Background: Extreme weather events affect health by directly and indirectly increasing illness burdens and changing healthcare usage patterns. These effects can be especially severe in rural and remote areas, exacerbating existing health disparities, and necessitating urgent mitigation or adaptation strategies. Despite increased research on health and climate change, studies focusing on rural and remote populations remain limited. This study aimed to review the relationships among extreme weather events, healthcare utilization, and health outcomes in rural and remote populations, identify research gaps, and inform policy development for adaptation and disaster management in these settings. Methods: A systematic scoping review was registered and conducted following the PRISMA-ScR guidelines. The search databases included PubMed, Web of Science, Scopus, the Cochrane Library, ProQuest, and the WHO IRIS. The included studies were primary research, focused on rural or remote areas, and investigated the effects of extreme weather events on either health outcomes or healthcare utilization. There were no methodological, date or language restrictions. We excluded protocols, reviews, letters, editorials, and commentaries. Two reviewers screened and extracted all data, other reviewers were invited to resolve conflicts. Findings are presented numerically or narratively as appropriate. Results: The review included 135 studies from 31 countries, with most from high-income countries. Extreme weather events exacerbate communicable and noncommunicable diseases, including cardiorespiratory, mental health, and malnutrition, and lead to secondary impacts such as mass migration and increased poverty. Healthcare utilization patterns changed during these events, with increased demand for emergency services but reduced access to routine care due to disrupted services and financial constraints. Conclusions: The results highlighted the essential role of community and social support in rural and remote areas during extreme weather events and the importance of primary healthcare services in disaster management. Future research should focus on developing and implementing effective mitigation and adaptation programs tailored to the unique challenges faced by these populations.

INTRODUCTION: Telemedicine may help improve older adults' access, health outcomes, and quality of life indicators. This review aims to provide current evidence on the effectiveness of telemedicine in the aged population. METHOD: A systematic literature search was conducted in PubMed, Google Scholar, and Web of Science electronic databases between January 2015 and September 2021 using the keywords "telemedicine" or "telehealth" and "older people" or "geriatrics" or "elderly." The articles were classified under three headings according to the purposes: feasibility, diagnosis and management of chronic diseases, and patient satisfaction. RESULTS: A total of 22 articles were included. Across most disciplines, evidence has shown that telemedicine is as effective as usual care, if not more so, in the feasibility, chronic disease management, and patient satisfaction of the elderly. However, a few studies reported challenges such as difficulty with technology, hearing problems, and the inability to perform hands-on examinations for physicians. CONCLUSION: Findings from this review support the view that health care providers can use telemedicine to manage elderly individuals in conjunction with usual health care. However, future research is needed to eliminate barriers to increasing telemedicine use among older adults.

Background Village doctors, as gatekeepers of the health system for rural residents in China, are often confronted with adversity in providing the basic public healthcare services. Objective We sought to summarize the training contents, training method, training location, and training costs most preferred by village doctors in China and hope to provide evidence and support for the government to deliver better training in the future. Methods Eight databases were searched to include studies that reported on the training needs of village doctors in China. We undertook a systematic review and a narrative synthesis of data. Results A total of 38 cross-sectional studies including 35,545 participants were included. In China, village doctors have extensive training needs. “Clinical knowledge and skill” and “diagnosis and treatment of common disease” were the most preferred training content; “continuing medical education” was the most preferred delivery method; above county- and county-level hospitals were the most desirable training locations, and the training costs were expected to be low or even free. Conclusion Village doctors in various regions of China have similar preferences for training. Thus, future training should focus more on the training needs and preferences of village doctors.

Today, 8.5% of the world's population is 65 and over, and this statistic will reach 17% by 2050 (He et al., U.S. Census Bureau, international population reports, P95/16-1, An ageing world: 2015, U.S., 2016). They are the people who, with increasing age, will find themselves more closely interfacing with the national health system, which in many countries shows strong imbalances between rural and urban areas. In this context, a fundamental role is played by the relatives who find themselves becoming informal caregivers to compensate for lack of services. To date, however, little has been done to help these people. In this article, we want to identify the nature and extent of research evidence that had its objective to help informal caregivers in rural, hard to reach areas (Grant & Booth, Health Information & Libraries Journal, 2009, 26, 91). Following the approach set out by Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19), we conducted a scoping review in May 2018 and closed the review with an update in September 2018. We identified 14 studies published from 2012, the European Year of Active Ageing, promoted by the European Commission, which had three domains of implementation: emotional support to decrease the emotional burden of caregivers, educational support to increase their skills, and organisational support to improve the mobility of caregivers and care receivers. Although informal caregivers play a fundamental role in many countries, the studies that have been involved in alleviating their caring burden are few; nevertheless, they provide interesting indications. This lack of attention confirms how this portion of the population is still neglected by scientific research and risks having unequal access to health and social care. Future research is needed, not only to create and improve services to caregivers in rural, hard to reach areas, but also to evaluate and focus on the participation and the engagement of caregivers in the co-design of these services.

Background: Current literature systematically reports that interventions to attract and retain health workers in underserved areas need to be context specific but rarely defines what that means. In this systematic review, we try to summarize and analyse context factors influencing the implementation of interventions to attract and retain rural health workers. Methods: We searched online databases, relevant websites and reference lists of selected literature to identify studies on compulsory rural service programmes and financial incentives. Forty studies were selected. Information regarding context factors at macro, meso and micro levels was extracted and synthesized. Results: Macro-level context factors include political, economic and social factors. Meso-level factors include health system factors such as maldistribution of health workers, growing private sector, decentralization and health financing. Micro-level factors refer to the policy implementation process including funding sources, administrative agency, legislation process, monitoring and evaluation. Conclusions: Macro-, meso- and micro-level context factors can play different roles in agenda setting, policy formulation and implementation of health interventions to attract and retain rural health workers. These factors should be systematically considered in the different stages of policy process and evaluation.

BACKGROUND: 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. OBJECTIVES: To synthesise the best available evidence on the experiences of women's needs in maternity care and existing service models in rural areas. METHODS: 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. FINDINGS: 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). CONCLUSION: 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.