gamblers. Methods: People who presented for treatment at a nurse-led Cognitive-Behavioural Therapy (CBT gambling treatment service were invited to take part in this study. A standardised clinical assessment and treatment service was provided to all participants. A series of validated questionnaires were given to all participants at (a assessment, (b discharge, (c at a one-month, and (d at a 3-month follow-up visit. Results: Differences emerged between urban and rural treatment-seeking gamblers. While overall treatment outcomes were much the same at three months after treatment, rural gamblers appeared to respond more rapidly and to have sustained improvements over time. Conclusion: This study suggests that rural problem gamblers experience different levels of co-morbid anxiety and depression from their urban counterparts, but once in treatment appear to respond quicker. ACBT approach was found to be effective in treating rural gamblers and outcomes were maintained. Ensuring better availability and access to such treatment in rural areas is important. Nurses are in a position as the majority health professional in rural areas to provide such help. Keywords: Evidence based health care, Health program evaluation, Models of care, Rural health services delivery, Rural mental health

  2. Skilled delivery care service utilization in Ethiopia: analysis of rural ...

    African Journals Online (AJOL)

    Only 4.5% women in rural areas received assistance from skilled birth attendants (SBAs) compared to 64.1 % of their urban counter parts. Through Bayesian logistic regression analysis, place of residence, ANC utilization, women's education, age and birth order were identified as key predictors of service utilization.

  3. Patient’s expectation on communication performances community of Dental Health Services providers located in urban and rural area

    Directory of Open Access Journals (Sweden)

    Taufan Bramantoro

    2013-03-01

    Full Text Available Background: The quality of dentist’s communication skills is considered as one of important aspects on the quality of dental health services assessment. During the initial interview conducted at Ketabang, Dupak, and Kepadangan community dental health services at Surabaya and Sidoarjo, Indonesia, it appeared that eighty percent of initial respondents were not satisfied with the communication aspect. Community Dental Health Services (CDHS need to assess the communication performances based on community characteristics in effort to promote the quality and effectiveness of the denta health services. Purpose: The objective of this study was to analyze patient’s expectation values priorities on dentists' communication performances in CDHS that located in urban and rural area. Methods: The study was conducted in Ketabang Surabaya, Dupak Surabaya and Kepadangan Sidoarjo CDHSs. The participants were 400 patients above 18 years old. Participants were assessed their expectation value using the communication performances of dental health services questionnaire. Results: Patients in urban CDHS appeared that there were two priority aspects which had high values, namely the clarity of instructions and the dentist’s ability of active listening to the patient, while patients in rural CDHS revealed that the clarity of instructions and dentist-patient relationship were the aspects with high values. Conclusion: Patients in CDHS that located in rural area expect more dentist-patient interpersonal relationship performance than patients in CDHS located in urban area. This finding becomes a valuable information for CDHS to develop communication strategies based on community characteristics.Latar belakang: Kualitas komunikasi dari dokter gigi merupakan salah satu aspek penting dalam penilaian kualitas layanan suatu sarana pelayanan kesehatan. Pada wawancara pendahuluan yang dilaksanakan di puskesmas Ketabang, Dupak dan Kepadangan di Surabaya dan Sidoarjo

  4. Prenatal care utilization in rural areas and urban areas of Haiti El uso de servicios de atención prenatal en áreas rurales y urbanas de Haití

    Directory of Open Access Journals (Sweden)

    Pierre Kébreau Alexandre

    2005-08-01

    Full Text Available OBJECTIVES: This study is based on the 2000 Demographic and Health Survey (DHS conducted in Haiti. Using the DHS information on women aged 15 to 49 who had given birth during the three years preceding the survey interview, this study was intended to: (1 examine the determinants of the likelihood of the women using prenatal care in the rural areas and in the urban areas of the country and (2 for the women who made at least one prenatal care visit, examine the determinants of the number of prenatal visits in the rural areas and the urban areas. METHODS: The multivariate analysis used logistic models to identify which factors explained the decision to seek prenatal care, and negative binomial models were used to determine how many prenatal visits were conducted by the subgroup of women who did make prenatal care visits. RESULTS: Estimated at the mean values of the control variables, the expected probability of using prenatal care services in rural Haiti was 77.16%, compared to 85.83% in urban Haiti. Among users of prenatal care services, mothers in rural areas made an expected number of 3.78 prenatal care visits, compared to 5.06 visits for the women in urban areas. CONCLUSIONS: A substantial percentage of pregnant women have access to prenatal care services in Haiti, but mothers in rural areas who decided to seek care still fell slightly below the four visits recommended by the World Health Organization. The education levels of both mothers and their partners is a dominant predictor of prenatal care use. Longer travel times and greater distances to health centers in rural areas constituted barriers to repeated visits. Policymakers and health care providers need to take these findings into consideration as they decide on the delivery and management of health care services in Haiti.OBJETIVOS: El presente estudio se basa en la Encuesta de Demografía y Salud del año 2000 en Haití. Los objetivos del estudio, que se basó en información sobre las

  5. [Fertility in rural and urban areas of Mexico].

    Science.gov (United States)

    Garcia Y Garma, I O

    1989-01-01

    Data from 6 fertility surveys conducted in Mexico between 1969-87 were used to compare rural and urban fertility and to determine whether a significant level of contraceptive usage could be achieved in rural areas despite their lack of socioeconomic development. Age-specific marital fertility rates were calculated for the 4 national-level and 2 rural fertility surveys. The index of fertility control developed by Coale and Trussel was calculated for rural, urban, and all areas. The marital total fertility rate in rural areas declined from 10.6 in 1970 to 7.4 in 1982, a decline of 2.5% annually. From 1982-87 the annual rate of decline in rural fertility slowed to 1.6%, reaching 6.8 children in 1987. The urban marital total fertility rate declined from 7.72 in 1976 to 5.03 in 1987, while the marital total fertility rate for Mexico as a whole declined from 9.04 in 1976 to 5.85 in 1987. The indices of fertility control showed slowly increasing use of contraception in rural areas starting from the very low level of 1969. The urban index of fertility control showed some contraceptive use for all age groups in all surveys. The increases in contraceptive usage were considerable in rural areas from 1976-82 and much less marked in urban areas. From 1982-87 the inverse was observed and the fertility decline in urban areas was more marked. The condition of natural fertility found in rural areas in 1969 subsequently disappeared. Over time, fertility decline and use of contraception have intensified. Contraception is widely practiced in urban areas and is continuing to become more prevalent. The rural fertility decline in 1976-82 suggests that at least sometimes increases in fertility control are more important in rural areas than in urban areas. The theory of modernization, which holds that fertility decline in developed countries is attributable to factors associated with the process of modernization, thus comes into question. However, it is probable that a sustained fertility

  6. Urban-rural difference in satisfaction with primary healthcare services in Ghana

    Directory of Open Access Journals (Sweden)

    Sanni Yaya

    2017-11-01

    Full Text Available Abstract Background Understanding regional variation in patient satisfaction about healthcare systems (PHCs on the quality of services provided is instrumental to improving quality and developing a patient-centered healthcare system by making it more responsive especially to the cultural aspects of health demands of a population. Reaching to the innovative National Health Insurance Scheme (NHIS in Ghana, surpassing several reforms in healthcare financing has been a milestone. However, the focus of NHIS is on the demand side of healthcare delivery. Studies focusing on the supply side of healthcare delivery, particularly the quality of service as perceived by the consumers are required. A growing number of studies have focused on regional differences of patient satisfaction in developed countries, however little research has been conducted concerning patient satisfaction in resource-poor settings like in Ghana. This study was therefore dedicated to examining the variation in satisfaction across rural and urban women in Ghana. Methods Data for the present study were obtained from the latest demographic and health survey in Ghana (GDHS 2014. Participants were 3576 women aged between 15 and 49 years living in non-institutional settings in Ghana. Summary statistics in percentages was used to present respondents’ demographic, socioeconomic characteristics. Chi-square test was used to find association between urban-rural differentials with socio-economic variables. Multiple logistic regression was performed to measure the association of being satisfied with primary healthcare services with study variables. Model fitness was tested by pseudo R 2. Statistical significance was set at p < 0.05. Results The findings in this study revealed that about 57.1% were satisfied with primary health care services. The urban and rural areas reported 57.6 and 56.6% respectively which showed no statistically significant difference (z = 0.64; p = 0.523; 95

  7. Urban-rural migration and cultural transformation of rural areas

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    Rural areas are presently challenged by various restructuring processes; functionally and economically with changes in employment structure etc. as well as social and cultural transformations due to demographic change, population loss but also due to in-migration. This paper addresses how rural...

  8. Evaluation of the Vocational Preparation and Success of Handicapped Individuals Who Reside in Rural Areas of Florida. Florida Rural Research Project. Final Report.

    Science.gov (United States)

    Budd, Diane M.

    Phase 2 of a three-phase project examined the secondary education background and employment adjustment of handicapped youth in rural counties in Florida. (Phase 1 was a pilot study.) Subjects were former special education students in five rural project counties who had been identified as needing services in the area of educable mental retardation,…

  9. Rural Runaways: Rurality and Its Implications for Services to Children and Young People Who Run Away

    Science.gov (United States)

    Franks, Myfanwy; Goswami, Haridhan

    2010-01-01

    This article debates options for service provision to young rural runaways in the UK. Using data drawn from two national surveys and follow-on qualitative studies, the authors trace urban myths of rurality and their effects on runaway provision. The authors review models of rural refuge, systemic advocacy and mobile services for rural runaways.…

  10. Evaluating the Development Levels of Rural Areas in Koohrang County

    Directory of Open Access Journals (Sweden)

    saleh shahrokhi sardo

    2016-02-01

    Full Text Available A better understanding of geographical phenomena and scientific comprehending of geographical locations requires comprehensive information about these areas. In addition, the awareness of the spatial distribution and development levels are considered as prerequisites for rural development plans and programs. Therefore, the aim of this study was to evaluate the development levels of rural areas in Koohrang County. Statistical population was over ten households selected among rural areas (132 villages in Koohrang County. The required secondary data were collected and designed from the statistical yearbook of Koohrang County in 2011. In this study, a combination method of VIKOR-AHP was used to measure level of development in the villages. In addition, in order to determine the optimal distribution of indices, the Gini coefficient was used. Data processing was conducted using MATLAB7.10 and Expert Choice software. Results showed that the highest and lowest degrees of development (0.994 and 0.005 were related to "Castle of Ali-Abad" and "Dezak-Cheshmeh" villages, respectively. Moreover, results indicated that there was the unfavorable development in the study area (with average of 0. 217 in the range 0-1 in a way that most of the villages (21.46% with 53.39% of the population in the area were completely undeveloped. Furthermore, the results based on Gini coefficient and coefficient of variability revealed that the conventional indices of rural development weren't distributed properly. Therefore, it is necessary to have special review and reconsider to determine the main service centers based on settlements hierarchical system.

  11. The Function Analysis of Informationization in New Rural Cooperatives Medical Service Management

    Science.gov (United States)

    Zhou, Yuefeng; Liu, Min

    The establishment of new rural cooperative medical system is an important action for comprehensive affluent society. It is an important measure for Central Party Committee and State Council to solve "three rural" issue effectively and to overall urban and rural, regional, coordinated economic and social development, building a well-off society in the new situation. It has important role to alleviate farmers to see a doctor expensively, see a doctor difficultly, reduce the burden on farmers and improve their level of health protection and quality of life, solve the problem of poor because of illness and the problem of returning poor due to illness, promote the production and rural economic development and stability in the rural areas. This article will analyze the function of informationization in new rural cooperative medical service management selectively.

  12. Can (ReCentralization Be a Modern Governance in Rural Areas?

    Directory of Open Access Journals (Sweden)

    István BALÁZS

    2017-02-01

    Full Text Available Concentration and recentralization can be described as a European trend in the fi eld of local governance, especially in the fi eld of the administration of rural areas. An important tool of the concentration of the local administration is the intercommunal cooperation. The Hungarian rural areas have fragmented spatial structures. Because of the fragmentation and the small number of the voluntary associations these types of local cooperation were signifi cantly supported by the central budget in the 1990s and 2000s. The economic crisis resulted in a strong concentration trend in Hungary, as well. The new Hungarian Municipal Code introduced a Janus-faced model. The administration of the rural areas was strongly concentrated by the establishment of the mandatory common municipal offi ces of the small villages (under 2000 inhabitants while the forms of the intercommunal associations were simplifi ed. This reform reduced the number of local offi ces signifi cantly. This type of intercommunal cooperation became the main form of the j oined public service management as well, because the former signifi cant state aid of the voluntary associations has been reduced.

  13. Can (ReCentralization Be a Modern Governance in Rural Areas?

    Directory of Open Access Journals (Sweden)

    István BALÁZS

    2017-02-01

    Full Text Available Concentration and recentralization can be described as a European trend in the fi eld of local governance, especially in the fi eld of the administration of rural areas. An important tool of the concentration of the local administration is the intercommunal cooperation. The Hungarian rural areas have fragmented spatial structures. Because of the fragmentation and the small number of the voluntary associations these types of local cooperation were signifi cantly supported by the central budget in the 1990s and 2000s. The economic crisis resulted a strong concentration trend in Hungary, as well. The new Hungarian Municipal Code introduced a Janus-faced model. The administration of the rural areas was strongly concentrated by the establishment of the mandatory common municipal offi ces of the small villages (under 2000 inhabitants while the forms of the intercommunal associations were simplifi ed. This reform reduced the number of local offi ces signifi cantly. This type of intercommunal cooperation became the main form of the j oined public service management as well, because the former signifi cant state aid of the voluntary associations have been reduced.

  14. Disseminating Ambient Assisted Living in Rural Areas

    Science.gov (United States)

    Leitner, Gerhard; Felfernig, Alexander; Fercher, Anton J.; Hitz, Martin

    2014-01-01

    The smart home, ambient intelligence and ambient assisted living have been intensively researched for decades. Although rural areas are an important potential market, because they represent about 80% of the territory of the EU countries and around 125 million inhabitants, there is currently a lack of applicable AAL solutions. This paper discusses the theoretical foundations of AAL in rural areas. This discussion is underlined by the achievements of the empirical field study, Casa Vecchia, which has been carried out over a four-year period in a rural area in Austria. The major goal of Casa Vecchia was to evaluate the feasibility of a specific form of AAL for rural areas: bringing AAL technology to the homes of the elderly, rather than moving seniors to special-equipped care facilities. The Casa Vecchia project thoroughly investigated the possibilities, challenges and drawbacks of AAL related to this specific approach. The findings are promising and somewhat surprising and indicate that further technical, interactional and socio-psychological research is required to make AAL in rural areas reasonable in the future. PMID:25068862

  15. Disseminating Ambient Assisted Living in Rural Areas

    Directory of Open Access Journals (Sweden)

    Gerhard Leitner

    2014-07-01

    Full Text Available The smart home, ambient intelligence and ambient assisted living have been intensively researched for decades. Although rural areas are an important potential market, because they represent about 80% of the territory of the EU countries and around 125 million inhabitants, there is currently a lack of applicable AAL solutions. This paper discusses the theoretical foundations of AAL in rural areas. This discussion is underlined by the achievements of the empirical field study, Casa Vecchia, which has been carried out over a four-year period in a rural area in Austria. The major goal of Casa Vecchia was to evaluate the feasibility of a specific form of AAL for rural areas: bringing AAL technology to the homes of the elderly, rather than moving seniors to special-equipped care facilities. The Casa Vecchia project thoroughly investigated the possibilities, challenges and drawbacks of AAL related to this specific approach. The findings are promising and somewhat surprising and indicate that further technical, interactional and socio-psychological research is required to make AAL in rural areas reasonable in the future.

  16. Integration and transformation of rural service delivery: The role of management information and decision support systems

    CSIR Research Space (South Africa)

    Mashiri, M

    2005-01-01

    Full Text Available The paper deals with two main themes: 1) the integration and transformation of rural service delivery; and 2) role of management information and decision support systems in this process. Referring specifically to the types of rural areas, conditions...

  17. The impact of innovation funding on a rural health nursing service: the Reporoa experience.

    Science.gov (United States)

    Connor, Margaret; Nelson, Katherine; Maisey, Jane

    2009-07-01

    Health Reporoa Inc. offers a first contact rural nursing service to the village of Reporoa and surrounding districts. From 2003 to 2006 it became a project site through selection for the Ministry of Health (MoH) primary health care nursing innovation funding. Health Reporoa Inc. successfully achieved its project goals and gained an ongoing contract from Lakes District Health Board to consolidate and further expand its services at the close of the funding period. This paper examines the impact of the innovation funding during the project period and in the two years that followed. The major impact came through an expansion of the accessible free health service to the local population; advancing nursing practice; increased connection to the nursing profession and wider health community, and enhanced affirmation of the nursing contribution. The rural nursing service model developed at Health Reporoa, through the benefit of innovation funding, can now act as a blueprint for other rural health services, particularly those in high deprivation areas.

  18. Aging and quality of life of elderly people in rural areas

    Directory of Open Access Journals (Sweden)

    Juliana Ladeira Garbaccio

    Full Text Available ABSTRACT Objective: To evaluate the quality of life and health of elderly in rural areas of Minas Gerais State’s center-west. Method: Cross-sectional study, in four municipalities of Minas Gerais State, by interviewing elderly people. Associations between socio-demographic and quality of life variables were tested, separated into “satisfactory”/“unsatisfactory” with values from the median of positive answers. It was used the chi-square test, Fisher’s test and regression. Results: 182 elderly answered the questions and showed a relation with the “satisfactory” quality of life - bivariate (p < 0.05: age by 69 years (61.6%, married (61.7%, living by 54 years in rural areas (68%, with no financial support (59.5%, living with someone else (61%, non-smoker (60%, presenting good health (76.7%, satisfied with life (69.6%; regression: not having financial support, living with someone else and not smoking. Conclusion: Elderly people in rural areas present good quality of life/health in the cognitive aspect, access to services, goods, habits, but awareness must be constant due to their weakness.

  19. Rural adolescents' access to adolescent friendly health services.

    Science.gov (United States)

    Secor-Turner, Molly A; Randall, Brandy A; Brennan, Alison L; Anderson, Melinda K; Gross, Dean A

    2014-01-01

    The purpose of this study was to assess rural North Dakota adolescents' experiences in accessing adolescent-friendly health services and to examine the relationship between rural adolescents' communication with health care providers and risk behaviors. Data are from the Rural Adolescent Health Survey (RAHS), an anonymous survey of 14- to 19-year-olds (n = 322) attending secondary schools in four frontier counties of North Dakota. Descriptive statistics were used to assess participants' access to adolescent-friendly health services characterized as accessible, acceptable, and appropriate. Logistic regressions were used to examine whether participant-reported risk behaviors predicted communication with health care providers about individual health risk behaviors. Rural adolescents reported high access to acceptable primary health care services but low levels of effective health care services. Participant report of engaging in high-risk behaviors was associated with having received information from health care providers about the leading causes of morbidity and mortality. These findings reveal missed opportunities for primary care providers in rural settings to provide fundamental health promotion to adolescents. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  20. For more than love or money: attitudes of student and in-service health workers towards rural service in India.

    Science.gov (United States)

    Ramani, Sudha; Rao, Krishna D; Ryan, Mandy; Vujicic, Marko; Berman, Peter

    2013-11-21

    While international literature on rural retention is expanding, there is a lack of research on relevant strategies from pluralistic healthcare environments such as India, where alternate medicine is an integral component of primary care. In such contexts, there is a constant tug of war in national policy on "Which health worker is needed in rural areas?" and "Who can, realistically, be got there?" In this article, we try to inform this debate by juxtaposing perspectives of three cadres involved in primary care in India-allopathic, ayurvedic and nursing-on rural service. We also identify key incentives for improved rural retention of these cadres. We present qualitative evidence from two states, Uttarakhand and Andhra Pradesh. Eighty-eight in-depth interviews with students and in-service personnel were conducted between January and July 2010. Generic thematic analysis techniques were employed, and the data were organized in a framework that clustered factors linked to rural service as organizational (salary, infrastructure, career) and contextual (housing, children's development, safety). Similar to other studies, we found that both pecuniary and non-pecuniary factors (salary, working conditions, children's education, living conditions and safety) affect career preferences of health workers. For the allopathic cadre, rural primary care jobs commanded little respect; respondents from this cadre aimed to specialize and preferred private sector jobs. Offering preferential admission to specialist courses in exchange for a rural stint appears to be a powerful incentive for this cadre. In contrast, respondents from the Ayurvedic and nursing cadres favored public sector jobs even if this meant rural postings. For these two cadres, better salary, working and rural living conditions can increase recruitment. Rural retention strategies in India have predominantly concentrated on the allopathic cadre. Our study suggests incentivizing rural service for the nursing and Ayurvedic

  1. Health Service Accessibility and Risk in Cervical Cancer Prevention: Comparing Rural Versus Nonrural Residence in New Mexico

    Science.gov (United States)

    McDonald, Yolanda J.; Goldberg, Daniel W.; Scarinci, Isabel C.; Castle, Philip E.; Cuzick, Jack; Robertson, Michael; Wheeler, Cosette M.

    2018-01-01

    Purpose Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Methods Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P < .05) was used to determine if differences were significant and Cohen's r to measure effect. Findings Across all cervical cancer preventive health care services and years, women who resided in rural areas had a significantly greater geographic accessibility burden when compared to nonrural areas (4.4 km vs 2.5 km and 4.9 minutes vs 3.0 minutes for screening; 9.9 km vs 4.2 km and 10.4 minutes vs 4.9 minutes for colposcopy; and 14.8 km vs 6.6 km and 14.4 minutes vs 7.4 minutes for precancer treatment services, all P < .001). Conclusion Improvements in cervical cancer prevention should address the potential benefits of providing the full spectrum of screening, diagnostic and precancer treatment services within individual facilities. Accessibility, assessments distinguishing rural and nonrural areas are essential when monitoring and recommending changes to service infrastructures (eg, mobile versus brick and mortar). PMID:27557124

  2. The provision of neuropsychological services in rural/regional settings: professional and ethical issues.

    Science.gov (United States)

    Allott, Kelly; Lloyd, Susan

    2009-07-01

    Despite rapid growth of the discipline of clinical neuropsychology during recent times, there is limited information regarding the identification and management of professional and ethical issues associated with the practice of neuropsychology within rural settings. The aim of this article is to outline the characteristics unique to practicing neuropsychology in rural communities and to describe the potential professional and ethical dilemmas that might arise. Issues are illustrated using examples from neuropsychological practice in a rural/regional setting in Victoria, Australia. Relative to urban regions, there is an inequality in the distribution of psychologists, including neuropsychologists, in rural areas. The unique characteristics of rural and regional communities that impact on neuropsychological practice are: 1) limited resources in expertise, technology, and community services, 2) greater travel distances and costs, 3) professional isolation, and 4) beliefs about psychological services. These characteristics lower the threshold for particular ethical issues. The ethical issues that require anticipation and careful management include: 1) professional competence, 2) multiple relationships, and 3) confidentiality. Through increased awareness and management of rural-specific professional and ethical issues, rural neuropsychologists can experience their work as rewarding and enjoyable. Specific guidelines for identifying, managing, and resolving ethically and professionally challenging situations that may arise during rural practice are provided.

  3. Rural areas of Eastern Germany: modern challenges

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    Klüter Helmut

    2012-03-01

    Full Text Available After the German reunification the agricultural development of eastern territories seemed to have picked up its pace. Yet the main problems those territories are facing today hatched already in the mid-1990s. In our study we address the problems and challenges that hinder sustainable development of East German rural areas. We analyse agricultural statistics and describe the structure of agricultural enterprises, land-use, and other critical dimensions of agriculture. We discuss pros and cons of modern rural areas spatial planning policy and take a critical look at the current status of rural areas. We also put forward a number of concrete proposals aimed at the development of the area and counteracting the negative trends it is now experiencing. Even taking into account all ‘positive’ development trends that are postulated to have occurred since the unification, we underline the crucial necessity of diversification of labour forces and of changing the spatial planning policies in the rural areas of East Germany.

  4. The development of a caseload midwifery service in rural Australia.

    Science.gov (United States)

    Tran, Tara; Longman, Jo; Kornelsen, Jude; Barclay, Lesley

    2017-08-01

    The past two decades have seen progressive decline in the number of rural birthing services across Australia. Despite health system pressures on small birthing units to close there have been examples of resistance and survival. This descriptive study explored the evolution of a rural birthing service in a small town to offer insight into the process of transition which may be helpful to other small healthcare services in rural Australia. Quantitative data derived from birth registers on number and types of birth from 1993-2011 were analysed. Interviews were conducted between January and August 2012 with nine participants (GP obstetricians, midwives, a health service manager and a consumer representative). This rural maternity service developed gradually from a GP obstetrician-led service to a collaborative care team approach with midwifery leadership. This development was in response to a changing rural medical workforce, midwifery capacity and the needs and wants of women in the local community. Four major themes were developed from interview data: (1) development of the service (2) drivers of change (3) outcomes and (4) collaborative care and inter-professional practice. The success of this transition was reported to rest on strategic planning and implementation and respectful inter-professional practice and alignment of birth philosophy across the team. This team created a unified, progressive community-focused birthing service. The development of collaborative care models that embrace and build on established inter-professional relationships can maximise existing rural workforce potential and create a sustainable rural service into the future. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  5. Service user preferences for diabetes education in remote and rural areas of the Highlands and Islands of Scotland.

    Science.gov (United States)

    Hall, Jenny; Skinner, Fiona; Tilley, Phil; MacRury, Sandra

    2018-03-01

    Diabetes prevalence in Scotland is 5.3%, with type 2 diabetes accounting for 86.7% of all cases in the National Health Service Highlands health board area and 85.7% in the Western Isles. Structured education is a key component in the management of this chronic disease. However, current group session models are less feasible in lower-population non-urban environments due to distance, participant numbers and access to appropriately trained healthcare professionals. Group sessions may also be a less attractive option in small communities, where people tend to have close day-to-day personal contact. This study assesses the access and delivery preferences of remote and rural service users in the Highlands and Western Isles to structured diabetes education programs. The study used a mixed methods approach of focus groups and questionnaires with people with type 2 diabetes in the Highlands and Islands of Scotland. Both modes of participation were designed to explore perception of diabetes knowledge, diabetes education and use of technology. One-to-one delivery was the delivery method of choice; however, there was a preference for a digital approach over group education sessions. Service users expressed a strong desire to be able to learn at their own pace, when and where they wanted to, and with no requirement to travel. To address these requirements an online resource, providing access to both learning sessions and trusted sources of information, was the preferred mode of delivery. People with type 2 diabetes living in remote and rural areas of the Scottish Highlands and Islands who already use the internet are receptive to the use of digital technology for delivery of diabetes education and are interested in learning more about management of their condition through this medium. They believe that a technology approach will provide them with more control over the pace of learning, and where and when this learning can take place.

  6. Attitude of would-be medical graduates toward rural health services: An assessment from Government Medical Colleges in Chhattisgarh

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    Meeta Jain

    2016-01-01

    Full Text Available Background: Understanding the attitude toward rural health care among future medical graduates, the health workforce of the near future, is an important exercise. Objective: The objective of this study is to understand the attitude of third year MBBS students in a Government Medical College of Chhattisgarh toward rural health services. Methodology: A cross-sectional study was conducted in 2014 using a semi-open-ended questionnaire. The analysis was primarily descriptive, and nonparametric test of significance was used. Results: Of a total of 293 students, 263 (89.7% rated the current rural health services to be unsatisfactory. Nearly 44% students were willing to serve in the rural area. There was no statistical difference among willing and nonwilling 3rd year Part I students regarding willingness to join rural services but mostly not willing among 3rd year Part II. Majority (66.2% were only willing to work in rural areas for <1 year. The oft-mentioned reason was reservation or added marks in postgraduate entrance examination by more than two-third respondents, “health services for the poor” by nearly two-third respondents and followed by “gain of knowledge about rural people and their diseases.” Nearly 10% would-be medical graduates perceived no apparent benefit. The greatest perceived disadvantage was “lack of infrastructural facilities” by more than 80% of the respondents, while “lack of education opportunities for children and basic amenities for family members” was a concern for nearly three-fourth of respondents. Less than half of the respondents thought that there were no career growth opportunities in rural practice. Conclusion: If the identified perceived factors of nonwillingness are taken care off, it would lead to a drastic increase in the number of doctors joining rural service. Not only that but also this would lead to more doctors staying in their position for a longer duration than currently mandated. This would

  7. Prevalence of Internet addiction and risk of developing addiction as exemplified by a group of Polish adolescents from urban and rural areas

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    Beata Pawłowska

    2015-02-01

    Full Text Available [b]Objective. [/b]The objective of the study was to determine the prevalence of Internet addiction and the risk of developing this addiction in Polish adolescents attending junior high schools and high school in Lublin Province, to indicate the differences regarding the intensity of Internet addiction symptoms, and the types of online activity of adolescents residing in urban and rural areas. [b]Material and Methods[/b]. The examined group comprised 1,860 participants (1,320 girls and 540 boys with an average age of 17 years. 760 students lived in urban areas and 1,100 lived in rural areas. The following were used in the study: the Socio-demographic Questionnaire designed by the authors, the Internet Addiction Questionnaire designed by Potembska, the Internet Addiction Test by Young and the Internet Addiction Questionnaire (Kwestionariusz do Badania Uzależnienia od Internetu – KBUI designed by Pawłowska and Potembska. [b]Results[/b]. The adolescents living in urban areas showed a significantly greater intensity of Internet and computer addiction symptoms measured by the KBUI Questionnaire, compared to those living in rural areas. [b]Conclusions.[/b] The Internet addiction criteria were fulfilled by 0.45% of adolescents living in urban areas and 2.9% of those living in rural areas, whereas 35.55% of urban dwelling students and 30.18% of students living in rural areas showed a risk of developing this addiction. More adolescents living in urban areas, compared to those living in rural areas, use Internet pornography, play computer games, disclose their personal data to unknown individuals encountered on the Internet, use Instant Messaging (IM services, electronic mail and Facebook social networking service. Compared to their peers from urban areas, significantly more adolescents from rural areas use ‘Nasza Klasa’ (Our Classmates online social networking service.

  8. Prevalence of Internet addiction and risk of developing addiction as exemplified by a group of Polish adolescents from urban and rural areas.

    Science.gov (United States)

    Pawłowska, Beata; Zygo, Maciej; Potembska, Emilia; Kapka-Skrzypczak, Lucyna; Dreher, Piotr; Kędzierski, Zbigniew

    2015-01-01

    The objective of the study was to determine the prevalence of Internet addiction and the risk of developing this addiction in Polish adolescents attending junior high schools and high school in Lublin Province, to indicate the differences regarding the intensity of Internet addiction symptoms, and the types of online activity of adolescents residing in urban and rural areas. The examined group comprised 1,860 participants (1,320 girls and 540 boys) with an average age of 17 years. 760 students lived in urban areas and 1,100 lived in rural areas. The following were used in the study: the Socio-demographic Questionnaire designed by the authors, the Internet Addiction Questionnaire designed by Potembska, the Internet Addiction Test by Young and the Internet Addiction Questionnaire (Kwestionariusz do Badania Uzależnienia od Internetu - KBUI) designed by Pawłowska and Potembska. The adolescents living in urban areas showed a significantly greater intensity of Internet and computer addiction symptoms measured by the KBUI Questionnaire, compared to those living in rural areas. The Internet addiction criteria were fulfilled by 0.45% of adolescents living in urban areas and 2.9% of those living in rural areas, whereas 35.55% of urban dwelling students and 30.18% of students living in rural areas showed a risk of developing this addiction. More adolescents living in urban areas, compared to those living in rural areas, use Internet pornography, play computer games, disclose their personal data to unknown individuals encountered on the Internet, use Instant Messaging (IM) services, electronic mail and Facebook social networking service. Compared to their peers from urban areas, significantly more adolescents from rural areas use 'Nasza Klasa' (Our Classmates) online social networking service.

  9. Haemodialysis in a rural area: a demanding form of treatment.

    Science.gov (United States)

    Brammah, A; Young, G; Allan, A; Robertson, S; Norrie, J; Isles, C

    2001-09-01

    To determine distances travelled and time spent waiting for transport among hospital haemodialysis patients living in a rural area. Cross sectional survey comparing the subregional dialysis unit in south west Scotland with 12 of the other 13 Scottish Adult Renal Units. Forty three Dumfries and Galloway patients and 935 other Scottish patients receiving hospital haemodialysis in November 1999. At the time of the survey 8/43 (19%) Dumfries patients travelled in excess of 100 miles per dialysis day (15,000 miles per year) solely for the purpose of dialysis, compared to 20/935 (2%) elsewhere in Scotland (p Scottish Units relied on hospital car, Patient Transport Service bus or ambulance for the journey home after treatment. Dumfries patients who travelled by Patient Transport Service or hospital ambulance had to wait twice as long before they left the renal unit as patients using a dedicated hospital car or private car. Haemodialysis in a rural area has every reason to be considered a demanding form of treatment. Greater promotion of home based treatment would improve the quality of life for many of these patients, while dedicated hospital cars would reduce 'car to needle time' for those who remain on hospital haemodialysis.

  10. [Social determinants of infant mortality in socioeconomic deprived rural areas in Mexico].

    Science.gov (United States)

    Duarte-Gómez, María Beatriz; Núñez-Urquiza, Rosa María; Restrepo-Restrepo, José Alonso; Richardson-López-Collada, Vesta Louise

    The aim of this study was to identify determinants of infant mortality in rural areas in Mexico and recommend strategies for its decrease. A study was conducted in a sample of 16 municipalities among those with the lowest index of human development. Infant deaths were identified through official data, records and through interviews with civil authorities, health workers and community leaders. Mothers of children who died were also interviewed. In most cases, deaths were related with intermediate social determinants (living conditions and health services converged). The most important critical factors were the prevention programs and delays in receiving healthcare. Deficiencies in intersectorial policies to guarantee effective access to health services were found. To decrease infant mortality in rural areas of Mexico, geographic access has to be improved as well as investment in resources and training health personnel in intercultural competence and primary health care skills. Copyright © 2015. Publicado por Masson Doyma México S.A.

  11. Measuring Administrative Burdens of e-Government Services for Rural SMEs

    Science.gov (United States)

    Costopoulou, Constantina; Ntaliani, Maria

    Administrative burdens comprise the second most important individual business constraint for SMEs. In this context, the Rural Inclusion project aims at reducing rural SMEs' administrative burdens related to particular public services. For succeeding this, it adopts, adapts, and deploys a Web infrastructure combining semantic services with a collaborative training and networking approach in five European rural regions. The paper presents the preliminary results of the initial phases of the project regarding the measurement of administrative burdens of SMEs in a specific rural region related to the service "Starting a new business".

  12. Training for Rural Radiology and Imaging in Sub-Saharan Africa: Addressing the Mismatch Between Services and Population

    Directory of Open Access Journals (Sweden)

    Michael G Kawooya

    2012-01-01

    Full Text Available The objectives of this review are to outline the needs, challenges, and training interventions for rural radiology (RR training in Sub-Saharan Africa (SSA. Rural radiology may be defined as imaging requirements of the rural communities. In SSA, over 80% of the population is rural. The literature was reviewed to determine the need for imaging in rural Africa, the challenges, and training interventions. Up to 50% of the patients in the rural health facilities in Uganda may require imaging, largely ultrasound and plain radiography. In Uganda, imaging is performed, on an average, in 50% of the deserving patients in the urban areas, compared to 10-13 % in the rural areas. Imaging has been shown to increase the utilization of facility-based rural health services and to impact management decisions. The challenges in the rural areas are different from those in the urban areas. These are related to disease spectrum, human resource, and socio-economic, socio-cultural, infrastructural, and academic disparities. Countries in Sub-Saharan Africa, for which information on training intervention was available, included: Uganda, Kenya, Tanzania, Rwanda, Zambia, Ghana, Malawi, and Sudan. Favorable national policies had been instrumental in implementing these interventions. The interventions had been made by public, private-for-profit (PFP, private-not-for profit (PNFP, local, and international academic institutions, personal initiatives, and professional societies. Ultrasound and plain radiography were the main focus. Despite these efforts, there were still gross disparities in the RR services for SSA. In conclusion, there have been training interventions targeted toward RR in Africa. However, gross disparities in RR provision persist, requiring an effective policy, plus a more organized, focused, and sustainable approach, by the stakeholders.

  13. The potentials of rural tourism in developing rural areas in Albania

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    Henrietta Nagy

    2017-12-01

    Full Text Available The inspiration that drove us to this study is that conventional tourism in Albania is focused more on promoting seaside, cultural tourism, luxury resorts, etc. which has demonstrated a good trend. At the same time, specific parts of the country have been abandoned due to their underdeveloped situation. Given their assets as constructed and indigenous habitat, they progressively appear as regions for rural tourism development. It could provide good development opportunities in remote mountainous areas that every day more are abandoned by the population because they do not have enough employment opportunities. But as for other rural areas which have a great potential for development of rural tourism, they are not preferred by the population either to live because they do not have developed agriculture. They do not provide the opportunity to earn enough money to live on at the appropriate standard. So the development of rural tourism would help the population in such areas to diversify their activities and earn some extra income, motivating inhabitants to stay in their own areas. Overall, it would contribute to the balanced development of the regions of Albania.

  14. Barriers to Rural Induced Abortion Services in Canada: Findings of the British Columbia Abortion Providers Survey (BCAPS)

    Science.gov (United States)

    Norman, Wendy V.; Soon, Judith A.; Maughn, Nanamma; Dressler, Jennifer

    2013-01-01

    Background Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of British Columbia (BC). Methods We used mixed methods to assess physicians on the BC registry of abortion providers. In 2011 we distributed a previously-published questionnaire and conducted semi-structured interviews. Results Surveys were returned by 39/46 (85%) of BC abortion providers. Half were family physicians, within both rural and urban cohorts. One-quarter (17/67) of rural hospitals offer abortion service. Medical abortions comprised 14.7% of total reported abortions. The three largest urban areas reported 90% of all abortions, although only 57% of reproductive age women reside in the associated health authority regions. Each rural physician provided on average 76 (SD 52) abortions annually, including 35 (SD 30) medical abortions. Rural physicians provided surgical abortions in operating rooms, often using general anaesthesia, while urban physicians provided the same services primarily in ambulatory settings using local anaesthesia. Rural providers reported health system barriers, particularly relating to operating room logistics. Urban providers reported occasional anonymous harassment and violence. Conclusions Medical abortions represented 15% of all BC abortions, a larger proportion than previously reported (under 4%) for Canada. Rural physicians describe addressable barriers to service provision that may explain the declining accessibility of rural abortion services. Moving rural surgical abortions out of operating rooms and into local ambulatory care settings has the potential to improve care and costs, while reducing logistical challenges facing rural physicians. PMID:23840578

  15. Updating Rurality Index for Small Areas in Spain

    Science.gov (United States)

    Prieto-Lara, Elisa; Ocana-Riola, Ricardo

    2010-01-01

    Nowadays, there is a wide debate about what rural means. An operational definition of rural concept is essential in order to measure health problems, optimize resource allocation and facilitate decision making aimed at closing the gap on inequity between areas. In 2005, the rurality index for Small Areas in Spain (IRAP) was developed using the…

  16. Gender differentials in readiness and use of mHealth services in a rural area of Bangladesh.

    Science.gov (United States)

    Khatun, Fatema; Heywood, Anita E; Hanifi, Syed Manzoor Ahmed; Rahman, M Shafiqur; Ray, Pradeep K; Liaw, Siaw-Teng; Bhuiya, Abbas

    2017-08-18

    Traditional gender roles result in women lagging behind men in the use of modern technologies, especially in developing countries. Although there is rapid uptake of mobile phone use in Bangladesh, investigation of gender differences in the ownership, access and use of mobile phones in general and mHealth in particular has been limited. This paper presents gender differentials in the ownership of mobile phones and knowledge of available mHealth services in a rural area of Bangladesh. We interviewed 4915 randomly selected respondents aged 18 years and above. Associations between gender and knowledge of available mHealth services, use of existing mHealth services and intentions to use mHealth services in the future were examined by multivariate logistic regression analysis, controlling for the effect of categorised covariates. Of the 4915 respondents to the survey, 61.8% of men (1213/1964) and 34.4% of women (1015/2951) owned a mobile phone. For men, mobile phone ownership was highest among those aged 18-29 years (n = 663, 76.3%), and for women among those aged 30-39 years (n = 825, 44.7%). A higher proportion of men owned phones compared to women, irrespective of socioeconomic status (SES) as indicated by asset index (p mHealth services was lower among women than men; however, intention to use mHealth services in the future was high for both genders, irrespective of age, education and socioeconomic status. Compared to men, women are less likely to own a mobile phone and less aware of available mHealth services, despite high intention to use mHealth among both genders. To optimise the use of mHealth services and to achieve equity of use, uptake strategies should target women, with a focus on the poorer and less educated groups.

  17. Referral for secondary restorative dental care in rural and urban areas of Scotland: findings from the Highlands Et Islands Teledentistry Project.

    Science.gov (United States)

    Nuttall, N M; Steed, M S; Donachie, M A

    2002-02-23

    To compare the reported level of use of secondary care services for restorative dental care in rural and urban areas of Scotland. Postal questionnaire survey Postal questionnaire sent to all dentists in the Highland region, the island regions in Scotland and Dumfries Et Galloway (n = 150) and an equal number were sampled from the remainder of Scotland stratified by health board area. Non-respondents were sent 2 reminders after which 62% of the sample had responded. Most dentists (85%) who practised in what they considered were urban areas of Scotland said they felt that they had good access to a secondary referral service. Whereas most of those who practised in what they considered were rural areas either said they had no access to such a service (26%) or that access was difficult (53%), only 3% of those in urban areas said they had no access to a secondary restorative consultative service compared with 14% of dentists practising in rural areas of mainland Scotland and 54% of those practising on Scottish islands. The survey suggests the people of the Scottish islands and some of the remoter parts of the Scottish mainland would be among those who might benefit from improvement in access to a restorative dentistry consultant service.

  18. Training resources and e-Government services for rural SMEs: the rural inclusion platform

    OpenAIRE

    Axel Maroudas; Pantelis Karamolegkos; Nikos Manouselis

    2010-01-01

    Rural Inclusion, a project supported by the Information and Communication Technologies Policy Support Programme of the European Commission, aims to adopt, adapt, and deploy a Web infrastructure, in rural settings, combining semantics with a collaborativetraining and networking approach, offering e-Government services that will be supported by a rigorous and reusable service process analysis and modeling, and facilitating the disambiguation of the small businesses needs and requirements when t...

  19. Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

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    Ligia Antezana

    2017-04-01

    Full Text Available Rural communities face significant challenges regarding the adequate availability of diagnostic-, treatment-, and support-services for individuals with autism spectrum disorder (ASD. Specifically, a variety of factors, including geographic distance between families and service providers, low reliance on health care professionals, and cultural characteristics, contribute to the diminished availability and utilization of services. Together, these factors lead to risks for delayed ASD screening and diagnosis, yielding lower educational and functional outcomes. The purpose of this review is to outline the specific diagnosis and treatment barriers that affect individuals with ASD and their families in rural settings. Telehealth feasibility and efficacy research is also reviewed, suggesting that telecommunication services may offer an inroad for addressing the specific service barriers faced by rural communities. Together, the current review identifies specific needs for both research and support services that address the specific access barriers characteristic of rural settings.

  20. 76 FR 30904 - Rural Utilities Service Telecommunications Loan and Loan Guarantee Program

    Science.gov (United States)

    2011-05-27

    ..., this new approach will give our customers increased flexibility to find and deploy technology that... DEPARTMENT OF AGRICULTURE Rural Utilities Service Rural Utilities Service Telecommunications Loan and Loan Guarantee Program AGENCY: Rural Utilities Service, USDA. ACTION: Notice of elimination of the...

  1. Determinants of maternity care services utilization among married adolescents in rural India.

    Directory of Open Access Journals (Sweden)

    Prashant Kumar Singh

    poor and specific sub-groups of the population in rural areas to address the unmet need for maternal healthcare service utilization.

  2. Rurality Index for Small Areas in Spain

    Science.gov (United States)

    Ocana-Riola, Ricardo; Sanchez-Cantalejo, Carmen

    2005-01-01

    An operational definition for "rural area" is pivotal if proposals, policies and decisions aimed at optimising the distribution of resources, closing the gap on inequity between areas and raising standards of living for the least advantaged populations are to be put in place. The concept of rurality, however, is often based on…

  3. Costs and outcome of assertive community treatment (ACT) in a rural area in Denmark

    DEFF Research Database (Denmark)

    Hastrup, Lene Halling; Aagaard, Jørgen

    2015-01-01

    Purpose: Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. Methods: The study was based on a quasi-experime......Purpose: Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. Methods: The study was based on a quasi...... only. Results: Seventy eight percent of the patients receiving ACT were in contact with psychiatric services at the 4-year follow-up, while 69% of the patients in the control group had contact with psychiatric services (P

  4. Feasibility of a rural palliative supportive service.

    Science.gov (United States)

    Pesut, B; Hooper, B P; Robinson, C A; Bottorff, J L; Sawatzky, R; Dalhuisen, M

    2015-01-01

    Healthcare models for the delivery of palliative care to rural populations encounter common challenges: service gaps, the cost of the service in relation to the population, sustainability, and difficulty in demonstrating improvements in outcomes. Although it is widely agreed that a community capacity-building approach to rural palliative care is essential, how that approach can be achieved, evaluated and sustained remains in question. The purpose of this community-based research project is to test the feasibility and identify potential outcomes of implementing a rural palliative supportive service (RPaSS) for older adults living with life-limiting chronic illness and their family caregiver in the community. This paper reports on the feasibility aspects of the study. RPaSS is being conducted in two co-located rural communities with populations of approximately 10 000 and no specialized palliative services. Participants living with life-limiting chronic illness and their family caregivers are visited bi-weekly in the home by a nurse coordinator who facilitates symptom management, teaching, referrals, psychosocial and spiritual support, advance care planning, community support for practical tasks, and telephone-based support for individuals who must commute outside of the rural community for care. Mixed-method collection strategies are used to collect data on visit patterns; healthcare utilization; family caregiver needs; and participant needs, functional performance and quality of life. A community-based advisory committee worked with the investigative team over a 1-year period to plan RPaSS, negotiating the best fit between research methods and the needs of the community. Recruitment took longer than anticipated with service capacity being reached at 8 months. Estimated service capacity of one nurse coordinator, based on bi-weekly visits, is 25 participants and their family caregivers. A total of 393 in-person visits and 53 telephone visits were conducted between

  5. Exploring the influence of Internet-based caregiver support on experiences of isolation for older spouse caregivers in rural areas: a qualitative interview study.

    Science.gov (United States)

    Blusi, Madeleine; Kristiansen, Lisbeth; Jong, Mats

    2015-09-01

    Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence. This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas. An intervention study where 63 older rural caregivers received an Internet-based caregiver support service. A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis. Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends. Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence. Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers. © 2014 John Wiley & Sons Ltd.

  6. Development Areas of Rural Tourism in Romania

    Directory of Open Access Journals (Sweden)

    Ramona Ciolac

    2012-05-01

    Full Text Available The popularity of rural tourism forms has increased in recent years. From the initiatives with individual character it has been reached a real alternative leisure. The reason? Authenticity of rural areas is a quality becoming more demanding in terms of current life. Synonymous with a holiday spent with little money in nature, rural tourism forms, like and are becoming increasingly popular. Folk heritage of folk architecture, folk customs and traditions, crafts, port and popular folklore, gastronomy specific is the most popular tourist attractions in rural tourism. Therefore, tourist villages and agro-tourist offer circumscribed, in particular, to Romanian folk brand areas, which fortunately, also benefits of natural attractions of great beauty.

  7. RURAL AREA – AN UNTAPPED OPPORTUNITY FOR ENTREPRENEURSHIP DEVELOPMENT ?

    Directory of Open Access Journals (Sweden)

    Alexandru Costin CÎRSTEA

    2013-01-01

    Full Text Available Romanian rural area faces a violent lack of entrepreneurship initiatives, which can generate negative economic and social phenomena, with medium and long-term effects, such as: the decreased living standards of people in rural areas, the migration of young people from rural areas, which generates psychosocial problems among children who have to stay with their grandparents, the sharp decrease of interest for agriculture and, thus, the decrease of GDP ratio from agricultural activities, the lack of education among rural people etc. Under these circumstances, thepaper tries, through documentation, analysis and processing statistical data, to quantify the development level of entrepreneurship in rural areas in Romania, compared with developed EU countries (such as: Germany, Great Britain, France etc., in order to reveal the gaps in this sector. To increase the relevance of the analysis, the paper also analyzes the possible causes that can stimulate or repress the expression of entrepreneurship and its implementation in Romanian and European rural areas, such as: different levels of fiscal pressure, the existence, effectiveness and efficiency of programs implementation for stimulating and supporting entrepreneurship in general and in rural areas, in particular, the different business culture etc. These results generated from the research will finally create a set of premises for adopting international best practices and develop pragmatic solutions and programs to increase entrepreneurship, which can leads to new business initiatives in the Romanian rural area.In conclusion, for a quality of life growth and a decrease of negative social and economic phenomena with medium and long-term impact, it is necessary an increase of the living standards, done by increasing the opportunities for entrepreneurship in agriculture and rural areas. Specifically, there are needed investments in the development of human resources in rural areas and in supporting its

  8. Urban-rural disparity in utilization of preventive care services in China.

    Science.gov (United States)

    Liu, Xiang; Li, Ningxiu; Liu, Chaojie; Ren, Xiaohui; Liu, Danping; Gao, Bo; Liu, Yuanyuan

    2016-09-01

    Preventive care service is considered pivotal on the background of demographic ageing and a rise in chronic diseases in China. The disparity in utilization of preventive care services between urban and rural in China is a serious issue. In this paper, we explored factors associated with urban-rural disparity in utilization of preventive care services in China, and determined how much of the urban-rural disparity was attributable to each determinant of utilization in preventive care services. Using representative sample data from China Health and Nutrition Survey in 2011 (N = 12,976), the present study performed multilevel logistic model to examine the factors that affected utilization of preventive care services in last 4 weeks. Blinder-Oaxaca decomposition method was applied to divide the utilization of preventive care disparity between urban and rural residents into a part that can be explained by differences in observed covariates and unobserved part. The percentage of rural residents utilizing preventive care service in last 4 weeks was lower than that of urban residents (5.1% vs 9.3%). Female, the aged, residents with higher education level and household income, residents reporting self-perceived illness in last 4 weeks and physician-diagnosed chronic disease had higher likelihood of utilizing preventive care services. Household income was the most important factor accounting for 26.6% of urban-rural disparities in utilization of preventive care services, followed by education (21.5%), self-perceived illness in last 4 weeks (7.8%), hypertension (4.4%), diabetes (3.3%), other chronic diseases (0.8%), and health insurance (-1.0%). Efforts to reduce financial barriers for low-income individuals who cannot afford preventive services, increasing awareness of the importance of obtaining preventive health services and providing more preventive health services covered by health insurance, may help to reduce the gap of preventive care services utilization between

  9. Dementia knowledge transfer project in a rural area.

    Science.gov (United States)

    Stark, C; Innes, A; Szymczynska, P; Forrest, L; Proctor, K

    2013-01-01

    Rural Scotland has an ageing population. There has been an increase in the number of people with dementia and as the proportion of people aged over 75 years continues to rise, this will increase still further. The Scottish Government has produced a dementia strategy and implementing this will be a challenge for rural Scotland. Transferring academic knowledge into practice is challenging. A Knowledge Transfer Partnership was formed between NHS Highland and the University of Stirling. A literature review was undertaken of the rural dementia literature; local services were surveyed and described; and interviews were undertaken with people with dementia and carers. Work was conducted on training, diagnostic service provision and local policy. Throughout the project, a collaborative approach was used, which aimed at the joint production of knowledge. Involving University staff in local service development had a substantial impact. Reviewing existing research knowledge and setting it in the context of local services, and of experience of service use, allowed the relevant priorities to be identified. As well as identifying training needs and providing training, the work influenced local decisions on diagnostic service design and standards, and on policy. This embedded engagement model appeared to produce more rapid change than traditional models of use of academic knowledge.

  10. Disparities in dental health of rural Australians: hospitalisation rates and utilisation of public dental services in three communities in North Queensland.

    Science.gov (United States)

    Carlisle, Karen; Larkins, Sarah; Croker, Felicity

    2017-01-01

    The oral health of rural Australians continues to lag behind that of those living in metropolitan areas. Research has shown that people living in rural areas are more likely to suffer from dental caries (decay), visit the dentist less often and have poorer access to oral health services. The purpose of the study was to examine hospitalisations for dental conditions and utilisation of public dental services in three rural communities in Queensland compared with the whole of Queensland. Aggregated hospitalisation data for dental conditions and counts of public outpatient service data were requested for residents of three rural communities in Queensland and for the whole of Queensland for the calendar year 2013. Hospitalisation rates per 1000 and risk ratios were calculated to examine the risk of hospitalisation for dental procedures for those living in the selected rural communities and the rest of Queensland. Data were grouped by gender, age and Indigenous status and comparisons made between Queensland and the rural communities. Outpatient service data were converted to percentage of all services delivered to allow comparisons between groups of different sizes. Population data were grouped into age cohorts and compared with the proportion of public oral health services delivered to each age cohort. Residents of the rural communities were twice as likely to be hospitalised and children aged 0-14 years living in the communities were three times more likely to be hospitalised for dental conditions compared to residents of the rest of Queensland. Outpatient oral service data showed that the proportion of services delivered to children aged up to 14 years living in the rural communities was less than the whole of Queensland. Interestingly, in one rural community where the public dental service was open to all, the distribution of public oral health services aligned with the age distribution of the population. The study showed that residents of these rural communities

  11. Index of Access: a new innovative and dynamic tool for rural health service and workforce planning.

    Science.gov (United States)

    McGrail, Matthew R; Russell, Deborah J; Humphreys, John S

    2017-10-01

    Objective Improving access to primary health care (PHC) remains a key issue for rural residents and health service planners. This study aims to show that how access to PHC services is measured has important implications for rural health service and workforce planning. Methods A more sophisticated tool to measure access to PHC services is proposed, which can help health service planners overcome the shortcomings of existing measures and long-standing access barriers to PHC. Critically, the proposed Index of Access captures key components of access and uses a floating catchment approach to better define service areas and population accessibility levels. Moreover, as demonstrated through a case study, the Index of Access enables modelling of the effects of workforce supply variations. Results Hypothetical increases in supply are modelled for a range of regional centres, medium and small rural towns, with resulting changes of access scores valuable to informing health service and workforce planning decisions. Conclusions The availability and application of a specific 'fit-for-purpose' access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities. What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifications). Both approaches have substantial limitations for informing rural health service planning and decision making. What does this paper add? The adoption of a new improved tool to measure access to PHC services, the Index of Access, is proposed to assist health service and workforce planning. Its usefulness for health service planning is

  12. Entrepreneurship in the rural areas of Romania. The impact of the 2007-2013 EU funding programmes

    Directory of Open Access Journals (Sweden)

    Dan Mihaela-Cornelia

    2017-07-01

    Full Text Available This paper contributes to the research on entrepreneurship in rural areas by focusing on the absorption and investment plans developed with European Funds and implemented in Romania in 2007-2013 for rural development. Entrepreneurship in the European Union is seen as the solution for creating and increasing jobs number, developing new business models, and is related very often with creativity and innovation. Moreover, entrepreneurship is directly linked to the economic performance of regions (Audretsch, D.B., Keilbach, M., 2005, poverty reduction and contributes to the economic advancement of rural communities. The focus on rural areas is given by the fact that almost half of the Romanian population lives in villages or communes (around 45%, and the main income source comes from agriculture. In the same time, there is an important potential for entrepreneurial projects because rural areas are high underdeveloped, there is a lack of services in major fields as education, social services, entertainment etc. Also, we find a high potential in tourism, especially in ecological, adventure or agro-tourism. We develop a theoretical framework to discuss the potential impact of EU Funds on rural development, the access to public funds for rural population, their readiness for business ownership, the most accessible fields for starting a business and regional variables. Our study is based on public data and official reports on the European Funds received by Romania in the budgetary period of 2007-2013 and other market data that round the entrepreneurship frame in rural areas. We analyze the number of start-ups financed by European funds, type and size of enterprises, number of jobs and reasons for contract cancellation. We find that regions with a reach cultural heritage and closer to the Western border have registered more applications and are more interested in self-employment, but also that given the administrative barriers many entrepreneurs decided to

  13. Rural and remote dental services shortages: filling the gaps through geo-spatial analysis evidence-based targeting.

    Science.gov (United States)

    Shiika, Yulia; Kruger, Estie; Tennant, Marc

    Australia has a significant mal-distribution of its limited dental workforce. Outside the major capital cities, the distribution of accessible dental care is at best patchy. This study applied geo-spatial analysis technology to locate gaps in dental service accessibility for rural and remote dwelling Australians, in order to test the hypothesis that there are a few key location points in Australia where further dental services could make a significant contribution to ameliorating the immediate shortage crisis. A total of 2,086 dental practices were located in country areas, covering a combined catchment area of 1.84 million square kilometers, based on 50 km catchment zones around each clinic. Geo-spatial analysis technology was used to identify gaps in the accessibility of dental services for rural and remote dwelling Australians. An extraction of data was obtained to analyse the integrated geographically-aligned database. Results: Resolution of the lack of dental practices for 74 townships (of greater than 500 residents) across Australia could potentially address access for 104,000 people. An examination of the socio-economic mix found that the majority of the dental practices (84%) are located in areas classified as less disadvantaged. Output from the study provided a cohesive national map that has identified locations that could have health improvement via the targeting of dental services to that location. The study identified potential location sites for dental clinics, to address the current inequity in accessing dental services in rural and remote Australia.

  14. What factors influence physiotherapy service provision in rural communities? A pilot study.

    Science.gov (United States)

    Adams, Robyn; Sheppard, Lorraine; Jones, Anne; Lefmann, Sophie

    2014-06-01

    To obtain stakeholder perspectives on factors influencing rural physiotherapy service provision and insights into decision making about service provision. Purposive sampling, open-ended survey questions and semi-structured interviews were used in this exploratory, qualitative study. A rural centre and its regional referral centre formed the pilot sites. Nine participant perspectives were obtained on rural physiotherapy services. Stakeholder perspectives on factors influencing rural physiotherapy service provision and service level decision making. Workforce capacity and capability, decision maker's knowledge of the role and scope of physiotherapy, consideration of physiotherapy within resource allocation decisions and proof of practice emerged as key issues. The latter three were particularly reflected in public sector participant comments. Business models and market size were identified factors in influencing private practice. Influencing factors described by participants both align and extend our understanding of issues described in the rural physiotherapy literature. Participant insights add depth and meaning to quantitative data by revealing impacts on local service provision. Available funding and facility priorities were key determinants of public sector physiotherapy service provision, with market size and business model appearing more influential in private practice. The level of self direction or choice about which services to provide, emerged as a point of difference between public and private providers. Decisions by public sector physiotherapists about service provision appear constrained by existing capacity and workload. Further research into service level decision making might provide valuable insights into rural health service delivery. © 2014 National Rural Health Alliance Inc.

  15. Frailty Among Elderly Adults in a Rural Area of Turkey

    Science.gov (United States)

    Çakmur, Hülya

    2015-01-01

    Background The elderly population is growing in Turkey, as it is worldwide. The average age of residents in rural areas of Turkey is relatively high and is gradually increasing. The purpose of this study is to summarize the fitness and frailty of elderly adults living in a rural area of Turkey characterized by a relatively low level of socioeconomic development. Material/Methods This study was designed as a prospective, cross-sectional study, and was conducted in a rural area of Kars Province. A total of 168 elderly adults (≥65 years old) from 12 central villages were included in the study. The Fried Frailty Criteria was used to assess the frailty of the participants. In addition to frailty, the physical, social, and mental status of elderly adults was examined. Results The prevalence of frailty in this rural area of Turkey was 7.1%. The study group ranged in age from 65 to 96 years (mean 72.70±7.73 years), and 53.6% were female. Among the elderly adult group, 84.3% had not completed elementary school, and 43.29% had a monthly income of ≤500 Turkish liras ($200). No significant relationship was identified between gender and frailty. There was a statistically significant relationship between frailty and older age, lower education level, lower economic level, co-morbidities, polypharmacy, diabetes, chronic obstructive pulmonary disease, gastric disease, arthritis, generalized pain, benign prostatic hyperplasia, urinary incontinence, auditory impairment, impaired oral care, caregiver burden, impaired cognitive function, depression, or a lack of social support (social isolation). Conclusions It is believed that this study will contribute considerably to understanding the health status and needs of elderly adults in Turkey and the health problems of this population as well as to planning the development of public health and geriatric services based on regional needs. PMID:25925800

  16. Recruiting and retaining high-quality teachers in rural areas.

    Science.gov (United States)

    Monk, David H

    2007-01-01

    In examining recruitment and retention of teachers in rural areas, David Monk begins by noting the numerous possible characteristics of rural communities--small size, sparse settlement, distance from population concentrations, and an economic reliance on agricultural industries that are increasingly using seasonal and immigrant workers to minimize labor costs. Many, though not all, rural areas, he says, are seriously impoverished. Classes in rural schools are relatively small, and teachers tend to report satisfaction with their work environments and relatively few problems with discipline. But teacher turnover is often high, and hiring can be difficult. Monk observes that rural schools have a below-average share of highly trained teachers. Compensation in rural schools tends to be low, perhaps because of a lower fiscal capacity in rural areas, thus complicating efforts to attract and retain teachers. Several student characteristics, including relatively large shares of students with special needs and with limited English skills and lower shares of students attending college, can also make it difficult to recruit and retain high-quality teachers. Other challenges include meeting the needs of highly mobile children of low-income migrant farm workers. With respect to public policy, Monk asserts a need to focus on a subcategory of what might be called hard-to-staff rural schools rather than to develop a blanket set of policies for all rural schools. In particular, he recommends a focus on such indicators as low teacher qualifications, teaching in fields far removed from the area of training, difficulty in hiring, high turnover, a lack of diversity among teachers in the school, and the presence of migrant farm workers' children. Successful efforts to stimulate economic growth in these areas would be highly beneficial. He also calls attention to the potential for modern telecommunication and computing technologies to offset some of the drawbacks associated with teaching

  17. Rurality study of restricted areas

    Directory of Open Access Journals (Sweden)

    Sergio Rivaroli

    2011-02-01

    Full Text Available Two main perspectives of investigation emerge from the study of a territory’s rurality: a geographical approach and a sociological approach. The research examines the sub-regional study case of ‘Nuovo circondario imolese’. The analysis shows that the combination of traditional institutional criteria with detailed informations about the territory, generates more accurate results which determine a better comprehension of the characteristics of restricted areas’ rurality. Over the period 1991-2001, the study highlights an increase in rural areas. This result could be interpreted as an effect of urban sprawl’s intensification, that increases the competition between non-farm residences and agricultural activities.

  18. 48 CFR 1852.219-74 - Use of rural area small businesses.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Use of rural area small... and Clauses 1852.219-74 Use of rural area small businesses. As prescribed in 1819.7103, insert the following clause: Use of Rural Area Small Business (SEP 1990) (a) Definitions. Rural area means any county...

  19. The extent of shifts in vegetation phenology between rural and urban areas within a human-dominated region.

    Science.gov (United States)

    Dallimer, Martin; Tang, Zhiyao; Gaston, Kevin J; Davies, Zoe G

    2016-04-01

    Urbanization is one of the major environmental challenges facing the world today. One of its particularly pressing effects is alterations to local and regional climate through, for example, the Urban Heat Island. Such changes in conditions are likely to have an impact on the phenology of urban vegetation, which will have knock-on implications for the role that urban green infrastructure can play in delivering multiple ecosystem services. Here, in a human-dominated region, we undertake an explicit comparison of vegetation phenology between urban and rural zones. Using satellite-derived MODIS-EVI data from the first decade of the 20th century, we extract metrics of vegetation phenology (date of start of growing season, date of end of growing season, and length of season) for Britain's 15 largest cities and their rural surrounds. On average, urban areas experienced a growing season 8.8 days longer than surrounding rural zones. As would be expected, there was a significant decline in growing season length with latitude (by 3.4 and 2.4 days/degree latitude in rural and urban areas respectively). Although there is considerable variability in how phenology in urban and rural areas differs across our study cities, we found no evidence that built urban form influences the start, end, or length of the growing season. However, the difference in the length of the growing season between rural and urban areas was significantly negatively associated with the mean disposable household income for a city. Vegetation in urban areas deliver many ecosystem services such as temperature mitigation, pollution removal, carbon uptake and storage, the provision of amenity value for humans and habitat for biodiversity. Given the rapid pace of urbanization and ongoing climate change, understanding how vegetation phenology will alter in the future is important if we wish to be able to manage urban greenspaces effectively.

  20. Electrification of rural areas by solar PV

    International Nuclear Information System (INIS)

    Lovejoy, D.

    1992-01-01

    More than 2000 million people, mostly in developing countries, live in rural areas without access to grid connected power. Conventional approaches to supplying power, whether through extension of existing grids or through stand-alone 'mini-grids' based on diesel generator sets, or even on renewable energy minigrids, require large investments which are unlikely to receive priority in competition with more economically and politically attractive investments in urban areas. Domestic PV lighting and broadcast reception kits (DLKs), comprising, typically, a 30-60 W panel, an automotive battery, a charge indicator, and dc fluorescent lamps can be furnished and installed for about $500. DLKs are now used in the Dominican Republic, Kenya, Sri Lanka and many other countries. DLKs provide a minimum essential service with low overheads. Given the necessary credit facilities, they can give better service at comparable costs in comparison with kerosene lamps and dry cell powered radios. They also permit a substantial degree of local manufacture, thus saving on foreign exchange. This movement is starting in many countries on a purely commercial basis. The process could be greatly accelerated if 'seed money' in the form of revolving funds could be made available. (author). 1 fig., 11 tabs

  1. [Comparison of Patients and their Care in Urban and Rural Specialised Palliative Home Care - A Single Service Analysis].

    Science.gov (United States)

    Heckel, M; Stiel, S; Frauendorf, T; Hanke, R M; Ostgathe, C

    2016-07-01

    Specialised outpatient palliative care teams (in Germany called SAPV) aim to ensure best possible end-of-life care for outpatients with complex needs. Information on the influence of living areas (rural vs. urban) on patient and care related aspects is rare. This study aims to explore differences between palliative care patients in urban and rural dwellings concerning their nursing and service characteristics. A retrospective data analysis of documentary data for 502 patients supplied by SAPV team from December 2009 to June 2012 was conducted. Patients and care characteristics were investigated by frequency analysis and were compared for both groups of urban and rural dwelling patients (T test, Chi², Fisher's exact test p care, disease and service related aspects of palliative home care could be detected. An exception is that the rate of re-admittance to hospital is higher for rural dwelling patients (Fisher's exact test p=0.022). Although predominantly presumed, the single service analysis shows - except for the re-admittance rate to hospital - no considerable differences between palliative care patients regarding their living area. Our findings indicate that patients cared for in rural and urban settings have similar needs and impose similar requirements on palliative care teams. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Home Care Services and the Rural Elderly.

    Science.gov (United States)

    Hayslip, Bert, Jr.; And Others

    1980-01-01

    Independent studies examined a needs v an agency perspective on home health care service needs within a rural county. Interviews with 299 elderly, aged 60-93, revealed there were substantial needs for home health care services and the desire for services varied with residence within the county. (Author)

  3. 50 CFR Figure 4 to Subpart E of... - Prince William Sound Rural and Non-Rural Areas

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Prince William Sound Rural and Non-Rural Areas 4 Figure 4 to Subpart E of Part 300 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED... to Subpart E of Part 300—Prince William Sound Rural and Non-Rural Areas ER04NO09.010 [74 FR 57110...

  4. Premises and Challenges of Entrepreneurship in Romanian Rural Areas

    Directory of Open Access Journals (Sweden)

    Raluca IGNAT

    2012-12-01

    Full Text Available The rural inhabitants need to face and survive structural changes in rural economy and, thus, to become more market oriented. Traditions and old skills were somehow lost and new activities were approached. In order to reach them, public policy intervened and supported several types of activities. The public authorities demand Romanian inhabitants from rural areas to be truly competitive in a fully shacked economy. Therefore, the research question is: what are the premises and challenges that Romanian inhabitants from rural areas confront to? Entrepreneurial skills of Romanians in rural areas are a matter of national interest. The problem of entrepreneurships has, at least, two meanings in the present paper: the premises and challenges of the free manifestation of private initiative and the importance of this manifestation for national economy. The approach is pragmatic, for public policy. The main objectives of the research are: to identify the premises and challenges of the entrepreneurship in Romanian rural areas and to elaborate relevant solution for public policy in order to conduct to robust rural economy as a result of entrepreneurial expression. Therefore, next financial plan of the Romanian national Rural Development Programme 2014-2020 needs to take into consideration the premises and challenges of entrepreneurship, as this is the only pertinent solution for added value creation in rural economy. And the strategic approach is to define the future profile of Romanian rural inhabitant.

  5. Characterizing Rural Food Access in Remote Areas.

    Science.gov (United States)

    Bardenhagen, Chris J; Pinard, Courtney A; Pirog, Rich; Yaroch, Amy Lazarus

    2017-10-01

    Residents of rural areas may have limited access to healthy foods, leading to higher incidence of diet related health issues. Smaller grocers in rural areas experience challenges in maintaining fresh produce and other healthy foods available for customers. This study assessed the rural food environment in northeast Lower Michigan in order to inform healthy food financing projects such as the Michigan Good Food Fund. The area's retail food businesses were categorized using secondary licensing, business, and nutrition program databases. Twenty of these stores were visited in person to verify the validity of the categories created, and to assess the availability of healthy foods in their aisles. In-depth interviews with key informants were carried out with store owners, economic development personnel, and other food system stakeholders having knowledge about food access, in order to learn more about the specific challenges that the area faces. Out-shopping, seasonality, and economic challenges were found to affect healthy food availability. Mid-sized independent stores were generally found to have a larger selection of healthy foods, but smaller rural groceries also have potential to provide fresh produce and increase food access. Potential healthy food financing projects are described and areas in need of further research are identified.

  6. Assessing the causes of under-five mortality in the Albert Schweitzer Hospital service area of rural Haiti.

    Science.gov (United States)

    Perry, Henry B; Ross, Allen G; Fernand, Facile

    2005-09-01

    Limited information is available regarding the causes of under-five mortality in nearly all of the countries in which mortality is the highest. The purpose of this study was to use a standard computerized protocol for defining the leading causes of death among children in a high-mortality rural population of Haiti and to highlight the need for similar studies else-where in Haiti and throughout the high-mortality areas of Latin America and the Caribbean. In 2001 a standardized, closed-ended verbal autopsy questionnaire endorsed by the World Health Organization was administered to a representative, population-based sample of the mothers or other caregivers of 97 children who had died before reaching 5 years of age between 1995 and 1999 in the service area of the Albert Schweitzer Hospital, which is located in the rural Artibonite Valley of Haiti. With the data from the questionnaires we used a computerized algorithm to generate diagnoses of the cause of death; the algorithm made it possible to have more than one cause of death. Acute lower respiratory infection (ALRI) was the leading diagnosis, present in 45% of all under-five deaths, followed by enteric diseases, present in 21% of deaths. Neonatal tetanus, preterm birth, and other early neonatal causes unassociated with ALRI or diarrhea were present in 41% of the neonatal deaths. Among children 1-59 months of age, ALRI was present in 51% of the deaths, and enteric diseases in 30%. Deaths were concentrated during the first few months of life, with 35% occurring during the first month. Among the neonatal deaths, 27% occurred on the first day of life, and 80% occurred during the first 10 days of life. In the Albert Schweitzer Hospital program area--and presumably in other areas of Haiti as well--priority needs to be given to the prevention of and the early, effective treatment of ALRI, diarrhea, and early neonatal conditions. This study points to the need for more, similar standardized assessments to guide local

  7. Management of water resources in the Cantareira Water Producer System area: a look at the rural context

    Directory of Open Access Journals (Sweden)

    Rafael Eduardo Chiodi

    2013-12-01

    Full Text Available The National Water Resources Policy established the principles of participation, integration and decentralization, as well as new instruments for the management of water resources in Brazil. The implementation of this policy created several challenges, such as establishing effective management within the framework of rural territorial structure. The example of the Cantareira’s System in Piracicaba river watershed is conducive to the understanding of this challenge. In this scenario, we analyzed the effective implementation of principles, and of two instruments of water resource management from the perspective of farmers’ participation: the integration of water management and rural land use, and public policies for rural areas. To accomplish this, we reviewed documents and literature, and considered conclusions drawn from meetings at the Technical Chamber of Use and Water Conservation in Rural Areas (CT-Rural. We identified a lack of participation by farmers’ representatives in the CT-Rural Chamber and little concern to increase their participation in the management practices. However, the support payments for environmental services projects (PES are stimulating farmers and calling attention to the Cantareira area, in addition to promoting the integration of water resource management and rural land use. However, even though this support acknowledges the importance of the farmers, we emphasize the low priority given by the Piracicaba, Capivari and Jundiaí Watershed Committee to the rural context of the area studied.

  8. Chronic disease patients' experiences with accessing health care in rural and remote areas: a systematic review and qualitative meta-synthesis.

    Science.gov (United States)

    Brundisini, F; Giacomini, M; DeJean, D; Vanstone, M; Winsor, S; Smith, A

    2013-01-01

    Rurality can contribute to the vulnerability of people with chronic diseases. Qualitative research can identify a wide range of health care access issues faced by patients living in a remote or rural setting. To systematically review and synthesize qualitative research on the advantages and disadvantages rural patients with chronic diseases face when accessing both rural and distant care. This report synthesizes 12 primary qualitative studies on the topic of access to health care for rural patients with chronic disease. Included studies were published between 2002 and 2012 and followed adult patients in North America, Europe, Australia, and New Zealand. Qualitative meta-synthesis was used to integrate findings across primary research studies. Three major themes were identified: geography, availability of health care professionals, and rural culture. First, geographic distance from services poses access barriers, worsened by transportation problems or weather conditions. Community supports and rurally located services can help overcome these challenges. Second, the limited availability of health care professionals (coupled with low education or lack of peer support) increases the feeling of vulnerability. When care is available locally, patients appreciate long-term relationships with individual clinicians and care personalized by familiarity with the patient as a person. Finally, patients may feel culturally marginalized in the urban health care context, especially if health literacy is low. A culture of self-reliance and community belonging in rural areas may incline patients to do without distant care and may mitigate feelings of vulnerability. Qualitative research findings are not intended to generalize directly to populations, although meta-synthesis across a number of qualitative studies builds an increasingly robust understanding that is more likely to be transferable. Selected studies focused on the vulnerability experiences of rural dwellers with chronic

  9. The influences of Taiwan's National Health Insurance on women's choice of prenatal care facility: Investigation of differences between rural and non-rural areas

    Directory of Open Access Journals (Sweden)

    Chen Chi-Liang

    2008-03-01

    Full Text Available Abstract Background Taiwan's National Health Insurance (NHI, implemented in 1995, substantially increased the number of health care facilities that can deliver free prenatal care. Because of the increase in such facilities, it is usually assumed that women would have more choices regarding prenatal care facilities and thus experience reduction in travel cost. Nevertheless, there has been no research exploring these issues in the literature. This study compares how Taiwan's NHI program may have influenced choice of prenatal care facility and perception regarding convenience in transportation for obtaining such care for women in rural and non-rural areas in Taiwan. Methods Based on data collected by a national survey conducted by Taiwan's National Health Research Institutes (NHRI in 2000, we tried to compare how women chose prenatal care facility before and after Taiwan's National Health Insurance program was implemented. Basing our analysis on how women answered questionnaire items regarding "the type of major health care facility used and convenience of transportation to and from prenatal care facility," we investigated whether there were disparities in how women in rural and non-rural areas chose prenatal care facilities and felt about the transportation, and whether the NHI had different influences for the two groups of women. Results After NHI, women in rural areas were more likely than before to choose large hospitals for prenatal care services. For women in rural areas, the relative probability of choosing large hospitals to choosing non-hospital settings in 1998–1999 was about 6.54 times of that in 1990–1992. In contrast, no such change was found in women in non-rural areas. For a woman in a non-rural area, she was significantly more likely to perceive the transportation to and from prenatal care facilities to be very convenient between 1998 and 1999 than in the period between 1990 and 1992. No such improvement was found for women in

  10. Attitudes toward working in rural areas of Thai medical, dental and pharmacy new graduates in 2012: a cross-sectional survey

    Science.gov (United States)

    2013-01-01

    Background Inequity in health workforce distribution has been a national concern of the Thai health service for decades. The government has launched various policies to increase the distribution of health workforces to rural areas. However, little is known regarding the attitudes of health workers and the factors influencing their decision to work in rural areas. This study aimed to explore the current attitudes of new medical, dental and pharmacy graduates as well as determine the linkage between their characteristics and the preference for working in rural areas. Methods A cross-sectional survey was conducted, using self-administered questionnaires, with a total of 1,225 medical, dental and pharmacy graduates. They were participants of the meeting arranged by the Ministry of Public Health (MOPH) on 1–2 April 2012. Descriptive statistics using mean and percentage, and inferential statistics using logistic regression with marginal effects, were applied for data analysis. Results There were 754 doctors (44.4%), 203 dentists (42.6%) and 268 pharmacists (83.8%) enrolled in the survey. Graduates from all professions had positive views towards working in rural areas. Approximately 22% of doctors, 31% of dentists and 52% of pharmacists selected ‘close proximity to hometown’ as the most important reason for workplace selection. The multivariable analysis showed a variation in attributes associated with the tendency to work in rural areas across professions. In case of doctors, special track graduates had a 10% higher tendency to prefer rural work than those recruited through the national entrance examination. Conclusions The majority of graduates chose to work in community hospitals, and attitudes towards rural work were quite positive. In-depth analysis found that factors influencing their choice varied between professions. Special track recruitment positively influenced the selection of rural workplaces among new doctors attending the MOPH annual meeting for

  11. Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study.

    Science.gov (United States)

    O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

    2017-01-07

    The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations. A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest. Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%). Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist's main practice is likely to support participation and improve service distribution.

  12. Evaluating the Peruvian Rural Communication Services Project.

    Science.gov (United States)

    Mayo, John

    1988-01-01

    Reviews the Peruvian Rural Communication Services (PRCS) Project and outlines selected findings. Topics discussed include a brief description of Peru's economic and social conditions; satellite communication systems; audio teleconferencing; telephone service; planning and administration; research design features; data collection; and project…

  13. Factors that influence the approach to leadership: directors of nursing working in rural health services.

    Science.gov (United States)

    Bish, Melanie; Kenny, Amanda; Nay, Rhonda

    2015-04-01

    To identify factors that influence directors of nursing in their approach to leadership when working in rural Victoria, Australia. In rural areas, nurses account for the largest component of the health workforce and must be equipped with leadership knowledge and skills to lead reform at a service level. A qualitative descriptive design was used. In-depth semi-structured interviews were undertaken with directors of nursing from rural Victoria. Data were analysed using thematic analysis and a thematic network was developed. Empowerment emerged as the highest order category in the thematic network. This was derived from three organising themes: influence, capital and contextual understanding and the respective basic themes: formal power, informal power, self-knowledge; information, support, resources; and situational factors, career trajectory, connectedness. Rural nurse leaders contend with several issues that influence their approach to leadership. This study provides a platform for further research to foster nurse leadership in rural healthcare services. Acknowledgement of what influences the rural nurse leaders' approach to leadership may assist in the implementation of initiatives designed to develop leadership in a manner that is contextually sensitive. © 2013 John Wiley & Sons Ltd.

  14. Theoretical framework for government information service delivery to deep rural communities in South Africa

    CSIR Research Space (South Africa)

    Mvelase, PS

    2009-10-01

    Full Text Available This paper reports on a study to determine the information requirements of communities in deep rural areas on government services and how this information can be made available to them. The study then proposes an e-government theoretical framework...

  15. Willingness to pay for rural telephone services: Implications for rural ...

    African Journals Online (AJOL)

    WTP) for rural telephone services and the implications on poverty reduction in Southeast Nigeria. The key research problem was the inability of the telephone providers or regulatory agencies to estimate the amount the people were willing to pay ...

  16. Service providers' experiences of using a telehealth network 12 months after digitisation of a large Australian rural mental health service.

    Science.gov (United States)

    Newman, Lareen; Bidargaddi, Niranjan; Schrader, Geoffrey

    2016-10-01

    Despite evidence of benefits of telehealth networks in increasing access to, or providing, previously unavailable mental health services, care providers still prefer traditional approaches. For psychiatric assessment, digital technology can offer improvements over analog systems for the technical and, subsequently, the social quality of provider-client interaction. This is in turn expected to support greater provider uptake and enhanced patient benefits. Within the framework of Innovation Diffusion Theory, to study service providers' experiences of an existing regional telehealth network for mental health care practice twelve months after digitisation in order to identify the benefits of digital telehealth over an analog system for mental health care purposes in rural Australia. Qualitative interviews and focus groups were conducted with over 40 service providers from June to September 2013 in South Australia, ranging from the metropolitan central operations to health providers located up to 600km away in rural and remote areas of the same state. Participants included rural mental health teams, directors of nursing at rural hospitals, metropolitan-based psychiatrists and registrars, the metropolitan-based mental health team dedicated to rural provider support, rural GPs, administrative staff, and the executive group of the state rural health department. Fieldwork was conducted 12 months after the analog system was digitised. The interview and focus group data were analysed using thematic analysis, focusing on three key areas of innovation diffusion theory: relative advantage, technical complexity and technical compatibility. Five themes with 11 sub-themes were identified: (1) "Existing Uses", with three sub-themes: current mental health use, use by GPs, and use for staff support; (2) "Relative Advantage", with four sub-themes: improved technical quality, improved clinical practice, time and cost benefits for providers, and improved patient care; (3) "Technical

  17. Utilization of maternal health services in rural primary health centers ...

    African Journals Online (AJOL)

    Utilization of maternal health services in rural primary health centers in Sub- Saharan Africa. ... their pregnancies were normal during antenatal care visits, hostile attitude of health workers, poverty and mode of payment. Majority of the PHCs provided antenatal, normal delivery, and post natal services. Rural mothers lacked ...

  18. Development of an integrated and sustainable rural service for people with diabetes in the Scottish Highlands.

    Science.gov (United States)

    Cramp, Geoffrey J

    2006-01-01

    The number of people with diabetes is increasing leading to a greater burden on health care services. The impact of the growing prevalence is accentuated by remote and rural demographic and geographic characteristics. Highland is a sparsely populated remote and rural area in the north of Scotland, characterised by poor access to health-care services and pockets of marked deprivation. Centralised policy developments demanding local implementation compounded the pressures on a system that already had waiting times of over 90 weeks for some people with diabetes. A regional review of services, engaging stakeholders from all disciplines and geographical locations was required to develop acceptable and sustainable solutions. This article describes the extensive mapping process involved, how solutions were derived, and suggests a new service structure to encompass remote health-care issues. Health-care professionals with an interest in diabetes were identified and workshops were organised to include the remote areas of Highland. Patient and carers views were ascertained through workshops and supplemented by written submissions. Using the redesign methodology the patient pathway was mapped, noting service deficiencies and good practice. The information gathered was constructed into a service-level map representing the patient journey. A conference was organised to develop solutions to the issues raised during the mapping process. From these solutions a new service configuration was constructed. Over 300 health-care professionals patients and carers contributed. Fourteen workshops were held across the region including the remote areas, providing 15 local maps of the patient pathways subsequently amalgamated into a service-level map. The current patient pathway in Highland follows a traditional and dichotomous cycle of care in the primary and secondary care setting, partly reflecting the rural nature of healthcare in the Highlands. Four main areas for service improvement

  19. Entrepreneurial inclinations of women from rural areas

    Directory of Open Access Journals (Sweden)

    Marković-Savić Olivera S.

    2014-01-01

    resources, knowledge and skills, entrepreneurial inclinations of rural women from northern Kosovo and Metohija are inhibited by: the limited freedom of movement of goods and services, the lack of access to financial institutions aimed at developing small and medium-sized enterprises, and the uncertainty of investing in areas with a high investment risk. The unstable political circumstances create a series of obstacles, -specific and incompatible procedures for the registration and operation of enterprises within the laws of the Republic of Serbia and the UNMIK administration being one of them. In addition to structural changes, it is necessary to work on increasing the social capital of rural women by nurturing the culture of association and organization. In addition to investments in social skills, it is very important to expand education programs for rural population with alternative educational programs related to labor market needs (courses in foreign languages, art, computer science, etc.. Finally, it is necessary to help maintaining authentic cultural activities that would bring entertainment and incite a desire to participate in community life.

  20. Rural Emergency Medical Services (EMS) and Trauma

    Science.gov (United States)

    ... for Success Am I Rural? Evidence-based Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning ... Program offers direct loans and/or grants for essential community facilities in rural areas, which can include ...

  1. DEVELOPMENT OF RURAL TERRITORIES IN LATVIA IMPLEMENTING TELEWORK

    OpenAIRE

    Vītola, Alise; Baltiņa, Iveta; Ādamsone, Liena; Judrupa, Ilze; Šenfelde, Maija

    2013-01-01

    Population decline is taking place in rural areas in Latvia as well as in rural areas in Europe. There is a question of utmost importance - will people choose to live in the rural area doing remote work or will they choose the job in the towns. Increased pace of population declining is forecasted in the event of steady decreasing working places and services. Growing service costs per inhabitant may infl uence lowering of accessibility of some services in the territory. Till nowadays measureme...

  2. The Activities and radioactive dispersion consequences for urban and rural area

    International Nuclear Information System (INIS)

    Pande Made Udiyani; Sri Kuntjoro; Jupiter Sitorus Pane

    2015-01-01

    The consequences of radioactive releases of contaminants by humans is influenced by many factors such as the amount of activity that spread contaminants and environmental conditions. Environmental conditions include meteorological conditions, the contours of the site and contaminant pathways to humans. The purpose of this research is the analysis of the consequences of radionuclide activity and long half-life time due to accidents in urban and rural areas. The specific objective is to calculate the activity of the air dispersion and surface deposition, dose rate predictions and the risks posed to urban and rural areas as a function of the location. The estimates method used is simulation of the consequences on fission products dispersion in the atmosphere due to the postulated accident Beyond Design Basis Accident, BDBA. The calculation is performed for radioactive releases from accidents in 1000 MWe PWR simulated for rural and urban areas on Bojanegara-Serang site. Results of the analysis are that the activity of air dispersion and deposition surface at rural areas higher than urban areas. The Acceptance dose is higher for rural areas compared with urban areas. The maximum effective individual dose for rural areas is 9.24 x 10"-"2 Sv and urban areas is 5.14 x 10"-"2 Sv. The total risk of cancer for people who live in urban areas is higher than rural areas. (author)

  3. Identifying maternity services in public hospitals in rural and remote Australia.

    Science.gov (United States)

    Longman, Jo; Pilcher, Jennifer M; Donoghue, Deborah A; Rolfe, Margaret; Kildea, Sue V; Kruske, Sue; Oats, Jeremy J N; Morgan, Geoffrey G; Barclay, Lesley M

    2014-06-01

    This paper articulates the importance of accurately identifying maternity services. It describes the process and challenges of identifying the number, level and networks of rural and remote maternity services in public hospitals serving communities of between 1000 and 25000 people across Australia, and presents the findings of this process. Health departments and the national government's websites, along with lists of public hospitals, were used to identify all rural and remote Australian public hospitals offering maternity services in small towns. State perinatal reports were reviewed to establish numbers of births by hospital. The level of maternity services and networks of hospitals within which services functioned were determined via discussion with senior jurisdictional representatives. In all, 198 rural and remote public hospitals offering maternity services were identified. There were challenges in sourcing information on maternity services to generate an accurate national picture. The nature of information about maternity services held centrally by jurisdictions varied, and different frameworks were used to describe minimum requirements for service levels. Service networks appeared to be based on a combination of individual links, geography and transport infrastructure. The lack of readily available centralised and comparable information on rural and remote maternity services has implications for policy review and development, equity, safety and quality, network development and planning. Accountability for services and capacity to identify problems is also compromised.

  4. Opinions of South African optometry students about working in rural areas after graduation

    Science.gov (United States)

    Oduntan, Olalekan A.; Hansraj, Rekha

    2015-01-01

    Background Eye and vision problems have been reported to be more prevalent in rural than urban areas; and a large proportion of South Africans live in the rural areas. Aim To investigate the opinions of South African optometry students about working in rural areas after completion of their training and to identify factors that may influence their decisions. Method This was a cross-sectional quantitative study using a survey instrument containing both closed and open-ended, semi-structured questions. Results Four hundred and thirty-eight students responded to the questionnaire (85.4% response rate). Overall, many of the respondents did not want to open their first (66%) or second practices (64.6%) in the rural areas. However, most respondents from rural backgrounds reported that they would open their first (77.2%) or second (79.4%) practice in the rural areas. The main reasons cited by the respondents for their unwillingness to work in the rural areas were financial concerns (81.2%), personal safety (80.1%) and poor living conditions (75.3%), with a significantly higher number (p influencer leur décision. Méthode C’est une étude quantitative transversale utilisant un instrument de sondage contenant des questions semi-structurées fermée et ouvertes. Résultats Quatre cent trente-huit étudiants ont répondu au questionnaire (un taux de réponse de 85.4%). En général, un grand nombre de répondants ne voulaient pas ouvrir leur premier (66%) ou deuxième cabinet (64.6%) dans les zones rurales. Cependant, la plupart des répondants originaires de la campagne ont répondu qu’ils ouvriraient leur premier cabinet (77.2%) ou leur second (79.4%) dans les zones rurales. Les raisons principales citées par les répondants pour ne pas vouloir travailler dans les zones rurales étaient des préoccupations financières (81.2%), la sécurité personnelle (80.1%) et les mauvaises conditions de vie (75.3%), avec un plus grand nombre (p < 0.05) de la part des r

  5. Empowering village doctors and enhancing rural healthcare using cloud computing in a rural area of mainland China.

    Science.gov (United States)

    Lin, Che-Wei; Abdul, Shabbir Syed; Clinciu, Daniel L; Scholl, Jeremiah; Jin, Xiangdong; Lu, Haifei; Chen, Steve S; Iqbal, Usman; Heineck, Maxwell J; Li, Yu-Chuan

    2014-02-01

    China's healthcare system often struggles to meet the needs of its 900 million people living in rural areas due to major challenges in preventive medicine and management of chronic diseases. Here we address some of these challenges by equipping village doctors (ViDs) with Health Information Technology and developing an electronic health record (EHR) system which collects individual patient information electronically to aid with implementation of chronic disease management programs. An EHR system based on a cloud-computing architecture was developed and deployed in Xilingol county of Inner Mongolia using various computing resources (hardware and software) to deliver services over the health network using Internet when available. The system supports the work at all levels of the healthcare system, including the work of ViDs in rural areas. An analysis done on 291,087 EHRs created from November 2008 to June 2011 evaluated the impact the EHR system has on preventive medicine and chronic disease management programs in rural China. From 2008 to 2011 health records were created for 291,087 (26.25%) from 1,108,951 total Xilingol residents with 10,240 cases of hypertension and 1152 cases of diabetes diagnosed and registered. Furthermore, 2945 hypertensive and 305 diabetic patients enrolled in follow-up. Implementing the EHR system revealed a high rate of cholecystectomies leading to investigations and findings of drinking water contaminated with metals. Measures were taken to inform the population and clean drinking water was supplied. The cloud-based EHR approach improved the care provision for ViDs in rural China and increased the efficiency of the healthcare system to monitor the health status of the population and to manage preventive care efforts. It also helped discover contaminated water in one of the project areas revealing further benefits if the system is expanded and improved. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Out-of-hours service in rural areas. An observational study of accessibility, attitudes and quality standards among general practitioners in Iceland.

    Science.gov (United States)

    Olafsson, G; Sigurdsson, J A

    2000-06-01

    To examine the access, workload, duties, commitments and quality standards of primary care physicians (GPs) resulting from out-of-hours service. All GPs (n = 96) in rural Iceland. Answers to a postal survey. The participation rate was 80%. The GPs estimated that in 97% of the cases they could be contacted within 5 minutes in an emergency. Under usual circumstances (weather conditions) and within a distance of 10 km, 70% of them could reach the patient within 30 minutes of receiving the call. In severe weather conditions, 50% of the GPs in smaller districts (650-6000 inhabitants) estimated that it could take up to 5 hours or more to reach the patient (which could happen once a year). In the least populated districts, 84% of the GPs had to be on call 14 days or more per month. Serious emergencies (involving special training such as cardiac resuscitation or tracheal intubation) were relatively rare, and GPs expressed the necessity for regular refresher courses in such fields. Modern telecommunication networks guarantee good access to out-of-hours service. The workload and on-call duties are great and do not comply with European Union (EU) recommendations regarding minimal rest time. If GPs in rural areas are to be expected to provide frontline health care, including in severe emergency situations, regular training courses are needed.

  7. Major incidents in rural areas: managing a pandemic A/H1N1/2009 cluster.

    Science.gov (United States)

    Stark, Cameron; Garman, Elaine; McMenamin, Jim; McCormick, Duncan; Oates, Ken

    2010-01-01

    Pandemic Influenza (A/H1N1/2009) caused worldwide concern because of its potential to spread rapidly in human populations. In Scotland, Government policy had been to seek to contain the spread of the virus for as long as possible in order to allow time for service preparations, and for vaccine development and supply. The first major Scottish outbreak of pandemic A/H1N1/2009 was in the rural area of Cowal and Bute. After two initial cases were identified, contact tracing found a cluster of cases associated with a football supporters' bus. Within 3 weeks, 130 cases had been identified in the area. Rapid provision of treatment doses of anti-viral medication to cases and prophylactic treatment of asymptomatic close contacts, advice on self-isolation and, where required, interruption of transmission by temporary school closure, were successful in containing the outbreak. Pre-existing Major Incident and Pandemic Flu plans were used and adapted to the particular circumstances of the outbreak and the area. Supporting operational decision-making as close to the cases as possible allowed for speed and flexibility of response. Contact tracing and tracking of cases and results was performed by specialist public health staff who were geographically removed from the cases. This was possible because of effective use of existing telephone conferencing facilities, clarity of roles, and frequent communication among staff working on all areas of the response. Basing the work on established plans, staff experience of rural areas and rural service provision was successful.

  8. New indices for home nursing care resource disparities in rural and urban areas, based on geocoding and geographic distance barriers: a cross-sectional study.

    Science.gov (United States)

    Lin, Shyang-Woei; Yen, Chia-Feng; Chiu, Tzu-Ying; Chi, Wen-Chou; Liou, Tsan-Hon

    2015-10-08

    Aging in place is the crucial object of long-term care policy worldwide. Approximately 15.6-19.4% of people aged 15 or above live with a disability, and 15.3% of them have moderate or severe disabilities. The allocation of home nursing care services is therefore an important issue. Service providers in Taiwan vary substantially across regions, and between rural and urban areas. There are no appropriate indices for describing the capacity of providers that it is due to the distances from care recipients. This study therefore aimed to describe and compare distance barriers for home nursing care providers using indices of the "profit willing distance" and the "tolerance limited distance". This cross-sectional study was conducted during 2012 and 2013 using geocoding and a geographic information system to identify the distance from the providers' locations to participants' homes in urban (Taipei City) and rural (Hualien County) areas in Taiwan. Data were collected in-person by professionals in Taiwanese hospitals using the World Health Organization Disability Assessment Schedule 2.0. The indices were calculated using regression curves, and the first inflection points were determined as the points on the curves where the first and second derivatives equaled 0. There were 5627 participants from urban areas and 956 from rural areas. In urban areas, the profit willing distance was 550-600 m, and we were unable to identify them in rural areas. This demonstrates that providers may need to supply services even when there is little profit. The tolerance limited distance were 1600-1650 m in urban areas and 1950-2000 m in rural areas. In rural areas, 33.3% of those living inside the tolerance limited distance and there was no provider within this distance, but this figure fell to just 13.9% in urban areas. There were strong disparities between urban and rural areas in home nursing care resource allocation. Our new "profit willing distance" and the "tolerance limited distance" are

  9. Use of support services in a sample of patients with high-risk primary melanomas in urban, regional and rural Queensland.

    Science.gov (United States)

    von Schuckmann, Lena A; Smithers, Bernhard M; Khosrotehrani, Kiarash; Beesley, Vanessa L; van der Pols, Jolieke C; Hughes, Maria B; Green, Adele C

    2017-06-01

    To characterise use of support services in patients diagnosed with high-risk primary melanoma by their location of residence. In a cross-sectional study of 787 patients with histologically-confirmed clinical stage 1B-2 melanoma, we estimated odds ratios (ORs) using regression models to assess the association of support service use with residence in rural, regional or urban areas. We also evaluated demographic and clinical correlates of support service use. Among 113 rural patients, 33 (29%) used support services around time of diagnosis compared to 88 (39%) of 224 regional participants and 164 of 448 (37%) urban participants. Regional participants more commonly used support services compared to rural participants (OR 1.84; CI 1.09-3.10), but there was no association with urban versus rural residence (OR 1.32; CI 0.82-2.13). As well, females (OR 1.58; CI 1.15-2.18), those <65 years (OR 1.96; CI 1.42-2.71), or with higher education (OR 2.30; CI 1.53-3.44), or those with T-stage 4B (OR 2.69; CI 1.36-5.32) were more likely to use support services than other patients. Use of support services is lower among rural patients and other sub-groups of primary melanoma patients who have poorer prognoses than others. Implications for public health: Appropriate triage to support services is required for rural and other vulnerable patient groups to ensure optimal patient care. © 2017 The Authors.

  10. Changes in utilization of health services among poor and rural residents in Uganda: are reforms benefitting the poor?

    Science.gov (United States)

    Pariyo, George W; Ekirapa-Kiracho, Elizabeth; Okui, Olico; Rahman, Mohammed Hafizur; Peterson, Stefan; Bishai, David M; Lucas, Henry; Peters, David H

    2009-11-12

    Uganda implemented health sector reforms to make services more accessible to the population. An assessment of the likely impact of these reforms is important for informing policy. This paper describes the changes in utilization of health services that occurred among the poor and those in rural areas between 2002/3 and 2005/6 and associated factors. Secondary data analysis was done using the socio-economic component of the Uganda National Household Surveys 2002/03 and 2005/06. The poor were identified from wealth quintiles constructed using an asset based index derived from Principal Components Analysis (PCA). The probability of choice of health care provider was assessed using multinomial logistic regression and multi-level statistical models. The odds of not seeking care in 2005/6 were 1.79 times higher than in 2002/3 (OR = 1.79; 95% CI 1.65 - 1.94). The rural population experienced a 43% reduction in the risk of not seeking care because of poor geographical access (OR = 0.57; 95% CI 0.48 - 0.67). The risk of not seeking care due to high costs did not change significantly. Private for profit providers (PFP) were the major providers of services in 2002/3 and 2005/6. Using PFP as base category, respondents were more likely to have used private not for profit (PNFP) in 2005/6 than in 2002/3 (OR = 2.15; 95% CI 1.58 - 2.92), and also more likely to use public facilities in 2005/6 than 2002/3 (OR = 1.31; 95% CI 1.15 - 1.48). The most poor, females, rural residents, and those from elderly headed households were more likely to use public facilities relative to PFP. Although overall utilization of public and PNFP services by rural and poor populations had increased, PFP remained the major source of care. The odds of not seeking care due to distance decreased in rural areas but cost continued to be an important barrier to seeking health services for residents from poor, rural, and elderly headed households. Policy makers should consider targeting subsidies to the poor and

  11. Changes in utilization of health services among poor and rural residents in Uganda: are reforms benefitting the poor?

    Directory of Open Access Journals (Sweden)

    Bishai David M

    2009-11-01

    Full Text Available Abstract Background Uganda implemented health sector reforms to make services more accessible to the population. An assessment of the likely impact of these reforms is important for informing policy. This paper describes the changes in utilization of health services that occurred among the poor and those in rural areas between 2002/3 and 2005/6 and associated factors. Methods Secondary data analysis was done using the socio-economic component of the Uganda National Household Surveys 2002/03 and 2005/06. The poor were identified from wealth quintiles constructed using an asset based index derived from Principal Components Analysis (PCA. The probability of choice of health care provider was assessed using multinomial logistic regression and multi-level statistical models. Results The odds of not seeking care in 2005/6 were 1.79 times higher than in 2002/3 (OR = 1.79; 95% CI 1.65 - 1.94. The rural population experienced a 43% reduction in the risk of not seeking care because of poor geographical access (OR = 0.57; 95% CI 0.48 - 0.67. The risk of not seeking care due to high costs did not change significantly. Private for profit providers (PFP were the major providers of services in 2002/3 and 2005/6. Using PFP as base category, respondents were more likely to have used private not for profit (PNFP in 2005/6 than in 2002/3 (OR = 2.15; 95% CI 1.58 - 2.92, and also more likely to use public facilities in 2005/6 than 2002/3 (OR = 1.31; 95% CI 1.15 - 1.48. The most poor, females, rural residents, and those from elderly headed households were more likely to use public facilities relative to PFP. Conclusion Although overall utilization of public and PNFP services by rural and poor populations had increased, PFP remained the major source of care. The odds of not seeking care due to distance decreased in rural areas but cost continued to be an important barrier to seeking health services for residents from poor, rural, and elderly headed households. Policy

  12. Capacity building for the effective adoption of renewable energy technologies in rural areas. Experience of India NGOs

    Energy Technology Data Exchange (ETDEWEB)

    Myles, R. [Integrated Sustainable Energy and Ecological Development Association (INSEDA), New Delhi (India)

    2002-07-01

    The experience of NGO network in the promotions of biogas and other low cost RET gadgets, devices, equipments and machines in the rural areas of India, for over two decades, have shown that there are serveral problems yet challenging opportunities in the promotion and implementation of renewable energy technologies in villages. First of all, the field and extension organizations should recognise that these technologies are new and aliens to the rural people, therefore like any other technologies, developed outside the rural environment, RETs are first view with skepticism by the rural community. Even if 100 units of a RE technology are successfully demonstrated, failure of even one could create negative impact within a radius of 30-50 KMs, and its shortcomings are spread like a wild fire. The appropriate technology demonstration backed by systematic capacity building of different stakeholders/actors/players (i.e. Energy Producers, Energy Service Providers and the Energy End Users) is a must for the acceptance and large-scale adoption of RETs in rural areas of the developing countries. The programme funds for the promotion and implementation of RETs should have good percentage earmarked for the capacity building as well as supporting infrastructure for awareness, motivation, promotional and post installation services activities by local field level organizations and NGOs on a long term basis. (orig.)

  13. Disparities in the access to primary healthcare in rural areas from the county of Iasi - Romania.

    Science.gov (United States)

    Duma, Olga-Odetta; Roşu, Solange Tamara; Manole, M; Petrariu, F D; Constantin, Brânduşa

    2014-01-01

    the interval of time spent to arrive at the primary healthcare office revealed, on average, 25 minutes in urban versus 75 minutes in rural areas. The research outcomes highlight the fact that the population living in rural communities from the county of Iasi, are disadvantaged in accessing the primary health services, with negative consequences on the health status.

  14. Social Impacts of Solar Home Systems in Rural Areas: A Case Study in Bangladesh

    Directory of Open Access Journals (Sweden)

    Ehsanul Kabir

    2017-10-01

    Full Text Available As an alternative source of off-grid electric power, solar home systems (SHS stand out above all other options (e.g., wind, hydro, geo-thermal, tidal systems because of their wide-scale potential at latitudes less than 45° north or south of the Equator where daily solar irradiance is more constant throughout the year and where the bulk of the Third World’s population live. A questionnaire-based survey study was carried out in a rural area of Bangladesh to ascertain the impacts of SHSs on the lives of the rural population. The installation of an SHS was found to improve the comfort and living standard of rural dwellers. Easier access to TV, radio, cellphone, and the Internet helped the rural population become part of a more global culture. More attractive down-payment and installment package options will allow poor target groups to adopt this system. The standard of SHS components and after-sales service should be improved to ensure sustainably and popularity among the mass population for at least 10 years at minimal cost to the consumer. Our findings can also help policymakers adopt more SHS-friendly policies to further the interests of inhabitants of rural areas that are not connected to the grid.

  15. Access to primary care for socio-economically disadvantaged older people in rural areas: A qualitative study.

    Science.gov (United States)

    Ford, John A; Turley, Rachel; Porter, Tom; Shakespeare, Tom; Wong, Geoff; Jones, Andy P; Steel, Nick

    2018-01-01

    We aim to explore the barriers to accessing primary care for socio-economically disadvantaged older people in rural areas. Using a community recruitment strategy, fifteen people over 65 years, living in a rural area, and receiving financial support were recruited for semi-structured interviews. Four focus groups were held with rural health professionals. Interviews and focus groups were audio-recorded and transcribed. Thematic analysis was used to identify barriers to primary care access. Older people's experience can be understood within the context of a patient perceived set of unwritten rules or social contract-an individual is careful not to bother the doctor in return for additional goodwill when they become unwell. However, most found it difficult to access primary care due to engaged telephone lines, availability of appointments, interactions with receptionists; breaching their perceived social contract. This left some feeling unwelcome, worthless or marginalised, especially those with high expectations of the social contract or limited resources, skills and/or desire to adapt to service changes. Health professionals' described how rising demands and expectations coupled with service constraints had necessitated service development, such as fewer home visits, more telephone consultations, triaging calls and modifying the appointment system. Multiple barriers to accessing primary care exist for this group. As primary care is re-organised to reduce costs, commissioners and practitioners must not lose sight of the perceived social contract and models of care that form the basis of how many older people interact with the service.

  16. Transportation Problems in Special Education Programs in Rural Areas - A Specific Solution and Some Suggestions for Delivery System Development.

    Science.gov (United States)

    Brody, Z. H.

    The paper describes transportation problems encountered and solutions employed in delivering systems of comprehensive services to handicapped children in Anderson County, Tennessee, a predominantly rural area with considerable mountain area. Detailed are methods of transportation utilized in the four different program areas of the county special…

  17. Community participation to design rural primary healthcare services.

    Science.gov (United States)

    Farmer, Jane; Nimegeer, Amy

    2014-03-21

    This paper explores how community participation can be used in designing rural primary healthcare services by describing a study of Scottish communities. Community participation is extolled in healthcare policy as useful in planning services and is understood as particularly relevant in rural settings, partly due to high social capital. Literature describes many community participation methods, but lacks discussion of outcomes relevant to health system reconfiguration. There is a spectrum of ideas in the literature on how to design services, from top-down standard models to contextual plans arising from population health planning that incorporates community participation. This paper addresses an evidence gap about the outcomes of using community participation in (re)designing rural community health services. Community-based participatory action research was applied in four Scottish case study communities in 2008-10. Data were collected from four workshops held in each community (total 16) and attended by community members. Workshops were intended to produce hypothetical designs for future service provision. Themes, rankings and selections from workshops are presented. Community members identified consistent health priorities, including local practitioners, emergency triage, anticipatory care, wellbeing improvement and health volunteering. Communities designed different service models to address health priorities. One community did not design a service model and another replicated the current model despite initial enthusiasm for innovation. Communities differ in their receptiveness to engaging in innovative service design, but some will create new models that fit in a given budget. Design diversity indicates that context influences local healthcare planning, suggesting community participation impacts on design outcomes, but standard service models maybe useful as part of the evidence in community participation discussions.

  18. Knowledge Access in Rural Inter-connected Areas Network ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Knowledge Access in Rural Inter-connected Areas Network (KariaNet) - Phase II ... the existing network to include two thematic networks on food security and rural ... Woman conquering male business in Yemen : Waleya's micro-enterprise.

  19. Increasing use of mental health services in remote areas using mobile technology: a pre-post evaluation of the SMART Mental Health project in rural India.

    OpenAIRE

    Maulik, PK; Kallakuri, S; Devarapalli, S; Vadlamani, VK; Jha, V; Patel, A

    2017-01-01

    BACKGROUND: About 25% of the Indian population experience common mental disorders (CMD) but only 15-25% of them receive any mental health care. Stigma, lack of adequate mental health professionals and mental health services account for this treatment gap, which is worse in rural areas. Our project evaluated task shifting and mobile-technology based electronic decision support systems to enhance the ability of primary care health workers to provide evidence-based mental health care for stress,...

  20. Rural migration and health care

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn

    This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role......, or no role at all? First, the paper reports on key findings from rural migration studies, in order to shed light on two migration trends: urbanization and counter-urbanization. Then we take a closer look on settlement preferences in rural areas, including the impact of health care facilities. Finally, we end...... up with a more deepgoing review of the relatively small number of studies, which explicitly deal with settlement preferences related to access to health care....

  1. Reconceptualising risk: Perceptions of risk in rural and remote maternity service planning.

    Science.gov (United States)

    Barclay, Lesley; Kornelsen, Jude; Longman, Jo; Robin, Sarah; Kruske, Sue; Kildea, Sue; Pilcher, Jennifer; Martin, Tanya; Grzybowski, Stefan; Donoghue, Deborah; Rolfe, Margaret; Morgan, Geoff

    2016-07-01

    to explore perceptions and examples of risk related to pregnancy and childbirth in rural and remote Australia and how these influence the planning of maternity services. data collection in this qualitative component of a mixed methods study included 88 semi-structured individual and group interviews (n=102), three focus groups (n=22) and one group information session (n=17). Researchers identified two categories of risk for exploration: health services risk (including clinical and corporate risks) and social risk (including cultural, emotional and financial risks). Data were aggregated and thematically analysed to identify perceptions and examples of risk related to each category. fieldwork was conducted in four jurisdictions at nine sites in rural (n=3) and remote (n=6) Australia. 117 health service employees and 24 consumers. examples and perceptions relating to each category of risk were identified from the data. Most medical practitioners and health service managers perceived clinical risks related to rural birthing services without access to caesarean section. Consumer participants were more likely to emphasise social risks arising from a lack of local birthing services. our analysis demonstrated that the closure of services adds social risk, which exacerbates clinical risk. Analysis also highlighted that perceptions of clinical risk are privileged over social risk in decisions about rural and remote maternity service planning. a comprehensive analysis of risk that identifies how social and other forms of risk contribute to adverse clinical outcomes would benefit rural and remote people and their health services. Formal risk analyses should consider the risks associated with failure to provide birthing services in rural and remote communities as well as the risks of maintaining services. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Telecommunication and Access to Information in Rural Areas of ...

    African Journals Online (AJOL)

    One major reason for this has been the differential access to telecommunication infrastructure between the rural and urban areas. The realization of this has prompted many governments in developing countries to extend telecommunication infrastructure to their rural areas. However, relatively little is known about the impact ...

  3. Outreach to health professionals in a rural area.

    Science.gov (United States)

    Pifalo, V

    1994-01-01

    An outreach project which juxtaposed technology (Grateful Med) and a human intermediary (a circuit librarian) to serve health professionals in a rural area of Illinois is described. The five goals of the project were: promote Grateful Med as a clinical tool; introduce circuit librarianship to Illinois; heighten the awareness of health professionals to the value of timely information services; increase the visibility of the resource library; and evaluate the impact of the two components, Grateful Med and circuit librarianship. While the project was well-received and enjoyed short-term success, sustaining the same level of information activity post-project has not been achieved. Insuring utilization of health information by remote health professionals may be characterized as a Sisyphean task.

  4. Rural and urban women entrepreneurs: A comparison of service needs and delivery methods priorities

    Directory of Open Access Journals (Sweden)

    Davis, A.

    2011-01-01

    Full Text Available Women entrepreneurs face a wide variety of barriers and challenges throughout the life and growth of their entrepreneurial venture. This study expands the knowledge base on women entrepreneurs’ needs, specifically their needs in terms of service areas and service delivery method preferences. Twenty three “needed” service areas were identified by 95 Manitoba based women entrepreneurs. The first five included: finding new customers, growth benefits and tools, market expansion, general marketing, and networking skills. This study also examined the differences between urban and rural based entrepreneurs. Two service need areas “how to find mentors and role models” and “legal issues” exhibited statistically significant priority differences. Service delivery methods did not produce any statistically significant differences. Overall, this study concludes that regardless of location, women entrepreneurs’ training and support needs are not significantly that different. The effects of entrepreneurial stage and years in business on entrepreneurial support needs are also examined.

  5. Consumers’ experiences of back pain in rural Western Australia: access to information and services, and self-management behaviours

    Directory of Open Access Journals (Sweden)

    Briggs Andrew M

    2012-10-01

    Full Text Available Abstract Background Coordinated, interdisciplinary services, supported by self-management underpin effective management for chronic low back pain (CLBP. However, a combination of system, provider and consumer-based barriers exist which limit the implementation of such models into practice, particularly in rural areas where unique access issues exist. In order to improve health service delivery for consumers with CLBP, policymakers and service providers require a more in depth understanding of these issues. The objective of this qualitative study was to explore barriers experienced by consumers in rural settings in Western Australia (WA to accessing information and services and implementing effective self-management behaviours for CLBP. Methods Fourteen consumers with a history of CLBP from three rural sites in WA participated. Maximum variation sampling was employed to ensure a range of experiences were captured. An interviewer, blinded to quantitative pain history data, conducted semi-structured telephone interviews using a standardised schedule to explore individuals’ access to information and services for CLBP, and self-management behaviours. Interviews were digitally recorded and transcribed verbatim. Inductive analysis techniques were used to derive and refine key themes. Results Five key themes were identified that affected individuals’ experiences of managing CLBP in a rural setting, including: 1 poor access to information and services in rural settings; 2 inadequate knowledge and skills among local practitioners; 3 feelings of isolation and frustration; 4 psychological burden associated with CLBP; and 5 competing lifestyle demands hindering effective self-management for CLBP. Conclusions Consumers in rural WA experienced difficulties in knowing where to access relevant information for CLBP and expressed frustration with the lack of service delivery options to access interdisciplinary and specialist services for CLBP. Competing

  6. A Comparative Analysis of the Environmental Benefits of Drone-Based Delivery Services in Urban and Rural Areas

    Directory of Open Access Journals (Sweden)

    Jiyoon Park

    2018-03-01

    Full Text Available Unmanned aerial vehicles (UAV, drones used as delivery vehicles have received increasing attention due to their mobility and accessibility to remote areas. The purpose of this study is to evaluate the environmental impacts of drone versus motorcycle delivery and to compare the expected environmental improvements due to drone delivery in urban and rural areas. In addition, the potential environmental contributions of electric motorcycles were assessed to determine the effects of introducing this new type of vehicle. Changes in the national electricity generation plan were also examined. The results showed that global warming potential (GWP per 1 km delivery by drone was one-sixth that of motorcycle delivery, and the particulates produced by drone delivery were half that of motorcycle delivery. The actual environmental impact reduction in consideration of the delivery distance was 13 times higher in a rural area than in an urban area. Increasing the use of environmentally friendly electricity systems, such as solar and wind power, would further enhance the environmental effects of a drone delivery system.

  7. Awareness and utilization of community clinic services among women in rural areas in Bangladesh: A cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Sanni Yaya

    Full Text Available In recent years, Bangladesh government has accomplished the ambitious project of establishing hospitals 18,000 Community Health Clinics in sub-districts across the country. Operating under the affiliation of the government hospitals, these community health clinics aim to provide free healthcare services and to increase health-awareness among the extreme poor communities in the rural areas. However, a great proportion of the people are still not well aware of the services offered by the community health clinics. Thus, it is imperative to identify the factors of awareness regarding the community clinics. Research-based evidence is necessary to improve the efficacy and service coverage of community clinics among key population.Cross-sectional data of size 11,673 women aged 15 to 49 years living in rural settings across seven divisions were extracted from the latest Bangladesh Demographic and Health Survey 2014. The main outcome measures of our study were awareness and utilization of Community Clinic Services (CCs. Descriptive statistics were used to present the baseline socio-demographic and economic characteristics; Chi-square test and logistic regression were performed to identify the factors associated with awareness of community clinics.About one-third (36.7% of the women were aware of community clinics. Geographical location, level of education, household wealth status and frequency of reading newspaper were found to be significantly associated with awareness about community clinic services. Services reported to be obtained in the community clinics include family planning, immunization, tetanus, antenatal care, vitamin A, and health care for children and child growth monitoring. In the multivariate logistic regression, the odds of awareness among participants with primary education [p<0.001, AOR = 1.255, 95%CI = 1.107-1.357], secondary qualification [p<0.001, AOR = 1.370, 95%CI = 1.242-1.510] and tertiary [p<0.001, AOR = 1.526, 95%CI = 1

  8. Integrated model of primary and secondary eye care for underserved rural areas: The L V Prasad Eye Institute experience

    Directory of Open Access Journals (Sweden)

    Gullapalli N Rao

    2012-01-01

    Full Text Available Blindness is a major global public health problem and recent estimates from World Health Organization (WHO showed that in India there were 62 million visually impaired, of whom 8 million are blind. The Andhra Pradesh Eye Disease Study (APEDS provided a comprehensive estimate for prevalence and causes of blindness for the state of Andhra Pradesh (AP. It also highlighted that uptake of services was also an issue, predominantly among lower socio-economic groups, women, and rural populations. On the basis of this analysis, L V Prasad Eye Institute (LVPEI developed a pyramidal model of eye care delivery. This article describes the LVPEI eye care delivery model. The article discusses infrastructure development, human resource development, and service delivery (including prevention and promotion in the context of primary and secondary care service delivery in rural areas. The article also alludes to opportunities for research at these levels of service delivery and the amenability of the evidence generated at these levels of the LVPEI eye health pyramid for advocacy and policy planning. In addition, management issues related to the sustainability of service delivery in rural areas are discussed. The article highlights the key factors required for the success of the LVPEI rural service delivery model and discusses challenges that need to be overcome to replicate the model. The article concludes by noting the potential to convert these challenges into opportunities by integrating certain aspects of the existing healthcare system into the model. Examples include screening of diabetes and diabetic retinopathy in order to promote higher community participation. The results of such integration can serve as evidence for advocacy and policy.

  9. A case study of the counterpart technical support policy to improve rural health services in Beijing

    Science.gov (United States)

    2012-01-01

    Background There is, globally, an often observed inequality in the health services available in urban and rural areas. One strategy to overcome the inequality is to require urban doctors to spend time in rural hospitals. This approach was adopted by the Beijing Municipality (population of 20.19 million) to improve rural health services, but the approach has never been systematically evaluated. Methods Drawing upon 1.6 million cases from 24 participating hospitals in Beijing (13 urban and 11 rural hospitals) from before and after the implementation of the policy, changes in the rural–urban hospital performance gap were examined. Hospital performance was assessed using changes in six indices over-time: Diagnosis Related Groups quantity, case-mix index (CMI), cost expenditure index (CEI), time expenditure index (TEI), and mortality rates of low- and high-risk diseases. Results Significant reductions in rural–urban gaps were observed in DRGs quantity and mortality rates for both high- and low-risk diseases. These results signify improvements of rural hospitals in terms of medical safety, and capacity to treat emergency cases and more diverse illnesses. No changes in the rural–urban gap in CMI were observed. Post-implementation, cost and time efficiencies worsened for the rural hospitals but improved for urban hospitals, leading to a widening rural–urban gap in hospital efficiency. Conclusions The strategy for reducing urban–rural gaps in health services adopted, by the Beijing Municipality shows some promise. Gains were not consistent, however, across all performance indicators, and further improvements will need to be tried and evaluated. PMID:23272703

  10. Barriers to offering French language physician services in rural and northern Ontario.

    Science.gov (United States)

    Timony, Patrick E; Gauthier, Alain P; Serresse, Suzanne; Goodale, Natalie; Prpic, Jason

    2016-01-01

    Rural and Northern Ontario francophones face many health-related challenges including poor health status, a poor supply of French-speaking physicians, and the potential for an inability or reduced ability to effectively communicate with anglophone healthcare providers. As such, it can reasonably be expected that rural and Northern Ontario francophones experience barriers when receiving care. However, the experience of physicians working in areas densely populated by francophones is largely unexplored. This paper identifies barriers experienced by French-speaking and Non-French-speaking rural and Northern Ontario physicians when serving francophone patients. A series of key informant interviews were conducted with 18 family physicians practicing in rural and urban francophone communities of Northeastern Ontario. Interviews were analyzed using a thematic analysis process. Five categories of barrier were identified: (1) language discordance, (2) characteristics of francophone patients, (3) dominance of English in the medical profession, (4) lack of French-speaking medical personnel, and (5) physicians' linguistic (in)sensitivity. Some barriers identified were unique to Non-French-speaking physicians (eg language discordance, use of interpreters, feelings of inadequacy), some were unique to French-speaking physicians (eg limited French education and resources), and some were common to both groups (eg lack of French-speaking colleagues/staff, added time commitments, and the particularities of Franco-Ontarian preferences and culture). Healthcare providers and decision makers may take interest in these results. Although physicians were the focus of the present article, the barriers expressed are likely experienced by other healthcare providers, and thus the lessons learned from this article extend beyond the physician workforce. Efforts must be made to offer educational opportunities for physicians and other healthcare providers working in areas densely populated by

  11. Mobile surgical services in primary care in a rural and remote setting: Experience and evidence from Yala, Cross River State, Nigeria

    Directory of Open Access Journals (Sweden)

    Emmanuel Monjok

    2009-07-01

    Full Text Available Surgical conditions account for 11 to 15% of the global burden of disease. Yet, surgical services are very scarce in the rural areas of Nigeria where approximately 60 to 80% of the population resides. Among other basic contributing factors is the shortage of surgical workforce, since Nigeria’s few surgeons practise in the urban centre of the major cities. One way to respond to this acute shortage of surgeons is the training of generalist medical doctors to undertake surgery in rural areas. The introduction of mobile surgical services in rural populations as part of the existing primary health care activities in the Local Government Areas (districts can reduce surgical morbidity and mortality in Nigeria. This can be done by the generalist physician with training and experience in surgery using local health staff and simple surgical equipment. A number of recommendations are made.

  12. Patent Medicine Vendors in Rural Areas of Lagos Nigeria ...

    African Journals Online (AJOL)

    Purpose: To determine the compliance of patent medicine vendors (PMVs) in rural areas of Lagos State, Nigeria with set guidelines to regulate their practice and its implications for malaria control. Methods: A baseline cross-sectional study was conducted as part of an intervention study in two rural local government areas ...

  13. Sustainable development of rural areas: Case studies Vojvodina - Serbia

    Directory of Open Access Journals (Sweden)

    Forcan Dejana

    2016-01-01

    Full Text Available One of the most important strategic aims of Serbian economic development is supporting of the villages sustainable development through rural economy diversification where rural tourism development has an important place. In spite of this model of tourism importance recognition as a possible way of rural areas development, Serbia is in an opening phase of. Although there are several positive examples, it is significant that recent projects haven't been established according to national and European development programs, but according to private initiatives of individuals and groups. Rural tourism is an important component of integrated and sustainable development and revitalization of villages, as well an an important factor in encouraging the development of local agricultural and non-farmer activities in rural areas and villages, and also a special incentive to employment. This work highlights the importance of rural tourism in the function of the revitalization of the village, focusing on the challenges of the environment and the possible directions of development in the context of creating a recognizable tourist product and brand of rural tourism in Vojvodina.

  14. The distribution of maternity services across rural and remote Australia: does it reflect population need?

    Science.gov (United States)

    Rolfe, Margaret I; Donoghue, Deborah Anne; Longman, Jo M; Pilcher, Jennifer; Kildea, Sue; Kruske, Sue; Kornelsen, Jude; Grzybowski, Stefan; Barclay, Lesley; Morgan, Geoffrey Gerard

    2017-02-23

    Australia has a universal health care system and a comprehensive safety net. Despite this, outcomes for Australians living in rural and remote areas are worse than those living in cities. This study will examine the current state of equity of access to birthing services for women living in small communities in rural and remote Australia from a population perspective and investigates whether services are distributed according to need. Health facilities in Australia were identified and a service catchment was determined around each using a one-hour road travel time from that facility. Catchment exclusions: metropolitan areas, populations above 25,000 or below 1,000, and a non-birthing facility within the catchment of one with birthing. Catchments were attributed with population-based characteristics representing need: population size, births, demographic factors, socio-economic status, and a proxy for isolation - the time to the nearest facility providing a caesarean section (C-section). Facilities were dichotomised by service level - those providing birthing services (birthing) or not (no birthing). Birthing services were then divided by C-section provision (C-section vs no C-section birthing). Analysis used two-stage univariable and multivariable logistic regression. There were 259 health facilities identified after exclusions. Comparing services with birthing to no birthing, a population is more likely to have a birthing service if they have more births, (adjusted Odds Ratio (aOR): 1.50 for every 10 births, 95% Confidence Interval (CI) [1.33-1.69]), and a service offering C-sections 1 to 2 h drive away (aOR: 28.7, 95% CI [5.59-148]). Comparing the birthing services categorised by C-section vs no C-section, the likelihood of a facility having a C-section was again positively associated with increasing catchment births and with travel time to another service offering C-sections. Both models demonstrated significant associations with jurisdiction but not socio

  15. Networked remote area dental services: a viable, sustainable approach to oral health care in challenging environments.

    Science.gov (United States)

    Dyson, Kate; Kruger, Estie; Tennant, Marc

    2012-12-01

    This study examines the cost effectiveness of a model of remote area oral health service. Retrospective financial analysis. Rural and remote primary health services. Clinical activity data and associated cost data relating to the provision of a networked visiting oral health service by the Centre for Rural and Remote Oral Health formed the basis of the study data frameset. The cost-effectiveness of the Centre's model of service provision at five rural and remote sites in Western Australia during the calendar years 2006, 2008 and 2010 was examined in the study. Calculations of the service provision costs and value of care provided were made using data records and the Fee Schedule of Dental Services for Dentists. The ratio of service provision costs to the value of care provided was determined for each site and was benchmarked against the equivalent ratios applicable to large scale government sector models of service provision. The use of networked models have been effective in other disciplines but this study is the first to show a networked hub and spoke approach of five spokes to one hub is cost efficient in remote oral health care. By excluding special cost-saving initiatives introduced by the Centre, the study examines easily translatable direct service provision costs against direct clinical care outcomes in some of Australia's most challenging locations. This study finds that networked hub and spoke models of care can be financially efficient arrangements in remote oral health care. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  16. Implementation of the principles of primary health care in a rural area of South Africa.

    Science.gov (United States)

    Visagie, Surona; Schneider, Marguerite

    2014-02-18

    The philosophy of primary healthcare forms the basis of South Africa's health policy and provides guidance for healthcare service delivery in South Africa. Healthcare service provision in South Africa has shown improvement in the past five years. However, it is uncertain as to whether the changes have reached rural areas and if primary healthcare is implemented successfully in these areas. The aim of this article is to explore the extent to which the principles of primary healthcare are implemented in a remote, rural setting in South Africa. A descriptive, qualitative design was implemented. Data were collected through interviews and case studies with 36 purposively-sampled participants, then analysed through Interpretative Phenomenological Analysis. Findings indicated challenges with regard to client-centred care, provision of health promotion and rehabilitation, the way care was organised, the role of the doctor, health worker attitudes, referral services and the management of complex conditions. The principles of primary healthcare were not implemented successfully. The community was not involved in healthcare management, nor were users involved in their personal health management. The initiation of a community-health forum is recommended. Service providers, users and the community should identify and address the determinants of ill health in the community. Other recommendations include the training of service managers in the logistical management of ensuring a constant supply of drugs, using a Kombi-type vehicle to provide user transport for routine visits to secondary- and tertiary healthcare services and increasing the doctors' hours.

  17. Health Service Accessibility and Risk in Cervical Cancer Prevention: Comparing Rural Versus Nonrural Residence in New Mexico.

    Science.gov (United States)

    McDonald, Yolanda J; Goldberg, Daniel W; Scarinci, Isabel C; Castle, Philip E; Cuzick, Jack; Robertson, Michael; Wheeler, Cosette M

    2017-09-01

    Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P brick and mortar). © 2016 National Rural Health Association.

  18. School Segregation and Disparities in Urban, Suburban, and Rural Areas

    Science.gov (United States)

    Logan, John R.; Burdick-Will, Julia

    2018-01-01

    Much of the literature on racial and ethnic educational inequality focuses on the contrast between Black and Hispanic students in urban areas and white suburban students. This study extends past research on school segregation and racial/ethnic disparities by highlighting the importance of rural areas and regional variation. Although schools in rural America are disproportionately white, they nevertheless are like urban schools, and disadvantaged relative to suburban schools, in terms of poverty and test performance. The group most affected by rural school disadvantage is Native Americans, who are a small share of students nationally but much more prominent and highly disadvantaged in rural areas, particularly in some parts of the country. These figures suggest a strong case for including rural schools in the continuing conversation about how to deal with unfairness in public education. PMID:29430018

  19. Applying Strengths Model principles to build a rural community-based mental health support service and achieve recovery outcomes.

    Science.gov (United States)

    Dunstan, Debra; Anderson, Donnah

    2018-02-01

    The Personal Helpers and Mentors (PHaMs) service is a non-clinical, community-based Australian Government initiative aimed at increasing opportunities for recovery for people whose lives are severely affected by mental illness. Using a strengths-based recovery model, PHaMs caseworkers support and mentor people 'at risk of falling through the gaps' between state funded clinical treatment services and federally funded social services (such as supported housing, education and employment). While there is evidence that PHaMs realises its aim in metropolitan areas, little is known about how services are developed and function in low resource rural settings and what outcomes are achieved. These questions were addressed in a case study of a PHaMs service in a rural town in the state of New South Wales, Australia. Data were collected from two sources: local service documents prepared for staff orientation and operational purposes, and records and reports of service participants\\' performance and achievements. Participants\\' gains in wellbeing, recovery goals, and the target outcome areas of increased access to services, increased personal capacity and self-reliance, and increased community participation, were gathered from self-reports. The Role Functioning Scale was used as a measure of caseworker ratings of participants\\' adaptive functioning. The qualitative data were examined for semantic content and underlying themes. The quantitative analyses involved repeated measures and between-groups comparisons of uncontrolled pre-test–post-test and retrospective pre-test data. From commencement of the service in October 2009 to June 2014, an estimated 31% of the people living with severe mental illness in the local government area had accessed the PHaMs service (N=126; mean age 31.9 years; 42% male, 27% Aboriginal). The document analysis revealed that despite a lack of detail on how a PHaMs service should be developed or delivered, by focusing on the goal of client recovery

  20. Mobile bone densitometry service in rural South Australia

    International Nuclear Information System (INIS)

    Tucker, K.N.; Schultz, C.G.; Chatterton, B.E.

    1997-01-01

    Full text: Twenty per cent of South Australia's population live rurally, with limited access to modern medical services. The Mobile Bone Densitometry Unit was established to address this problem. The Unit began in 1994 with cooperation from private industry. In fostering the service, many issues were addressed, including choice of appropriate sites; selection of a liaison person at each site; towing of the Unit; transportation and accommodation of staff; education of local health professionals and community members; promotion of the service to the community: and timely reporting of results to referring doctors. The scanner is an Hologic ODR-1000+ densitometer, housed in a 5.9 1.8 metre, 2200 kg caravan. It is necessary to reduce vibration and motion during travel, control the internal environment, and have an electrically clean power supply. Addressing these parameters result in the critical value for quality control being 2500 patients, averaging 13 patients/working day. The mean age of the patients was 64 y (range 30-90 y), with 93 % of patients being >50 y. Results show a normally distributed Z score, suggesting that non-selected 'normal' population is being studied and the Hologic normal range matches that of the South Australian rural community. Local communities have utilised the service to full capacity resulting in future visits being extended. In conclusion, it is possible to provide a high quality, reliable bone densitometry service to rural communities

  1. ON THE EMPIRICAL FINDING OF A HIGHER RISK OF POVERTY IN RURAL AREAS: IS RURAL RESIDENCE ENDOGENOUS TO POVERTY?

    OpenAIRE

    Fisher, Monica G.

    2004-01-01

    Includes: On the Empirical Finding of a Higher Risk of Poverty in Rural Areas: Is Rural Residence Endogenous to Poverty?:COMMENT, by Thomas A. Hirschl; On the Empirical Finding of a Higher Risk of Poverty in Rural Areas: Is Rural Residence Endogenous to Poverty?: REPLY, by Monica Fisher. Research shows people are more likely to be poor in rural versus urban America. Does this phenomenon partly reflect that people who choose rural residence have unmeasured attributes related to human impoveris...

  2. Access to primary care for socio-economically disadvantaged older people in rural areas: A qualitative study

    Science.gov (United States)

    Turley, Rachel; Porter, Tom; Shakespeare, Tom; Wong, Geoff; Jones, Andy P.; Steel, Nick

    2018-01-01

    Objective We aim to explore the barriers to accessing primary care for socio-economically disadvantaged older people in rural areas. Methods Using a community recruitment strategy, fifteen people over 65 years, living in a rural area, and receiving financial support were recruited for semi-structured interviews. Four focus groups were held with rural health professionals. Interviews and focus groups were audio-recorded and transcribed. Thematic analysis was used to identify barriers to primary care access. Findings Older people’s experience can be understood within the context of a patient perceived set of unwritten rules or social contract–an individual is careful not to bother the doctor in return for additional goodwill when they become unwell. However, most found it difficult to access primary care due to engaged telephone lines, availability of appointments, interactions with receptionists; breaching their perceived social contract. This left some feeling unwelcome, worthless or marginalised, especially those with high expectations of the social contract or limited resources, skills and/or desire to adapt to service changes. Health professionals’ described how rising demands and expectations coupled with service constraints had necessitated service development, such as fewer home visits, more telephone consultations, triaging calls and modifying the appointment system. Conclusion Multiple barriers to accessing primary care exist for this group. As primary care is re-organised to reduce costs, commissioners and practitioners must not lose sight of the perceived social contract and models of care that form the basis of how many older people interact with the service. PMID:29509811

  3. Rural Depopulation Pattern at Yogyakarta Special Province (DIY

    Directory of Open Access Journals (Sweden)

    M Baiquni

    2004-01-01

    This paper is based on a secondary data research i.e. statistical data at rural levels in Yogyakarta, thematics maps and other documents. Statistical methodes and map pattern analysis are employed to analysis data. The result of this research are as follows: a the rural depopulation in DIY can be found in 189 rural areas of 393 rural areas (48.09%; b the spatial distribution of the rural depopulation are in Gunung Kidul District (80 rural areas, Kulon Progo District (59 rural areas Sleman District (33 rural areas, and Bantul District (17 rural areas; c the rural depopulation in Yogyakarta at least related to six factors whih have been identified as out – migration, local resources, carrying capacity, geographycal location or accessibility, rural infrastructure, and service availability.

  4. Energy services and energy poverty for sustainable rural development

    International Nuclear Information System (INIS)

    Kaygusuz, K.

    2011-01-01

    In many rural areas, poor people still depend on wood and other biomass fuels for most of their household and income-generating activities. The difficult, time-consuming work of collecting and managing traditional fuels is widely viewed as women's responsibility, which is a factor in women's disproportionate lack of access to education and income, and inability to escape from poverty. Therefore, it is important for energy access programs to have a special focus on women. New options for energy access and sustainable livelihoods, like small-scale biofuels production, can have dramatic benefits for rural women, and their families and communities. Energy development, as both a driving force and a consequence of such tremendous changes, has had profound impact on economic, social, and environmental development. Rural energy has always been a critical issue due to years of energy shortage for both households and industries. Biomass, for long time, has been the only available fuel in many rural areas. The situation in rural areas is even more critical as local demand for energy outstrips availability and the vast majority of people depend on non-commercial energy supplies. Energy is needed for household uses, such as cooking, lighting, heating; for agricultural uses, such as tilling, irrigation and post-harvest processing; and for rural industry uses, such as milling and mechanical energy and process heat. Energy is also an input to water supply, communication, commerce, health, education and transportation in rural areas. (author)

  5. Extending access to essential services against constraints: the three-tier health service delivery system in rural China (1949-1980).

    Science.gov (United States)

    Feng, Xing Lin; Martinez-Alvarez, Melisa; Zhong, Jun; Xu, Jin; Yuan, Beibei; Meng, Qingyue; Balabanova, Dina

    2017-05-23

    China has made remarkable progress in scaling up essential services during the last six decades, making health care increasingly available in rural areas. This was partly achieved through the building of a three-tier health system in the 1950s, established as a linked network with health service facilities at county, township and village level, to extend services to the whole population. We developed a Theory of Change to chart the policy context, contents and mechanisms that may have facilitated the establishment of the three-tier health service delivery system in rural China. We systematically synthesized the best available evidence on how China achieved universal access to essential services in resource-scarce rural settings, with a particular emphasis on the experiences learned before the 1980s, when the country suffered a particularly acute lack of resources. The search identified only three peered-reviewed articles that fit our criteria for scientific rigor. We therefore drew extensively on government policy documents, and triangulated them with other publications and key informant interviews. We found that China's three-tier health service delivery system was established in response to acute health challenges, including high fertility and mortality rates. Health system resources were extremely low in view of the needs and insufficient to extend access to even basic care. With strong political commitment to rural health and a "health-for-all" policy vision underlying implementation, a three-tier health service delivery model connecting villages, townships and counties was quickly established. We identified several factors that contributed to the success of the three-tier system in China: a realistic health human resource development strategy, use of mass campaigns as a vehicle to increase demand, an innovative financing mechanisms, public-private partnership models in the early stages of scale up, and an integrated approach to service delivery. An

  6. Utilization of health care services in rural and urban areas: a ...

    African Journals Online (AJOL)

    2014-06-02

    Jun 2, 2014 ... related problem, being consumer-oriented with diverse dimensions ... The order of importance of the factors is need, enabling, predisposing and health services. 11 variables .... influence utilization behavior, they have the advantage of reminding .... area and also from the researcher's personal knowledge.

  7. Design and Technical Validation of a Telemedicine Service for Rural Healthcare in Ecuador.

    Science.gov (United States)

    Vasquez-Cevallos, Leonel A; Bobokova, Jana; González-Granda, Patricia V; Iniesta, José M; Gómez, Enrique J; Hernando, M Elena

    2017-12-12

    Telemedicine is becoming increasingly important in Ecuador, especially in areas such as rural primary healthcare and medical education. Rural telemedicine programs in the country need to be strengthened by means of a technological platform adapted to local surroundings and offering advantages such as access to specialized care, continuing education, and so on, combined with modest investment requirements. This present article presents the design of a Telemedicine Platform (TMP) for rural healthcare services in Ecuador and a preliminary technical validation with medical students and teachers. An initial field study was designed to capture the requirements of the TMP. In a second phase, the TMP was validated in an academic environment along three consecutive academic courses. Assessment was by means of user polls and analyzing user interactions as registered automatically by the platform. The TMP was developed using Web-based technology and open code software. One hundred twenty-four students and 6 specialized faculty members participated in the study, conducting a total of 262 teleconsultations of clinical cases and 226 responses, respectively. The validation results show that the TMP is a useful communication tool for the documentation and discussion of clinical cases. Moreover, its usage may be recommended as a teaching methodology, to strengthen the skills of medical undergraduates. The results indicate that implementing the system in rural healthcare services in Ecuador would be feasible.

  8. PROTECTION, UTILIZATION AND ANALYSIS OF HIGH MAST STREET LIGHT IN RURAL AREA.

    OpenAIRE

    Bhagawati Chandra , Miss Anjali Karsh

    2017-01-01

    High Mast Light gives the several cost effective advantages and cost is a major issue for rural area general services. This project illustrates the theoretical basis and the analytical development of the high mast lighting poles. In the late 1960"s, studies were conducted to investigate the impact that high-mast lighting gives on traffic performance, driver visibility, and illumination costs. It was found that increasing the height of the lighting offered a noticeable advantage in that it pr...

  9. Retaining health workforce in rural and underserved areas of India: What works and what doesn't? A critical interpretative synthesis.

    Science.gov (United States)

    Goel, Sonu; Angeli, Federica; Bhatnagar, Nidhi; Singla, Neetu; Grover, Manoj; Maarse, Hans

    2016-01-01

    Human resource for health is critical in quality healthcare delivery. India, with a large rural population (68.8%), needs to urgently bridge the gaps in health workforce deployment between urban and rural areas. We did a critical interpretative synthesis of the existing literature by using a predefined selection criteria to assess relevant manuscripts to identify the reasons for retaining the health workforce in rural and underserved areas. We discuss different strategies for retention of health workforce in rural areas on the basis of four major retention interventions, viz. education, regulation, financial incentives, and personal and professional support recommended by WHO in 2010. This review focuses on the English-language material published during 2005-14 on human resources in health across low- and middle-income countries. Healthcare in India is delivered through a diverse set of providers. Inequity exists in health manpower distribution across states, area (urban-rural), gender and category of health personnel. India is deficient in health system development and financing where health workforce education and training occupy a low priority. Poor governance, insufficient salary and allowances, along with inability of employers to provide safe, satisfying and rewarding work conditions-are causing health worker attrition in rural India. The review suggests that the retention of health workers in rural areas can be ensured by multiplicity of interventions such as medical schools in rural areas, rural orientation of medical education, introducing compulsory rural service in lieu of incentives providing better pay packages and special allowances, and providing better living and working conditions in rural areas. A complex interplay of factors that impact on attraction and retention of health workforce necessitates bundling of interventions. In low-income countries, evidence- based strategies are needed to ensure context-specific, field- tested and cost

  10. The Impact Of Shopping Centers In Rural Areas And Small Towns In The Outer Metropolitan Zone (The Example Of The Silesian Voivodeship

    Directory of Open Access Journals (Sweden)

    Heffner Krystian

    2015-06-01

    Full Text Available Shopping centers in the Silesian Voivodeship have a significant impact on smaller settlement units located in outer areas of agglomerations. It consists mainly in changes related to social, economic, as well as functional and spatial spheres. Studies shows that shopping centers take over more and more functions of higher order (services, public culture, administration and restrict the economic activity in rural areas outer areas of agglomerations. At the stage of the irrepressible process of suburbanisation of rural areas surrounding large urban agglomerations and structural changes in towns, it is difficult to conclusively assess the consequences of the operation of shopping centers in outer metropolitan areas. The impact of shopping centers on small towns and rural areas is a very dynamic process and requires systematic research.

  11. Listening to the Patient: Women Veterans' Insights About Health Care Needs, Access, and Quality in Rural Areas.

    Science.gov (United States)

    Brooks, Elizabeth; Dailey, Nancy K; Bair, Byron D; Shore, Jay H

    2016-09-01

    Many work to ensure that women veterans receive appropriate and timely health care, yet the needs of those living in rural areas are often ignored. This is a critical oversight given the multitude of reports documenting rural access problems and health disparities. Lacking this, we are unable to plan for and evaluate appropriate care for this specific group. In this project, we spoke with rural women veterans to document service needs and quality of care from their perspective. Rural women veterans' views about health care access and quality were ascertained in a series of five, semistructured focus groups (n = 35) and completion of a demographic questionnaire. Content analysis documented focus-group themes. Participants said that local dental, mental health, and gender-specific care options were needed, as well as alternative healing options. Community-based support for women veterans and interaction with female peers were absent. Participants' support for telehealth was mixed, as were requests for gender-specific care. Personal experiences in the military impacted participants' current service utilization. Action by both Veterans Affairs and the local community is vital to improving the health of women veterans. Service planning should consider additional Veterans Affairs contracts, mobile health vans, peer support, and enhanced outreach. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  12. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

    Directory of Open Access Journals (Sweden)

    Buykx Penny

    2011-03-01

    Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how

  13. Investigation and Control Mode of Domestic Pollution in Rural Areas of Guangxi Province

    Science.gov (United States)

    Duan, Chunyi; Chen, Hong

    2018-01-01

    Due to the unbalanced economic development and scattered residence in rural areas, it was difficult to adopt a centralized approach in rural environmental governance. Based on the survey results of the present situation of rural environment in Guangxi and the analysis of the pollution characteristics in rural areas, the control mode of domestic pollution suitable for rural areas was obtained. Based on this research, a demonstration project of Guangxi’s administrative village was selected.

  14. Summer atmospheric polybrominated diphenyl ethers in urban and rural areas of northern China

    International Nuclear Information System (INIS)

    Wang Chen; Li Wei; Chen Jiwei; Wang Hongqijie; Li Tongchao; Shen Guofeng; Shen Huizhong; Huang Ye; Wang Rong; Wang Bin; Zhang Yanyan; Tang Jianhui; Liu Wenxin; Wang Xilong; Tao Shu

    2012-01-01

    High levels of polybrominated diphenyl ethers (PBDEs) have been extensively reported in urban areas and at e-waste recycling sites in coastal China. However, data are scarce in northern China and are not available in rural areas at all. In addition, it is often believed that air concentrations in rural areas are lower than those in urban areas without distinguishing rural residential areas and open fields. In this study, air samples were collected at 17 sites covering urban and rural (residential and open field) areas in northern China using active samplers. With BDE-209 dominated in all congeners, the average concentrations of BDE-209 (41 ± 72 pg/m 3 ) and other 13 PBDEs (16 ± 12 pg/m 3 ) were significantly lower than those found in south China, such as in Guangzhou or Hong Kong. On average, the total PBDE concentrations at the urban sites were 2.2 and 2.9 times of those at the rural residential and field sites, respectively. - Graphical abstract: Concentration of PBDEs at each site of the studied area. Highlights: ► High levels of PBDEs with BDE-209 domination were detected in air in northern China. ► PBDE concentrations in rural residential areas were significantly higher than those in rural open fields. ► Proportions of BDE-209 in urban areas were higher than those in rural areas. ► PBDE concentrations were correlated to local population density and Gross Domestic Production. - In northern China, PBDEs in air in rural residential areas were significantly higher than those in open fields.

  15. Syphilis screening among 27,150 pregnant women in South Chinese rural areas using point-of-care tests.

    Directory of Open Access Journals (Sweden)

    Li-Gang Yang

    Full Text Available To determine the prevalence and correlates of syphilis among pregnant women in rural areas of South China.Point-of-care syphilis testing was provided at 71 health facilities in less developed, rural areas of Guangdong Province. Positive samples were confirmed at a local referral center by toluidine red unheated serum tests (TRUST and Treponema pallidum particle agglutination (TPPA tests.Altogether 27,150 pregnant women in rural Guangdong were screened for syphilis. 106 (0.39% syphilis cases were diagnosed, of which 78 (73.6% received treatment for syphilis. Multivariate analysis revealed that older pregnant women (31-35 years old, aOR 2.7, 95% CI 0.99-7.32; older than 35 years old, aOR 5.9, 95% CI 2.13-16.34 and those with a history of adverse pregnant outcomes (aOR 3.64, 95% CI 2.30-5.76 were more likely to be infected with syphilis.A high prevalence of syphilis exists among pregnant women living in rural areas of South China. Enhanced integration of syphilis screening with other routine women's health services (OB GYN, family planning may be useful for controlling China's syphilis epidemic.

  16. A qualitative study in rural and urban areas on whether – and how – to consult during routine and out of hours

    Directory of Open Access Journals (Sweden)

    Guest Clare

    2006-04-01

    Full Text Available Abstract Background Patients vary widely when making decisions to consult primary care. Some present frequently with trivial illness: others delay with serious disease. Differences in health service provision may play a part in this. We aimed to explore whether and how patients' consulting intentions take account of their perceptions of health service provision. Methods Four focus groups and 51 semi-structured interviews with 78 participants (45 to 64 years in eight urban and rural general practices in Northeast and Southwest Scotland. We used vignettes to stimulate discussion about what to do and why. Inductive analysis identified themes and explored the influence of their perceptions of health service provision on decision-making processes. Results Anticipated waiting times for appointments affected consulting intentions, especially when the severity of symptoms was uncertain. Strategies were used to deal with this, however: in cities, these included booking early just in case, being assertive, demanding visits, or calling out-of-hours; in rural areas, participants used relationships with primary care staff, and believed that being perceived as undemanding was advantageous. Out-of-hours, decisions to consult were influenced by opinions regarding out-of-hours services. Some preferred to attend nearby emergency departments or call 999. In rural areas, participants tended to delay until their own doctor was available, or might contact them even when not on call. Conclusion Perceived barriers to health service access affect decisions to consult, but some patients develop strategies to get round them. Current changes in UK primary care are unlikely to reduce differences in consulting behaviour and may increase delays by some patients, especially in rural areas.

  17. Access to health and human services for drug users: an urban/rural community systems perspective.

    Science.gov (United States)

    Rivers, J E; Komaroff, E; Kibort, A C

    1999-01-01

    Publicly funded drug-user treatment programs in both urban and rural areas are under unprecedented pressure to adapt to multiple perspectives of their mission, reduced governmental funding, diminished entitlement program resources for clients, managed care reforms, and continuing unmet need for services. This article describe an ongoing health services research study that is investigating how these and related health and human service programs currently serve and cross-refer chronic drug users and how they perceive and are reacting to systemic pressures. Interim analysis on intra-agency diversity and managed care perceptions are reported.

  18. Why Rural Schools Are Important for Pre-Service Teacher Preparation

    Science.gov (United States)

    Blanks, Brooke; Robbins, Holly; Rose, Dana; Beasley, Loren; Greene, Michelle; Kile, Melissa; Broadus, Allison

    2013-01-01

    Rural schools are often overlooked in educational research. At least one in five children in the United States attends a rural school and one-third of all public schools are located in rural areas. Research on the effects of teacher education in rural schools on teacher candidates and the rural schools themselves is almost nonexistent. This…

  19. The inequity of inpatient services in rural areas and the New-Type Rural Cooperative Medical System (NRCMS) in China: repeated cross sectional analysis.

    Science.gov (United States)

    Pan, Bingbing; Towne, Samuel D; Chen, Yuxing; Yuan, ZhaoKang

    2017-06-01

    The main aim of the New-type Rural Cooperative Medical System (NRCMS) put into effect in 2003 was to reduce financial barriers in accessing health care services among vulnerable populations. The aim of this study was to assess the association between NRCMS and income related inequality in hospital utilization among rural inhabitants in Jiangxi Province, China. A multistage stratified random cluster sampling method was adopted to select 1838, 1879, and 1890 households as participants in 2003/2004, 2008 and 2014, respectively. The Erreygers Concentration index (EI) of two measures of hospital inpatient care including admission to hospital and hospital avoidance, were calculated to measure income-related inequality. The decomposition of the EI was performed to characterize the contributions of socioeconomic and need factors to the measured inequality. An affluent-focused (pro-rich) inequity was observed for hospital admission adjusting for need factors over time. The level of inequity for hospital admission decreased dramatically, while hospital avoidance decreased marginally, and with a high value (EI, -0.0176) in 2008. The implementation of the NRCMS was associated with decreased inequity in 2008 and in 2014, but the associations were limited. Income contributed the most to the inequality of hospital utilization each year. The coverage of the NRCMS expanded to cover nearly all rural inhabitants in Jiangxi province by 2014 and was associated with a very small reduction in inequalities in admission to hospital. In order to increase equitable access to health care, additional financial protections for vulnerable populations are needed. Improving the relatively low level of medical services in township hospitals, and low rate of reimbursement and financial assistance with the NRCMS is recommended. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e

  20. The Poor Rural Areas That Must Support The City of the Future

    Directory of Open Access Journals (Sweden)

    Ron Wimberley

    2006-11-01

    Full Text Available Cities have exported poverty to rural areas, yet we forget that cities do not exist in nature. Sociologists and others often seem to forget that. Cities are a product of social behavior. Neither do cities exist in self-sustained vacuums unto themselves. Cities are dependent and interdependent with rural areas and through forms of social interaction that link people living in urban and rural areas. While cities are a product of social behavior, they are dependent upon natural resources. It is from rural areas that the natural resources which sustain cities are produced and extracted.

  1. Rural Poultry Production in Ondo South Senatorial District Area of ...

    African Journals Online (AJOL)

    Rural Poultry Production in Ondo South Senatorial District Area of Ondo State, Nigeria. ... African Journal of Livestock Extension ... The need to obtain baseline information on rural poultry with respect to their population and the production potentials of the indigenous chicken under the village conditions in Ondo Area formed ...

  2. Water Service Areas - Public Water Supplier's (PWS) Service Areas

    Data.gov (United States)

    NSGIC Education | GIS Inventory — Boundaries of current public water supplier's (PWS) service areas. This data set contains the present service area boundary of the water system and does not contain...

  3. ECONOMIC REVIVAL OF THE RURAL AREA THROUGH TOURISM

    Directory of Open Access Journals (Sweden)

    Gheorghe Pribeanu

    2012-01-01

    Full Text Available Romania’s entry on the european coordonates imposes a continue economical development. The achievement of this target implies the use of the existing methods and the capitalization of all opportunities at best parameters. In this way, optimizing the economical results which appeared as a result of the practice of a bio agriculture (the attainment of natural products in enviroments untouched by the destructive effects of pollution and also the profesionalistic capitalization of the turistic potential, in all its forms, will lead to a certain economical efficiency.Turistic services extent and diversify according to the socio-economical changes and their favourable area of development. The the appearance of the „rural tourism” and „agrotourism” terms enriches the whole notion of „tourism” by diversifying it’s forms of expression.

  4. Implementing Housing First in Rural Areas: Pathways Vermont

    Science.gov (United States)

    Henwood, Benjamin F.; Melton, Hilary; Shin, Soo-Min; Lawrence-Gomez, Rebeka; Tsemberis, Sam

    2013-01-01

    The benefits of Pathways Housing First in addressing chronic homelessness for persons with severe mental illness have been well established. However, the implementation and effectiveness of such programs in rural areas has yet to be examined. We described the model’s adaptations in Vermont, including the use of hybrid assertive community treatment–intensive case management teams, which consisted of service coordinators with geographically based caseloads (staff/client ratio of 1:20) and regional multidisciplinary specialists. The program’s innovative and widespread inclusion of technology into operations facilitated efficiency and responsiveness, and a pilot telehealth initiative supplemented in-person client visits. The program achieved a housing retention rate of 85% over approximately 3 years, and consumers reported decreased time spent homeless, demonstrating that program adaptations and technological enhancements were successful. PMID:24148038

  5. Defining urban and rural areas: a new approach

    Science.gov (United States)

    Arellano, Blanca; Roca, Josep

    2017-10-01

    The separation between the countryside and the city, from rural and urban areas, has been one of the central themes of the literature on urban and territorial studies. The seminal work of Kingsley Davis [10] in the 1950s introduced a wide and fruitful debate which, however, has not yet concluded in a rigorous definition that allows for comparative studies at the national and subnational levels of a scientific nature. In particular, the United Nations (UN) definition of urban and rural population is overly linked to political and administrative factors that make it difficult to use data adequately to understand the human settlement structure of different countries. The present paper seeks to define a more rigorous methodology for the identification of rural and urban areas. For this purpose it uses the night lights supplied by the SNPP satellite, and more specifically by the VIIRS sensor for the determination of the urbanization gradient, and by means of the same construct a more realistic indicator than the statistics provided by the UN. The arrival of electrification to nearly every corner of the planet is certainly the first and most meaningful indicator of artificialization of land. In this sense, this paper proposes a new methodology designed to identify highly impacted (urbanized) landscapes worldwide based on the analysis of satellite imagery of night-time lights. The application of this methodology on a global scale identifies the land highly impacted by light, the urbanization process, and allows an index to be drawn up of Land Impacted by Light per capita (LILpc) as an indicator of the level of urbanization. The methodology used in this paper can be summarized in the following steps: a) a logistic regression between US Urban Areas (UA), as a dependent variable, and night-time light intensity, as an explanatory variable, allows us to establish a nightlight intensity level for the determination of Areas Highly Impacted by Light (AHIL); b) the delimitation of

  6. An experiment in using open-text comments from the Australian Rural Mental Health Study on health service priorities.

    Science.gov (United States)

    Rich, Jane; Handley, Tonelle; Inder, Kerry; Perkins, David

    2018-02-01

    Conducting research in rural and remote areas is compounded by challenges associated with accessing relatively small populations spread over large geographical areas. Open-ended questions provided in a postal survey format are an advantageous way of including rural and remote residents in research studies. This method means that it is possible to ask for in-depth perspectives, from a large sample, in a relatively resource-efficient way. Such questions are frequently included in population-based surveys; however, they are rarely analysed. The aim of this article is to explore word cloud analysis, to evaluate the utility of automated programs to supplement the analysis of open-ended survey responses. Participants from the Australian Rural Mental Health Study completed the open-ended question 'What health services would you like to see the local health district providing that are currently not available in your area?' A word cloud analysis was then undertaken using the program Wordle; the size of the word in the cloud illustrates how many times, in proportion to other words, a word has appeared in responses, and provides an easily interpretable visual illustration of research results. In total, 388 participants provided a response to the free-text question. Using the word cloud as a visual guide, key words were identified and used to locate relevant quotes from the full open-text responses. \\'Mental health\\' was the most frequent request, cited by 81 people (20.8%). Following mental health, requests for more \\'specialists\\' (n=59) and \\'services\\' (n=53) were the second and third most frequent responses respectively. Visiting specialists were requested by multiple respondents (n=14). Less frequent requests illustrated in the word cloud are important when considering representatives from smaller population groups such as those with specific health needs or conditions including \\'maternity\\' services (n=13), \\'cancer\\' (n=10), \\'drug and alcohol\\' services

  7. Urban versus rural populations' views of health care in Scotland.

    Science.gov (United States)

    Farmer, Jane; Hinds, Kerstin; Richards, Helen; Godden, David

    2005-10-01

    To compare satisfaction with, and expectations of, health care of people in rural and urban areas of Scotland. Questions were included in the 2002 Scottish Social Attitudes Survey (SSAS). The Scottish House-hold Survey urban-rural classification was used to categorize locations. A random sample of 2707 people was contacted to participate in a face-to-face interview and a self-completion questionnaire survey. SPSS (v.10) was used to analyse the data. Relationships between location category and responses were explored using logistic regression analysis. In all, 1665 (61.5%) interviews were conducted and 1507 (56.0%) respondents returned self-completion questionnaires. Satisfaction with local doctors and hospital services was higher in rural locations. While around 40% of those living in remote areas thought A&E services too distant, this did not rank as a top priority for health service improvement. This could be due to expectations that general practitioners would assist in out-of-hours emergencies. Most Scots thought services should be good in rural areas even if this was costly, and that older people should not be discouraged from moving to rural areas because of their likely health care needs. In all, 79% of respondents thought that care should be as good in rural as urban areas. Responses to many questions were independently significantly affected by rural/urban location. Most Scots want rural health care to continue to be good, but the new UK National Health Service (NHS) general practitioner contract and service redesign will impact on provision. Current high satisfaction, likely to be due to access and expectations about local help, could be affected. This study provides baseline data on attitudes and expectations before potential service redesign, which should be monitored at intervals in future.

  8. A Comparative Analysis of the Environmental Benefits of Drone-Based Delivery Services in Urban and Rural Areas

    OpenAIRE

    Jiyoon Park; Solhee Kim; Kyo Suh

    2018-01-01

    Unmanned aerial vehicles (UAV, drones) used as delivery vehicles have received increasing attention due to their mobility and accessibility to remote areas. The purpose of this study is to evaluate the environmental impacts of drone versus motorcycle delivery and to compare the expected environmental improvements due to drone delivery in urban and rural areas. In addition, the potential environmental contributions of electric motorcycles were assessed to determine the effects of introducing t...

  9. Perceptions of newly admitted undergraduate medical students on experiential training on community placements and working in rural areas of Uganda

    Directory of Open Access Journals (Sweden)

    Tugumisirize Joshua

    2010-06-01

    Full Text Available Abstract Background Uganda has an acute problem of inadequate human resources partly due to health professionals' unwillingness to work in a rural environment. One strategy to address this problem is to arrange health professional training in rural environments through community placements. Makerere University College of Health Sciences changed training of medical students from the traditional curriculum to a problem-based learning (PBL curriculum in 2003. This curriculum is based on the SPICES model (student-centered, problem-based, integrated, community-based and services oriented. During their first academic year, students undergo orientation on key areas of community-based education, after which they are sent in interdisciplinary teams for community placements. The objective was to assess first year students' perceptions on experiential training through community placements and factors that might influence their willingness to work in rural health facilities after completion of their training. Methods The survey was conducted among 107 newly admitted first year students on the medical, nursing, pharmacy and medical radiography program students, using in-depth interview and open-ended self-administered questionnaires on their first day at the college, from October 28-30, 2008. Data was collected on socio-demographic characteristics, motivation for choosing a medical career, prior exposure to rural health facilities, willingness to have part of their training in rural areas and factors that would influence the decision to work in rural areas. Results Over 75% completed their high school from urban areas. The majority had minimal exposure to rural health facilities, yet this is where most of them will eventually have to work. Over 75% of the newly admitted students were willing to have their training from a rural area. Perceived factors that might influence retention in rural areas include the local context of work environment, support from

  10. A Study of the Application of Big Data in a Rural Comprehensive Information Service

    Directory of Open Access Journals (Sweden)

    Leifeng Guo

    2015-05-01

    Full Text Available Big data has attracted extensive interest due to its potential tremendous social and scientific value. Researchers are also trying to extract potential value from agriculture big data. This paper presents a study of information services based on big data from the perspective of a rural comprehensive information service. First, we introduce the background of the rural comprehensive information service, and then we present in detail the National Rural Comprehensive Information Service Platform (NRCISP, which is supported by the national science and technology support program. Next, we discuss big data in the NRCISP according to data characteristics, data sources, and data processing. Finally, we discuss a service model and services based on big data in the NRCISP.

  11. Effects of modifiable prehospital factors on survival after out-of-hospital cardiac arrest in rural versus urban areas.

    Science.gov (United States)

    Mathiesen, Wenche Torunn; Bjørshol, Conrad Arnfinn; Kvaløy, Jan Terje; Søreide, Eldar

    2018-04-18

    The modifiable prehospital system factors, bystander cardiopulmonary resuscitation (CPR), emergency medical services (EMS), response time, and EMS physician attendance, may affect short- and long-term survival for both rural and urban out-of-hospital cardiac arrest (OHCA) patients. We studied how such factors influenced OHCA survival in a mixed urban/rural region with a high survival rate after OHCA. We analyzed the association between modifiable prehospital factors and survival to different stages of care in 1138 medical OHCA patients from an Utstein template-based cardiac arrest registry, using Kaplan-Meier type survival curves, univariable and multivariable logistic regression and mortality hazard plots. We found a significantly higher probability for survival to hospital admission (OR: 1.84, 95% CI 1.43-2.36, p rural group. In patients receiving bystander CPR before EMS arrival, the odds of survival to hospital discharge increased more than threefold (OR: 3.05, 95% CI 2.00-4.65, p rural areas, patients with EMS physician attendance had an overall better survival to hospital discharge (survival probability 0.17 with EMS physician vs. 0.05 without EMS physician, p = 0.019). Adjusted for modifiable factors, the survival differences remained. Overall, OHCA survival was higher in urban compared to rural areas, and the effect of bystander CPR, EMS response time and EMS physician attendance on survival differ between urban and rural areas. The effect of modifiable factors on survival was highest in the prehospital stage of care. In patients surviving to hospital admission, there was no significant difference in in-hospital mortality or in 1 year mortality between OHCA in rural versus urban areas.

  12. Emotional exhaustion and job satisfaction of tour guides in rural areas

    Directory of Open Access Journals (Sweden)

    Anđelković Željko

    2017-01-01

    Full Text Available The purpose of this study was to determinate the job satisfaction and emotional exhaustion of tour guides in rural areas and to show how these two concepts are related to each other. A total of 102 tour guides, who lead tours or have experience in leading tours in rural areas took part in the questionnaire and the results were given and processed in SPSS version 17. Tour guides have a great importance in interpretation of rural areas as well as a significant role in presenting local customs and products in rural tourism. Exploring their satisfaction but also emotional exhaustion is of paramount importance for maintaining their excellence in interpretation of these areas. The results indicate that job satisfaction is still not on satisfying level, while emotional exhaustion is under acceptable limits. The results also showed that there is a negative connection between these two concepts. The obtained data should be beneficial not only to tour-operators but also to other tourism-related companies dealing with FDA (Front Desk Activities and employees in rural tourism: the data about job satisfaction and emotional exhaustion of tour guides can be used in developing management and work motivation strategies. The profound insight in job satisfaction and emotional exhaustion is important in order to achieve business excellence of tour guides in rural areas.

  13. Implementation of the principles of primary health care in a rural area of South Africa

    Directory of Open Access Journals (Sweden)

    Surona Visagie

    2014-02-01

    Full Text Available Background: The philosophy of primary healthcare forms the basis of South Africa’s health policy and provides guidance for healthcare service delivery in South Africa. Healthcare service provision in South Africa has shown improvement in the past five years. However, it is uncertain as to whether the changes have reached rural areas and if primary healthcare is implemented successfully in these areas. Objectives: The aim of this article is to explore the extent to which the principles of primary healthcare are implemented in a remote, rural setting in South Africa. Method: A descriptive, qualitative design was implemented. Data were collected through interviews and case studies with 36 purposively-sampled participants, then analysed through Interpretative Phenomenological Analysis. Results: Findings indicated challenges with regard to client-centred care, provision of health promotion and rehabilitation, the way care was organised, the role of the doctor, healthworker attitudes, referral services and the management of complex conditions. Conclusion: The principles of primary healthcare were not implemented successfully. The community was not involved in healthcare management, nor were users involved in their personal health management. The initiation of a community-health forum is recommended. Service providers, users and the community should identify and address the determinants of ill health in the community. Other recommendations include the training of service managers in the logistical management of ensuring a constant supply of drugs, using a Kombi-type vehicle to provide user transport for routine visits to secondary- and tertiary healthcareservices and increasing the doctors’ hours.

  14. An integrated village maternity service to improve referral patterns in a rural area in West-Java.

    Science.gov (United States)

    Alisjahbana, A; Williams, C; Dharmayanti, R; Hermawan, D; Kwast, B E; Koblinsky, M

    1995-06-01

    The Regionalization of Perinatal Care, an intervention study carried out in Tanjungsari, a subdistrict in rural West Java, aimed to develop a comprehensive maternal health program to improve maternal and perinatal health outcomes. The main inputs included training at all levels of the health care system (informal and formal) and the establishment of birthing homes in villages to make services more accessible. Special attention was given to referral, transportation, communication and appropriate case management, A social marketing program was conducted to inform people of the accessible birthing homes for clean delivery, located near the women, and with better transportation and communications to referral facilities should complications arise. The study design was longitudinal, following all pregnant women from early pregnancy until 42 days postpartum in an intervention and a comparison area. The population was +/- 90,000 in the intervention area and 40,000 in the comparison area. Inclusion criteria were all mother and infant units delivered between June 1st, 1992 and May 31st, 1993. Analysis showed the following results: Most women sought antenatal care (> 95%). In Tanjungsari, nearly 90% sought such care from professional providers as versus 75% in the control area of Cisalak. Most women with bleeding or bleeding and edema during pregnancy sought professional assistance in both the study and control areas. However, fever for more than 3 days received more attention in the study area versus control area (93 vs. 69%). Greater than 85% of deliveries in both areas were conducted by TBAs. However, in the study area, nearly one-third of those with intrapartum complications (17%) delivered in a health facility compared to one-tenth in the control area. This meant a hospital delivery, primarily with assistance of a doctor or doctor/midwife combination. Overall referral rates by TBAs were low -13% of women with complications in Tanjungsari and 6% in Cisalak. More women

  15. An estimation of tourism dependence in French rural areas

    OpenAIRE

    Dissart, Jean-Christophe; Aubert, Francis; Truchet, Stéphanie; European Regional Science Association; Association de Science Régionale de Langue Française

    2007-01-01

    This paper intends to estimate the importance of tourism in the economy of rural areas. Considering previous analyses of rural dynamics, this paper 1) focuses on tourism activity, 2) analyzes the situation of Functional Economic Areas, and 3) takes into account socioeconomic indicators as well as landscape features. Based on secondary data, resource like regions are defined, the local share of tourism employment is estimated, stylized facts regarding tourism indicators by cluster are produced...

  16. Using mobile clinics to deliver HIV testing and other basic health services in rural Malawi.

    Science.gov (United States)

    Lindgren, T G; Deutsch, K; Schell, E; Bvumbwe, A; Hart, K B; Laviwa, J; Rankin, S H

    2011-01-01

    The majority of Malawians are impoverished and primarily dependant on subsistence farming, with 85% of the population living in a rural area. The country is highly affected by HIV and under-resourced rural health centers struggle to meet the government's goal of expanding HIV testing, antiretroviral treatment, and other basic services. This report describes the work of two four-wheel drive mobile clinics launched in 2008 to fill an identified service gap in the remote areas of Mulanje District, Malawi. The program was developed by an international non-governmental organization, Global AIDS Interfaith Alliance (GAIA), and the Mulanje District Health Office, with funding from the Elizabeth Taylor HIV/AIDS Foundation. The clinics provide: (1) rapid HIV testing and treatment referral; (2) diagnosis and treatment of malaria; (3) sputum collection for TB screening; (4) diagnosis and treatment of sexually transmitted and opportunistic infections; and (5) pre-natal care. The clinic vehicles provide medical supplies and personnel (a clinical officer, nurse, and nurse aide) to set up clinics in community buildings such as churches or schools. In such a project, the implementation process and schedule can be affected by medication, supply chain and infrastructural issues, as well as governmental and non-governmental requirements. Timelines should be sufficiently flexible to accommodate unexpected delays. Once established, service scheduling should be flexible and responsive; for instance, malaria treatment rather than HIV testing was most urgently needed in the season when these services were launched. Assessing the impact of healthcare delivery in Malawi is challenging. Although mobile clinic and the government Health Management Information System (HMIS) data were matched, inconsistent variables and gaps in data made direct comparisons difficult. Data collection was compromised by the competing demand of high patient volume; however, rather than reducing the burden on

  17. Wind energy for water pumping in rural areas of China

    International Nuclear Information System (INIS)

    Dechang, S.

    1991-01-01

    After 1980, as the supply of conventional energy has not been able to follow the tremendous increase of the production demand in rural areas of China, a renewed interest for the application of wind energy was shown in many places. Therefore, the Chinese government began to pay more attention to wind energy utilization in rural areas. During the last ten years, several R ampersand D tasks for new modern wind pumps were carried out. Among them, three projects are the developments of wind energy screw pump systems (FDG-5 wind pump, FDG-7 wind pump and TFS-5 wind pump). At present, 50 of these wind pumps are working successfully in the rural areas for farmland drainage, salt ponds water lifting and aquatic product breeding, etc. The field tests show that these wind energy screw pump systems are suitable for low lifting head (< 3 meter) and large water flow (50 m/hr to 120 m/hr) operation in the coastal areas. Because the wind energy resource in many rural areas is sufficient for attractive application of wind pumps, and the supply of electricity as well as fuels is insufficient in these areas, the wind pumps will be spread on a rather large scale in the near future. 7 figs., 2 tabs., 3 refs

  18. The impact of air quality conditioned by emission of pollutants to the development of rural tourism and potentials of rural areas

    Directory of Open Access Journals (Sweden)

    Cvijanović Drago

    2017-01-01

    Full Text Available Significant potentials for tourism development in Serbia are related to rural areas. Rural development, on its basis, includes the agrarian, but also the non-agrarian sector in rural areas, thus encompassing every vital component of the development of rural areas. This paper is, following the relevant theoretical positions, focused on key issues in the field of air quality impacts caused by the emission of pollutants to the development of rural tourism and the potentials of rural areas. These are primarily the following issues: which are the criteria for assessing air quality, or what are the limit values of the parameters for the protection of human health, and what is the trend of air quality by zones and agglomerations and what is the percentage of the population potentially exposed to concentrations of pollutants above the reference level. The mentioned topic is analyzed for the period 2012-2015. Analysis of the results of the degree of emission of suspended particles by zones and agglomerations in Serbia is presented correlatively in conclusion with concluding reviews on the existing ecological potential for the development of the basic rural areas in Serbia - Vojvodina, which makes up 28% of the total area of Serbia, Central Serbia, which consists of 29% of the total area of Serbia and South Serbia, which accounts for 44% of the total area of Serbia.

  19. SMALL FARMERS FROM RURAL AREAS ATTITUDE ON ORGANIC FOOD

    Directory of Open Access Journals (Sweden)

    Ron#537;ca Mihai Ioan

    2012-07-01

    Full Text Available This paper is one of the few marketing research done in rural areas of attitudes towards green products. Even if the subject is generally treated at the international level, Romania has an important specific is to be taken into account in the European area. Size of agricultural holdings and their degree of technology do not have the desired agricultural economic efficiency of modern economies. But by applying marketing techniques and by approaching customer needs, the agricultural sector in Romania can develop in another direction no longer going through the business model of major West European farmers. We are referring here to transition to a agriculture on small areas, intensively exploited and ecology and a system of distributed in the markets with a big search for such products. But he must know how people in rural areas see these green products and how they are trained to understand the concepts of green marketing and marketing organic products. These issues have been dealt with in the first part of the work. The second part of this paper aims to describe the attitude of small agricultural producers towards organic products and the degree in which they are willing to go to such a production. Research is based on a survey an explorer in two rural areas of Romania one at the mountain and the other in lowlands and shows the degree of adaptation for small producers to new market requirements. Results have been contradictory. Some of them have confirmed the assumptions, namely the opening to such a grown for, and others have shown a much greater degree of the use of chemical compounds in agriculture than expected. Also the degree of taking the initiative in rural areas was an issue that came out at a level lower than expected. This is a worrying conclusion but worth being taken into account. This research gives the image concept in rural areas being the starting point for further research and strategies which to propose turning Romania into a

  20. Case studies in rural recycling. Public service report series

    Energy Technology Data Exchange (ETDEWEB)

    Cosper, S.D.; Hallenbeck, W.H.; Brenniman, G.R.

    1994-02-01

    Due to state planning requirements and federal landfill regulations, solid waste management in rural areas (particularly recycling) has received much attention in recent years. The growth of recycling during the 1980s occurred mainly in urban and suburban areas. Therefore, rural recycling is still a relatively new enterprise. This report presents several rural recycling case studies from Colorado, Illinois, Indiana, Iowa, Minnesota, Tennessee, and Ontario, Canada to provide examples of successes and problems. This report also discusses the current issues of cooperative marketing of recyclables and municipal solid waste flow control. With respect to recycling, a rural region does not have ready access to markets for collected materials and has difficulty in generating easily marketable quantities of recyclables. (Copyright (c) 1994 The Board of Trustees of the University of Illinois.)

  1. Factors affecting access to healthcare services by intermarried Filipino women in rural Tasmania: a qualitative study.

    Science.gov (United States)

    Hannah, Chona T; Lê, Quynh

    2012-10-01

    Access to health care services is vital for every migrant's health and wellbeing. However, migrants' cultural health beliefs and views can hinder their ability to access available services. This study examined factors affecting access to healthcare services for intermarried Filipino women in rural Tasmania, Australia. A qualitative approach using semi-structured interviews was employed to investigate the factors affecting access to healthcare services for 30 intermarried Filipino women in rural Tasmania. The study used grounded theory and thematic analysis for its data analysis. Nvivo v8 (www.qsrinternational.com) was also used to assist the data coding process and analysis. Five influencing factors were identified: (1) language or communication barriers; (2) area of origin in the Philippines; (3) cultural barriers; (4) length of stay in Tasmania; and (5) expectations of healthcare services before and after migration. Factors affecting intermarried Filipino women in accessing healthcare services are shaped by their socio-demographic and cultural background. The insights gained from this study are useful to health policy-makers, healthcare professionals and to intermarried female migrants. The factors identified can serve as a guide to improve healthcare access for Filipino women and other migrants.

  2. Implementation of a national, nurse-led telephone health service in Scotland: assessing the consequences for remote and rural localities.

    Science.gov (United States)

    Roberts, A; Heaney, D; Haddow, G; O'Donnell, C A

    2009-01-01

    Internationally, nurse-led models of telephone triage have become commonplace in unscheduled healthcare delivery. Various existing models have had a positive impact on the delivery of healthcare services, often reducing the demand on accident and emergency departments and staff workload 'out of hours'. Our objective was to assess whether a model of centralised nurse telephone triage (NHS 24, introduced in Scotland in 2001) was appropriate for remote and rural areas. In this qualitative study the views and perspectives of health professionals across Scotland are explored. Thirty-five participants were purposively selected for interviews during 2005. Two types of interview were conducted: detailed, semi-structured, face-to-face interviews with key stakeholders of NHS 24; and briefer telephone interviews with partners from NHS Boards across Scotland. A constant comparative approach was taken to analysis. Ethical approval for the study was obtained from the Scottish Multi-site Research Ethics Committee. The findings are comparable with other research studies of new service developments in remote and rural health care. The rigidity of the centralised triage model introduced, the need to understand variation of health service delivery, and the importance of utilising local professional knowledge were all key issues affecting performance. Remote and rural complexities need to be considered when designing new healthcare services. It is suggested that new health service designs are 'proofed' for remote and rural complexities. This study highlights that a centralised nurse-led telephone triage model was inappropriate for remote and rural Scotland, and may not be appropriate for all geographies and circumstances.

  3. Aging and quality of life of elderly people in rural areas.

    Science.gov (United States)

    Garbaccio, Juliana Ladeira; Tonaco, Luís Antônio Batista; Estêvão, Wilson Goulart; Barcelos, Bárbara Jacome

    2018-01-01

    To evaluate the quality of life and health of elderly in rural areas of Minas Gerais State's center-west. Cross-sectional study, in four municipalities of Minas Gerais State, by interviewing elderly people. Associations between socio-demographic and quality of life variables were tested, separated into "satisfactory"/"unsatisfactory" with values from the median of positive answers. It was used the chi-square test, Fisher's test and regression. 182 elderly answered the questions and showed a relation with the "satisfactory" quality of life - bivariate (p cognitive aspect, access to services, goods, habits, but awareness must be constant due to their weakness.

  4. Rural Satellite Services--Getting the Mixture Right.

    Science.gov (United States)

    Stahmer, Anna

    1987-01-01

    This discussion of satellite services for education and rural development in less developed countries emphasizes the importance of adequate telephone systems to support development programs. Programs in Peru, Indonesia, and the West Indies are highlighted, and current and future problems in planning satellite systems are reviewed. (LRW)

  5. Sustainable sewerage servicing options for peri-urban areas with failing septic systems.

    Science.gov (United States)

    Sharma, A K; Tjandraatmadja, G; Grant, A L; Grant, T; Pamminger, F

    2010-01-01

    The provision of water and wastewater services to peri-urban areas faces very different challenges to providing services to cities. Sustainable solutions for such areas are increasingly being sought, in order to solve the environmental and health risks posed by failing septic systems. These solutions should have the capability to reduce potable water demand, provide fit for purpose reuse options, and minimise impacts on the local and global environment. A methodology for the selection of sustainable sewerage servicing systems and technologies is presented in this paper. This paper describes the outcomes of applying this methodology to a case study in rural community near Melbourne, Australia, and describes the economic and environmental implications of various sewerage servicing options. Applying this methodology has found that it is possible to deliver environmental improvements at a lower community cost, by choosing servicing configurations not historically used by urban water utilities. The selected solution is currently being implemented, with the aim being to generate further transferable learnings for the water industry.

  6. Distribution of atmospheric particulate matter (PM) in rural field, rural village and urban areas of northern China

    International Nuclear Information System (INIS)

    Li, Wei; Wang, Chen; Wang, Hongqijie; Chen, Jiwei; Yuan, Chenyi; Li, Tongchao; Wang, Wentao; Shen, Huizhong; Huang, Ye; Wang, Rong; Wang, Bin; Zhang, Yanyan; Chen, Han; Chen, Yuanchen; Tang, Jianhui; Wang, Xilong; Liu, Junfeng; Coveney, Raymond M.; Tao, Shu

    2014-01-01

    Atmospheric PM 10 were measured for 12 months at 18 sites along a 2500 km profile across northern China. Annual mean PM 10 concentrations in urban, rural village, and rural field sites were 180 ± 171, 182 ± 154, and 128 ± 89 μg/m 3 , respectively. The similarities in PM 10 concentrations between urban and rural village sites suggest that strong localized emissions and severe contamination in rural residential areas are derived from solid fuels combustion in households. High PM 10 concentrations in Wuwei and Taiyuan were caused by either sandstorms or industrial activities. Relatively low PM 10 concentrations were observed in coastal areas of Dalian and Yantai. Particulate air pollution was much higher in winter and spring than in summer and fall. Multiple regression analysis indicates that 35% of the total variance can be attributed to sandstorms, precipitation and residential energy consumption. Over 40% of the measurements in both urban and rural village areas exceeded the national ambient air quality standard. Highlights: • Spatial distribution of PM 10 concentrations in northern China was investigated. • High levels of PM 10 in rural villages were caused by solid fuel emission. • A strong seasonality with high levels of PM 10 in spring and winter was observed. • Influence of sandstorm, energy consumption, and precipitation were evaluated. • Over 40% of the measurements exceeded the national ambient air quality standard. -- PM 10 concentrations in rural villages of China were comparable with those in the cities, indicating severe air pollution in the rural villages caused by coal and biofuel combustion

  7. Motives for moving to rural, peripheral areas - work, “rural idyll” or “income transfer”

    DEFF Research Database (Denmark)

    Andersen, Hans Skifter; Nørgaard, Helle

    2012-01-01

    Much interest is given to attracting new settlement in rural, peripheral areas due to long-term population loss. The ideal type of settler is identified as families with young children. However, various studies on rural migration show that migrants are a mixed group of young, middle aged and older...... couples and individuals as well as families with children. A large part of the migrants have jobs while other are unemployed or on other types of social welfare. In a Danish context a key hypothesis is that especially welfare recipients and those outside the labor market settle in the countryside due...... to low housing prices. This article explores which groups of people move to rural, peripheral areas and why they chose to do so....

  8. The Utility of Rural and Underserved Designations in Geospatial Assessments of Distance Traveled to Healthcare Services: Implications for Public Health Research and Practice

    Directory of Open Access Journals (Sweden)

    Matthew Lee Smith

    2013-01-01

    Full Text Available Health disparities research in rural populations is based on several common taxonomies identified by geography and population density. However, little is known about the implications of different rurality definitions on public health outcomes. To help illuminate the meaning of different rural designations often used in research, service delivery, or policy reports, this study will (1 review the different definitions of rurality and their purposes; (2 identify the overlap of various rural designations in an eight-county Brazos Valley region in Central Texas; (3 describe participant characteristic profiles based on distances traveled to obtain healthcare services; and (4 examine common profile characteristics associated with each designation. Data were analyzed from a random sample from 1,958 Texas adults participating in a community assessment. K-means cluster analysis was used to identify natural groupings of individuals based on distance traveled to obtain three healthcare services: medical care, dental care, and prescription medication pick-up. Significant variation in cluster representation and resident characteristics was observed by rural designation. Given widely used taxonomies for designating areas as rural (or provider shortage in health-related research, this study highlights differences that could influence research results and subsequent program and policy development based on rural designation.

  9. The utility of rural and underserved designations in geospatial assessments of distance traveled to healthcare services: implications for public health research and practice.

    Science.gov (United States)

    Smith, Matthew Lee; Dickerson, Justin B; Wendel, Monica L; Ahn, Sangnam; Pulczinski, Jairus C; Drake, Kelly N; Ory, Marcia G

    2013-01-01

    Health disparities research in rural populations is based on several common taxonomies identified by geography and population density. However, little is known about the implications of different rurality definitions on public health outcomes. To help illuminate the meaning of different rural designations often used in research, service delivery, or policy reports, this study will (1) review the different definitions of rurality and their purposes; (2) identify the overlap of various rural designations in an eight-county Brazos Valley region in Central Texas; (3) describe participant characteristic profiles based on distances traveled to obtain healthcare services; and (4) examine common profile characteristics associated with each designation. Data were analyzed from a random sample from 1,958 Texas adults participating in a community assessment. K-means cluster analysis was used to identify natural groupings of individuals based on distance traveled to obtain three healthcare services: medical care, dental care, and prescription medication pick-up. Significant variation in cluster representation and resident characteristics was observed by rural designation. Given widely used taxonomies for designating areas as rural (or provider shortage) in health-related research, this study highlights differences that could influence research results and subsequent program and policy development based on rural designation.

  10. Attitude towards working in rural areas: a cross-sectional survey of rural-oriented tuition-waived medical students in Shaanxi, China.

    Science.gov (United States)

    Liu, Jinlin; Zhang, Kun; Mao, Ying

    2018-05-02

    Attracting and recruiting health workers to work in rural areas is still a great challenge in China. The rural-oriented tuition-waived medical education (RTME) programme has been initiated and implemented in China since 2010. This study aimed to examine the attitudes of rural-oriented tuition-waived medical students (RTMSs) in Shaanxi towards working in rural areas and the related influencing factors. A cross-sectional survey was conducted in 2015 among 232 RTMSs in two medical universities from the first group of students enrolled in the RTME programme in Shaanxi. Descriptive and analytical statistics were used for the data analyses. Of the 230 valid responses, 92.6% expressed their intentions of breaking the contract for working in rural township hospitals for 6 years after their graduation under the RTME programme. After the contract expired, only 1.3% intended to remain in the rural areas, 66.5% had no intention of remaining, and 32.2% were unsure. The factors related to a positive attitude among the RTMSs towards working in rural areas (no intention of breaking the contract) included being female, having a mother educated at the level of primary school or below, having a good understanding of the policy, having a good cognition of the value of rural medical work, and being satisfied with the policy. The factors related to a positive attitude of the RTMSs towards remaining in rural areas included being female, having a rural origin, having no regular family monthly income, having a father whose occupation was farmer, having a mother educated at the level of postsecondary or above, having the RTMSs be the final arbiter of the policy choice, having a good understanding of the policy, having a good cognition of the value of rural medical work, and being satisfied with the educational scheme. Related policy makers and health workforce managers may benefit from the findings of this study. Appropriate strategies should be implemented to stimulate the RTMSs

  11. Women Living with HIV in Rural Areas. Implementing a Response using the HIV and AIDS Risk Assessment and Reduction Model

    Directory of Open Access Journals (Sweden)

    Sarah Bandali

    2014-01-01

    Full Text Available The global fight against HIV is progressing; however, women living in rural areas particularly in sub-Saharan Africa (SSA continue to face the devastating consequences of HIV and AIDS. Lack of knowledge and geographical barriers to HIV services are compounded by gender norms often limiting the negotiation of safe sexual practices among women living in rural areas. This paper discusses findings from a qualitative study conducted in rural areas of Mozambique examining factors that influenced women to engage in HIV risk-reduction practices. The findings from this study led to the emergence of an HIV and AIDS risk assessment and reduction (HARAR model, which is described in detail. The model helps in understanding gender-related factors influencing men and women to engage in risk-reduction practices, which can be used as a framework in other settings to design more nuanced and contextual policies and programs.

  12. Analyze of Tourism Development Impacts on the Development of Rural Areas (Case Study: Kesselian County

    Directory of Open Access Journals (Sweden)

    Mohammad Sadegh Ebrahimi Koohbone

    2014-06-01

    Full Text Available Tourism development in rural areas is one of the main strategies to achieve rural development. The aim of this descriptive-analytical study is to analyze the impact of rural tourism in the socio-economic development of rural areas (Kesselian County of Mazandaran province. Data collected using 190 questionnaires determined using Cochrane formula. The validity of the questionnaires were confirmed by Cronbach Alpha equal to 0.796. The results show that there is significant positive relationship between rural tourism and improve in rural household income, health, sewage and waste disposal systems as well as development of rural homes and roads. The factor analysis results show that the best important positive effects of rural tourism in rural areas are infrastructural development, economic development and development of employment; and main negative effects of rural tourism in rural areas are destruction of the business environment, increased of social abnormalities and destruction of cultural environment.

  13. Multipath for Agricultural and Rural Information Services in China

    Science.gov (United States)

    Ge, Ningning; Zang, Zhiyuan; Gao, Lingwang; Shi, Qiang; Li, Jie; Xing, Chunlin; Shen, Zuorui

    Internet cannot provide perfect information services for farmers in rural regions in China, because farmers in rural regions can hardly access the internet by now. But the wide coverage of mobile signal, telephone line, and television network, etc. gave us a chance to solve the problem. The integrated pest management platform of Northern fruit trees were developed based on the integrated technology, which can integrate the internet, mobile and fixed-line telephone network, and television network, to provide integrated pest management(IPM) information services for farmers in rural regions in E-mail, telephone-voice, short message, voice mail, videoconference or other format, to users' telephone, cell phone, personal computer, personal digital assistant(PDA), television, etc. alternatively. The architecture and the functions of the system were introduced in the paper. The system can manage the field monitoring data of agricultural pests, deal with enquiries to provide the necessary information to farmers accessing the interactive voice response(IVR) in the system with the experts on-line or off-line, and issue the early warnings about the fruit tree pests when it is necessary according to analysis on the monitoring data about the pests of fruit trees in variety of ways including SMS, fax, voice and intersystem e-mail.The system provides a platform and a new pattern for agricultural technology extension with a high coverage rate of agricultural technology in rural regions, and it can solve the problem of agriculture information service 'last kilometer' in China. The effectiveness of the system was certified.

  14. [Health and social services used by the rural elderly].

    Science.gov (United States)

    Rubio, Encarnación; Comín, Magdalena; Montón, Gema; Martínez, Tomás; Magallón, Rosa

    2014-01-01

    To describe the use of health and social services, and to analyze the influence of functional capacity for Instrumental Activities of Daily Living (IADL) and other factors in their use. Cross-sectional study in a non-institutionalized population older than 64 years old in a basic rural health area of Zaragoza. use of different health and social services. Main independent variable: functional capacity for IADL according to the Lawton-Brody. Confounding variables: sociodemographic, physical exercise, comorbidity, self-perceived health, walking aids, social resources and economic resources (OARS-MAFQ). The relationship between the use of services and functional capacity for IADL was assessed using crude OR (ORC) and adjusted (adjusted OR) with CI95% by means of multivariate logistic regression models. The use of social and health services increased with age and worse functional capacity for IADL. The increased use of health services was related with bad stage of health, limited social and economic resources, physical inactivity and female. The increased use of home help services was related with limited social resources, low education level and male. Regular physical activity and using walking aids were associated with greater participation in recreational activities. The probability of using social and health services increased in older people with impaired functional capacity for IADL. The specific use of them changed according to differences in health, demographic and contextual features. Copyright © 2013 SEGG. Published by Elsevier Espana. All rights reserved.

  15. TOURIST MOTIVATION FOR RURAL DESTINATIONS

    Directory of Open Access Journals (Sweden)

    Angela BOTEZATU

    2014-04-01

    Full Text Available City daily overexertion impels tourists wish to travel. Rural tourism behavior is determined by a set of motivational factors that makes him appreciate favorable tourist destinations. In order to analyze and assess the opinions and attitudes of tourists in rural areas we realized a market survey, the results being presented in the article below. Future trends, the growth rate of market depend largely on the wishes and intentions of goods or services consumers. This study involves the engagement of a number of 658 respondents, which were interviewed to determine the basic motivations in choosing countryside. The working methods used were analysis, synthesis and questionnaire survey as a research method. Results refer to the following: about 59 percent, spend up to 10% of annual income for vacations and travel, for rural tourism this amount is much lower; the association of the term „rural tourism” in the local tourist mind, oscillates among „a villa” in rural areas or „active vacation” (biking, hiking, riding, swimming or hunting; customer loyalty is one of the goals of marketing activities undertaken in hostels or other travel service providers. In conclusion, we mention that the variety of motivational factors in choosing tourist destinations in rural areas drive this type of tourism.

  16. The important role of springs in South Africa's rural water supply: The case study of two rural communities in South Africa

    CSIR Research Space (South Africa)

    Nkuna, Z

    2014-12-01

    Full Text Available rural communities are geographically located in hard to reach areas due to their dispersed nature and bad terrain. In South Africa, these conditions have made it particularly expensive and difficult for water service providers to effect services to rural...

  17. Neighbourhood Environmental Attributes Associated with Walking in South Australian Adults: Differences between Urban and Rural Areas.

    Science.gov (United States)

    Berry, Narelle M; Coffee, Neil T; Nolan, Rebecca; Dollman, James; Sugiyama, Takemi

    2017-08-26

    Although the health benefits of walking are well established, participation is lower in rural areas compared to urban areas. Most studies on walkability and walking have been conducted in urban areas, thus little is known about the relevance of walkability to rural areas. A computer-assisted telephone survey of 2402 adults (aged ≥18 years) was conducted to determine walking behaviour and perceptions of neighbourhood walkability. Data were stratified by urban (n = 1738) and rural (n = 664). A greater proportion of respondents reported no walking in rural (25.8%) compared to urban areas (18.5%). Compared to urban areas, rural areas had lower walkability scores and urban residents reported higher frequency of walking. The association of perceived walkability with walking was significant only in urban areas. These results suggest that environmental factors associated with walking in urban areas may not be relevant in rural areas. Appropriate walkability measures specific to rural areas should be further researched.

  18. Recreating of rurality around the totoro forest in the outer fringe of tokyo metropolitan area : the spirituality of rurality

    OpenAIRE

    Kikuchi, Toshio; Obara, Norihiro

    2005-01-01

    In this paper we made a point of rural land use and its conservation as the reflection of rurality in outer fringes, and discussed about recreating of rurality with utilising its conservation activities and the spirituality. In Sayama hill region of Tokyo metropolitan area, restructuring of rural land use and recreating rurality have been practised with conservation and maintenance activities in the Totoro forest. Although rural and urban residents think about those activities and their parti...

  19. Why is child malnutrition lower in urban than rural areas?

    OpenAIRE

    Smith, Lisa C.; Ruel, Marie T.; Ndiaye, Aida

    2004-01-01

    "While ample evidence documents that urban children generally have better nutritional status than their rural counterparts, recent research suggests that urban malnutrition is on the rise. The environment, choices, and opportunities of urbanites differ greatly from those of rural dwellers' from employment conditions to social and family networks to access to health care and other services. Given these differences, understanding the relative importance of the various determinants of child maln...

  20. Teenagers in Rural Areas Faced With Organ Donation and Transplantation.

    Science.gov (United States)

    Febrero, B; Almela, J; Ríos, A; Ros, I; Pérez-Sánchez, B; Martínez-Alarcón, L; Ruiz-Carreño, P; Ferreras, D; Ramírez, P; Parrilla, P

    2018-03-01

    In rural areas it is common to find unfavorable attitudes toward organ donation, and therefore it is important to find out the attitude and profile of new generations for improving predisposition to organ donation in these areas. Our objective was to analyze the attitude toward organ donation and the related variables of teenagers in a rural area. Students in the final year of compulsory education (mostly 15-16 years of age) were selected from secondary schools in a rural area in southeastern Spain (n = 319; population density donating their organs, 30% (n = 90) were undecided, and 5% (n = 16) were against. Attitude toward the donation of one's own organs was related with sex (P = .015), previous experience of organ donation or transplantation (P = .046), comment on the topic of organ donation within the family (P = .003; odds ratio 2.155), knowing one's mother's opinion about the matter (P = .021), knowing the correct concept of brain death (P = .012; odds ratio 2.076), and religion (P = .014). A favorable attitude of teenagers in rural areas toward organ donation is slightly higher than in the adult population and is determined by many psychosocial variables, above all family discussion about organ donation and transplantation and correct knowledge of the brain death concept. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. The development of rural area residence based on participatory planning case study: A rural residential area of Pucungrejo village, Magelang through "neighborhood development" program

    Science.gov (United States)

    KP, R. M. Bambang Setyohadi; Wicaksono, Dimas

    2018-03-01

    The poverty is one of the prevailing problems in Indonesia until now. Even a change of the era of governance has not succeeded in eradicating the problem of poverty. The program of poverty alleviation program has always been a focus in the budget allocation in all era of leadership in Indonesia. Those programs were strategic because it prepared the foundation of community self-reliance in the form of representative, entrenched and conducive community leadership institutions to develop of social capital of society in the future. Developing an area of the village requires an integrated planning (Grand Design) to figure out the potential and the problems existing in the rural area as well as the integration of the rural area surrounding. In addition, the grand design needs to be synchronized to the more comprehensive spatial plan with a hierarchical structure such as RTBL, RDTRK / RRTRK, RTRK, and RTRW. This rural area management plan can be oriented or refer to the pattern developed from neighborhood Development program which is part of the PNPM Mandiri program. The neighborhood development program is known as residential area development plan whose process involves of the entire community. Therefore, the regional development up to the scale of the environment requires the planning phase. Particularly, spatial planning which emphasizes the efforts to optimize sectorial development targets to be integrated into an integrated development process must be conducted, in addition to taking into consideration the opportunities, potentials and limitations of the resources, the level of interconnection with the central government within the district and between sub-districts and rural areas.

  2. Social Innovations in the Field of Wastewater Treatment in Rural Areas

    Directory of Open Access Journals (Sweden)

    Eymontt Andrzej

    2014-12-01

    Full Text Available In order to meet social needs and create new social relations, the EU Commission classified under the concept of social innovations, development and implementation of new ideas (products, services, models. In rural areas, this kind of social needs is represented among others by the need of solving the issue of domestic wastewater treatment. The paper describes the imple-mentation of sewerage development program in Poland, as well as problems derived from large value variation of factors encoun-tered characterising the domestic sewage contamination. In view of the current state, the environmental risks due to improper use of domestic wastewater treatment technologies were specified.

  3. Rural Areas: The Real Home of the Nigerian Economy

    Directory of Open Access Journals (Sweden)

    Raji Abdullateef

    2017-10-01

    Full Text Available The current troubles facing the Nigerian economy seem insurmountable. Should we speak of the current recession or the oil crash experienced in the international market? Should the case of oil-pipe vandalization as well as that of insurgency be breached? We could as well debate on the fall of the naira as against the US dollars and other recognized currencies in the international market. This could go on and on. It is as a consequence of this that this study tried to look at the central position of rural communities in finding lasting solutions to these economic woes. The utilitarian theory was employed in examining the phenomenon. The study revealed that rural areas can go a long way to advance the Nigerian economy if properly taken care of but if the current underuse of rural resources continues, the economy could be derailed. It is therefore recommended that renewed efforts should be made to explore the resources available in rural areas in order to tremendously increase the wealth of the nation as soon as possible.

  4. Effect of Outsourced Pharmacies of Rural Healthcare Centers on Service Quality in Abharand Soltanieh Counties

    Directory of Open Access Journals (Sweden)

    Ali Maher

    2016-05-01

    Full Text Available Recently, a part of healthcare services has been assigned to the private sector to increase the quality of medical services, increase patient satisfaction and reduce costs. In this regard, the outsourcing approach has been significantly considered for pharmaceutical services provided by healthcare centers. The purpose of this study is to evaluate the effect of outsourced pharmacies of rural healthcare centers on service quality using structural equations modelling. The methodology used was descriptive using correlation by structural equations modelling. The studied population included those patients who provided their medicines from pharmacies of rural healthcare centers in Abhar and Soltanieh counties. The samples included 384 of these patients. Data was collected by outsourcing and service quality questionnaires. A structural equation modelling was used to analyze data by LISREAL software. Results indicated a positive significant effect of outsourced pharmacies of rural healthcare centers on quality of tangibles, reliability, responsiveness, assurance and empathy. findings emphasize the role of outsourcing on quality of services. Outsourced pharmacies of rural healthcare centers of Abhar and Soltanieh counties lead to improved service quality.

  5. Enhancing transit service in rural areas and native american tribal communities : potential mechanisms to improve funding and service.

    Science.gov (United States)

    2014-08-01

    Primary funding for rural transit comes from federal and state Departments of Transportation (DOTs). However, through numerous : surveys, rural transit providers have cited financial constraints as a major limitation to providing adequate desired tra...

  6. Issues affecting therapist workforce and service delivery in the disability sector in rural and remote New South Wales, Australia: perspectives of policy-makers, managers and senior therapists.

    Science.gov (United States)

    Veitch, Craig; Dew, Angela; Bulkeley, Kim; Lincoln, Michelle; Bundy, Anita; Gallego, Gisselle; Griffiths, Scott

    2012-01-01

    The disability sector encompasses a broad range of conditions and needs, including children and adults with intellectual and developmental disabilities, people with acquired disabilities, and irreversible physical injuries. Allied health professionals (therapists), in the disability sector, work within government and funded or charitable non-government agencies, schools, communities, and private practice. This article reports the findings of a qualitative study of therapist workforce and service delivery in the disability sector in rural and remote New South Wales (NSW), Australia. The aim was to investigate issues of importance to policy-makers, managers and therapists providing services to people with disabilities in rural and remote areas. The project gathered information via semi-structured interviews with individuals and small groups. Head office and regional office policy-makers, along with managers and senior therapists in western NSW were invited to participate. Participants included 12 policy-makers, 28 managers and 10 senior therapists from NSW government agencies and non-government organisations (NGOs) involved in providing services and support to people with disabilities in the region. Information was synthesised prior to using constant comparative analysis within and across data sets to identify issues. Five broad themes resonated across participants' roles, locations and service settings: (1) challenges to implementing policy in rural and remote NSW; (2) the impact of geographic distribution of workforce and clients; (3) workforce issues - recruitment, support, workloads, retention; (4) equity and access issues for rural clients; and (5) the important role of the NGO sector in rural service delivery and support. Although commitment to providing best practice services was universal, policy-related information transfer between organisations and employees was inconsistent. Participants raised some workforce and service delivery issues that are similar to

  7. Policy talk: incentives for rural service among nurses in Ghana.

    Science.gov (United States)

    Kwansah, Janet; Dzodzomenyo, Mawuli; Mutumba, Massy; Asabir, Kwesi; Koomson, Elizabeth; Gyakobo, Mawuli; Agyei-Baffour, Peter; Kruk, Margaret E; Snow, Rachel C

    2012-12-01

    Like many countries in sub-Saharan Africa, Ghana is faced with the simultaneous challenges of increasing its health workforce, retaining them in country and promoting a rational distribution of staff in remote or deprived areas of the country. Recent increases in both public-sector doctor and nurse salaries have contributed to a decline in international out-migration, but problems of geographic mal-distribution remain. As part of a research project on human resources in the Ghanaian health sector, this study was conducted to elicit in-depth views from nursing leaders and practicing nurses in rural and urban Ghana on motivations for urban vs rural practice, job satisfaction and potential rural incentives. In-depth interviews were conducted with 115 nurses selected using a stratified sample of public, private and Christian Health Association of Ghana (CHAG) facilities in three regions of the country (Greater Accra, Brong Ahafo and Upper West), and among 13 nurse managers from across Ghana. Many respondents reported low satisfaction with rural practice. This was influenced by the high workload and difficult working conditions, perception of being 'forgotten' in rural areas by the Ministry of Health (MOH), lack of professional advancement and the lack of formal learning or structured mentoring. Older nurses without academic degrees who were posted to remote areas were especially frustrated, citing a lack of opportunities to upgrade their skills. Nursing leaders echoed these themes, emphasizing the need to bring learning and communication technologies to rural areas. Proposed solutions included clearer terms of contract detailing length of stay at a post, and transparent procedures for transfer and promotion; career opportunities for all cadres of nursing; and benefits such as better on-the-job housing, better mentoring and more recognition from leaders. An integrated set of recruitment and retention policies focusing on career development may improve job satisfaction

  8. Rural:urban inequalities in post 2015 targets and indicators for drinking-water

    Energy Technology Data Exchange (ETDEWEB)

    Bain, R.E.S. [The Water Institute at UNC, University of North Carolina at Chapel Hill, NC (United States); Wright, J.A. [Geography and Environment, University of Southampton, Southampton (United Kingdom); Christenson, E. [The Water Institute at UNC, University of North Carolina at Chapel Hill, NC (United States); Bartram, J.K., E-mail: jbartram@unc.edu [The Water Institute at UNC, University of North Carolina at Chapel Hill, NC (United States)

    2014-08-15

    Disparities in access to drinking water between rural and urban areas are pronounced. Although use of improved sources has increased more rapidly in rural areas, rising from 62% in 1990 to 81% in 2011, the proportion of the rural population using an improved water source remains substantially lower than in urban areas. Inequalities in coverage are compounded by disparities in other aspects of water service. Not all improved sources are safe and evidence from a systematic review demonstrates that water is more likely to contain detectable fecal indicator bacteria in rural areas. Piped water on premises is a service enjoyed primarily by those living in urban areas so differentiating amongst improved sources would exacerbate rural:urban disparities yet further. We argue that an urban bias may have resulted due to apparent stagnation in urban coverage and the inequity observed between urban and peri-urban areas. The apparent stagnation at around 95% coverage in urban areas stems in part from relative population growth – over the last two decades more people gained access to improved water in urban areas. There are calls for setting higher standards in urban areas which would exacerbate the already extreme rural disadvantage. Instead of setting different targets, health, economic, and human rights perspectives, We suggest that the focus should be kept on achieving universal access to safe water (primarily in rural areas) while monitoring progress towards higher service levels, including greater water safety (both in rural and urban areas and among different economic strata)

  9. Rural:urban inequalities in post 2015 targets and indicators for drinking-water.

    Science.gov (United States)

    Bain, R E S; Wright, J A; Christenson, E; Bartram, J K

    2014-08-15

    Disparities in access to drinking water between rural and urban areas are pronounced. Although use of improved sources has increased more rapidly in rural areas, rising from 62% in 1990 to 81% in 2011, the proportion of the rural population using an improved water source remains substantially lower than in urban areas. Inequalities in coverage are compounded by disparities in other aspects of water service. Not all improved sources are safe and evidence from a systematic review demonstrates that water is more likely to contain detectable fecal indicator bacteria in rural areas. Piped water on premises is a service enjoyed primarily by those living in urban areas so differentiating amongst improved sources would exacerbate rural:urban disparities yet further. We argue that an urban bias may have resulted due to apparent stagnation in urban coverage and the inequity observed between urban and peri-urban areas. The apparent stagnation at around 95% coverage in urban areas stems in part from relative population growth - over the last two decades more people gained access to improved water in urban areas. There are calls for setting higher standards in urban areas which would exacerbate the already extreme rural disadvantage. Instead of setting different targets, health, economic, and human rights perspectives, We suggest that the focus should be kept on achieving universal access to safe water (primarily in rural areas) while monitoring progress towards higher service levels, including greater water safety (both in rural and urban areas and among different economic strata). Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Rural:urban inequalities in post 2015 targets and indicators for drinking-water

    International Nuclear Information System (INIS)

    Bain, R.E.S.; Wright, J.A.; Christenson, E.; Bartram, J.K.

    2014-01-01

    Disparities in access to drinking water between rural and urban areas are pronounced. Although use of improved sources has increased more rapidly in rural areas, rising from 62% in 1990 to 81% in 2011, the proportion of the rural population using an improved water source remains substantially lower than in urban areas. Inequalities in coverage are compounded by disparities in other aspects of water service. Not all improved sources are safe and evidence from a systematic review demonstrates that water is more likely to contain detectable fecal indicator bacteria in rural areas. Piped water on premises is a service enjoyed primarily by those living in urban areas so differentiating amongst improved sources would exacerbate rural:urban disparities yet further. We argue that an urban bias may have resulted due to apparent stagnation in urban coverage and the inequity observed between urban and peri-urban areas. The apparent stagnation at around 95% coverage in urban areas stems in part from relative population growth – over the last two decades more people gained access to improved water in urban areas. There are calls for setting higher standards in urban areas which would exacerbate the already extreme rural disadvantage. Instead of setting different targets, health, economic, and human rights perspectives, We suggest that the focus should be kept on achieving universal access to safe water (primarily in rural areas) while monitoring progress towards higher service levels, including greater water safety (both in rural and urban areas and among different economic strata)

  11. Entrepreneurship within Urban and Rural Areas

    DEFF Research Database (Denmark)

    Freire-Gibb, L. Carlos; Nielsen, Kristian

    2014-01-01

    The entrepreneurial dynamics of urban and rural areas are different, and this paper explores creativity and social networks factors in both places. The probabilities of becoming an entrepreneur and of surviving are analyzed. The results are based on longitudinal data combined with a questionnaire......, common entrepreneurship beliefs can be questioned and entrepreneurship theory benefited....

  12. Young People's Preferences for Family Planning Service Providers in Rural Malawi: A Discrete Choice Experiment.

    Directory of Open Access Journals (Sweden)

    Christine Michaels-Igbokwe

    Full Text Available To quantify the impact of service provider characteristics on young people's choice of family planning (FP service provider in rural Malawi in order to identify strategies for increasing access and uptake of FP among youth.A discrete choice experiment was developed to assess the relative impact of service characteristics on preferences for FP service providers among young people (aged 15-24. Four alternative providers were included (government facility, private facility, outreach and community based distribution of FP and described by six attributes (the distance between participants' home and the service delivery point, frequency of service delivery, waiting time at the facility, service providers' attitude, availability of FP commodities and price. A random parameters logit model was used to estimate preferences for service providers and the likely uptake of services following the expansion of outreach and community based distribution (CBDA services. In the choice experiment young people were twice as likely to choose a friendly provider (government service odds ratio [OR] = 2.45, p<0.01; private service OR = 1.99, p<0.01; CBDA OR = 1.88, p<0.01 and more than two to three times more likely to choose a provider with an adequate supply of FP commodities (government service OR = 2.48, p<0.01; private service OR = 2.33, p<0.01; CBDA = 3.85, p<0.01. Uptake of community based services was greater than facility based services across a variety of simulated service scenarios indicating that such services may be an effective means of expanding access for youth in rural areas and an important tool for increasing service uptake among youth.Ensuring that services are acceptable to young people may require additional training for service providers in order to ensure that all providers are friendly and non-judgemental when dealing with younger clients and to ensure that supplies are consistently available.

  13. Improved services to enrollees into an HIV rural care and treatment ...

    African Journals Online (AJOL)

    Better quality of services is essential for the sustainability of HIV programs, in particular in rural Sub-Saharan Africa, to support the increasing number of individuals treated with combination antiretroviral therapy (cART). However, longitudinal data from rural care and treatment centers (CTC) are scarce. The objective was to ...

  14. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    Directory of Open Access Journals (Sweden)

    Resham Bahadur Khatri

    Full Text Available Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers.We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis.Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center.The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

  15. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    Science.gov (United States)

    Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E

    2017-01-01

    Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

  16. Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA.

    Science.gov (United States)

    Smith, Matthew Lee; Prohaska, Thomas R; MacLeod, Kara E; Ory, Marcia G; Eisenstein, Amy R; Ragland, David R; Irmiter, Cheryl; Towne, Samuel D; Satariano, William A

    2017-02-10

    Background : Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods : Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results : Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions : Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients.

  17. Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA

    Directory of Open Access Journals (Sweden)

    Matthew Lee Smith

    2017-02-01

    Full Text Available Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3% and urban (30.9% areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results: Rural (37.2% and urban (41.2% participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip, which was attributed to the greater distance per trip in rural areas. Conclusions: Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients.

  18. 47 CFR 54.607 - Determining the rural rate.

    Science.gov (United States)

    2010-10-01

    .... (a) The rural rate shall be the average of the rates actually being charged to commercial customers... programs, charged for the same or similar services in that rural area over the same distance as the... into account anticipated and actual demand for telecommunications services by all customers who will...

  19. Social aspects of revitalization of rural areas. Implementation of the rural revival programme in lodzkie voivodeship. Assumptions for sociological research

    Directory of Open Access Journals (Sweden)

    Pamela Jeziorska-Biel

    2012-04-01

    Full Text Available Essential elements of the process of rural renovation programme are: stimulating activity of local communities, cooperation for development, while preserving social identity, cultural heritage and natural environment. Implementing a rural revival programme in Poland: Sectoral Operational Programme “The Restructuring and Modernisation of the Food Sector and the Development of Rural Areas in 2004-2006” (action 2.3 “Rural renovation and protection and preservation of cultural heritage” evokes criticism. A wide discussion is carried amongst researchers, politicians, social activists, and local government practitioners. The main question remains: “is rural renovation process in Poland conducted in accordance with the rules in European countries or it is only a new formula of rural modernisation with the use of European funds?” The authors are joining the discussion and in the second part of the article they are presenting the assumption of sociological research. The aim of the analysis is to grasp the essence of revitalization of rural areas located in Łódzkie voivodeship, and analyse the question of specificity of rural Revival Programmes. What is the scope and manner of use of local capital? If so, are the results obtained from implementing a rural revival programme in 2004-2006 within the scope of sustainable development? What activities are predominant in the process of project implementation? Is it rural modernisation, revitalization of the rural areas, barrier removal and change in Infrastructure, or creation of social capital and subjectivity of the local community? Has the process of rural renovation in Łódzkie voivodeship got the so called “social face” and if so, to what extent? The major assumption is that rural renovation programme in Łódzkie voivodeship relates more to revitalization material aspects than “spirituality”.

  20. Exposing some important barriers to health care access in the rural USA.

    Science.gov (United States)

    Douthit, N; Kiv, S; Dwolatzky, T; Biswas, S

    2015-06-01

    To review research published before and after the passage of the Patient Protection and Affordable Care Act (2010) examining barriers in seeking or accessing health care in rural populations in the USA. This literature review was based on a comprehensive search for all literature researching rural health care provision and access in the USA. Pubmed, Proquest Allied Nursing and Health Literature, National Rural Health Association (NRHA) Resource Center and Google Scholar databases were searched using the Medical Subject Headings (MeSH) 'Rural Health Services' and 'Rural Health.' MeSH subtitle headings used were 'USA,' 'utilization,' 'trends' and 'supply and distribution.' Keywords added to the search parameters were 'access,' 'rural' and 'health care.' Searches in Google Scholar employed the phrases 'health care disparities in the USA,' inequalities in 'health care in the USA,' 'health care in rural USA' and 'access to health care in rural USA.' After eliminating non-relevant articles, 34 articles were included. Significant differences in health care access between rural and urban areas exist. Reluctance to seek health care in rural areas was based on cultural and financial constraints, often compounded by a scarcity of services, a lack of trained physicians, insufficient public transport, and poor availability of broadband internet services. Rural residents were found to have poorer health, with rural areas having difficulty in attracting and retaining physicians, and maintaining health services on a par with their urban counterparts. Rural and urban health care disparities require an ongoing program of reform with the aim to improve the provision of services, promote recruitment, training and career development of rural health care professionals, increase comprehensive health insurance coverage and engage rural residents and healthcare providers in health promotion. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights

  1. [Medical Service Information Seeking Behaviors in Rural and Urban Patients in Sichuan Province].

    Science.gov (United States)

    Zhang, Wen-Jie; Xue, Li; Chen, Rao; Duan, Zhan-Qi; Liu, Dan-Ping

    2018-03-01

    To understand how rural and urban patients seek medical service information in Sichuan province. A self-designed questionnaire was distributed randomly to patients who visited primary,secondary and tertiary health facilities in Chengdu,Yibin and Suining,collecting data in relation to their sources of medical service information,as well as the contents and credibility of the information. The major sources of medical service information came from friends,past experiences and television programs,which were consistent with the most desirable access channels. The urban patients were more likely to trust (5.3%) and use (10.6%) the Internet to obtain medical service information compared with their rural counterparts (3.4% and 5.5%,respectively, P marketing strategies for urban and rural patients should be developed to channel patients to appropriate health facilities. Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).

  2. Spatial Heterogeneity of Sustainable Transportation Offer Values: A Comparative Analysis of Nantes Urban and Periurban/Rural Areas (France

    Directory of Open Access Journals (Sweden)

    Julie Bulteau

    2018-02-01

    Full Text Available Innovative solutions have been implemented to promote sustainable mobility in urban areas. In the Nantes area (northwestern part of France, alternatives to single-occupant car use have increased in the past few years. In the urban area, there is an efficient public transport supply, including tramways and a “busway” (Bus Rapid Transit, as well as bike-sharing services. In periurban and rural areas, there are carpool areas, regional buses and the new “tram-train” lines. In this article, we focus on the impact on house prices of these “sustainable” transportation infrastructures and policies, in order to evaluate their values. The implicit price of these sustainable transport offers was estimated through hedonic price functions describing the Nantes urban and periurban/rural housing markets. Spatial regression models (SAR, SEM, SDM and GWR were carried out to capture the effect of both spatial autocorrelation and spatial heterogeneity. The results show patterns of spatial heterogeneity of transportation offer implicit prices at two scales: (i between urban and periurban/rural areas, as well as (ii within each territory. In the urban area, the distance to such offers was significantly associated with house prices. These associations varied by type of transportation system (positive for tramway and railway stations and negative for bike-sharing stations. In periurban and rural areas, having a carpool area in a 1500-m buffer around the home was negatively associated with house prices, while having a regional bus station in a 500-m buffer was non-significant. Distance to the nearest railway station was negatively associated with house prices. These findings provide research avenues to help public policy-makers promote sustainable mobility and pave the way for more locally targeted interventions.

  3. Coroners' records of rural and non-rural cases of youth suicide in New South Wales.

    Science.gov (United States)

    Dudley, M; Kelk, N; Florio, T; Waters, B; Howard, J; Taylor, D

    1998-04-01

    The aim of this study is to compare the frequency of certain putative risk factors for youth suicide in New South Wales (especially use of alcohol, social class, unemployment, and internal migration) in metropolitan and rural settings. A review of 137 files for 10-19-year-old subjects judged by the Coroner to have committed suicide in 1988-1990 was carried out. One hundred and fifteen males and 21 females were identified (one subjects sex was unavailable). The male-female ratio was higher in rural (13.0) areas than non-rural (4.9 chi 2 = 12.14, p Australia, most migrated in a rural direction, and most to rural shires. Unemployment was somewhat more common among rural (38.5%) than non-rural (28.9%) subjects (chi 2 = 0.75, p = 0.39). Eleven of 50 non-rural parents of the deceased, but none of the 11 rural parents, were ranked as being in social classes 2 or 3. Alcohol consumption appeared more common in rural shires (44%) than metropolitan areas (32.9%), but this was not statistically significant. Medical services were less utilised prior to death in rural (15%) than non-rural (25%) areas (chi 2 = 1.69, p = 0.19), and a psychiatric diagnosis was recorded more commonly in non-rural areas. Incomplete coronial file data and relatively small numbers limit this study's conclusions. Male suicides, principally by firearms, predominated in rural areas. Youth firearm access remains highly relevant to rural communities. Possible trends among rural subjects toward rural migration, higher unemployment, lower social class and lower medical attendance may point to resource deprivation among this group; these matters require further investigation.

  4. Remote eye care screening for rural veterans with Technology-based Eye Care Services: a quality improvement project.

    Science.gov (United States)

    Maa, April Y; Wojciechowski, Barbara; Hunt, Kelly; Dismuke, Clara; Janjua, Rabeea; Lynch, Mary G

    2017-01-01

    Veterans are at high risk for eye disease because of age and comorbid conditions. Access to eye care is challenging within the entire Veterans Hospital Administration's network of hospitals and clinics in the USA because it is the third busiest outpatient clinical service and growing at a rate of 9% per year. Rural and highly rural veterans face many more barriers to accessing eye care because of distance, cost to travel, and difficulty finding care in the community as many live in medically underserved areas. Also, rural veterans may be diagnosed in later stages of eye disease than their non-rural counterparts due to lack of access to specialty care. In March 2015, Technology-based Eye Care Services (TECS) was launched from the Atlanta Veterans Affairs (VA) as a quality improvement project to provide eye screening services for rural veterans. By tracking multiple measures including demographic and access to care metrics, data shows that TECS significantly improved access to care, with 33% of veterans receiving same-day access and >98% of veterans receiving an appointment within 30 days of request. TECS also provided care to a significant percentage of homeless veterans, 10.6% of the patients screened. Finally, TECS reduced healthcare costs, saving the VA up to US$148 per visit and approximately US$52 per patient in round trip travel reimbursements when compared to completing a face-to-face exam at the medical center. Overall savings to the VA system in this early phase of TECS totaled US$288,400, about US$41,200 per month. Other healthcare facilities may be able to use a similar protocol to extend care to at-risk patients.

  5. Globalisation, rural restructuring and health service delivery in Australia: policy failure and the role of social work?

    Science.gov (United States)

    Alston, Margaret

    2007-05-01

    The impacts of globalisation and rural restructuring on health service delivery in rural Australia have been significant. In the present paper, it is argued that declining health service access represents a failure of policy. Rural communities across the world are in a state of flux, and Australia is no different: rural communities are ageing at faster rates than urban communities and young people are out-migrating in large numbers. During the past 5 years, rural Australia has also experienced a severe and widespread drought that has exacerbated rural poverty, and impacted on the health and well-being of rural Australians. Australian governments have responded to globalising forces by introducing neoliberal policy initiatives favouring market solutions and championing the need for self-reliance among citizens. The result for rural Australia has been a withdrawal of services at a time of increased need. This paper addresses the social work response to these changes.

  6. Solar base rural electrification in Balochistan

    International Nuclear Information System (INIS)

    Mahar, F.

    2001-01-01

    In Balochistan province, most of the population is living in rural areas and devoid of life's basic facilities. In rural areas of Balochistan where most of the population up to 85% is located, more than four million people lack the essential energy services needed to satisfy the most basic needs and to improve living standards. In this paper, author has suggested some technique which will reduce the load and make solar photovoltaic system quite viable for rural electrification in Balochistan. (author)

  7. Trends in Rural Water Supply: Towards a Service Delivery Approach

    Directory of Open Access Journals (Sweden)

    Patrick Moriarty

    2013-10-01

    The papers in this special issue argue that tackling these challenges requires a shift in emphasis in rural water supply in developing countries: away from a de-facto focus on the provision of hardware for first-time access towards the proper use of installed hardware as the basis for universal access to rural water services. The outline of the main actions required to achieve this shift are becoming clearer. Chief amongst these are the professionalisation of community management and/or provision of direct support to community service providers; adoption of a wider range of service delivery models than community management alone; and addressing the sustainable financing of all costs with a particular focus on financing capital maintenance (asset management and direct support costs. This introductory paper provides an overview of these issues and a guide to the other articles, which demonstrate these points.

  8. Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Mburu, Grace; George, Gavin

    2017-07-31

    Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges. This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas. The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa. The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis. Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas. South Africa's HRH strategy for the Health Sector 2012/13-2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be realised.

  9. ENTERTAINMENT SERVICES IN RURAL AREAS – PART OF TOURISM ACTIVITIES

    Directory of Open Access Journals (Sweden)

    Dionisie Marian TURCU

    2014-04-01

    Full Text Available The work aims to highlight the niche forms of tourism (active tourism and ecotourism, showing similarities and differences between them. However it argues the need to introduce the occupation of rural tourism entertainer, showing the main tasks incumbent upon it to organize leisure tourists. The research was conducted by studying the latest articles in the field and by consulting specific websites.

  10. Comparison of Migrants in Two Rural and an Urban Area of Central Brazil.

    Science.gov (United States)

    Wilkening, E. A.

    The goal of this study was to compare the migration and adaptation of settlers in urban areas with settlers in rural areas of Brazil. A sample of 1,255 families, divided into an urban group, a near-urban rural group, and a rural group were interviewed. The migration patterns of the groups were discussed and factors related to migration were…

  11. Comparison of domestic violence against women in urban versus rural areas of southeast Nigeria

    Science.gov (United States)

    Ajah, Leonard Ogbonna; Iyoke, Chukwuemeka Anthony; Nkwo, Peter Onubiwe; Nwakoby, Boniface; Ezeonu, Paul

    2014-01-01

    Background The perception and prevalence of domestic violence (DV) in rural areas is poorly understood; the result is that most efforts at eradicating this harmful practice are concentrated in urban areas. The objective of the study was to compare the burden and perception of DV among women living in rural and urban Igbo communities of southeast Nigeria. Methods This was a comparative, cross-sectional study of women residing in rural and urban communities in Enugu, Nigeria, who had gathered for an annual religious meeting from August 1–7, 2011. Data analysis involved descriptive and inferential statistics and was conducted with the Statistical Package for Social Sciences, software version 17.0, at a 95% level of confidence. Results A total of 836 women who met the eligibility criteria participated in the survey. Of these, 376 were from Okpanku, a rural community, while 460 were from Ogui Nike, an urban community. The prevalence of DV among rural women was significantly higher than that among urban women (97% versus 81%, P<0.001). In particular, the prevalence of physical violence was significantly higher among rural women than among urban women (37.2% versus 23.5%; P=0.05). In contrast, rural and urban women did not differ significantly in the proportions that had experienced psychological or sexual violence. The proportion of women who believed that DV was excusable was significantly higher among rural dwellers than among urban dwellers (58.5% versus 29.6%; P=0.03). Conclusion The burden of DV against women may be higher in rural communities than in urban communities in southeast Nigeria. More rural women perceived DV as excusable; this finding suggests that factors that sustain DV could be strong in rural areas. A comprehensive program to curb DV in this area may need to significantly involve the rural areas. PMID:25336992

  12. Availability and Primary Health Care Orientation of Dementia-Related Services in Rural Saskatchewan, Canada.

    Science.gov (United States)

    Morgan, Debra G; Kosteniuk, Julie G; Stewart, Norma J; O'Connell, Megan E; Kirk, Andrew; Crossley, Margaret; Dal Bello-Haas, Vanina; Forbes, Dorothy; Innes, Anthea

    2015-01-01

    Community-based services are important for improving outcomes for individuals with dementia and their caregivers. This study examined: (a) availability of rural dementia-related services in the Canadian province of Saskatchewan, and (b) orientation of services toward six key attributes of primary health care (i.e., information/education, accessibility, population orientation, coordinated care, comprehensiveness, quality of care). Data were collected from 71 rural Home Care Assessors via cross-sectional survey. Basic health services were available in most communities (e.g., pharmacists, family physicians, palliative care, adult day programs, home care, long-term care facilities). Dementia-specific services typically were unavailable (e.g., health promotion, counseling, caregiver support groups, transportation, week-end/night respite). Mean scores on the primary health care orientation scales were low (range 12.4 to 17.5/25). Specific services to address needs of rural individuals with dementia and their caregivers are limited in availability and fit with primary health care attributes.

  13. Demographic Ageing in Romania’s Rural Area

    Directory of Open Access Journals (Sweden)

    Daniela Violeta Nancu

    2010-05-01

    Full Text Available Europe has faced for several decades and is still facing an ageing process of its population. Within it, Romania, a country, striving to successfully integrate into the European Union, is also experiencing the same process. The ageing process of the Romanian population started at the beginning of the 20th century and evolved progressively, ever since, with significant visible rates in the rural areas. Romania’s population age structure, at the beginning of the Third Millennium, was, according to international experts, not significantly aged compared to populations of the economically advanced countries of Europe. Due to falling birth-rates and the labor emigration rush, the ageing process of the Romanian population has become increasingly serious, argued by a rate of 19.4% over 60-year-old population, of which 24.5% (2008 belongs to the rural area. The main responsible reason for this demographic and social situation is the replacement of the traditional reproduction pattern, mainly characterized by high birth and death rates, with a modern one, characterized by very low rates of the same kind. Low values in natality were, on one hand, the result of a steady regression of fertility, and on the other of, a drop in general mortality, hence the lengthening of the average life-span. To be able to cope with a relatively new phenomenon such as ageing of population, Romania needs to seriously consider adequate measures and steps towards achieving balance. Visionary strategy and plans require, well-grounded medium-and-long-term development programmes especially for the Romanian rural area.

  14. Connecting rural-urban economies?

    DEFF Research Database (Denmark)

    Larsen, Marianne Nylandsted; Birch-Thomsen, Torben; Lazaro, Evelyn

    The interlinked relationships between urban settlements and their rural hinterlands in Sub-Saharan Africa are perceived crucial in enhancing possibilities for livelihood diversification and poverty reduction. Urban settlements provide opportunities for investment in more remunerative economic...... activities, job/employment opportunities that retain potential migrants in the area, and access to services for the rural hinterlands. This paper examines the role of emerging urban centres (EUCs) as ‘drivers’ of rural development based on a study of two EUCs and their rural hinterlands in Tanzania. Findings...... and poverty reduction....

  15. Rural settlements transition (RST) in a suburban area of metropolis: Internal structure perspectives.

    Science.gov (United States)

    Ma, Wenqiu; Jiang, Guanghui; Wang, Deqi; Li, Wenqing; Guo, Hongquan; Zheng, Qiuyue

    2018-02-15

    Rural settlements transition (RST) is one of the most significant indices for understanding the phenomena of rural reconstruction and urban-rural transformation in China. However, a systematic overview of RST is missing, and there is a lack of evidence regarding its characteristics from the internal structure perspectives. In this paper, we systematically explore the RST regarding spatio-temporal change characteristics of internal structure, patterns and impacts on rural environment and development by using practical survey internal land-use data from 2005 to 2015. The results show that the temporal change characteristics of the internal structure of rural settlements demonstrate a tendency for housing land to decrease and other land-use types to increase. The spatial change characteristics reveal that the structure inclines to more complexity and diversity from an exurban area to an urban-rural fringe area. Based on this finding, we identify that rapid development of rural industrialization, more agglomerate and effective industrial land-use, and improved public infrastructure construction are the general RST patterns. Spatially, there exists a physical decay pattern in the exurban area, thereby resulting in the hollowing-out of rural industries and of the population. In addition, the extensive and disorderly pattern in the suburban area causes low efficiency output and serious environmental pollution. The RST pattern in the urban hinterland promoted the "men-environment" compatible development. The study concludes that regional differentiation in patterns and impacts are significant in the process of RST. Future adaptive strategies for rural settlements adjustment should be conducted according to regional characteristics, including socio-economic status, physical geography condition and economic location to improve the rural environmental sustainability. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study

    Science.gov (United States)

    Shrestha, Khadka Narayan; Homer, Caroline S. E.

    2017-01-01

    Background Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. Methods We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Results Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. Conclusion The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries. PMID:28493987

  17. Rural energy and development

    Energy Technology Data Exchange (ETDEWEB)

    Stern, R.

    1997-12-01

    The author discusses the worldwide problem and need for rural electrification to support development. He points out that rural areas will pay high rates to receive such services, but cannot afford the capital cost for conventional services. The author looks at this problem from the point of energy choices, subsides, initial costs, financing, investors, local involvement, and governmental actions. In particular he is concerned with ways to make better use of biofuels, to promote sustainable harvesting, and to encourage development of more modern fuels.

  18. Managing Urban Wellbeing in Rural Areas : The Potential Role of Online Communities to Improve the Financing and Governance of Highly Valued Nature Areas

    NARCIS (Netherlands)

    Bijker, Rixt; Mehnen, Nora; Sijtsma, Frans; Daams, Michiel

    2014-01-01

    The urban and the rural are increasingly interconnected. Rural areas have become places of consumption, as leisure and recreation have become important functions of rural areas. There are also indications that increased urbanisation even leads to a stronger appreciation of green areas situated far

  19. Relationships between population and environment in rural areas of developing countries.

    Science.gov (United States)

    Rudel, T I

    1991-01-01

    Studies that have assessed the impact of population change on the environment in rural areas of selected developing countries are reviewed. The implications are that both developed and developing countries might focus on single aspects of a much larger global problem. Rural areas were selected because the bulk of the world's population lives in rural areas. Population environment interactions are 1st discussed at the global level. Studies on changing import patterns of developing countries are usless in accounting for agricultural policy shifts or other factors that may be unrelated to population growth but may be related to food imports. When the magnitude of food production and population growth is examined, there is a balance established between the two. However, analysis of the spatial distribution of desertification and soil degradation shows greater local level effects. Population/environment relationships are examined in critical ecological zones: tropical deforestation, desertification, land degradation in resource poor zones, and responses to population pressures and resource degradation. The conclusions reached are that better statistics on degradation are needed and that the trends in the human ecology of rural populations have clear implications for government policies on the environment. Agricultural development has been uneven and inequitable such that many peasant populations have suffered a decline in standards of living, particularly in Africa. There has also been an accelerated increase in rates of land degradation in resource poor areas, which are densely populated. The population response has been migration shifts out of resource poor areas to ecologically marginal areas, which has resulted in extensive desertification and deforestation. Expansion of the areas under cultivation has not just increased agricultural production but agriculture and population have invaded ecologically marginal zones in deserts and rain forests. Measurement of the

  20. Expanding health insurance to increase health care utilization: will it have different effects in rural vs. urban areas?

    Science.gov (United States)

    Erlyana, Erlyana; Damrongplasit, Kannika Kampanya; Melnick, Glenn

    2011-05-01

    This study investigates the importance of medical fee and distance to health care provider on individual's decision to seek care in developing countries. The estimation method used a mixed logit model applied to data from the third wave of the Indonesian family life survey (2000). The key variables of interest include medical fee and distance to different types of health care provider and individual characteristic variables. Urban dweller's decision to choose health care providers are sensitive to the monetary cost of medical care as measured by medical fee but they are not sensitive to distance. For those who reside in rural area, they are sensitive to the non-medical component cost of care as measured by travel distance but they are not sensitive to medical fee. As a result of those findings, policy makers should consider different sets of policy instruments when attempting to expand health service's usage in urban and rural areas of Indonesia. To increase access in urban areas, we recommend expansion of health insurance coverage in order to lower out-of-pocket medical expenditures. As for rural areas, expansion of medical infrastructures to reduce commuting distance and costs will be needed to increase utilization. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  1. Pico hydro turbines for electricity in rural areas

    OpenAIRE

    Descotte, Gérard

    2016-01-01

    This article discusses the feedback and lessons learned, particularly from a survey carried out following the deployment program of a pico hydro power solution in a very isolated rural area in north Laos. This project is part of the strategic development for the rural electrification of Laos, in which pico hydro power facilities constitute the main avenue of progress for the electrification of isolated villages.

  2. Inclusive education in schools in rural areas

    Directory of Open Access Journals (Sweden)

    J. Antonio Callado Moreno

    2015-07-01

    Full Text Available Since Spain decided to embark on the development of inclusive schooling, studies have taken place to see if the inclusive principle is being developed satisfactorily. Inclusive schooling implies that all students, regardless of their particular characteristics, may be taught in ordinary schools, and in the majority of cases receive help in the classroom in which they have been integrated in order to cover any special educational needs. Our research aims to find out if schools situated in rural areas follow this principle and, once it has been put into practice, what strategies are being used. To this end, we designed a questionnaire addressed to Infant and Primary school teachers in the Sierra Sur area in the province of Jaén, in an agricultural context where most of the population live on olive picking and the cultivation of olive groves. Given the extension of the area, our research concentrated on schools situated in urban nuclei with a population of less than one thousand five hundred inhabitants. The results obtained demonstrate that rural areas do not take full advantage of the context they are in to favour inclusion processes and continue to develop proposals that are merely integrative.

  3. Characteristics of Poverty in Rural Communities of Gold Mining District Area West Sumbawa

    OpenAIRE

    Ibrahim, Ibrahim; Baiquni, Muhammad; Ritohardoyo, Su; Setiadi, Setiadi

    2016-01-01

    The research is conducted in rural areas of gold mining with the aim to find out the characteristics of poverty in the rural area of gold mining in West Sumbawa regency. The survey method is used in this study, focusing on the rural mining area. Sample of respondents are 167 households, selected by purposive sampling from four villages, which are determined based on the first ma slope. The data analysis uses cross tabulation and frequency tables. The results showes that the poverty rate in th...

  4. Psychology and Rural America: Current Status and Future Directions.

    Science.gov (United States)

    Murray, J. Dennis; Keller, Peter A.

    1991-01-01

    Rural people constitute about one-fourth of the U.S. population; their special mental health needs have largely been neglected. Psychologists are needed to practice in rural areas, to develop rural service models, and to support the development of state and federal policies that address rural needs. (DM)

  5. Knowledge, awareness, and utilization pattern of services under Janani Suraksha Yojana among beneficiaries in rural area of Himachal Pradesh

    OpenAIRE

    Prem Lal Chauhan; Dineshwar Dhadwal; Anjali Mahajan

    2015-01-01

    Introduction: Safe motherhood is perceived as a human right, and the health sector is always encouraged to provide quality services to ensure the same. Government of India launched a scheme called Janani Suraksha Yojana (JSY) on April 11, 2005, under the flagship of National Rural Health Mission to reduce maternal and neonatal mortality, by promoting institutional deliveries for which financial incentives are provided to mothers delivering in the health facilities. Objective: To study the kno...

  6. Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply.

    Science.gov (United States)

    McGrail, Matthew R; Wingrove, Peter M; Petterson, Stephen M; Humphreys, John S; Russell, Deborah J; Bazemore, Andrew W

    2017-01-01

    Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on supply. Place-related attributes contribute to a community's overall amenity or attractiveness, which arguably influence both rural recruitment and retention relocation decisions of doctors. This bi-national study of Australia and the USA, two developed nations with similar geographic and rural access profiles, investigates the extent to which variations in community amenity indicators are associated with spatial variations in the supply of rural primary care doctors. Measures from two dimensions of community amenity: geographic location, specifically isolation/proximity; and economics and sociodemographics were included in this study, along with a proxy measure (jurisdiction) of a third dimension, environmental amenity. Data were chiefly collated from the American Community Survey and the Australian Census of Population and Housing, with additional calculated proximity measures. Rural primary care supply was measured using provider-to-population ratios in 1949 US rural counties and in 370 Australian rural local government areas. Additionally, the more sophisticated two-step floating catchment area method was used to measure Australian rural primary care supply in 1116 rural towns, with population sizes ranging from 500 to 50 000. Associations between supply and community amenity indicators were examined using Pearson's correlation coefficients and ordinary least squares multiple linear regression models. It was found that increased population size, having a hospital in the county, increased house prices and affluence, and a more educated and older population were all significantly associated with increased workforce supply across rural areas of both countries

  7. Urban dogs in rural areas: Human-mediated movement defines dog populations in southern Chile.

    Science.gov (United States)

    Villatoro, Federico J; Sepúlveda, Maximiliano A; Stowhas, Paulina; Silva-Rodríguez, Eduardo A

    2016-12-01

    Management strategies for dog populations and their diseases include reproductive control, euthanasia and vaccination, among others. However, the effectiveness of these strategies can be severely affected by human-mediated dog movement. If immigration is important, then the location of origin of dogs imported by humans will be fundamental to define the spatial scales over which population management and research should apply. In this context, the main objective of our study was to determine the spatial extent of dog demographic processes in rural areas and the proportion of dogs that could be labeled as immigrants at multiple spatial scales. To address our objective we conducted surveys in households located in a rural landscape in southern Chile. Interviews allowed us to obtain information on the demographic characteristics of dogs in these rural settings, human influence on dog mortality and births, the localities of origin of dogs living in rural areas, and the spatial extent of human-mediated dog movement. We found that most rural dogs (64.1%) were either urban dogs that had been brought to rural areas (40.0%), or adopted dogs that had been previously abandoned in rural roads (24.1%). Some dogs were brought from areas located as far as ∼700km away from the study area. Human-mediated movement of dogs, especially from urban areas, seems to play a fundamental role in the population dynamics of dogs in rural areas. Consequently, local scale efforts to manage dog populations or their diseases are unlikely to succeed if implemented in isolation, simply because dogs can be brought from surrounding urban areas or even distant locations. We suggest that efforts to manage or study dog populations and related diseases should be implemented using a multi-scale approach. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. An evaluation of rural health care research.

    Science.gov (United States)

    Kane, R; Dean, M; Solomon, M

    1979-05-01

    Reviews the state of the art of rural health research and evaluation in the U.S. with particular emphasis on the questions of access, health personnel, and financing. The current state of knowledge both in the published and unpublished literature in each area is summarized and a series of unresolved issues is proposed. A strategy for further research to include the various types of rural health care programs is described. Major findings suggest that, although rural populations do have somewhat less access to care than do urban populations, our ability to quantify precisely the extent and importance of this discrepancy is underdeveloped. Despite a substantial investment in a variety of rural health care programs there is inadequate information as to their effectiveness. Programs designed to increase the supply of health personnel to rural areas have met with mixed success. Sites staffed by National Health Service Corps personnel show consistently lower productivity than do sites under other sponsorship. Nonphysician personnel (physician assistants and nurse practitioners) offer a promising source of primary care for rural areas: recent legislation that reimburses such care should increase their utilization. A persistent problem is the expectation (often a mandate) incorporated into many rural health care demonstration efforts that the programs become financially self-sufficient in a finite period of time. Self-sufficiency is a function of utilization, productivity, and the ability to recover charges for services. In many instances stringent enforcement of the self-sufficiency requirement may mean those who need services most will be least likely to receive them.

  9. Tourist Activity of Senior Citizens (60+ Residing in Urban and Rural Areas

    Directory of Open Access Journals (Sweden)

    Omelan Aneta

    2016-12-01

    Full Text Available The objective of this study was to analyze the influence of place of permanent residence (urban or rural on the tourist activity of senior citizens (60+ of different socioeconomic statuses. The study involved 380 senior citizens (305 female and 75 male aged 60 years and older who were permanent residents of the region of Warmia and Mazury, Poland. In this group, 244 subjects resided in urban areas and 136 participants were rural dwellers. The respondents were asked to complete a questionnaire regarding their socioeconomic status (place of permanent residence, age, gender, educational attainment, financial status, membership in senior organizations, marital status, and professional activity and tourist activity. A significance test of two structure coefficients (α=0.05 was applied. Factors such as gender, professional activity, and marital status were not related with the travel propensity of seniors from different groups (urban and rural, but were significant when rural residents were compared with urban dwellers. Seniors residing in urban areas of Warmia and Mazury, Poland, were significantly more likely to travel for leisure than those residing in rural areas. The tourist activity of seniors decreased significantly (p<0.05 with the age (60-74 years and financial status of rural residents. The travel propensity of elderly people increased significantly (p<0.05 with educational attainment and membership in senior organizations. The study revealed considerable differences in the socioeconomic status and social characteristics of seniors residing in rural and urban areas, and those variations significantly influenced their propensity for travel: urban residents traveled more frequently than rural residents. It can be concluded that place of residence was a crucial factor determining the tourist behavior of senior citizens, and urban dwellers were more likely to travel.

  10. Bringing fiber to the home to rural areas in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Jens Myrup; Riaz, M. Tahir

    2009-01-01

    In order to support development of rural areas, and avoid that these  areas are being depopulated, access to fast broadband networks can contribute by facilitating tele working, distance learning, ICT for industries and farming etc. In this paper we show how broadband and Fiber To The Home (FTTH......) is developing in Denmark, and that FTTH is also being deployed in rural areas. A main reason for this is that consumer-owed utility companies have decided to invest heavily in the field, to a large extent with the philosophy that, since all consumers are a part of the investment, everybody should also benefit...

  11. Evaluation of immunization coverage in the rural area of Pune, Maharashtra, using the 30 cluster sampling technique

    Directory of Open Access Journals (Sweden)

    Pankaj Kumar Gupta

    2013-01-01

    Full Text Available Background: Infectious diseases are a major cause of morbidity and mortality in children. One of the most cost-effective and easy methods for child survival is immunization. Despite all the efforts put in by governmental and nongovernmental institutes for 100% immunization coverage, there are still pockets of low-coverage areas. In India, immunization services are offered free in public health facilities, but, despite rapid increases, the immunization rate remains low in some areas. The Millennium Development Goals (MDG indicators also give importance to immunization. Objective: To assess the immunization coverage in the rural area of Pune. Materials and Methods: A cross-sectional study was conducted in the field practice area of the Rural Health Training Center (RHTC using the WHO′s 30 cluster sampling method for evaluation of immunization coverage. Results: A total of 1913 houses were surveyed. A total of 210 children aged 12-23 months were included in the study. It was found that 86.67% of the children were fully immunized against all the six vaccine-preventable diseases. The proportion of fully immunized children was marginally higher in males (87.61% than in females (85.57%, and the immunization card was available with 60.95% of the subjects. The most common cause for partial immunization was that the time of immunization was inconvenient (36%. Conclusion: Sustained efforts are required to achieve universal coverage of immunization in the rural area of Pune district.

  12. Knowledge Access in Rural Inter-connected Areas Network ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Knowledge Access in Rural Inter-connected Areas Network (KariaNet) - Phase II ... poor by sharing innovations, best practices and indigenous knowledge using ... A third thematic network - on knowledge management strategies - will play an ...

  13. Area-Based Partnerships in Rural Poland: The Post-Accession Experience

    Science.gov (United States)

    Furmankiewicz, Marek; Thompson, Nicola; Zielinska, Marta

    2010-01-01

    The paper examines the characteristics of area-based partnerships in rural Poland. It is based on the study of partnerships created after the accession to the European Union in 2004. Partnership structures have been rapidly adopted in rural Poland due to opportunities provided by the LEADER+ Pilot Programme. However, the research showed that…

  14. Quantifying the Spatio-Temporal Dynamics of Rural Settlements and the Associated Impacts on Land Use in an Undeveloped Area of China

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2018-05-01

    Full Text Available Rapid urbanization and economic growth in China have accelerated changes in rural settlements and associated land-use types that are expected to alter ecological services and the environment. Relevant studies of the dynamics of rural settlements and corresponding rural land-use changes are in short supply, however, especially in undeveloped areas in China. This study, therefore, investigated the spatio-temporal dynamics of rural settlements and their impacts on other land-use types by using 30 m rural settlement status and dynamic maps from the end of the 1980s to 2010. These maps were generated by visual interpretation with strict product quality control and accuracy. Henan province was selected as a case study of undeveloped regions in China. We examined in particular how the expansion of rural settlements affected cultivated lands and the processes of rural settlement urbanization. This study looked at three periods: the end of the 1980s–2000, 2000–2010, and the end of the 1980s–2010, with two spatial scales of province and prefecture city. Major findings about the rural settlements in Henan from the end of the 1980s to 2010 include (1 the area of rural settlements grew continuously, although the increasing trend slowed; (2 the expansion of rural settlements showed a negative trend contrary to the trend of the urbanization of rural settlements; (3 rural settlement expansion occupied considerable expanse of cultivated lands, which accounted for up to 96% of the total expansion lands; (4 urbanization of rural settlements was the main mode by which rural residential lands vanished, accounting for more than 98% of the lost lands. This study can provide suggestions for the conservation and sustainability of the rural environment and inform reasonable policies on rural development.

  15. Access to and use of sexual and reproductive health services provided by midwives among rural immigrant women in Spain: midwives’ perspectives

    Science.gov (United States)

    Otero-Garcia, Laura; Goicolea, Isabel; Gea-Sánchez, Montserrat; Sanz-Barbero, Belen

    2013-01-01

    Background There is insufficient information regarding access and participation of immigrant women in Spain in sexual and reproductive health programs. Recent studies show their lower participation rate in gynecological cancer screening programs; however, little is known about the participation in other sexual and reproductive health programs by immigrant women living in rural areas with high population dispersion. Objectives The objective of this study is to explore the perceptions of midwives who provide these services regarding immigrant women's access and participation in sexual and reproductive health programs offered in a rural area. Design A qualitative study was performed, within a larger ethnographic study about rural primary care, with data collection based on in-depth interviews and field notes. Participants were the midwives in primary care serving 13 rural basic health zones (BHZ) of Segovia, a region of Spain with high population dispersion. An interview script was designed to collect information about midwives’ perceptions on immigrant women's access to and use of the healthcare services that they provide. Interviews were recorded and transcribed with participant informed consent. Data were analyzed based on the qualitative content analysis approach and triangulation of results with fieldwork notes. Results Midwives perceive that immigrants in general, and immigrant women in particular, underuse family planning services. This underutilization is associated with cultural differences and gender inequality. They also believe that the number of voluntary pregnancy interruptions among immigrant women is elevated and identify childbearing and childrearing-related tasks and the language barrier as obstacles to immigrant women accessing the available prenatal and postnatal healthcare services. Conclusions Immigrant women's underutilization of midwifery services may be linked to the greater number of unintended pregnancies, pregnancy terminations, and the

  16. Access to and use of sexual and reproductive health services provided by midwives among rural immigrant women in Spain: midwives' perspectives.

    Science.gov (United States)

    Otero-Garcia, Laura; Goicolea, Isabel; Gea-Sánchez, Montserrat; Sanz-Barbero, Belen

    2013-11-08

    There insufficient information regarding access and participation of immigrant women in Spain in sexual and reproductive health programs. Recent studies show their lower participation rate in gynecological cancer screening programs; however, little is known about the participation in other sexual and reproductive health programs by immigrant women living in rural areas with high population dispersion. The objective of this study is to explore the perceptions of midwives who provide these services regarding immigrant women's access and participation in sexual and reproductive health programs offered in a rural area. A qualitative study was performed, within a larger ethnographic study about rural primary care, with data collection based on in-depth interviews and field notes. Participants were the midwives in primary care serving 13 rural basic health zones (BHZ) of Segovia, a region of Spain with high population dispersion. An interview script was designed to collect information about midwives' perceptions on immigrant women's access to and use of the healthcare services that they provide. Interviews were recorded and transcribed with participant informed consent. Data were analyzed based on the qualitative content analysis approach and triangulation of results with fieldwork notes. Midwives perceive that immigrants in general, and immigrant women in particular, underuse family planning services. This underutilization is associated with cultural differences and gender inequality. They also believe that the number of voluntary pregnancy interruptions among immigrant women is elevated and identify childbearing and childrearing-related tasks and the language barrier as obstacles to immigrant women accessing the available prenatal and postnatal healthcare services. Immigrant women's underutilization of midwifery services may be linked to the greater number of unintended pregnancies, pregnancy terminations, and the delay in the first prenatal visit, as discerned by

  17. Access to and use of sexual and reproductive health services provided by midwives among rural immigrant women in Spain: midwives’ perspectives

    Directory of Open Access Journals (Sweden)

    Laura Otero-Garcia

    2013-11-01

    Full Text Available Background: There insufficient information regarding access and participation of immigrant women in Spain in sexual and reproductive health programs. Recent studies show their lower participation rate in gynecological cancer screening programs; however, little is known about the participation in other sexual and reproductive health programs by immigrant women living in rural areas with high population dispersion. Objectives: The objective of this study is to explore the perceptions of midwives who provide these services regarding immigrant women's access and participation in sexual and reproductive health programs offered in a rural area. Design: A qualitative study was performed, within a larger ethnographic study about rural primary care, with data collection based on in-depth interviews and field notes. Participants were the midwives in primary care serving 13 rural basic health zones (BHZ of Segovia, a region of Spain with high population dispersion. An interview script was designed to collect information about midwives’ perceptions on immigrant women's access to and use of the healthcare services that they provide. Interviews were recorded and transcribed with participant informed consent. Data were analyzed based on the qualitative content analysis approach and triangulation of results with fieldwork notes. Results: Midwives perceive that immigrants in general, and immigrant women in particular, underuse family planning services. This underutilization is associated with cultural differences and gender inequality. They also believe that the number of voluntary pregnancy interruptions among immigrant women is elevated and identify childbearing and childrearing-related tasks and the language barrier as obstacles to immigrant women accessing the available prenatal and postnatal healthcare services. Conclusions: Immigrant women's underutilization of midwifery services may be linked to the greater number of unintended pregnancies, pregnancy

  18. Smart street lighting solution for remote rural areas of India

    Science.gov (United States)

    Hajra, Debdyut

    2017-09-01

    Though many smart street lighting solutions is available for urban areas, comparatively fewer solutions exist for rural areas. In the recent times, village streets have been illuminated with artificial lights as a part of rural development drive undertaken by the governments of respective countries. But, vehicle and pedestrian traffic is quite low through village roads. Hence, if light remains on all night long on such roads, then there is a huge wastage of energy. This calls for solutions to reduce this energy loss in an efficient manner. There are a lot of factors which must be kept in mind while designing solutions. Many villages lack the proper infrastructure to support new technologies. Communication facilities are limited, lack of local technically skilled labor, lack of security, etc. After evaluating these opportunities and challenges, an attempt has been made to devise a smart street lighting solution tailored for remote rural areas in India. One part of the solution discusses how intensity of the LED street lights can be varied according to the ambient lighting conditions using sensors and LED switching in LED matrix. An artificial intelligence (AI) has also been modelled to identify traffic conditions using PIR sensors and object identification through image processing and independently control the lights. It also tracks the performance and status of each light. It would send this data and necessary notifications to a distant control center for human evaluation. This solution is also applicable for other rural areas throughout the world.

  19. Paradoxes of Providing Rural Social Services: The Case of Homeless Youth

    Science.gov (United States)

    Edwards, Mark Evan; Torgerson, Melissa; Sattem, Jennifer

    2009-01-01

    Economic and demographic changes in rural areas continue to introduce big-city problems in small towns. These communities' ability and willingness to respond are likely to be influenced by the geography, culture, and array of organizations in rural places. But how these characteristics of rural places shape local response is hard to predict and as…

  20. Water Service Areas - MDC_WaterServiceArea

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — The Water and Sewer Service Area layer was derived from the original paper based sketches which contained both water and sewer utility boundary information. This...

  1. Sewerage Service Areas - MDC_SewerServiceArea

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — The Water and Sewer Service Area layer was derived from the original paper based sketches which contained both water and sewer utility boundary information. This...

  2. Egypt : Operational Framework for Integrated Rural Sanitation Service Delivery

    OpenAIRE

    World Bank

    2005-01-01

    The Framework presented in this report links - for the first time in the Egyptian context - access to investment in rural sanitation services to quantifiable water quality (and health) improvements, in a given hydrologic basin. The Framework provides an integrated, institutional structure of relevant Government agencies and of serviced communities, which is built on integrated water resources management (IWRM) principles: treating water as a holistic resource, management at the lowest appropr...

  3. Study on Investing and Financing Development in Rural Area:A Case Study of Guangxi Zhuang Autonomous Region

    Institute of Scientific and Technical Information of China (English)

    Junyong; HUANG; Bin; YAO

    2013-01-01

    "Surplus income" of farmers has been increasing steadily with the marked improvement of rural economy. However,development of rural financing market in China is rather backward. To satisfy the financing requirement of farmers and meet the demand of the construction of new countryside as well as harmonious society,development of financing market in rural area is eager to be quickened. Taking Guangxi Autonomous Region as an example,there are problems in rural investing and financing development. Firstly,farmers are in lacking of accurate understanding of investing and financing. Secondly,investors in rural area lack professional knowledge about financing generally. Thirdly,rural area has underdeveloped information degree as well as imperfect investing and financing environment. Fourthly,there are no financial products developed for rural area. Fifthly,economic development is unbalanced and relatively underdeveloped in rural area. Lastly,rural financial market has long been neglected by financial intermediaries. In order to cope with these problems,firstly,farmers should be assisted to establish accurate financial awareness and master necessary financial knowledge. Secondly,local intermediaries like securities firms and banks should be encouraged to exert impact on rural financial market. Thirdly,financial products suitable for Guangxi rural area are to be developed. Fourthly, construction and perfection of rural financial market should be quickened. Lastly,rural economic development should be quickened to enlarge capital source of financing.

  4. Catering and gastronomy services in the rural tourism: the case of Lubuskie voivodeship.

    Science.gov (United States)

    Woźniczko, Magdalena; Orłowski, Dominik; Zelazna, Krystyna

    2007-01-01

    In this paper we showed the results of studies about gastronomy services in the rural tourism and the range of this services using about which the respondents talked. The studies also took the feeding offer (rural dishes and regional feeding) influence for the choosing the rest offer in the countryside. In the studies took part people who live in the countryside and have homesteads and of course tourist rest in their homesteads.

  5. Predictors of happiness among retired from urban and rural areas in Brazil

    Directory of Open Access Journals (Sweden)

    Silvia Miranda Amorim

    2017-03-01

    Full Text Available Abstract This study compared differences in degree of happiness, social support, activities performed, and health and economic situation among retirees from urban and rural areas in Minas Gerais State in Brazil. The influences of these predictors over individuals’ level of happiness were also analyzed. We included 279 retired individuals living in Abre Campo (a municipality with a population fewer than 20,000 inhabitants, which is considered a rural area and in Belo Horizonte (a municipality with a population of almost 2.5 million inhabitants, which is considered an urban area. Participants responded to a questionnaire that included scales of happiness, social support, diversity of activities, and issues about satisfaction with health and economic situation. Retirees from the urban area had a higher happiness level than retirees from the rural area (β= 0.16. The most important predictors of happiness were health (β= 0.42, social support (β= 0.26, and economic situation (β= 0.15, but no moderation effects of urban and rural areas were found. Our findings support the implementation of actions to offer financial planning before retirement and to stimulate social support and health promotion for retirees, particularly given the importance of these factors in perception of happiness.

  6. The Effects of Rent Restructuring on Social Housing in English Rural Areas

    Science.gov (United States)

    Walker, Bruce

    2004-01-01

    This paper discusses the impact of central government's rent restructuring policy on social housing in rural areas in England. It examines the effect that restructuring will have on the rents set by social landlords in a set of case study areas then considers some of the likely impacts on affordability and on new investment in rural social…

  7. Persistent problems of access to appropriate, affordable TB services in rural China: experiences of different socio-economic groups.

    Science.gov (United States)

    Zhang, Tuohong; Tang, Shenglan; Jun, Gao; Whitehead, Margaret

    2007-02-08

    Large-scale Tuberculosis (TB) control programmes in China have been hailed a success. Concerns remain, however, about whether the programme is reaching all sections of the population, particularly poorer groups within rural communities, and whether there are hidden costs. This study takes a household perspective to investigate receipt of appropriate care and affordability of services for different socio-economic groups with TB symptoms in rural China. Secondary analysis of Chinese National Household Health Survey for 2003: 40,000 rural households containing 143,991 individuals, 2,308 identified as TB suspects. use of services and expenditure of TB suspects, by gender and socio-economic position, indicated by household income, education, material assets, and insurance status. 37% of TB suspects did not seek any professional care, with low-income groups less likely to seek care than more affluent counterparts. Of those seeking care, only 35% received any of the recommended diagnostic tests. Of the 182 patients with a confirmed TB diagnosis, 104 (57%) received treatment at the recommended level, less likely if lacking health insurance or material assets. The burden of payment for services amounted to 45% of annual household income for the low-income group, 16% for the high-income group. Access to appropriate, affordable TB services is still problematic in some rural areas of China, and receipt of care and affordability declines with declining socio-economic position. These findings highlight the current shortcomings of the national TB control programme in China and the formidable challenge it faces if it is to reach all sections of the population, including the poor with the highest burden of disease.

  8. Developing a funding model for an after-hours primary medical care service in a rural town.

    Science.gov (United States)

    O'Meara, P; Hall, R H; Strasser, R; Speck, V

    1998-01-01

    The study described in this paper aimed to determine a funding model for an after-hours primary medical care service in the rural town of Moe, a socioeconomically disadvantaged area of Victoria suffering the rigours of industry restructuring and privatisation. It has 12.5 equivalent full-time general practitioners servicing 21,966 persons. A break-even analysis of the financial viability compared the expected costs of providing the service with the anticipated income. A mixed funding model is recommended. This would incorporate a general practitioner incentive scheme and State Government underwriting of infrastructure and basic non-medical staffing costs during the business development phase to supplement the income from the Health Insurance Commission.

  9. Comparison of domestic violence against women in urban versus rural areas of southeast Nigeria

    Directory of Open Access Journals (Sweden)

    Ajah LO

    2014-10-01

    Full Text Available Leonard Ogbonna Ajah,1,2 Chukwuemeka Anthony Iyoke,1 Peter Onubiwe Nkwo,1 Boniface Nwakoby,3 Paul Ezeonu2 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria; 2Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria; 3Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria Background: The perception and prevalence of domestic violence (DV in rural areas is poorly understood; the result is that most efforts at eradicating this harmful practice are concentrated in urban areas. The objective of the study was to compare the burden and perception of DV among women living in rural and urban Igbo communities of southeast Nigeria. Methods: This was a comparative, cross-sectional study of women residing in rural and urban communities in Enugu, Nigeria, who had gathered for an annual religious meeting from August 1–7, 2011. Data analysis involved descriptive and inferential statistics and was conducted with the Statistical Package for Social Sciences, software version 17.0, at a 95% level of confidence. Results: A total of 836 women who met the eligibility criteria participated in the survey. Of these, 376 were from Okpanku, a rural community, while 460 were from Ogui Nike, an urban community. The prevalence of DV among rural women was significantly higher than that among urban women (97% versus 81%, P<0.001. In particular, the prevalence of physical violence was significantly higher among rural women than among urban women (37.2% versus 23.5%; P=0.05. In contrast, rural and urban women did not differ significantly in the proportions that had experienced psychological or sexual violence. The proportion of women who believed that DV was excusable was significantly higher among rural dwellers than among urban dwellers (58.5% versus 29.6%; P=0.03. Conclusion: The burden of DV against women may be higher in rural

  10. Smart work centres in rural areas

    DEFF Research Database (Denmark)

    Lorentzen, Anne Birte

    This paper discusses the establishment of telework centres as an element in local development strategies in rural areas, with a particular view to two new telework centres in region North Denmark. The paper argues that telework centres do not represent an easy solution to problems of local...... development and environmental sustainability, and further, that technology may not even be the most important feature needed to make them function as such....

  11. Benefits of donkeys in rural and urban areas in northwest Nigeria

    NARCIS (Netherlands)

    Hassan, M.R.; Steenstra, F.A.; Udo, H.M.J.

    2013-01-01

    The objective of this study is to explore the benefits of donkeys for rural and urban smallholder farmers in northwest Nigeria. We visited 112 smallholder donkey farmers located in rural and urban areas from four states in northwest Nigeriathrough four focus group meetings, interviews with

  12. The Effectiveness of New Solar Photovoltaic System with Supercapacitor for Rural Areas

    Directory of Open Access Journals (Sweden)

    Muhammad Izuan Fahmi Romli

    2016-11-01

    Full Text Available Countries like Malaysia have more that 70% of its population living in rural areas. Majority of these rural areas lie in regions where most villages do not have grid connected electricity. Renewable energy using photovoltaic (PV panels offers an alternative and cost efficient solution that exploits the yearlong abundance of sunlight available in countries like Malaysia. The main problem with PV systems is the high maintenance costs in replacing batteries every few years which makes PV systems unattractive for rural areas. A full scale PV system, developed in Semenyih Malaysia, aims to increase battery lifetime and reduce maintenance costs by incorporating supercapacitors. The system was developed in a life-sized cabin to mimic a rural home. A programmable load is used to test the system with the load profile of a typical rural household usage. Experimental and simulation results show that the supercapacitor bank is able to reduce the stress on the battery by absorbing peak current surges. Results also show that the system is able to maintain a high battery state of charge during the entire day. Article History: Received June 17th 2016; Received in revised form August 16th 2016; Accepted Sept 10th 2016; Available online How to Cite This Article: Fahmi, M.I., Rajkumar, R.,  Wong, Y.W., Chong, L.W., Arelhi, R., and Isa, D. (2016 The Effectiveness of New Solar Photovoltaic System with Supercapacitor for Rural Areas. Int. Journal of Renewable Energy Development, 5(3, 249-257. http://dx.doi.org/10.14710/ijred.5.3.249-257

  13. Promotion and diffusion of tha career Bachelor and Licenciature of Mathematics Teaching in rural areas of Costa Rica project: effects and results

    Directory of Open Access Journals (Sweden)

    Jorge Arroyo Hernández

    2016-03-01

    Full Text Available This article describes the purpose and activities of the project Promoting Mathematics Education in Rural Areas of Costa Rica. The activity has focused on two objectives. First, supporting and monitoring students who have expressed interest in studying a mathematics teacher. To achieve this, it has been working with students who have an ideal profile for the career, mainly from rural areas. The second objective is to conduct training workshops for high school in-service teachers, to strengthen and improve their knowledge in the area of mathematics. Among the results of the project, it can be highlighted a significant increase in the enrollment of students in the career of Mathematics Education in 2010 and 2011, and the training processes in the field of Real Functions of Real Variable and Geometry at different regional areas mostly rural as Aguirre, Sarapiquí, Coto, Buenos Aires, Limón, Cañas, Pérez Zeledón, Nicoya, Los Santos, Turrialba, Puriscal, Desamparados, San Carlos, Puntarenas, Limón, Liberia, Santa Cruz y Upala.

  14. Training child psychiatrists in rural public mental health.

    Science.gov (United States)

    Petti, T A; Benswanger, E G; Fialkov, M J; Sonis, M

    1987-04-01

    Lack of appropriate training in both public mental health service and rural mental health service is a major factor in the critical shortage of child psychiatrists in rural settings. The authors describe a residency training program in rural public mental health designed to help alleviate that shortage. The program familiarizes fourth-year residents in child psychiatry with the clinical, political, and social aspects of rural public mental health services through didactic and supervisory sessions as well as an eight-month practicum experience involving provision of inservice training and administrative and case-related consultation to staff of mental health agencies. An assessment of the program indicated that participants felt it was beneficial, but the program was only partly successful in increasing the number of child psychiatrists entering practice in rural areas. The authors urge that residency programs in child psychiatry give priority to training child psychiatrists for work in rural settings.

  15. Cardiovascular Morbidity Profile Of Population Aged 60 Years And Above In Rural And Urban Areas Of Kanpur

    Directory of Open Access Journals (Sweden)

    Saurabh Goel

    2009-06-01

    Full Text Available Background: Cardiovascular morbidity is a major contributor towards old age health problems which requires specialized care and if left unattended can deteriorate the quality of life and also lead to mortality. Therefore a study was planned to find out the prevalence of cardiovascular morbidity among geriatric population living in rural and urban areas ofKanpur.Objective: To find out the prevalence of cardiovascular morbidity in geriatric population in rural and urban area of Kanpur and also to study the pattern of cardiovascular morbidity in two areas.Material and methods: a cross sectional study was carried out in a randomly selected rural and urban area of Kanpur. 443 geriatrics in rural and 401 in urban area were interviewed and physically examined.Results: Geriatrics constituted 8.2% and 7.7% of total population in rural and urban area respectively. Majority ofpopulation in both areas belonged to 60-70years age group i.e. 78.8% and 75.8% respectively. 12.2% of rural geriatric and 12.5% of urban geriatric were suffering from some or other kind of cardiovascular morbidity. In rural area 39.1%>of geriatric population is hypertensive while in urban area hypertension is prevalent in 41.6%> of geriatric population. 98. l%>of morbid in rural and 86.0% in urban area were not doing any kind of exercise. A majority of population suffering from cardiovascular morbidity were not smoking currently. Majority i.e. 72.2% of geriatric population suffering from cardiovascular morbidity in rural area were having BMJ between 18.5-24.99 while in urban area 57.4% of them were having BMl>-25. Hypertensives consitiuted 57.4% in rural and 66.0% in urban area towards those who are suffering from cardiovascular morbidity.

  16. Cardiovascular Morbidity Profile Of Population Aged 60 Years And Above In Rural And Urban Areas Of Kanpur

    Directory of Open Access Journals (Sweden)

    Saurabh Goel

    2009-06-01

    Full Text Available Background: Cardiovascular morbidity is a major contributor towards old age health problems which requires specialized care and if left unattended can deteriorate the quality of life and also lead to mortality. Therefore a study was planned to find out the prevalence of cardiovascular morbidity among geriatric population living in rural and urban areas ofKanpur. Objective: To find out the prevalence of cardiovascular morbidity in geriatric population in rural and urban area of Kanpur and also to study the pattern of cardiovascular morbidity in two areas. Material and methods: a cross sectional study was carried out in a randomly selected rural and urban area of Kanpur. 443 geriatrics in rural and 401 in urban area were interviewed and physically examined. Results: Geriatrics constituted 8.2% and 7.7% of total population in rural and urban area respectively. Majority ofpopulation in both areas belonged to 60-70years age group i.e. 78.8% and 75.8% respectively. 12.2% of rural geriatric and 12.5% of urban geriatric were suffering from some or other kind of cardiovascular morbidity. In rural area 39.1%>of geriatric population is hypertensive while in urban area hypertension is prevalent in 41.6%> of geriatric population. 98. l%>of morbid in rural and 86.0% in urban area were not doing any kind of exercise. A majority of population suffering from cardiovascular morbidity were not smoking currently. Majority i.e. 72.2% of geriatric population suffering from cardiovascular morbidity in rural area were having BMJ between 18.5-24.99 while in urban area 57.4% of them were having BMl>-25. Hypertensives consitiuted 57.4% in rural and 66.0% in urban area towards those who are suffering from cardiovascular morbidity.

  17. What Impact Does Behavior of Doctors and Patients on Service Integration of Multi-institutional Readmission cross Township—county Hospitals in Rural China

    OpenAIRE

    Zhang, Yan; Tang, Wenxi; Zhang, Liang

    2017-01-01

    Background: With the change of rural residents’ disease spectrum and patients with chronic diseases boom, multi-institutional health service utilization of rural residents and the continuous service demands are growing sharply in rural China.Objective: Evaluate the service integration of multi-institutional readmission cross township—county hospitals (MRCTCH) in rural China, and figure out determines of service integration.Methods: This study featured 7 sample counties in rural China. Based o...

  18. Do features of public open spaces vary between urban and rural areas?

    Science.gov (United States)

    Veitch, Jenny; Salmon, Jo; Ball, Kylie; Crawford, David; Timperio, Anna

    2013-02-01

    Parks are an important setting for physical activity and specific park features have been shown to be associated with park visitation and physical activity. Most park-based research has been conducted in urban settings with few studies examining rural parks. This study examined differences in features of parks in urban compared with rural areas. In 2009/10 a tool was developed to audit 433 urban and 195 rural parks located in disadvantaged areas of Victoria, Australia. Features assessed included: access; lighting/safety; aesthetics; amenities; paths; outdoor courts/ovals; informal play spaces; and playgrounds (number, diversity, age appropriateness and safety of play equipment). Rural parks scored higher for aesthetics compared with urban parks (5.08 vs 4.44). Urban parks scored higher for access (4.64 vs 3.89), lighting/safety (2.01 vs 1.76), and diversity of play equipment (7.37 vs 6.24), and were more likely to have paths suitable for walking/cycling (58.8% vs 40.9%) and play equipment for older children (68.2% vs 17.1%). Although the findings cannot be generalized to all urban and rural parks, the results may be used to inform advocacy for park development in rural areas to create parks that are more supportive of physical activity for children and adults. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Willingness to Pay for Rural Telephone Services: Implications for ...

    African Journals Online (AJOL)

    Global Approaches to Extension Practice: A Journal of Agricultural Extension ... This study assessed Willingness to Pay (WTP) for rural telephone services and the implications for agricultural technology transfer in Southeast Nigeria. ... The sample was made up of 240 agro-based entrepreneurs and 60 extension staff.

  20. Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey

    Directory of Open Access Journals (Sweden)

    Setel Philip

    2005-01-01

    Full Text Available Abstract Background Injuries are becoming a major health problem in developing countries. Few population based studies have been carried out in African countries. We examined the pattern of nonfatal injuries and associated risk factors in an urban and rural setting of Tanzania. Methods A population-based household survey was conducted in 2002. Participants were selected by cluster sampling. A total of 8,188 urban and 7,035 rural residents of all ages participated in the survey. All injuries reported among all household members in the year preceding the interview and resulting in one or more days of restricted activity were included in the analyis. Results A total of 206 (2.5% and 303 (4.3% persons reported to have been injured in the urban and rural area respectively. Although the overall incidence was higher in the rural area, the incidence of major injuries (≥ 30 disability days was similar in both areas. Males were at a higher risk of having an injury than females. Rural residents were more likely to experience injuries due to falls (OR = 1.6; 95% CI = 1.1 – 2.3 and cuts (OR = 4.3; 95% CI = 3.0 – 6.2 but had a lower risk of transport injuries. The most common causes of injury in the urban area were transport injuries and falls. In the rural area, cuts and stabs, of which two thirds were related to agriculture, formed the most common cause. Age was an important risk factor for certain types of injuries. Poverty levels were not significantly associated with experiencing a nonfatal injury. Conclusion The patterns of injury differ in urban and rural areas partly as a reflection of livelihoods and infrastructure. Rural residents are at a higher overall injury risk than urban residents. This may be important in the development of injury prevention strategies.

  1. Fuel poverty in the UK: Is there a difference between rural and urban areas?

    International Nuclear Information System (INIS)

    Roberts, Deborah; Vera-Toscano, Esperanza; Phimister, Euan

    2015-01-01

    Fuel poverty is a significant policy issue. An argument often made is that rural households are more likely to be fuel poor due to the nature of rural housing stock and the more limited choice of energy sources in rural areas. This paper uses panel data to compare the level and dynamics of fuel poverty in rural and urban areas of the UK. In addition to descriptive analysis, discrete hazard models of fuel poverty exit and re-entry are estimated and used to assess the influence of housing and personal characteristics on the time spent in fuel poverty. The results indicate that, on average, the experience of fuel poverty in urban areas is longer with a higher probability of fuel poverty persistence. However, on average the rural fuel poor appear more vulnerable to energy price increases while living in private accommodation or a flat increases their probability of remaining fuel poor relative to their urban counterparts. These results indicate policy effectiveness may differ across rural and urban space. However, they also emphasise the limits of spatial targeting. Monitoring the dynamics of fuel poverty is important for ensuring that policy targets are effective and reaching those most in need. - Highlights: • Urban fuel poverty is more persistent on average than rural fuel poverty. • Rural fuel poor are on average more vulnerable to energy price shocks. • Fuel poverty policy measures may have different effects in rural and urban areas. • Both spatial and household targeting required for policy effectiveness. • Policy makers should to consider additional monitoring of dynamics of fuel poverty.

  2. Knowledge Access in Rural Inter-connected Areas Network ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Knowledge Access in Rural Inter-connected Areas Network (KariaNet) - Phase II ... and indigenous knowledge using information and communication technologies (ICTs) ... for research proposals on the aforementioned topics, action-research projects, ... Evaluating knowledge-sharing methods to improve land utilization and ...

  3. A comparison of mental health, substance use, and sexual risk behaviors between rural and non-rural transgender persons.

    Science.gov (United States)

    Horvath, Keith J; Iantaffi, Alex; Swinburne-Romine, Rebecca; Bockting, Walter

    2014-01-01

    The aim of this study was to compare the mental health, substance use, and sexual risk behaviors of rural and non-rural transgender persons. Online banner advertisements were used to recruit 1,229 self-identified rural and non-rural transgender adults (18+ years) residing in the United States. Primary findings include significant differences in mental health between rural and non-rural transmen; relatively low levels of binge drinking across groups, although high levels of marijuana use; and high levels of unprotected sex among transwomen. The results confirm that mental and physical health services for transgender persons residing in rural areas are urgently needed.

  4. Back to the future; new functions for rural areas in Europe

    NARCIS (Netherlands)

    Os, van J.; Klundert, van de A.F.; Dietvorst, A.G.J.

    1995-01-01

    As part of the project Rural Areas and Europe of the Netherlands Spatial Planning Department a study was carried out in which integrated rural development was one of the answers to the economic and environmental problems of agriculture. The study focused on four possible new functions: water

  5. Air pollution and decreased semen quality: A comparative study of Chongqing urban and rural areas

    International Nuclear Information System (INIS)

    Zhou, Niya; Cui, Zhihong; Yang, Sanming; Han, Xue; Chen, Gangcai; Zhou, Ziyuan; Zhai, Chongzhi; Ma, Mingfu; Li, Lianbing; Cai, Min; Li, Yafei; Ao, Lin; Shu, Weiqun; Liu, Jinyi; Cao, Jia

    2014-01-01

    To investigate the association and effects of air pollution level on male semen quality in urban and rural areas, this study examines the outdoor concentrations of particulate matter (PM 10 ), sulfur dioxide (SO 2 ), nitrous dioxide (NO 2 ) and semen quality outcomes for 1346 volunteers in both urban and rural areas in Chongqing, China. We found the urban area has a higher pollution level than the rural area, contrasted with better semen quality in the rural residents, especially for sperm morphology and computer assistant semen analysis (CASA) motility parameters. A multivariate linear regression analysis demonstrates that concentrations of PM 10 , SO 2 , and NO 2 significantly and negatively are associated with normal sperm morphology percentage (P  10 , SO 2 , and NO 2 in urban ambient air may account for worse semen quality in urban males. - Highlights: • We investigate the distributions of PM 10 , SO 2 and NO 2 in urban and rural areas in Chongqing, China. • We explore the associations of air pollution and male semen quality. • The concentrations of PM 10 , SO 2 , and NO 2 are significantly higher in urban areas. • Median values of some semen quality parameters in rural male were higher than urban male. • PM 10 , SO 2 , and NO 2 were negatively associated with semen quality parameters. - Air pollution is higher in the urban area while there is better semen quality in rural males. Polluted air may thus account for worse semen quality in urban males

  6. Managing Urban Wellbeing in Rural Areas: The Potential Role of Online Communities to Improve the Financing and Governance of Highly Valued Nature Areas

    Directory of Open Access Journals (Sweden)

    Rixt A. Bijker

    2014-06-01

    Full Text Available The urban and the rural are increasingly interconnected. Rural areas have become places of consumption, as leisure and recreation have become important functions of rural areas. There are also indications that increased urbanisation even leads to a stronger appreciation of green areas situated far beyond city limits. Rural areas with their highly valued natural amenities nowadays seem increasingly to host urban wellbeing, given the positive relation found between green areas and human wellbeing. We provide empirical evidence for this urban–rural interconnection, using results from a survey in the Netherlands. In addition to their attachment to local and regional green places, survey results show that residents of the capital city of Amsterdam have a high appreciation of a wide range of natural, rural places throughout the country. We argue that these (until now invisible urban–rural ties should be made more visible because these natural areas enjoyed by urban residents can no longer be taken for granted. Financial and other support for nature conservation are therefore needed. However, to organise support for nature can often be problematic because nature is a public good and collective action is often difficult to launch. The invisible and distant ties of urban dwellers for rural areas complicate the task even more. Nevertheless, it is increasingly recognised that the Internet opens many doors for community building and may help to overcome the “illogic” of collective action. In the research project “Sympathy for the Commons”, we aim to investigate the possibilities provided by the internet by building online communities around nature areas and enquiring into the available support and funding that these communities can provide.

  7. An evaluation of a community pharmacy-based rural asthma management service.

    Science.gov (United States)

    Saini, Bandana; Filipovska, Julija; Bosnic-Anticevich, Sinthia; Taylor, Susan; Krass, Ines; Armour, Carol

    2008-04-01

    To compare the effect of a pharmacist-delivered rural asthma management service (RAMS) on health outcomes for people with asthma in a rural/regional area with 'standard care' delivered through community pharmacies. A parallel group controlled repeated measures study. Community pharmacies in Central West New South Wales. Standardised protocols and resources based on national asthma management guidelines, delivered by specially trained community pharmacists. Patients visited the pharmacy at baseline and 1, 3 and 6 months after baseline in the intervention group and at baseline plus 6 months after baseline in the control group. The intervention pharmacists (n = 12) were trained to deliver the RAMS model, while control pharmacists (n = 8) provided standard asthma care to their recruited patients. Fifty-one and 39 patients were recruited by intervention and control pharmacists. Asthma severity score which was a composite score based on recency, frequency and severity of asthma symptoms, and asthma history. Data compared at the final visit between groups indicated that the RAMS patient group demonstrated a significant reduction in the asthma severity scores (7.9 +/- 2.6 versus 10.4 +/- 2.6, P < 0.001); a reduction in the risk of non-adherence to medication scores (1.6 +/- 0.7 versus 2.3 +/- 1.1, P < 0.001); and an increase in the proportion of patients owning a written action plan (50% versus 23%, P = 0.04). These results indicated that the community pharmacy-based RAMS model can improve asthma outcomes for patients in rural settings, and similar models for asthma and other chronic diseases should be tested rigorously and adopted in rural primary care practice.

  8. Analysis of Home Safety of the Elderly Living in City and Rural Areas

    Directory of Open Access Journals (Sweden)

    Nihal Buker

    2008-08-01

    Full Text Available BACKGROUND: Physiological changes and chronic diseases arising during aging process increase risk of accident of the elderly, especially the elderly living alone at their homes. Home accidents are the most commonly health problem in the elderly. This study was carried out to describe home safety of the elderly living in a city or rural area using a home safety checklist. MEDHODS: 512 living in Turkey (330 in city; 182 in rural area were evaluated via face-to-face interview using a home safety checklist during a period between December and March in 2007. In addition to sociodemographics, a questionnaire including home characteristics and life style of participants was applied. To describe home safety level, Home Safety Checklist was used. RESULTS: 51.8% of the participants living in a city and 42.8% living in rural area were aged 65-69 years. Of the participants living in a city, 59.4% were living with their partners (61.5% of the participants living in rural area. While 63.9% of the participants living in a city reported that they had a private room in their homes, 53.8% of the participants living in rural area reported that they had a private room in their homes. 2.1% of participants living in a city had an excellent home safety score. Percentage for participants living in rural area was 0.5. CONCLUSION: The results obtained from this study show that majority of houses of the elderly living in Turkey were unsafe and hazardous. Therefore, health providers and architects should work together to prevent home accidents. [TAF Prev Med Bull 2008; 7(4.000: 297-300

  9. 7 CFR 2.48 - Administrator, Rural Business-Cooperative Service.

    Science.gov (United States)

    2010-01-01

    ... organizations throughout the world on subjects related to the development and operation of agricultural... Product Market Development Grant program (note to 7 U.S.C. 1621). (29) Administer the Agriculture... 7 Agriculture 1 2010-01-01 2010-01-01 false Administrator, Rural Business-Cooperative Service. 2...

  10. Remote rural women's choice of birthplace and transfer experiences in rural Otago and Southland New Zealand.

    Science.gov (United States)

    Patterson, Jean; Foureur, Maralyn; Skinner, Joan

    2017-09-01

    specialist care. Themes included, deciding about the safest place to give birth; making the decision to transfer; experiencing transfer in labour, and reflecting on their birth experience and considering future birthplace choices. The experiences of the women show that for some, distance from a base hospital influences their place of birth decisions in remote rural areas of New Zealand and increases the distress for those needing to transfer over large distances. These experiences can result in women choosing, or needing to make different choices for subsequent births; the consequences of which impact on the future sustainability of midwifery services in remote rural areas, a challenge which resonates with maternity service provision internationally. While choices about birth place cannot be reliably predicted, creative solutions are needed to provide rural midwifery care and birth options for women and more timely and efficient transfer services when required. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Building a sustainable workforce in a rural and remote health service: A comprehensive and innovative Rural Generalist training approach.

    Science.gov (United States)

    Orda, Ulrich; Orda, Sabine; Sen Gupta, Tarun; Knight, Sabina

    2017-04-01

    Historically it has been challenging to recruit and retain an appropriately trained medical workforce to care for rural and remote Australians. This paper describes the Queensland North West Hospital and Health Service (NWHHS) workforce redesign, developing education strategies and pathways to practice, thereby improving service provision, recruitment and retention of staff. The Mount Isa-based Medical Education Unit sought accreditation for a Rural Generalist (RG) training pathway from Internship to Fellowship with the Australian College of Rural and Remote Medicine (ACRRM) and the Regional Training Provider (RTP). This approach enhanced the James Cook University (JCU) undergraduate pathway for rurally committed students while improving recruitment and retention of RMOs/Registrars. Accreditation was achieved through collaboration with training providers, accreditation agencies, ACRRM and a local general practice. The whole pathway from ignore Internship to Fellowship is offered with the RG Intern intake as a primary allocation site beginning in 2016. Comprehensive supervision and excellent clinical exposure provide an interesting and rewarding experience - for staff at all levels. Since 2013 RMO locum rates have been <1%. Registrars on the ACRRM pathway and Interns increased from 0 to 7 positions each in 2015, with similar achievements in SMO staffing. Three RMOs expressed interest in a Registrar position, CONCLUSIONS: Appropriate governance is needed to develop and advertise the program. This includes the NWHHS, the RG Pathway and JCU. © 2016 National Rural Health Alliance Inc.

  12. Dietary behaviors and nutritional status of adolescents in a remote rural area of Thailand.

    Science.gov (United States)

    Areekul, Wirote; Viravathana, Nantaporn; Aimpun, Pote; Watthanakijthavongkul, Khanin; Khruacharooen, Jakkapong; Awaiwanont, Abhinant; Khumtuikhrua, Chaowanan; Silsrikul, Pichayen; Nilrat, Pawarid; Saksoong, Saksit; Watthanatham, Jirawat; Suwannahitatorn, Picha; Sirimaneethum, Pornsirin; Meeprom, Natee; Somboonruangsri, Wuttiwong; Pongmanee, Koonphol; Rangsin, Ram

    2005-11-01

    Nutritional status among adolescents is an important health indicator. The up-to-date information about nutritional status and food consumption pattern in the remote rural area is required for the effective public health intervention in the rural area of the country. The present study aimed to demonstrate the prevalence of malnutrition, eating behavior and nutritional knowledge among secondary school students in a remote rural area in Thailand. Body weight and height data were collected from 298 secondary school students for nutritional status calculation using the Institute of Nutrition Research, Mahidol University, INMU-Thaigrowth program. Eating behavior and nutritional knowledge were observed by self-administrated questionnaires. The prevalence low height-for-age (instant noodles (64.4%). The prevalence of malnutrition was low among this population. The studied population had a fair knowledge about nutrition. The authoes found that regular consumption of highly commercialized snack products especially salted chips and instant noodles were at a high level in this remote rural area of Thailand. The pattern of nutritional problems in Thailand may have changed in which a public health program for children in rural areas of the country should recognize this transition.

  13. THE LEVEL OF BREAST AND CERVICAL CANCER AWARENESS AMONG WOMEN IN A RURAL AREA OF SOUTH AFRICA.

    Science.gov (United States)

    Zeitoun, O; Shemesh, N

    2017-06-01

    In South Africa breast and cervical cancer are the most predominant cancers amongst women, with mortality rates reaching surprising proportions. As a result of the continued rise of these conditions it is vital to determine these women's awareness of both, so as to determine the exact factors contributing to this rise. Whilst both urban and rural areas are afflicted, this study focused primarily on women in a rural area. This was a descriptive cross-sectional study conducted in a shopping mall located in the rural area of Bushbuckridge, Mpumalanga, South Africa. A total of 300 women of reproductive age were randomly identified and requested to fill out a study questionnaire assessing their level of breast and cervical cancer awareness. A total of 300 women participated in the study. The mean age of participants was 35.66 with a range of 13.53. Overall levels of knowledge about breast and cervical cancer in rural Bushbuckridge were found to be reduced with 66.89% and 74.49% of women who rated themselves with a poor understanding of breast and cervical cancer knowledge respectively. Among the participating women, those over the age of 40, with higher level of education were found to be more cognizant in terms of breast and cervical cancer awareness with a 30% (p = 0.0923) and 52% (p < 0.001) respectively. Their younger and less educated counterparts had a 21% (p = 0.078) and 32% (p = 0.034) awareness of breast and cervical cancer, respectively. The leading source of information for both breast and cervical cancer was healthcare facilities with a 67.11% and 63.5% respectively. This study highlights the lack of awareness and knowledge of breast and cervical cancer in women living in the rural area of Bushbuckridge, South Africa. There is also evidence showing that the older and more educated women have better knowledge than their younger and less educated counterparts, therefore there is a need for increased breast and cervical cancer education and awareness campaigns

  14. Work motivation and job satisfaction of health workers in urban and rural areas.

    Science.gov (United States)

    Grujičić, Maja; Jovičić-Bata, Jelena; Rađen, Slavica; Novaković, Budimka; Šipetić-Grujičić, Sandra

    2016-08-01

    Motivated and job satisfied health professionals represent a basis of success of modern health institutions. The aim of this study was to investigate whether there was a difference in work motivation and job satisfaction between health workers in urban and rural areas in the region of Central Serbia. The study included 396 health professionals from urban setting, and 436 from a rural area, employed in four randomly selected health facilities. An anonymous questionnaire was used for data gathering. Statistical analysis was performed using χ2, Student t-test, Spearman's correlation coefficient, and logistic regression analysis. Urban health professionals were significantly more motivated and job satisfied than respondents from rural area. In relation to work motivation factors and job satisfaction of health professionals in urban and rural areas, there were no significant differences in working conditions and current equipment, and in terms of job satisfaction there were no significant differences in relation to income either. In order to increase the level of work motivation and job satisfaction of health workers in rural areas, apart from better income, they should get more assistance and support from their supervisors, and awards for good job performance; interpersonal relationships, promotion and advancement opportunities, managerial performance and cooperation at work should be improved; employment security should be provided, as well as more independence at work, with professional supervision of health workers.

  15. IMPLEMENTING TQM IN RURAL MONUMENTAL BAROQUE SCULPTURE IN THE BANAT AREA

    Directory of Open Access Journals (Sweden)

    I. PETROMAN

    2008-05-01

    Full Text Available The cultural patrimony preserves the memory and identity of the Banat’s rural area, defining the personality specific to each locality depending on the colonizing ethnic group after the liberation from the Turkish yoke. Steadily degrading, this baroque sculptural patrimony must be saved and integrated into a tourist circuit through the development of a managerial strategy and the implementation of a total quality management that cover the widest area possible of issues related to the intact preservation of monuments and to their conservation. The valorisation of monumental baroque sculpture in the rural area must be done together with the development of a managerial strategy of sustainable development thus contributing to the making up of an emblematic image specific to the Banat village and to the inclusion into regional, national, and international tourist circuits through such modern forms of tourism as cultural tourism, rural tourism, heritage tourism, interethnic tourism, religious tourism, and business tourism.

  16. Assessing Sustainable Rural Community Tourism Using the AHP and TOPSIS Approaches under Fuzzy Environment

    Directory of Open Access Journals (Sweden)

    Mujiya Ulkhaq M.

    2016-01-01

    Full Text Available Tourism is currently a sector that is growing into an important and significant world activity. The development of an area where the tourist destination located in affects the growth of the tourism. In addition, the success of tourist destinations are influenced by their relative competitiveness; hence, they do compete each other to offer the best service to satisfy their customers. Rural tourism in Indonesia is believed as emerging business since there are abundant sites located in rural area that offers fascinating attractions to the visitors. This study aims to evaluate the rural tourism using sustainable indicators, namely, service quality, facilities, management system, and outcome. A combination of fuzzy AHP and TOPSIS are employed to select five rural tourism in Central Java Province. Result shows that service quality is considered as the most important attribute with weight of 28.6%, while Dieng is named for the excellent rural tourism. This finding might offer the service providers with valuable insights into the attribute that reflects customers’ perceptions about rural tourism; also to position their services based on their competitors.

  17. Infrastructure Development: Public Private Partnership Path for Developing Rural Telecommunications in Africa

    Directory of Open Access Journals (Sweden)

    Idongesit William Williams

    2012-06-01

    Full Text Available It is the quest of every government to achieve universal Access and service of telecommunication services and ICTs. Unfortunately due to the high cost of deploying infrastructure in rural areas of developing countries due to non-significant or no economic activity, this dream of achieving Universal access and service of telecommunications/ICTs have been stalled. This paper throws light on a possible Public Private Partnership framework as a development path that will enable affordable network technologies to be deployed in rural areas at a cost that will translate to what the rural dweller in a developing country in Africa can afford. The paper is a conceptual paper

  18. Supporting the Establishment of Climate-Resilient Rural Livelihoods in Mongolia with EO Services

    Science.gov (United States)

    Grosso, Nuno; Patinha, Carla; Sainkhuu, Tserendash; Bataa, Mendbayar; Doljinsuren, Nyamdorj

    2016-08-01

    The work presented here shows the results from the project "Climate-Resilient Rural Livelihoods in Mongolia", included in the EOTAP (Earth Observation for a Transforming Asia Pacific) initiative, a collaboration between the European Space Agency (ESA) and the Asian Development Bank (ADB), developed in cooperation with the Ministry of Food and Agriculture of Mongolia.The EO services developed within this EOTAP project primarily aimed at enriching the existing environmental database maintained by the National Remote Sensing Center (NRSC) in Mongolia and sustaining the collaborative pasture management practices introduced by the teams within the Ministry of Food and Agriculture of Mongolia. The geographic area covered by the EOTAP services is Bayankhongor province, in western Mongolia region, with two main services: drought monitoring at the provincial level for the year 2014 and Land Use/Land Cover (LULC) and changes mapping for three districts of this province (Buutsagaan, Dzag and Khureemaral) for the years 2013, 2014.

  19. Delivery Mechanisms for Rural Electrification. A report from a workshop

    Energy Technology Data Exchange (ETDEWEB)

    Gullberg, Monica; Ilskog, Elisabeth; Arvidson, Anders; Katyega, Maneno (eds.)

    2004-04-01

    The workshop was attended by 28 participants from Kenya, Mozambique South Africa, Sweden, Tanzania, Uganda, Zambia and Zimbabwe, representing energy service providers (private, public and cooperative), consumer groups, public energy authorities, researchers, consultants, NGOs and the Swedish International Development Cooperation Agency. The topic of the workshop was how different types of electricity delivery mechanisms - i.e. the combination of an energy supply technology and the organisation managing it - can support rural development. Which energy services have high priority for rural development? What are the appropriate delivery mechanisms? How can the expansion of different delivery mechanisms be supported and made to work efficiently? These are some of the key questions that were discussed in the workshop. The objectives of the workshop were to share experiences and develop a better understanding of existing and potential energy delivery mechanisms that contribute to development in rural areas in Eastern and Southern Africa. The workshop was targeted at, amongst others, the authorities which are in the process of being formed, or have recently been formed, to take charge of rural electrification such as the Rural Electrification Agencies and Rural Electrification Funds. Four case studies were presented and discussed to provide an introduction to the topic, and concrete examples of different delivery mechanisms were given to inspire the workshop discussions. Focus group discussions were used to explore the participants perceptions and experience of: (i) what rural development is, (ii) what role energy plays in rural development, (iii) which energy services are important for rural development, (iv) which delivery mechanisms are used and appropriate for different situations of energy service delivery in rural areas, and (v) what the institutional framework requirements are for delivering different types of energy services and supporting different types of

  20. Quality-of life of the elderly in urban and rural areas in Serbia.

    Science.gov (United States)

    Urosević, Jadranka; Odović, Gordana; Rapaić, Dragan; Davidović, Mladen; Trgovcević, Sanja; Milovanović, Verica

    2015-11-01

    The number of elderly people in the world is growing, in Serbia as well. Serbia is already among the top ten countries with the oldest population, it is the fact. Aging influences the quality of life in different ways. The aim of this study was to assess the health-related quality of life of the elderly in urban and rural areas in Serbia. The study included 100 elderly people aged 65 years and above in urban and rural areas in Serbia. The next questionnaires were used: a socio-demographic questionnaire and a Serbian version of standardized European Euro-QoL questionnaire (EQ-5D-3L), as a basic index for the assessment and description of the quality of life. In the structure of the respondents, according to the achieved social contacts (p = 0.012), the life of those with family members (p = 0.009), and health status (p = 0.000), in relation to the place of residence there was a statistically significant difference. There was a significant difference (p = 0.040), predominantly poor score for anxiety/depression within the rural population. The average value of quality of life in urban and rural areas was not statistically significant (p = 0.720). For those living in rural areas there was a statistically significant positive correlation between anxiety/depression and age, wealth status, marital status, living with family members and achieving social contacts, while a negative correlation was observed between anxiety/depression and education. On the basis of the data of our study, we can say that the presence of anxiety/depression among older people is greater in rural than in urban areas. The results of this study show that the perception of anxiety/depression among older in rural areas is bigger with the age and poverty increasing, the loss of a spouse, life without family members, lack of achievement of social contacts and lower education.

  1. Quality of life of the elderly in urban and rural areas in Serbia

    Directory of Open Access Journals (Sweden)

    Urošević Jadranka

    2015-01-01

    Full Text Available Background/Aim. The number of elderly people in the world is growing, in Serbia as well. Serbia is already among the top ten countries with the oldest population, it is the fact. Aging influences the quality of life in different ways. The aim of this study was to assess the health-related quality of life of the elderly in urban and rural areas in Serbia. Methods. The study included 100 elderly people aged 65 years and above in urban and rural areas in Serbia. The next questionnaires were used: a sociodemographic questionnaire and a Serbian version of standardized European Euro-QoL questionnaire (EQ-5D-3L, as a basic index for the assessment and description of the quality of life. Results. In the structure of the respondents, according to the achieved social contacts (p = 0.012, the life of those with family members (p = 0.009, and health status (p = 0.000, in relation to the place of residence there was a statistically significant difference. There was a significant difference (p = 0.040, predominantly poor score for anxiety/depression within the rural population. The average value of quality of life in urban and rural areas was not statistically significant (p = 0.720. For those living in rural areas there was a statistically significant positive correlation between anxiety/depression and age, wealth status, marital status, living with family members and achieving social contacts, while a negative correlation was observed between anxiety/depression and education. Conclusion. On the basis of the data of our study, we can say that the presence of anxiety/depression among older people is greater in rural than in urban areas. The results of this study show that the perception of anxiety/depression among older in rural areas is bigger with the age and poverty increasing, the loss of a spouse, life without family members, lack of achievement of social contacts and lower education.

  2. Census in a rural area of Ethiopia: methodology and results.

    Science.gov (United States)

    Materia, E; Mehari, W; Mele, A; Rosmini, F; Stazi, M A; Damen, H M; Basile, G; Kifle, T; Miuccio, G; Ferrigno, L

    1993-01-01

    A census and an ecologic survey were performed in 39 villages of a rural district of Arsi Region, Ethiopia, in difficult field circumstances. Information on age, ethnic group, education and family relationship, as well as data on health facilities and availability of basic services were collected. Supervised students, working in teams, were used as interviewers. Communities were involved through plenary meetings and community health agents participated in the data collection process. A total of 64,714 people in 12,152 households were registered. The repeatability of age assessment was investigated by comparing the results from two villages with data obtained in a pilot study carried out 6 months earlier. The technical error was only 0.80 and 1.67 in the 0-5 and 6-15 age-groups, respectively. Three percent of the total population was under one year, less than previously estimated. This may, in part, be due to the family planning programme in the region. Eighteen percent of the households were headed by females. School attendance was less common among females and in the Oromo ethnic group. The availability of basic services, including safe water and basic sanitation supplies, was very poor in the area.

  3. CHANGING SCHOOL NEEDS IN RURAL AREAS.

    Science.gov (United States)

    RHODES, ALVIN E.

    AS THE RURAL ECONOMY HAS BECOME MORE AFFECTED BY AUTOMATION, RURAL SOCIETY HAS BECOME MORE INDUSTRIAL. FARM POPULATION AND THE NUMBER OF FARMS HAVE DECREASED, WHILE NON-FARM RURAL POPULATION HAS INCREASED. THE CHANGING RURAL SCENE IS REFLECTED IN CHANGES IN RURAL EDUCATION. EDUCATIONAL OPPORTUNITIES HAVE GREATLY INCREASED DUE TO SCHOOL…

  4. Factors with to intestinal constipation in the rural area elderly

    Directory of Open Access Journals (Sweden)

    Sara Franco Diniz Heitor

    2013-12-01

    Full Text Available The objective of this study was to identify the prevalence of intestinal constipation in the rural area elderly and verify the factors associated. This is a home survey performed with 850 elderly residents of the rural area of Uberaba, Minas Gerais state. A structured instrument was used; information regarding their eating habits was obtained using an adapted questionnaire for food consumption frequency, and intestinal constipation was self-reported. Descriptive analysis, chi-square test and multiple logistic regression (p<0.05 were performed. The prevalence of intestinal constipation was 13.2%. The factors associated with intestinal constipation were: female gender (p<0.001, 80 years of age or older (p=0.035, living with another person (p=0.004, having no income (p=0.033, inadequate consumption of fruits (p=0.005 and vegetable (p=0.002. It is considered that client-centered nutritional education can help remove the factors associated with the outcome. Descriptors: Constipation; Aged; Gastrointestinal Motility; Rural Population; Geriatric Nursing.

  5. Area-level risk factors for adverse birth outcomes: trends in urban and rural settings.

    Science.gov (United States)

    Kent, Shia T; McClure, Leslie A; Zaitchik, Ben F; Gohlke, Julia M

    2013-06-10

    Significant and persistent racial and income disparities in birth outcomes exist in the US. The analyses in this manuscript examine whether adverse birth outcome time trends and associations between area-level variables and adverse birth outcomes differ by urban-rural status. Alabama births records were merged with ZIP code-level census measures of race, poverty, and rurality. B-splines were used to determine long-term preterm birth (PTB) and low birth weight (LBW) trends by rurality. Logistic regression models were used to examine differences in the relationships between ZIP code-level percent poverty or percent African-American with either PTB or LBW. Interactions with rurality were examined. Population dense areas had higher adverse birth outcome rates compared to other regions. For LBW, the disparity between population dense and other regions increased during the 1991-2005 time period, and the magnitude of the disparity was maintained through 2010. Overall PTB and LBW rates have decreased since 2006, except within isolated rural regions. The addition of individual-level socioeconomic or race risk factors greatly attenuated these geographical disparities, but isolated rural regions maintained increased odds of adverse birth outcomes. ZIP code-level percent poverty and percent African American both had significant relationships with adverse birth outcomes. Poverty associations remained significant in the most population-dense regions when models were adjusted for individual-level risk factors. Population dense urban areas have heightened rates of adverse birth outcomes. High-poverty African American areas have higher odds of adverse birth outcomes in urban versus rural regions. These results suggest there are urban-specific social or environmental factors increasing risk for adverse birth outcomes in underserved communities. On the other hand, trends in PTBs and LBWs suggest interventions that have decreased adverse birth outcomes elsewhere may not be reaching

  6. Obstacles to the take-up of mental health-care provision by adult males in rural and remote areas of Australia: A systematic review protocol.

    Science.gov (United States)

    Stroud, Peter; Lockwood, Craig

    The objective is to identify and synthesise the best available evidence on the obstacles to the take-up of health-care provision by adult rural and remote dwelling males in Australia seeking mental health services. Men's health, in general health-care practice, is defined as the global management of mental, emotional, and physical health conditions, and related risk factors, that are specific to men in order to promote and generate optimal health.Research and practice tends to suggest that health-care and mental-health care practitioners seem to be confronted with obstacles such as distance clients need to travel and rurality in delivering care to adult rural males. Possible issues might be whether, or to what extent, care providers are conscious of these obstacles. Another issue might be how care providers work with these obstacles in practice, and whether or not they may, also to some extent, share some of the responsibility for the existence of these obstacles, on their own, or in conjunction with other factors which might be said to exist purely in the rural context. There is also a need to explore the contributions to obstacles from the adult rural male side as well. There may also be factors at work in the particular unique nature of rural and remote health-care and mental-health care as well, which could also be involved in the creation of obstacles.The structure and functioning of rural care available to adult males of all cultural backgrounds and the obstacles to the take-up of that care represents an area which warrants further exploration and understanding. A foundation paper in this field by Karoski suggests that obstacles exist in health-care provision, particularly in the field of mental-health care to adult males. Other research suggests that, while obstacles in service provision are common to all areas, some obstacles are more significant for rural and remote areas.The reasons for framing this review in terms of the adult rural and remote male (ARRM

  7. APRECIERI ASUPRA FENOMENULUI TURISTIC RURAL

    Directory of Open Access Journals (Sweden)

    Puiu NISTOREANU

    2007-06-01

    Full Text Available The rural areas are rich in their ecological and cultural diversity. The dimension and complexity of the rural communities make difficult a generalization regarding their problems or values, even if some common characteristics exist. For a long time in their existence, the rural communities have relied on the abundance of natural resources. But, in the 20th century, the great technological, political and economical changes have brought a profound transformation in agriculture, and other renewable industrial resources, fact which led the rural communities to a dependency towards these. Although these changes occurred, many reasons for optimism still exist. Involvement of new households in offering touristic services constitutes a new dimension of the development of the rural areas, and on a secondary plane the touristic activity in the rural environment registers new ways of manifestation. Even more, we are able to appreciate the dimensions and evolution of one of the most spectacular social – economic phenomena; the rural tourism.

  8. HAPPINESS ORIENTATIONS AMONG ADOLESCENTS RAISED IN URBAN AND RURAL AREAS

    Directory of Open Access Journals (Sweden)

    Anisti Anggraeny

    2016-08-01

    Full Text Available Researcher takes particular interest to discover the respondents’ orientation towards happiness based on where the respondent was raised. The study involves 467 senior high school students with ages ranging from 14-17 years old. The data is analyzed using an adapted society psychological approach. The results shows that adolescents raised in rural areas are consider the family to be a factor that contributes to their happiness. Second, achievement is also a factor that leads to happiness. However for the category, to love and be loved, adolescents growing in urban areas place this as a factor that leads to happiness. Similar with spirituality, friends and leisure time are factors that make adolescents raised in urban areas to become happy. Nevertheless, the results of cross tabulation with Pearson chi square test scoring demonstrates that no correlations exist between adolescent happiness raised from urban or rural areas.

  9. The use of home-based therapy with ready-to-use therapeutic food to treat malnutrition in a rural area during a food crisis

    Science.gov (United States)

    When the international community declared a famine in Malawi in January 2006, emergency food aid reached only populations with pre-existing health care services. To treat the widespread childhood malnutrition in Machinga district, a rural area lacking health care facilities, in February 2006 five ou...

  10. Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2-8 Years in Rural and Urban Areas - United States, 2011-2012.

    Science.gov (United States)

    Robinson, Lara R; Holbrook, Joseph R; Bitsko, Rebecca H; Hartwig, Sophie A; Kaminski, Jennifer W; Ghandour, Reem M; Peacock, Georgina; Heggs, Akilah; Boyle, Coleen A

    2017-03-17

    subtypes, children with an MBDD more often lacked a medical home, had a parent with poor mental health, lived in families with financial difficulties, and lived in a neighborhood lacking physical and social resources than children without an MBDD within each of those community types. Only in urban areas did a higher percentage of children with MBDDs lack health insurance than children without MBDDs. After adjusting for race/ethnicity and poverty among children with MBDDs, those in rural areas more often had a parent with poor mental health and lived in resource-low neighborhoods than those in urban areas. Certain health care, family, and community disparities were more often reported among children with MBDDS than among children without MBDDs in rural and urban areas. Collaboration involving health care, family, and community services and systems can be used to address fragmented services and supports for children with MBDDs, regardless of whether they live in urban or rural areas. However, addressing differences in health care, family, and community factors and leveraging community strengths among children who live in rural areas present opportunities to promote health among children in rural communities.

  11. Comparison between motorcyclist’ violation behavior and accidents in urban and rural area in Indonesia: A comparative study

    Science.gov (United States)

    Rahmawati, N.; Widyanti, A.

    2017-12-01

    Some studies stated that the main factor related to the accident was driving behavior. This study aims to explore the differences between motorcyclist” behaviour and repetitive violation behaviour in two different area, urban and rural area in Indonesia. Respondents were selected based on convenience sampling method in Bandung as a representative of urban area and Kulon Progo as a representative of rural area. They were asked to fill in a questionnaire about driving behaviour, consists of 10 dimensions or 51 questions with Likert scales ranging from 1 (very often) to 6 (never). The results of this study shows that the motorcyclists’ behavior differ significantly between rural and urban area. Motorcyclists in the urban area (Bandung) are more committed to violations than in rural area (Kulon Progo). This result is not in line with previous studies in Australia and United States which stated that motorcyclists in rural area more frequently speeding than in urban area. Implications of the result are discussed.

  12. Prevalence of hypertension in rural areas of china: a meta-analysis of published studies.

    Directory of Open Access Journals (Sweden)

    Xiaofang Chen

    Full Text Available Hypertension is one of the leading causes of disease burden across the world. In China, the latest nationwide survey of prevalence of hypertension was ten year ago, and data in rural areas is little known. More information about hypertension prevalence could help to improve overall antihypertensive health care. We aimed to estimate the pooled prevalence of hypertension in rural areas of China.Comprehensive electronic searches of PubMed, Web of Knowledge, Chinese Web of Knowledge, Wangfang, Weipu and SinoMed databases were conducted to identify any study in each database published from January 1, 2004 to December 31, 2013, reporting the prevalence of hypertension in Chinese rural areas. Prevalence estimates were stratified by age, area, sex, publication year, and sample size. All statistical calculations were made using the Stata Version 11.0 (College Station, Texas and Statsdirect Version 2.7.9.We identified 124 studies with a total population of 3,735,534 in the present meta-analysis. Among people aged 18 years old in Chinese rural areas, the summarized prevalence is 22.81% (19.41%-26.41%. Subgroup analysis shows the following results: for male 24.46% (21.19%-27.89%, for female 22.17% (18.25%-26.35%. For 2004-2006: 18.94% (14.41%-23.94%, for 2007-2009, 21.24% (15.98%-27.01% for 2010-2013: 26.68%, (20.79%-33.02%. For Northern region 25.76% (22.36%-29.32%, for Southern region 19.30%, (15.48%-24.08%.The last decade witnessed the growth in prevalence of hypertension in rural areas of China compared with the fourth national investigation, which has climbed the same level as the urban area. Guidelines for screening and treatment of hypertension in rural areas need to be given enough attention.

  13. Relative professional roles in antenatal care: results of a survey in Scottish rural general practice.

    Science.gov (United States)

    Farmer, Jane; Stimpson, Paul; Tucker, Janet

    2003-11-01

    There is evidence of variation and some ambiguity about self-perceived relative professional roles in antenatal care in the UK. There is little information about models of antenatal care provision in UK rural areas. In rural areas, in particular, women have limited choice in accessing health care professionals or alternative primary care delivery settings. In the light of a recent review of Scottish maternity services, it is important and timely to examine models of care and interprofessional working in antenatal care in rural areas. This study explores midwives' and GPs' perceptions about their relative professional roles in remote and rural general practice in Scotland. A questionnaire survey involving all 174 Scottish remote and rural general practices (using one definition of rurality) was conducted, followed by 20 interviews. At least one professional returned a completed questionnaire from 91% of rural practices. A number of areas of dissonance were noted between GPs' and midwives' perceptions of their roles in maternity care and, given the context of service provision, these may impact upon rural patients. Findings are relevant to wider debates on extending the primary care team and strengthening inter-disciplinary working, particularly in rural areas.

  14. The impact of husbands' gender equity awareness on wives' reproductive health in rural areas of China.

    Science.gov (United States)

    Ying, Cui; Li, Yang; Hui, Han

    2011-02-01

    The aim of this study was to investigate the effect of husbands' gender equity awareness on wives' reproductive health in rural areas of China. A qualitative study of 1919 wives aged from 18 to 69 years and their husbands was conducted in rural China. Data were collected through 3838 structured interviews. We quantified "belief in gender equity" based on responses to 7 specific statements and graded the responses according to a system scoring the strength of the overall belief (a total score 19 or higher, strong; 15-18, moderate; and 14 or less, weak). Data were recorded by bi-input with EpiData 3.1 after being carefully checked. χ(2) tests and logistic regression were performed in this study. Only 20.0% of the husbands demonstrated strong convictions about gender equity. Husbands' gender equity awareness is related to wives' receiving any prenatal care, the number of prenatal visits to a healthcare provider, having a hospital delivery of a newborn, and having gynecological examination one time per year. Raising husbands' gender awareness on wives' reproductive health and reducing female illiteracy were very necessary. The whole community should participate actively in the progress of reproductive health promotion. China's Health System requires an integration of its various sectors, including family planning, maternal and child care in resource sharing, and service delivery. Obstetricians & gynecologists. After completing this CME activity, physicians should be better able to evaluate the impact of husbands' gender equity awareness on wives' reproductive health in rural areas of China; assess how raising husbands' gender awareness on wives' reproductive health and reducing female illiteracy will improve wives' reproductive health; and analyze how China's Health System can integrate its various sectors, including family planning, maternal, and childcare in resource sharing, and service delivery, to improve wives' reproductive health.

  15. Work motivation and job satisfaction of health workers in urban and rural areas

    Directory of Open Access Journals (Sweden)

    Grujičić Maja

    2016-01-01

    Full Text Available Background/Aim. Motivated and job satisfied health professionals represent a basis of success of modern health institutions. The aim of this study was to investigate whether there was a difference in work motivation and job satisfaction between health workers in urban and rural areas in the region of Central Serbia. Methods. The study included 396 health professionals from urban setting, and 436 from a rural area, employed in four randomly selected health facilities. An anonymous questionnaire was used for data gathering. Statistical analysis was performed using χ2, Student t-test, Spearman's correlation coefficient, and logistic regression analysis. Results. Urban health professionals were significantly more motivated and job satisfied than respondents from rural area. In relation to work motivation factors and job satisfaction of health professionals in urban and rural areas, there were no significant differences in working conditions and current equipment, and in terms of job satisfaction there were no significant differences in relation to income either. Conclusion. In order to increase the level of work motivation and job satisfaction of health workers in rural areas, apart from better income, they should get more assistance and support from their supervisors, and awards for good job performance; interpersonal relationships, promotion and advancement opportunities, managerial performance and cooperation at work should be improved; employment security should be provided, as well as more independence at work, with professional supervision of health workers.

  16. Comparative Research on Human Settlements in Asian Rural Areas Based on Collaborative Construction Mechanism

    Science.gov (United States)

    Xin, Sui; Chaoyang, Sun; Mo, Li

    2018-02-01

    Rural planning is perceived as a spatial planning centered on the human settlements and there are many activities for rural reconstruction and researches conducted from the perspective of active intervention, with fewer studies regarding the village as the main body for the establishment of self-built system. And the other-organization built by the rural areas is strongly oriented. In Asian countries like China, South Korea and Japan, there are farming traditions, in which the familial and small-scale farmland holding and agricultural production mode are deep-rooted. Traditional agriculture and rural areas are not fundamentally changed by industrialization and modernization process. And the small-scale peasant in the East is marked by the decentralized possession of farmland and management in the rural areas and a large number of farmers to be remained. But the rural population keeps decreasing. After analyzing the status quo of human settlements in China, Korea and Japan, the paper makes an analysis from the different ways of thinking and professional perspective and focuses on putting forward the solutions to the problems on macro level, with the feasibility of the practical significance and the landing researches still staying in the testing stage. In the context of increasingly missing regional and contextual features, the launching and researches of “co-constructed community” as the folk protection way to emerging rural heritage are just started, and the researches on rural construction in Northeast China from the perspective of catalyst are absent. The contact agent with the catalytic action mechanism of seeing big things through small ones fits the rural areas marked by vast territory and diversified aspect, which is applicable to the bottom-up operation mechanism autonomously built by the villagers.

  17. The preference and actual use of different types of rural recreation areas by urban dwellers--the Hamburg case study.

    Directory of Open Access Journals (Sweden)

    Thiemen Boll

    Full Text Available In the wake of urbanisation processes and the constitution of metropolitan regions, the role of the city's rural surroundings is receiving more attention from researchers and planners as rural areas offer various (cultural ecosystem services for the urban population. Urban dwellers increasingly desire recreation and landscape experience. Although this need for recreation is generally recognized, few studies have focused on the question of people's preferences for certain types and characteristics of outdoor recreation areas in relation to the frequency of use. In order to acquire baseline data on this subject, the main objectives of this study were to explore recreation preferences of urban dwellers and the relation between actual use and perceived value of recreation areas in a case study in the Hamburg Metropolitan Region (Germany. In a social survey, Hamburg residents (n = 400 were asked about their preferences and use of four important regional recreation areas with different landscape characteristics in face-to-face interviews in different locations in the city. We found that both outdoor recreation within and outside of the city were fairly or very important for more than 70% of the questioned urban dwellers. Interestingly, the preference for a recreation area outside of the city did not depend on the frequency of use, which indicates that certain recreation areas had a symbolic value besides their use value. When people were questioned on the characteristics of recreation areas, perceived naturalness was found to be strongly related to preference. Respondents considered the diversity, uniqueness, and naturalness of the landscape to be far more important than the accessibility of the recreation areas and the provision of service facilities.

  18. [Use of emergency departments in rural and urban areas in Spain].

    Science.gov (United States)

    Sarría-Santamera, A; Prado-Galbarro, J; Ramallo-Farina, Y; Quintana-Díaz, M; Martínez-Virto, A; Serrano-Aguilar, P

    2015-03-01

    Describe the use of emergency departments (ED), and analyse the differences in use between residents in rural and urban areas. Using data from the National Health Survey of 2006 and 2011, the profiles of patients with ED visits by population size of place of residence were obtained. The variables associated with making one visit to the ED were also evaluated, in order to determine the effect of the population size of place of residence. A higher use of ED is observed in persons with a higher frequency of use of Primary Care and hospital admissions, and increases with worse self-perceived health and functional status, with more chronic diseases, in people from lower social classes, and younger ages. Adjusting for the other variables, residents in larger cities have a higher use of ED than residents in rural areas, who show a higher use of public and non-hospital based ED, than residents in urban areas. There is a higher use of ED by inhabitants of urban areas that cannot be justified by a worst health status of that population. This tends to indicate that the use of ED is not under-used in rural areas, but overused in urban areas. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  19. [Malnutrition and cognitive development if infants in rural marginalized areas in Mexico].

    Science.gov (United States)

    Carrasco Quintero, María Del Refugio; Ortiz Hernández, Luis; Roldán Amaro, José Antonio; Chávez Villasana, Adolfo

    2016-01-01

    To analyze the relationship between nutritional status measured by anthropometry and the mental, psychomotor and language development of infants in marginalized rural areas of Mexico. Cross-sectional study with 576 infants aged from 7 to 26 months in four rural locations. Variables consisted of measures of anthropometric and cognitive development. Infants with short stature had a lower rate of language development, while birth weight was marginally associated with psychomotor development. Although acute malnutrition (identified by underweight) is no longer a problem in rural areas of Mexico, chronic malnutrition (expressed as stunting) is still common and is associated with alterations in mental development in the child population. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  20. Early implementation of WHO recommendations for the retention of health workers in remote and rural areas.

    Science.gov (United States)

    Buchan, James; Couper, Ian D; Tangcharoensathien, Viroj; Thepannya, Khampasong; Jaskiewicz, Wanda; Perfilieva, Galina; Dolea, Carmen

    2013-11-01

    The maldistribution of health workers between urban and rural areas is a policy concern in virtually all countries. It prevents equitable access to health services, can contribute to increased health-care costs and underutilization of health professional skills in urban areas, and is a barrier to universal health coverage. To address this long-standing concern, the World Health Organization (WHO) has issued global recommendations to improve the rural recruitment and retention of the health workforce. This paper presents experiences with local and regional adaptation and adoption of WHO recommendations. It highlights challenges and lessons learnt in implementation in two countries - the Lao People's Democratic Republic and South Africa - and provides a broader perspective in two regions - Asia and Europe. At country level, the use of the recommendations facilitated a more structured and focused policy dialogue, which resulted in the development and adoption of more relevant and evidence-based policies. At regional level, the recommendations sparked a more sustained effort for cross-country policy assessment and joint learning. There is a need for impact assessment and evaluation that focus on the links between the rural availability of health workers and universal health coverage. The effects of any health-financing reforms on incentive structures for health workers will also have to be assessed if the central role of more equitably distributed health workers in achieving universal health coverage is to be supported.

  1. Service system and cognitive outcomes for young children with autism spectrum disorders in a rural area of Taiwan.

    Science.gov (United States)

    Chu, Ching-Lin; Chiang, Chung-Hsin; Wu, Chin-Chin; Hou, Yuh-Ming; Liu, Jiun-Horng

    2017-07-01

    Chiayi is a rural county located in southwestern Taiwan, and the effectiveness of its early intervention service system for autism spectrum disorders was studied in detail. A total of 71 children with autism spectrum disorders ( n = 35) and developmental delay ( n = 36) aged 2.5 years were referred from the only Early Intervention Reporting and Referral Center in Chiayi and followed up at 4 years. Results showed relatively low and varied services of early intervention for both groups during two time-point periods and a relative lack of specific early intervention programs for children with autism spectrum disorders. It was found, however, that cognitive abilities were increased for autism spectrum disorders and developmental delay groups. Additionally, the Early Learning Score at the initial evaluation could contribute to the high learner autism spectrum disorders subgroup. Parental socio-economic level was also determined to benefit the high learner developmental delay subgroup.

  2. Mobility and the spread of human immunodeficiency virus into rural areas of West Africa

    NARCIS (Netherlands)

    Lagarde, E.; Schim van der Loeff, M.; Enel, C.; Holmgren, B.; Dray-Spira, R.; Pison, G.; Piau, J. P.; Delaunay, V.; M'Boup, S.; Ndoye, I.; Coeuret-Pellicer, M.; Whittle, H.; Aaby, P.

    2003-01-01

    In eastern and southern Africa, the human immunodeficiency virus (HIV) epidemic appeared first in urban centres and then spread to rural areas. Its overall prevalence is lower in West Africa, with the highest levels still found in cities. Rural areas are also threatened, however, because of the

  3. Characteristics of Poverty in Rural Communities of Gold Mining District Area West Sumbawa

    Directory of Open Access Journals (Sweden)

    Ibrahim Ibrahim

    2016-06-01

    Full Text Available The research is conducted in rural areas of gold mining with the aim to find out the characteristics of poverty in the rural area of gold mining in West Sumbawa regency. The survey method is used in this study, focusing on the rural mining area. Sample of respondents are 167 households, selected by purposive sampling from four villages, which are determined based on the first ma slope. The data analysis uses cross tabulation and frequency tables. The results showes that the poverty rate in the research area is still low. The results of the combined value of the characteristic size of the hilly topography of poverty are 84 per cent and 83.7 per cent flat topography caused by low levels of income, quality of houses, agricultural land ownership, livestock ownership, ownership of valuables

  4. SOCIAL AND PROFESSIONAL STATUS OF WOMEN IN THE PROCESS OF TRANSFORMATIONS IN RURAL AREAS

    Directory of Open Access Journals (Sweden)

    Jan Sikora

    2014-12-01

    Full Text Available The paper presents a characterisation of socio-professional status and socio-political activity of women in rural areas in Poland. Traditional, stereotypical approach was compared to the contemporary perception of the social roles performed by women in the countryside, and the results of recent empirical studies concerning the problems discussed were presented. The causes of the lack of socio-professional and political activity were discussed. The opportunities for the support that helps improve social activity of women from rural areas were also presented. The analysis carried out in the study revealed that the status of women in contemporary rural areas is close to traditional stereotypes used in this social category. The need for inclusion of the analysis of socio-professional situation of women in socio-economic strategies of development of rural areas was emphasized. The basis for writing the paper was analysis of the related literature and the results obtained in a national-level empirical research.

  5. A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services.

    Science.gov (United States)

    Mitchell, Olivia; Malatzky, Christina; Bourke, Lisa; Farmer, Jane

    2018-03-23

    The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated. © 2018 National Rural Health Alliance Ltd.

  6. Investigation of training and support needs in rural and remote disability and mainstream service providers: implications for an online training model.

    Science.gov (United States)

    Johnsson, Genevieve; Kerslake, Rachel; Crook, Sarah; Cribb, Corinne

    2017-12-01

    Objectives It is known that there are difficulties in recruiting and retaining practitioners in rural and remote communities and that access to support and professional development can be key in breaking this cycle. Technology provides a possible solution not only for increasing access to these opportunities, but also in building community capacity to support children with autism. The aim of the present study was to investigate the current learning and support needs within rural and remote professionals prior to setting up a model of support. Methods An online survey was used to gather information from service providers in rural and remote communities on their demographics, current skills and confidence in working with clients on the autism spectrum, current supervision and professional development, identified learning and support needs, and the availability and uptake of technology for accessing professional development. Results Respondents reported below average levels of perceived confidence and skills when working with children with autism, most notably children with challenging behaviour. Half the respondents do not currently attend supervision sessions, with only 15% receiving regular supervision (fortnightly or more often), and 66% of respondents had travelled more than 3h to access professional development workshops. The majority of participants had access to technology and over half had already used this for online training. Conclusion Overall, service providers in rural and remote areas are generally not currently meeting their needs in terms of frequency of supervision and professional development. The present needs analysis identifies key areas for learning, the ideal frequency of support and the acceptability of using technology to deliver this support. This information will guide future researchers in the development of an evidence-based model that will be accessible and meaningful to its participants. What is known about the topic? It is known that

  7. Spatial distribution of biomass consumption as energy in rural areas of the Indo-Gangetic plain

    International Nuclear Information System (INIS)

    Saud, T.; Singh, D.P.; Gadi, Ranu; Mandal, T.K.; Saxena, M.; Sharma, S.K.; Gautam, R.; Mukherjee, A.; Bhatnagar, R.P.; Pathak, H.

    2011-01-01

    Biomass is widely used as energy source in rural households in India. Biomass samples and socio-economic data have been collected at district level in the rural areas of Indo-Gangetic plain (IGP), India to determine the emissions of trace gases and aerosols from domestic fuels. Dung cake, fuelwood and crop residue are main sources of energy in rural areas of the IGP. Dung cake is the major domestic fuel (80-90%) in the rural areas of Delhi, Punjab, Haryana, Uttar Pradesh, Bihar and West Bengal, whereas, 99% of rural households in Uttarakhand use wood as the main energy source. Using crop production data and usage of crop residues as energy, new consumption values have been estimated (21.13 Mt). Present information on the domestic fuel usage would be helpful in determining budgets estimates of trace gases and aerosols for India. (author)

  8. Advertising sexual health services that provide sexually transmissible infection screening for rural young people - what works and what doesn't.

    Science.gov (United States)

    Gamage, Deepa G; Fuller, Candice A; Cummings, Rosey; Tomnay, Jane E; Chung, Mark; Chen, Marcus; Garrett, Cameryn C; Hocking, Jane S; Bradshaw, Catriona S; Fairley, Christopher K

    2011-09-01

    'TESTme' is a sexually transmissible infection (STI) screening service for Victorian young people living in rural areas. We evaluated the effectiveness of advertising for this service over an 11-month pilot period. The advertising that was used included websites, a Facebook page, posters, flyers, business cards, wrist bands and professional development sessions for health nurses that occurred throughout the pilot period. We also used once-off methods including advertisements in newspapers, student diaries and short messages to mobile phones. Twenty-eight clients had a consultation through TESTme. Twenty found the service through health professionals, six through the Melbourne Sexual Health Centre (MSHC) web page, one through the Facebook page and one through the student diary. The total direct costs incurred by the centre for advertising were $20850. The advertising cost per client reached for each advertising method was $26 for health professionals, $80 for the MSHC web advertisement, $1408 for Facebook and $790 for the student diary. Other advertising methods cost $12248 and did not attract any clients. Advertising STI health services for rural young people would be best to focus on referrals from other health services or health care websites.

  9. [Healthy habits and osteoporosis prevention in perimenopausal women from rural areas].

    Science.gov (United States)

    Pérez-Fernández, M Reyes; Almazán Ortega, Raquel; Martínez Portela, José M; Alves Pérez, M Teresa; Segura-Iglesias, M Carmen; Pérez-Fernández, Román

    2014-01-01

    The probability of developing osteoporosis decreases with an adequate supply of vitamin D, a balanced diet, and increased physical activity. In this study, we evaluated whether an educational intervention improves osteoporosis-related behavior in perimenopausal women from rural areas. A randomized experimental evaluation was performed of an educational intervention. The variables were physical activity, calcium intake and sun exposure in women from rural areas aged 45-54 years (n=216) at time 0 and 12 months after the educational intervention. In the control group (n=106), the information was sent by surface mail (month 0). In the intervention group (n=110), two interactive workshops were given (month 0). The topic of the workshops and the information sent by surface mail was healthy habits for osteoporosis prevention. After 12 months, the intervention group, but not the control group, had increased their physical activity (p=0.006), sun exposure (p=0.029), and calcium intake (53% to 64%). A simple educational intervention in perimenopausal women from rural areas improved healthy habits for osteoporosis prevention. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. Utilising a collective case study system theory mixed methods approach: a rural health example.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2014-07-28

    Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services

  11. English Language Teaching in Rural Areas: A Scenario and Problems and Prospects in Context of Bangladesh

    Directory of Open Access Journals (Sweden)

    Md.Mahroof Hossain

    2016-06-01

    Full Text Available Language is one of the medium of expressing our ideas, feelings and emotions. And if we think about language in present world then English is one of the most used languages in the world and English is used as a second language in Bangladesh. English is introduced here at the primary level and its inclusion continues till the tertiary level of education. Most of the students of the primary schools in rural areas are weak in English language due to lack of skilled and trained teachers who are familiar to the modern methods and approaches of teaching and lack of materials for teaching in the classroom. Primary level English curriculum implementation is essential in Bangladesh to achieve the set English language competency in the rural areas. Students in the rural areas are performing poorly in English compared to their urban counterparts. Statistics showed that there was a gulf of difference between the facilities enjoyed by rural schools and urban schools. The study explores the challenges of teaching English language in rural areas in context of Bangladesh. This study investigated the factors affecting student’s performance in English language in rural areas. Data were collected using interviews, classroom observation and questionnaire. Result of the study reveals that students were highly motivated to learn English for future expectations such as local and international communication, academic advancement and employment prospects. It also provide a scenario of English teaching system in rural areas of Bangladesh as well as the problems and prospects of English language in perspective of Bangladesh. Keywords: English language, rural areas, education, learning and teaching, competency

  12. Determining the competences of community based workers for disability-inclusive development in rural areas of South Africa, Botswana and Malawi.

    Science.gov (United States)

    Lorenzo, Theresa; van Pletzen, Ermien; Booyens, Margaret

    2015-01-01

    Persons with disabilities and their families still live with stigma and a high degree of social exclusion especially in rural areas, which are often poorly resourced and serviced. Community-based workers in health and social development are in an ideal position to assist in providing critical support for some of those most at risk of neglect in these areas. This article analyses the work of community disability workers (CDWs) in three southern African countries to demonstrate the competencies that these workers acquired to make a contribution to social justice for persons with disabilities and their families. It points to some gaps and then argues that these competencies should be consolidated and strengthened in curricula, training and policy. The article explores local experiences and practices of CDWs so as to understand and demonstrate their professional competencies and capacity to deliver disability-inclusive services in rural areas, ways that make all information, activities and programs offered accessible and available to persons with disabilities. A qualitative interpretive approach was adopted, informed by a life history approach. Purposive sampling was used to select 16 CDWs who had at least 5 years experience of disability-related work in a rural area. In-depth interviews with CDWs were conducted by postgraduate students in Disability Studies. An inductive and interpretative phenomenological approach was used to analyse data. Three main themes with sub-categories emerged demonstrating the competencies of CDWs. First, integrated management of health conditions and impairments within a family focus comprised 'focus on the functional abilities' and 'communication, information gathering and sharing'. Second, negotiating for disability-inclusive community development included four sub-categories, namely 'mobilising families and community leaders', 'finding local solutions with local resources', 'negotiating retention and transitions through the education

  13. Accessible Transportation, Geographic Elevation, and Masticatory Ability Among Elderly Residents of a Rural Area.

    Science.gov (United States)

    Hamano, Tsuyoshi; Tominaga, Kazumichi; Takeda, Miwako; Sundquist, Kristina; Nabika, Toru

    2015-06-26

    Given that public transportation networks are often worse in rural areas than in urban areas, rural residents who do not drive can find it difficult to access health-promoting goods, services, and resources related to masticatory ability. Moreover, geographical location, assessed by elevation, could modify this association. The aim of this study was to test whether the association between access to transportation and masticatory ability varied by elevation. Data were collected from a cross-sectional study conducted in Mizuho and Iwami counties, Japan. Objective masticatory ability was evaluated using a test gummy jelly and elevation was estimated by the geographic information systems according to the participant's address. After excluding subjects with missing data, 672 subjects (Mizuho = 401 and Iwami = 271) were analyzed. After adjustment for potential confounders, being a driver was not significantly associated with masticatory ability among elderly people living at low elevation (≤313 m) in Mizuho county. However, after the same adjustment, being a driver remained significantly associated with increased masticatory ability among elderly at high elevations. Similar findings were observed in Iwami county. Accessible transportation was significantly associated with increased mastication ability in elderly people living at high elevations, but not in those living at low elevations.

  14. Accessible Transportation, Geographic Elevation, and Masticatory Ability Among Elderly Residents of a Rural Area

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Hamano

    2015-06-01

    Full Text Available Given that public transportation networks are often worse in rural areas than in urban areas, rural residents who do not drive can find it difficult to access health-promoting goods, services, and resources related to masticatory ability. Moreover, geographical location, assessed by elevation, could modify this association. The aim of this study was to test whether the association between access to transportation and masticatory ability varied by elevation. Data were collected from a cross-sectional study conducted in Mizuho and Iwami counties, Japan. Objective masticatory ability was evaluated using a test gummy jelly and elevation was estimated by the geographic information systems according to the participant’s address. After excluding subjects with missing data, 672 subjects (Mizuho = 401 and Iwami = 271 were analyzed. After adjustment for potential confounders, being a driver was not significantly associated with masticatory ability among elderly people living at low elevation (≤313 m in Mizuho county. However, after the same adjustment, being a driver remained significantly associated with increased masticatory ability among elderly at high elevations. Similar findings were observed in Iwami county. Accessible transportation was significantly associated with increased mastication ability in elderly people living at high elevations, but not in those living at low elevations.

  15. Feasibility of LTE 700 MHz Digital Dividend for Broadband Development Acceleration in Rural Areas

    Directory of Open Access Journals (Sweden)

    Denny Setiawan

    2012-04-01

    Full Text Available The need of broadband services to reduce digital divide in rural areas had increased in the recent years. The government of the Republic Indonesia shared similar intention and had set guidance of ICT development in its "economic master plan" and "medium term development plan". This paper addressed feasibility and suitability of its implementation in Indonesia, by conducting assessment of possible solutions. Using mixed method, the study was started with qualitative approach to identify possible options, conducted benchmarking and case study analysis to narrow down the options and finally conducted quantitative calculation for the two remaining options and measure performance of the solutions. The results of analysis concluded that early implementation of LTE in 700 MHz Digital Dividend would be feasible in certain geographical areas to fasten the broadband plan development in Indonesia.

  16. Feasibility of LTE 700 MHz Digital Dividend for Broadband Development Acceleration in Rural Areas

    Directory of Open Access Journals (Sweden)

    Denny Setiawan

    2013-09-01

    Full Text Available The need of broadband services to reduce digital divide in rural areas had increased in the recent years. The government of the Republic Indonesia shared similar intention and had set guidance of ICT development in its "economic master plan" and "medium term development plan". This paper addressed feasibility and suitability of its implementation in Indonesia, by conducting assessment of possible solutions. Using mixed method, the study was started with qualitative approach to identify possible options, conducted benchmarking and case study analysis to narrow down the options and finally conducted quantitative calculation for the two remaining options and measure performance of the solutions. The results of analysis concluded that early implementation of LTE in 700 MHz Digital Dividend would be feasible in certain geographical areas to fasten the broadband plan development in Indonesia.

  17. Reforming Victoria's primary health and community service sector: rural implications.

    Science.gov (United States)

    Alford, K

    2000-01-01

    In 1999 the Victorian primary care and community support system began a process of substantial reform, involving purchasing reforms and a contested selection process between providers in large catchment areas across the State. The Liberal Government's electoral defeat in September 1999 led to a review of these reforms. This paper questions the reforms from a rural perspective. They were based on a generic template that did not consider rural-urban differences in health needs or other differences including socio-economic status, and may have reinforced if not aggravated rural-urban differences in the quality of and access to primary health care in Victoria.

  18. Improving Maternal and Child Health in Underserved Rural Areas of ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Maternal and child health is a priority for Nigeria, but there are significant challenges and opportunities at state levels that influence efforts to reduce deaths. This project will contribute to government efforts in Delta State to improve delivery and use of maternal and child healthcare services in three marginalized rural ...

  19. Providing Cardiology Care in Rural Areas Through Visiting Consultant Clinics.

    Science.gov (United States)

    Gruca, Thomas S; Pyo, Tae-Hyung; Nelson, Gregory C

    2016-06-30

    Workforce experts predict a future shortage of cardiologists that is expected to impact rural areas more severely than urban areas. However, there is little research on how rural patients are currently served through clinical outreach. This study examines the impact of cardiology outreach in Iowa, a state with a large rural population, on participating cardiologists and on patient access. Outreach clinics are tracked annually in the Office of Statewide Clinical Education Programs Visiting Medical Consultant Database (University of Iowa Carver College of Medicine). Data from 2014 were analyzed. In 2014, an estimated 5460 visiting consultant clinic days were provided in 96 predominantly rural cities by 167 cardiologists from Iowa and adjoining states. Forty-five percent of Iowa cardiologists participated in rural outreach. Visiting cardiologists from Iowa and adjoining states drive an estimated 45 000 miles per month. Because of monthly outreach clinics, the average driving time to the nearest cardiologist falls from 42.2±20.0 to 14.7±11.0 minutes for rural Iowans. Cardiology outreach improves geographic access to office-based cardiology care for more than 1 million Iowans out of a total population of 3 million. Direct travel costs and opportunity costs associated with physician travel are estimated to be more than $2.1 million per year. Cardiologists in Iowa and adjoining states have expanded access to office-based cardiology care from 18 to 89 of the 99 counties in Iowa. In these 71 counties without a full-time cardiologist, visiting consultant clinics can accommodate more than 50% of office visits in the patients' home county. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  20. Health literacy in a community with low levels of education: findings from Chakaria, a rural area of Bangladesh

    Directory of Open Access Journals (Sweden)

    Susmita Das

    2017-02-01

    Full Text Available Abstract Background Health literacy (HL helps individuals to make effective use of available health services. In low-income countries such as Bangladesh, the less than optimum use of services could be due to low levels of HL. Bangladesh’s health service delivery is pluralistic with a mix of public, private and informally trained healthcare providers. Emphasis on HL has been inadequate. Thus, it is important to assess the levels of HL and service utilization patterns. The findings from this study aim to bridge the knowledge gap. Materials and Methods The data for this study came from a cross-sectional survey carried out in September 2014, in Chakaria, a rural area in Bangladesh. A total of 1500 respondents were randomly selected from the population of 80,000 living in the Chakaria study area of icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh. HL was assessed in terms of knowledge of existing health facilities and sources of information on health care, immunization, diabetes and hypertension. Descriptive and cross-tabular analyses were carried out. Results Chambers of the rural practitioners of allopathic medicine, commonly known as ‘village doctors’, were mentioned by 86% of the respondents as a known health service facility in their area, followed by two public sector community clinics (54.6% and Union Health and Family Welfare Centres (28.6%. Major sources of information on childhood immunization were government health workers. Almost all of the respondents had heard about diabetes and hypertension (97.4% and 95.4%, respectively. The top three sources of information for diabetes were neighbours (85.7%, followed by relatives (27.9% and MBBS (Bachelor of Medicine and Bachelor of Surgery doctors (20.4%. For hypertension, the sources were neighbours (78.0%, followed by village doctors (38.2%, MBBS doctors (23.2% and relatives (15%. The proportions of respondents who knew diabetes and hypertension control measures

  1. Health literacy in a community with low levels of education: findings from Chakaria, a rural area of Bangladesh.

    Science.gov (United States)

    Das, Susmita; Mia, Mohammad Nahid; Hanifi, Syed Manzoor Ahmed; Hoque, Shahidul; Bhuiya, Abbas

    2017-02-16

    Health literacy (HL) helps individuals to make effective use of available health services. In low-income countries such as Bangladesh, the less than optimum use of services could be due to low levels of HL. Bangladesh's health service delivery is pluralistic with a mix of public, private and informally trained healthcare providers. Emphasis on HL has been inadequate. Thus, it is important to assess the levels of HL and service utilization patterns. The findings from this study aim to bridge the knowledge gap. The data for this study came from a cross-sectional survey carried out in September 2014, in Chakaria, a rural area in Bangladesh. A total of 1500 respondents were randomly selected from the population of 80,000 living in the Chakaria study area of icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh). HL was assessed in terms of knowledge of existing health facilities and sources of information on health care, immunization, diabetes and hypertension. Descriptive and cross-tabular analyses were carried out. Chambers of the rural practitioners of allopathic medicine, commonly known as 'village doctors', were mentioned by 86% of the respondents as a known health service facility in their area, followed by two public sector community clinics (54.6%) and Union Health and Family Welfare Centres (28.6%). Major sources of information on childhood immunization were government health workers. Almost all of the respondents had heard about diabetes and hypertension (97.4% and 95.4%, respectively). The top three sources of information for diabetes were neighbours (85.7%), followed by relatives (27.9%) and MBBS (Bachelor of Medicine and Bachelor of Surgery) doctors (20.4%). For hypertension, the sources were neighbours (78.0%), followed by village doctors (38.2%), MBBS doctors (23.2%) and relatives (15%). The proportions of respondents who knew diabetes and hypertension control measures were 40.9% and 28.0%, respectively. More females knew about the

  2. Development of a nurse case management service: a proposed business plan for rural hospitals.

    Science.gov (United States)

    Adams, Marsha Howell; Crow, Carolyn S

    2005-01-01

    The nurse case management service (NCMS) for rural hospitals is an entrepreneurial endeavor designed to provide rural patients with quality, cost-effective healthcare. This article describes the development of an NCMS. A detailed marketing and financial plan, a review of industry trends, and the legal structure and risks associated with the development of the venture are presented. The financial plan projects a minimum savings of 223,200 dollars for rural institutions annually. To improve quality and reduce cost for rural hospitals, the authors recommend implementation of an NCMS.

  3. Recent trends in rural Geography studies. Theoretical developments and research areas in Latin America

    Directory of Open Access Journals (Sweden)

    Héctor Ávila Sánchez

    2015-12-01

    Full Text Available In this paper it is made a tour through the various theoretical and methodological routes that support the Rural Geography, in its current forms. The article is part of a wider investigation into the trends and state of the art of rurality between the years 1990 and 2010, with emphasis on rural geography perspective and particularly on the contributions that establish French geography and Anglo-Saxon geography. It highlights how these influences have transcended national geographical schools in some countries of Latin America. At the beginning of the discipline in the early twentieth century, emphasizing the identification and description of landscapes, influenced by the importance of regionalist discourse. Subsequently, rural geographical studies developed under the influence of economic geography, mainly describing large areas of agricultural specialization worldwide (cereal production areas, or Mediterranean agriculture, etc.. Later, from the decade of the eighties, analyze the depth of the territorial changes that occur in rural areas, due to changes in the Fordist and post-Fordist production paradigm, and the arrangements resulting from globalization.

  4. Problemy razvitija sel'skoj mestnosti Severo-Vostochnoj Germanii [Rural areas of Eastern Germany: modern challenges

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    Levchenkov Andrei

    2012-01-01

    Full Text Available After the German reunification the agricultural development of eastern territories seemed to have picked up its pace. Yet the main problems those territories are facing today hatched already in the mid-1990s. In our study we address the problems and challenges that hinder sustainable development of East German rural areas. We analyse agricultural statistics and describe the structure of agricultural enterprises, land-use, and other critical dimensions of agriculture. We discuss pros and cons of modern rural areas spatial planning policy and take a critical look at the current status of rural areas. We also put forward a number of concrete proposals aimed at the development of the area and counteracting the negative trends it is now experiencing. Even taking into account all ‘positive’ development trends that are postulated to have occurred since the unification, we underline the crucial necessity of diversification of labour forces and of changing the spatial planning policies in the rural areas of East Germany.

  5. Comparative characteristics of the home care nursing services used by community-dwelling older people from urban and rural environments.

    Science.gov (United States)

    Borowiak, Ewa; Kostka, Tomasz

    2013-06-01

    To compare home care nursing services use by community-dwelling older people from urban and rural environments in Poland. In the current literature, there is a lack of data based on multidimensional geriatric assessment concerning the provision of care delivered by nurses for older people from urban and rural environments. Cross-sectional random survey. Between 2006-2010, a random sample of 935 older people (over 65 years of age) from an urban environment and 812 from a neighbouring rural environment were interviewed in a cross-sectional survey. The rural dwellers (82·8%) nominated their family members as care providers more often than the city inhabitants (51·2%). Home nursing care was provided to 4·1% of people in the city and 6·5% in the county. Poststroke condition, poor nutritional status, and low physical activity level, as well as low scores for activities of daily living, instrumental activities of daily living, and Mini-Mental State Examination values, were all determinants of nursing care, both in urban and rural areas. In the urban environment, additional predictors of nursing care use were age, presence of ischaemic heart disease, diabetes and respiratory disorders, number of medications taken, and a high depression score. Poor functional status is the most important determinant of nursing care use in both environments. In the urban environment, a considerable proportion of community-dwelling elders live alone. In the rural environment, older people usually have someone available for potential care services. The main problem seems to be seeking nursing care only in advanced deterioration of functional status. © 2012 Blackwell Publishing Ltd.

  6. Uruguaian rural area: energy demand and sources supply

    International Nuclear Information System (INIS)

    Reolon, R.

    1994-01-01

    The present work is about the energy demand in rural areas and its electrification like one of the factors of its residents maintenance, in the means that they are essential for the development but intensive of agrarian intensity, nevertheless we will try to determine their quantity and the character one of them

  7. Design framework for developing ict products and services for rural development : A persuasive health information system for rural India

    NARCIS (Netherlands)

    Parmar, V.S.

    2009-01-01

    Information poverty cannot be addressed by simply giving away computers and installing internet connections in rural areas. What is really needed is to offer rural users relevant, personalized information that enables them to make positive changes in their daily lives, rather than give them the type

  8. Implementing a Comprehensive Program for the Prevention of Conduct Problems in Rural Communities: The Fast Track Experience1

    Science.gov (United States)

    Bierman, Karen L.

    2012-01-01

    Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program. PMID:9338956

  9. Recruitment of rural healthcare professionals for live continuing education.

    Science.gov (United States)

    Holuby, Ronnie Scott; Pellegrin, Karen L; Barbato, Anna; Ciarleglio, Anita

    2015-01-01

    The availability of rural healthcare is a growing concern in the United States as fewer healthcare providers choose to work in rural areas. Accessing quality continuing education (CE) for rural healthcare practitioners (HCPs) remains a challenge and may pose a barrier to quality care. To maximize attendance at a live, in-person, free CE program focusing on geriatric medication and issues specifically targeted to HCPs in rural areas, two methods were implemented sequentially. The first method used formal advertising implemented by a professional marketing service to promote CE events. The second method enlisted local healthcare organizations and physician groups to promote the CE event to their employees. Cost per attendee was calculated for comparison. Professional marketing services recruited 31 HCPs (March 2011) and resulted in a per-participant recruitment cost of US$428.62. Local healthcare organizations and physician groups' marketing recruited 48 HCPs (July-August 2011) and resulted in a per-participant recruitment cost of US$55.19. Providing free CE coordinated through local healthcare organizations and physician groups was the most cost-effective method of recruiting rural HCPs for CE. Formal advertising added cost without increasing the number of participants per event. Although this is the first study of the cost-effectiveness of recruitment methods targeting HCPs in rural areas, results are consistent with research on cost-effectiveness of outreach to rural lay community members.

  10. EARLY CHILDHOOD AND RURAL EDUCATION: A NECESSARY MEETING AIMING THE ACHIEVEMENT OF JUSTICE WITH YOUNG CHILDREN LIVING IN RURAL AREAS

    Directory of Open Access Journals (Sweden)

    Maria Carmen Silveira Barbosa

    2013-04-01

    Full Text Available Over the past 40 years the Brazilian government has constituted a major basic education attendance programmed for Brazilian citizens. The 1988 Federal Constitution states the right to education for all Brazilians, whether living in rural or urban areas, and it set kindergarten as the first level in basic education, it constituted a space to be filled by a large contingent of children who, until then, were without an institutional educational space guaranteed for them. Although, the kindergarten coverage in large urban centers has been effective in numerical terms, especially, regarding the pre-school provision, in rural areas this is still not a reality. IBGE (Brazilian Institute of Geography and Statistics - Demographic Census, 2010 reports that Brasil has 16,044 children under 6 years old, in other words, 12% of the total population of Brazil, 3,546 are living in rural areas. According to INEP (National Institute of Educational Studies - School Census, INEP, 2010, from the universe of children aged 0-6 years living in rural areas, only 12.1% attend day care centers and 67.6% attend preschools, a value lower than the urban areas where the coverage is 26% for attendance to day cares and 83% for attendance to pre-school classes. Besides questioning the exiguity of this coverage, especially from the point of view of the mandatory provision of pre-school, it is necessary to map the points of connection and tension between the areas, so it would be possible to give an expansion linked to a qualified and contextualized offer.

  11. Incentive Mechanism Model Design for Sharing of Information Resources in Rural Areas

    OpenAIRE

    Gao, Xirong; Shan, Lingling

    2013-01-01

    In order to solve the issues concerning the cross-unit sharing of information resources in rural areas, we analyze the incentive problem of the sharing of information resources in rural areas using the incentive theory method; establish corresponding incentive mechanism model (It is divided into positive incentive model and negative incentive model, and only when the two models guarantee each other and are used at the same time can they be effective). Based on this, we put forward the institu...

  12. Attracting and retaining doctors in rural Nepal.

    Science.gov (United States)

    Shankar, P R

    2010-01-01

    In Nepal, a number of private sector medical schools have opened recently; although sufficient numbers of doctors are graduating there continues to be a doctor shortage in rural areas. This article analysed the rural doctor shortage in Nepal and reviewed the international literature for strategies that may be suitable for use in Nepal. Original research articles, reviews, magazine articles and project reports dealing with Nepal and other developing countries during the period 1995 to 2010 were sourced via Google, Google Scholar and Pubmed. Full text access was obtained via WHO's HINARI database. The health workforce in Nepal is unevenly distributed resulting in doctor shortages in rural areas. The recent introduction of mandatory rural service for scholarship students was aimed to reduce the loss of medical graduates to developed nations. High tuition fees in private medical schools and low Government wages prevent recent graduates from taking up rural positions, and those who do face many challenges. Potential corrective strategies include community-based medical education, selecting rural-background medical students, and providing a partial or complete tuition fee waiver for medical students who commit to rural service. Traditional healers and paramedical staff can also be trained for and authorized to provide rural health care. A range of strategies developed elsewhere could be used in Nepal, especially community-oriented medical education that involves rural doctors in training medical students. The reimbursement of tuition fees, assistance with relocation, and provision of opportunities for academic and professional advancement for rural doctors should also be considered. Government investment in improving working conditions in rural Nepal would assist rural communities to attract and retain doctors.

  13. Beyond physical access: a qualitative analysis into the barriers to policy implementation and service provision experienced by persons with disabilities living in a rural context.

    Science.gov (United States)

    Neille, Joanne; Penn, Claire

    2015-01-01

    Persons with disabilities make up approximately 15% of the world's population, with vulnerable communities disproportionately affected by the incidence of disability. Research reflects that persons with disabilities are vulnerable to stigma and discrimination, social isolation, and have physical barriers to accessing support services, all of which serve to perpetuate a sense of uncertainty and vulnerability within their lives. Recently a number of policies and models of intervention have been introduced intended to protect the rights of those affected by disability, yet limited research has been conducted into the lived experiences of persons with disabilities, particularly in rural contexts. This implies that little is known about the impact of the rural context on the lived experience of disability and the ways in which context impacts on the implementation of policies and practices. The current study employed a qualitative design underpinned by the principles of narrative inquiry and participant observation. Thirty adults with a variety of congenital and acquired disabilities (15 men and 15 women, ranging in age from 19 to 83 years) living in 12 rural communities in the Mpumalanga Province of South Africa were recruited through snowball sampling. Data collection comprised a combination of narrative inquiry and participant observation. Narratives were collected in SiSwati with the assistance of a SiSwati-speaking research mediator and were transcribed and translated into English. Data were analysed inductively according to the principles of thematic analysis. Findings confirmed that the experience of living with a disability in a rural area is associated with discrimination, social exclusion, and isolation and barriers to accessing services, underpinned by numerous context-specific experiences, including mortality rates, exposure to numerous and repeated forms of violence across the lifespan, and corruption and lack of transparency in the implementation of

  14. Better Country: A Strategy for Rural Development in the 1980's.

    Science.gov (United States)

    Department of Agriculture, Washington, DC.

    The report of the 25-member National Advisory Council on Rural Development, appointed by the Secretary of Agriculture, defines rural needs and sets forth strategies for rural development in the 1980's. A review of the decade between 1970 and 1980 discusses rapid economic growth of rural areas, social progress, and changes in public service, and…

  15. Remoteness and maternal and child health service utilization in rural Liberia: A population–based survey

    Directory of Open Access Journals (Sweden)

    Avi Kenny

    2015-12-01

    Full Text Available This study seeks to understand distance from health facilities as a barrier to maternal and child health service uptake within a rural Liberian population. Better understanding the relationship between distance from health facilities and rural health care utilization is important for post–Ebola health systems reconstruction and for general rural health system planning in sub–Saharan Africa.

  16. Feasibility of water purification technology in rural areas of developing countries.

    Science.gov (United States)

    Johnson, Dana M; Hokanson, David R; Zhang, Qiong; Czupinski, Kevin D; Tang, Jinxian

    2008-08-01

    Water scarcity is threatening social and economic growth in rural areas of developing countries. There are potential markets for water purification technologies in these regions. The main focus of this article is to evaluate the social, economic and political feasibilities of providing water purification technologies to rural areas of developing countries. The findings of this research can serve as the basis for private investors interested in entering this market. Four representative regions were selected for the study. Economic, demographic, and environmental variables of each region were collected and analyzed along with domestic markets and political information. Rural areas of the developing world are populated with poor people unable to fulfill the basic needs for clean water and sanitation. These people represent an important group of potential users. Due to economic, social, and political risks in these areas, it is difficult to build a strong case for any business or organization focusing on immediate returns on capital investment. A plausible business strategy would be to approach the water purification market as a corporate responsibility and social investing in the short term. This would allow an organization to be well positioned once the economic ability of individuals, governments, and donor agencies are better aligned.

  17. Nine years of publications on strengths and weaknesses of Family Physician Program in rural area of Iran: A systematic review

    Directory of Open Access Journals (Sweden)

    Saber Azami-Aghdash

    2016-12-01

    Full Text Available Introduction: One of the most important duties of a family physician is to provide primary health care. This is completely considered in the Family Physician Program for a target population. The aim of this study was to systematically review the Family Physician and Referral System strength and weakness in rural area of Iran. Methods: In this systematic review, Scientific Information Database (SID, Science Direct, and PubMed databases were searched and Google search engine was employed using key words such as family medicine, family physician, and referral system for the period of January 2005 to June 2013, both in English and Persian. For identifying duplicated references, Endnote Software was used and for summarizing results of fully assessed articles extraction table was employed. Results: Strengths and weaknesses of Family Physician Program and referral system in rural areas of Iran were extracted from 28 studies. In total, 115 weaknesses (3.96 per study and 103 strengths (3.55 per study were obtained. Content analysis was used and 218 items were summarized into 29 items. Strengths of Family Physician Program were: access of villagers to health services, filling health document for clients, improving services for pregnant mothers, and family planning; while its obvious weaknesses included repeated unnecessary referral of clients as well as lack of providing job stability. Conclusion: Results of studies conducted in Iran showed that Family Physician and Referral System in rural area of Iran could not be successful enough and has many shortcomings. Therefore, a growing body of effective changes must be made for a better performance and to obtain better outcomes.

  18. Youth Restiveness in Niger Delta rural areas: Lesson for .Contemporary Nigerian Society

    Science.gov (United States)

    Nlerum, F. E.

    2012-12-01

    This study reviewed the youth restiveness in Niger Delta rural areas as lesson for the contemporary Nigerian society. The study was based on secondary sources of information. The study identified youths in the area as people between the ages of 15 ñ 40 years. Youths possess viable characteristics for rural development which if mismanaged results into restiveness. The study showed that the primary causes of youth restiveness in the area were proliferation of arms, misuse of the military to suppress protests, misappropriation of benefits from crude oil, youth unemployment and environmental degradation. Consequences of youth restiveness among others included loss of life and properties, rural-urban migration of the farm families, breeding defective future leaders, disruption of oil and gas activities and food insecurity. In order to eradicate youth restiveness, the contemporary Nigeria society should check the rate of arm proliferation, misuse of the military to suppress youth protests, misappropriation of benefits accruing to the communities, youth unemployment and environmental degradation.

  19. Utilization of Electronic Learning System in Swat Rural Areas

    Directory of Open Access Journals (Sweden)

    Nazir Ahmed Sangi

    2017-12-01

    Full Text Available As developments in electronic technologies i.e. personal computers, laptops, tablets, mobiles and wearable devices, the way of learning is also changing. Therefore, utilization of Information and Communication Technology (ICT has great important role in schools and colleges. ICT is using by students, teachers and societies in District Swat, KP, Pakistan in the form of mobiles internet (for social contact and chat, computers internet (for knowledge exploration and entertainment and multimedia (for teaching and learning. One of the difficulties involved in rural areas’ students of District Swat is that they cannot join class rooms due to their poor livelihood condition and far away from schools and colleges. Especially most of the females of rural areas of Swat do not come to schools and colleges for their family tradition and culture. Various questions were examined in every aspect of educational technologies in this study. We surveyed 50 responded randomly at District Swat from different schools and colleges and discovered that the responded were generally positive and have great interest about e-learning in Swat. The use of proposed electronic system for the learning, the literacy rate will increase in rural areas and students will achieve their individual goals.

  20. 78 FR 21891 - Rural Call Completion

    Science.gov (United States)

    2013-04-12

    ... email: [email protected] or phone: 202-418- 0530 or TTY: 202-418-0432. In addition to filing comments with... relatives in rural areas, and creates potential for dangerous delays in public safety communications in..., interexchange carriers, commercial mobile radio service (CMRS) providers, and interconnected VoIP service...

  1. Small rural emergency services can electronically collect accurate episode-level data: A cross-sectional study.

    Science.gov (United States)

    Dawson, Samantha L; Baker, Tim; Salzman, Scott

    2015-04-01

    There is little evidence that useful electronic data could be collected at Australian small rural emergency services. If in future their funding model changed to the Activity-Based Funding model, then they would need to collect and submit more data. We determine whether it is possible to collect episode-level data at six small rural emergency services and quantify the accuracy of eight fields. A prospective cross-sectional study. South-West Victoria, Australia. Six small rural emergency services. We collected and audited episode-level emergency data from participating services between 1 February 2011 and 31 January 2012. A random sample of these data were audited monthly. Research assistants located at each service supported data entry and audited data accuracy for four hours per week. Rates for data completeness, accuracy and total accuracy were calculated using audit data. Episode-level data were collected for 20 224 presentations across six facilities. The audit dataset consisted of 8.5% (1504/17 627) of presentations from five facilities. For all fields audited, the accuracy of entered data was high (>93%).Triage category was deemed appropriate for 95.9% (95% confidence interval (CI): 94.9-96.9%) of the patient records reviewed. Some procedures were missing (28.7%, 95%CI: 27.2-30.3%). No significant improvement in data accuracy over 12 months was observed. All six services collected useful episode-level data for 12-months with four hours per week of assistance. Data entry accuracy was high for all fields audited, and data entry completeness was low for procedures. © 2015 National Rural Health Alliance Inc.

  2. Visioning for secondary palliative care service hubs in rural communities: a qualitative case study from British Columbia's interior

    Directory of Open Access Journals (Sweden)

    Hanlon Neil

    2009-10-01

    Full Text Available Abstract Background As the populations of many developed nations continue to age at rapid rates it is becoming increasingly important to enhance palliative care service delivery in order to meet anticipated demand. Rural areas face a number of challenges in doing this, and thus dedicated attention must be given to determining how to best enhance service delivery in ways that are sensitive to their particular needs. The purposes of this article are to determine the vision for establishing secondary palliative care service hubs (SPCH in rural communities through undertaking a case study, and to ascertain the criteria that need to be considered when siting such hubs. Methods A rural region of British Columbia, Canada was selected for primary data collection, which took place over a five-month period in 2008. Formal and informal palliative care providers (n = 31 were interviewed. A purposeful recruitment strategy was used to maximize occupational and practice diversity. Interviews were conducted by phone using a semi-structured guide. Interviews were audio recorded and transcribed verbatim. Data were managed using NVivo8™ software and analyzed thematically, using investigator triangulation to strengthen interpretation. Results Four themes emerged from the dataset: (1 main SPCH features; (2 determining a location; (3 value-added outcomes; and (4 key considerations. It was found that participants generally supported implementing a SPCH in the rural region of focus. Several consistent messages emerged, including that: (1 SPCHs must create opportunities for two-way information exchange between specialists and generalists and communities; (2 SPCHs should diffuse information and ideas throughout the region, thus serving as a locus for education and a means of enhancing training opportunities; and (3 hubs need not be physical sites in the community (e.g., an office in a hospice or hospital, but may be virtual or take other forms based upon local needs

  3. Rendimento escolar de alunos da área rural em escola urbana School performance of rural area students in urban school

    Directory of Open Access Journals (Sweden)

    Stella Maris Cortez Bacha

    2006-12-01

    Full Text Available OBJETIVO: analisar e comparar as notas dos boletins de alunos residentes na área rural e na área urbana, estando ambos estudando nas mesmas escolas urbanas. MÉTODOS: analisaram-se as notas do primeiro semestre de 2005 de 641 alunos do Ensino Fundamental das escolas públicas urbanas de Terenos, Mato Grosso do Sul (MS, sendo 81,1% residentes na área urbana e 18,9% na rural. Os alunos foram comparados segundo a sua performance nas disciplinas de Língua Portuguesa, Matemática, Ciências, Educação Física, Geografia, História e Educação Artística, considerando-se o local de residência (urbana e rural, turno de estudo (diurno ou noturno, tipo de escola (municipal ou estadual e gênero. RESULTADOS: não foram encontradas diferenças significativas nas performances dos alunos da primeira a quarta séries, em nenhuma disciplina. Da quinta a oitava séries encontraram-se performances ligeiramente melhores nos alunos que residem na área urbana, medido por meio do Teste t-Student. Contudo, ao se analisar conjuntamente todas as variáveis citadas acima, nenhuma delas foi preponderante na explicação da performance do aluno nas diversas disciplinas analisadas pela Regressão Linear Múltipla. CONCLUSÃO: no estudo realizado não foram encontradas diferenças significativas no rendimento escolar entre alunos da escola urbana e da rural, estando ambos estudando nas mesmas escolas urbanas.PURPOSE: to analyze and compare grades in bulletins of students who lived in rural area and in urban area, with both kinds studying in the same urban schools. METHODS: we analyzed the grades in the first semester of 2005 of 641 student in the basic education of the urban public schools of Terenos / MS, being 81.1% residents in urban area and 18.9% in rural area. The students were compared according to their performances in the discipline of Portuguese, Mathematics, Sciences, Physical Education, Geography, History and Artistic Education, considering the place of

  4. Availability and Utilization of Anganwadi Services in an Adopted Urban Area of Wardha

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    Bhagat VM

    2016-01-01

    Full Text Available Background - The ICDS is world’s largest community-based child nutrition and development programme aimed at holistic development of children (0-6 years, expectant and nursing mothers through the Anganwadi centers (AWC. Improvement in nutritional and health status of their beneficiaries to prevent morbidities and mortalities due to malnutrition is one of the important objectives of ICDS. Objectives: To determine the availability and extent of utilization of AWC services by the beneficiaries, and to study factors influencing utilization and reasons for non/under utilization. Methodology: A community based cross-sectional study conducted in three well defined adopted urban field practice areas of a rural tertiary health care facility in Wardha, Maharashtra. A cluster comprising of 40 households was identified in each area to provide 140 study participants. Epi-info-3.7.1 for univariate and SYSTAT-12 used for multivariate analysis. Results: Overall 89.29% of beneficiaries utilized one or more services of AWC. Working women and those with lower socio-economic status had significantly and independently lower/non utilization of AWC services. Conclusions: Most of the study participants were aware and utilized the services of AWC. Among the women not utilizing the services; the reasons for non-utilization need to be addressed for optimal utilization of AWCs.

  5. Breastfeeding Supports and Services in Rural Hawaii: Perspectives of Community Healthcare Workers

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    Jeanie L. Flood

    2017-01-01

    Full Text Available Background. In the state of Hawaii, breastfeeding initiation rates are higher than the national average but fall below target rates for duration. Accessing breastfeeding support services is challenging for mothers living in rural areas of the state. Healthcare workers (HCWs working with mothers and infants are in a key position to encourage and support breastfeeding efforts. The purpose of this study is to gain a better understanding of a Hawaiian community’s (specifically Hilo, Hawai‘i breastfeeding service and support issues. Method. The qualitative study design utilized was a focused ethnography. This approach was used to gather data from participant HCWs (N=23 about their individual or shared experience(s about the breastfeeding supports and services available in their community. An iterative process of coding and categorizing the data followed by conceptual abstraction into patterns was completed. Results. Three patterns emerged from the qualitative interviews: Operating within Constraints of the Particular Environment, Coexisting Messages, and Process Interrupted. Participants identified a number of gaps in breastfeeding services available to their clients including the lack of available lactation consultants and the inconsistent communication between hospital and community providers. A number of implications for practice and further research were suggested within the results and are discussed.

  6. Constraints to the economic activities of women in rural areas ...

    African Journals Online (AJOL)

    Despite decades of gender research and public action by civil society, policy makers continue to neglect the rich indigenous knowledge (IK) and the role of women as breadwinners in rural areas. These women have little or no access to economic assets as they are located in poverty-stricken areas lacking in basic ...

  7. Meeting EFA: Bangladesh Rural Advancement Committee (BRAC) Primary Schools. Case Study

    Science.gov (United States)

    Chaboux, Collette

    2006-01-01

    This case study describes the Bangladesh Rural Advancement Committee (BRAC), which was formed to explore ways to help children from its rural development program gain access to improved education. Working mainly in rural areas, BRAC focused on improved quality through improved education service delivery, management detail, and finance. While…

  8. Coordinating technology introduction and entrepreneurial activities in rural areas

    NARCIS (Netherlands)

    Fokkema, J.E.; Pennink, B.J.W.; Simatupang, T.M.

    2017-01-01

    © Copyright 2017 Inderscience Enterprises Ltd. The main purpose of this research is to investigate how technology introduction projects in rural areas should be coordinated in order to achieve local economic development and the role of social capital and entrepreneurial activities. Characteristics

  9. Social constructions of environmental services in a rapidly densifying peri-urban area under dual governance in Durban, South Africa

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    Catherine Sutherland

    2016-12-01

    Full Text Available Background: Biodiversity plays a critical role in improving the quality of life and resilience of poor urban communities in Durban. Objectives: However, the rapid densification that is taking place in the ‘rural periphery’ of the city is impacting significantly on the integrity of ecosystems, which provide valuable ecosystem services. It is also changing the relations between people and the environment. Mzinyathi and eSkebheni, in the north-west of Durban, are peri-urban areas located on Ingonyama Trust land and hence they are governed by both the traditional authority and the eThekwini Municipality. The settlement pattern is changing rapidly here as middle and upper income residents move into the area, changing the way of life from being rural and ‘traditional’ to urban and ‘modern’. Method: This paper focused on the nexus of rapid urban growth, dual governance systems, biodiversity loss and cultural change in these two areas. It adopted a qualitative methodology and social constructivist approach. Data on the value of environmental services in the area was collected through interviewing the traditional authority, provincial and municipal planners and environmentalists, and household members. Results: The paper revealed that environmental services are constructed in multiple ways within a particular socio-historical and political context, that they have value to peri-urban communities, and that their function and use is changing as a result of the ‘modernisation’ of the area. The impact of the dual governance system and traditional land allocation process on environmental services is significant. This has implications for long term sustainability, for the quality of life of peri-urban residents and for planning and urban governance.

  10. Rural and remote speech-language pathology service inequities: An Australian human rights dilemma.

    Science.gov (United States)

    Jones, Debra M; McAllister, Lindy; Lyle, David M

    2018-02-01

    Access to healthcare is a fundamental human right for all Australians. Article 19 of the Universal Declaration of Human Rights acknowledges the right to freedom of opinion and to seek, receive and impart information and ideas. Capacities for self-expression and effective communication underpin the realisation of these fundamental human rights. For rural and remote Australian children this realisation is compromised by complex disadvantages and inequities that contribute to communication delays, inequity of access to essential speech-language pathology services and poorer later life outcomes. Localised solutions to the provision of civically engaged, accessible, acceptable and sustainable speech-language pathology services within rural and remote Australian contexts are required if we are to make substantive human rights gains. However, civically engaged and sustained healthcare can significantly challenge traditional professionalised perspectives on how best to design and implement speech-language pathology services that seek to address rural and remote communication needs and access inequities. A failure to engage these communities in the identification of childhood communication delays and solutions to address these delays, ultimately denies children, families and communities of their human rights for healthcare access, self-expression, self-dignity and meaningful inclusion within Australian society.

  11. Skilled delivery care service utilization in Ethiopia: analysis of rural-urban differentials based on national demographic and health survey (DHS) data.

    Science.gov (United States)

    Fekadu, Melaku; Regassa, Nigatu

    2014-12-01

    Despite the slight progress made on Antenatal Care (ANC) utilization, skilled delivery care service utilization in Ethiopia is still far-below any acceptable standards. Only 10% of women receive assistance from skilled birth attendants either at home or at health institutions, and as a result the country is recording a high maternal mortality ratio (MMR) of 676 per 100,000 live births (EDHS, 2011). Hence, this study aimed at identifying the rural-urban differentials in the predictors of skilled delivery care service utilization in Ethiopia. The study used the recent Ethiopian Demographic and Health Survey (EDHS 2011) data. Women who had at least one birth in the five years preceding the survey were included in this study. The data were analyzed using univariate (percentage), bivariate (chi-square) and multivariate (Bayesian logistic regression). The results showed that of the total 6,641 women, only 15.6% received skilled delivery care services either at home or at health institution. Rural women were at greater disadvantage to receive the service. Only 4.5% women in rural areas received assistance from skilled birth attendants (SBAs) compared to 64.1 % of their urban counter parts. Through Bayesian logistic regression analysis, place of residence, ANC utilization, women's education, age and birth order were identified as key predictors of service utilization. The findings highlight the need for coordinated effort from government and stakeholders to improve women's education, as well as strengthen community participation. Furthermore, the study recommended the need to scale up the quality of ANC and family planning services backed by improved and equitable access, availability and quality of skilled delivery care services.

  12. Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014

    Science.gov (United States)

    Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

    2018-01-01

    Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction. PMID:29791470

  13. Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014.

    Science.gov (United States)

    Guo, Lijun; Bao, Yong; Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

    2018-01-01

    Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction.

  14. Effect of medicare payment on rural health care systems.

    Science.gov (United States)

    McBride, Timothy D; Mueller, Keith J

    2002-01-01

    Medicare payments constitute a significant share of patient-generated revenues for rural providers, more so than for urban providers. Therefore, Medicare payment policies influence the behavior of rural providers and determine their financial viability. Health services researchers need to contribute to the understanding of the implications of changes in fee-for-service payment policy, prospects for change because of the payment to Medicare+Choice risk plans, and implications for rural providers inherent in any restructuring of the Medicare program. This article outlines the basic policy choices, implications for rural providers and Medicare beneficiaries, impacts of existing research, and suggestions for further research. Topics for further research include implications of the Critical Access Hospital program, understanding how changes in payment to rural hospitals affect patient care, developing improved formulas for paying rural hospitals, determining the payment-to-cost ratio for physicians, measuring the impact of changes in the payment methodology used to pay for services delivered by rural health clinics and federally qualified health centers, accounting for the reasons for differences in historical Medicare expenditures across rural counties and between rural and urban counties, explicating all reasons for Medicare+Choice plans withdrawing from some rural areas and entering others, measuring the rural impact of proposals to add a prescription drug benefit to the Medicare program, and measuring the impact of Medicare payment policies on rural economies.

  15. Competition and rural primary care programs.

    Science.gov (United States)

    Ricketts, T C

    1990-04-01

    Rural primary care programs were established in areas where there was thought to be no competition for patients. However, evidence from site visits and surveys of a national sample of subsidized programs revealed a pattern of competitive responses by the clinics. In this study of 193 rural primary care programs, mail and telephone surveys produced uniform data on the organization, operation, finances, and utilization of a representative sample of clinics. The programs were found to compete in terms of: (1) price, (2) service mix, (3) staff availability, (4) structural accessibility, (5) outreach, and (6) targeting a segment of the market. The competitive strategies employed by the clinics had consequences that affected their productivity and financial stability. The strategies were related to the perceived missions of the programs, and depended heavily upon the degree of isolation of the program and the targeting of the services. The competitive strategy chosen by a particular program could not be predicted based on service area population and apparent competitors in the service area. The goals and objectives of the programs had more to do with their competitive responses than with market characteristics. Moreover, the chosen strategies may not meet the demands of those markets.

  16. An exploration of the longer-term impacts of community participation in rural health services design.

    Science.gov (United States)

    Farmer, Jane; Currie, Margaret; Kenny, Amanda; Munoz, Sarah-Anne

    2015-09-01

    This article explores what happened, over the longer term, after a community participation exercise to design future rural service delivery models, and considers perceptions of why more follow-up actions did or did not happen. The study, which took place in 2014, revisits three Scottish communities that engaged in a community participation research method (2008-2010) intended to design rural health services. Interviews were conducted with 22 citizens, healthcare practitioners, managers and policymakers all of whom were involved in, or knew about, the original project. Only one direct sustained service change was found - introduction of a volunteer first responder scheme in one community. Sustained changes in knowledge were found. The Health Authority that part-funded development of the community participation method, through the original project, had not adopted the new method. Community members tended to attribute lack of further impact to low participation and methods insufficiently attuned to the social nuances of very small rural communities. Managers tended to blame insufficient embedding in the healthcare system and issues around power over service change and budgets. In the absence of convincing formal community governance mechanisms for health issues, rural health practitioners tended to act as conduits between citizens and the Health Authority. The study provides new knowledge about what happens after community participation and highlights a need for more exploration. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. [Impact of rural or urban areas on disability after a stroke].

    Science.gov (United States)

    Ortega-Barrio, M Ángeles; Herce-Martínez, M Begoña; Valiñas-Sieiro, Florita; Mariscal-Pérez, Natividad; López-Cunquero, M Ángeles; Cubo-Delgado, Esther

    2013-01-01

    To assess the residual disability in a sample of patients after suffering a first episode of a stroke and to compare the disability of those patients who live in rural areas with those living in urban areas. An observational, longitudinal study of a cohort of 89 patients from a Neurology Unit, affected by cerebrovascular accident. The following factors were assessed: sociodemographic and environmental factors, co-morbidity, functional status, disability, depression and anxiety, and quality of life. The different clinical and demographic variables were compared after admission to the unit, at hospital discharge, and 3 months afterwards. Regression analyses were also carried out in order to study the association between the clinical and sociodemographic factors, and post-stroke disability. Compared to their previous clinical state, after suffering a stroke patients showed a higher rate of co-morbidity (P<.0001), disability (P<.0001), depression (P=.002), and a poorer quality of life (P=.013). The difference between patients coming from rural and urban areas was not statistically significant in terms of disability, quality of life, anxiety, depression, or co-morbidity. The level of disability, depression and co-morbidity that patients showed after suffering a stroke was similar to the results obtained in other studies. As a novel feature, there were no differences between patients living in rural areas after suffering a stroke and those living in urban areas, as regards disability, depression, or co-morbidity. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  18. New payment model for rural health services in Mongolia.

    Science.gov (United States)

    Hindle, Don; Khulan, Buyankhishig

    2006-01-01

    This article describes experiences in Mongolia in designing and implementing a new method of payment for rural health services. The new method involves using a formula that allocates 65% of available funding on the basis of risk-adjusted capitation, 20% on the basis of asset costs, 10% on the basis of variations in distance-related costs, and 5% on the basis of satisfactory attainment of quality of care targets. Rural populations have inferior health services in most countries, whether rich or poor. Their situation has deteriorated in most transition economies, including Mongolia since 1990. One factor has been the use of inappropriate methods of payment of care providers. Changes in payment methods have therefore been made in most transition economies with mixed success. One factor has been a tendency to over-simplify, for example, to introduce capitation without risk adjustment or to make per case payments that ignored casemix. In 2002, the Mongolian government decided that its crude funding formula for rural health services should be replaced. It had two main components. The first was payment of an annual grant by the local government from its general revenue on the basis of estimated service population, number of inpatient beds, and number of clinical staff. The second was an output-based payment per inpatient day from the National Health Insurance Fund. The model was administratively complicated, and widely believed to be unfair. The two funding agencies were giving conflicting types of financial incentives. Most important, the funding methods gave few incentives or rewards for service improvement. In some respects, the incentives were perverse (such as the encouragement of hospital admission by the National Health Insurance Fund). A new funding model was developed through statistical analysis of data from routine service reports and opinions questionnaires. As noted above, there are components relating to per capita needs for care, capital assets, distance

  19. Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2–8 Years in Rural and Urban Areas — United States, 2011–2012

    Science.gov (United States)

    Holbrook, Joseph R.; Bitsko, Rebecca H.; Hartwig, Sophie A.; Kaminski, Jennifer W.; Ghandour, Reem M.; Peacock, Georgina; Heggs, Akilah; Boyle, Coleen A.

    2017-01-01

    (18.6%) than in urban areas (15.2%). In urban and the majority of rural subtypes, children with an MBDD more often lacked a medical home, had a parent with poor mental health, lived in families with financial difficulties, and lived in a neighborhood lacking physical and social resources than children without an MBDD within each of those community types. Only in urban areas did a higher percentage of children with MBDDs lack health insurance than children without MBDDs. After adjusting for race/ethnicity and poverty among children with MBDDs, those in rural areas more often had a parent with poor mental health and lived in resource-low neighborhoods than those in urban areas. Interpretation Certain health care, family, and community disparities were more often reported among children with MBDDS than among children without MBDDs in rural and urban areas. Public Health Action Collaboration involving health care, family, and community services and systems can be used to address fragmented services