PURPOSE: Health care delivery systems in rural areas face numerous challenges in meeting the community's needs. There is a lack of adequate attention for this problem. This study aims to explore the challenges of the health care process in rural Iran according to health care providers' experiences. METHODS: This was a qualitative study that used the content analysis method. We selected a total of 21 health care providers based on purposive sampling. Data collection consisted of semi-structured individual interviews that were analyzed by qualitative content analysis. RESULTS: Data analysis led to the formation of one main category, the challenges of process of health care in rural society. Within this main category, we created the following subcategories: change in characteristics of the rural society, increase in complexity of the health care process, decrease in workforce efficiency, and decrease in propensity of people's care. CONCLUSION: The findings of this study indicate that the process of health care in Iranian rural society is changing rapidly with community health workers encountering new challenges. There is diminished efficiency in responding to the changing care process in Iran's rural society. Considering this change in process of care, therefore, the health care system should respond to these new challenges by establishing new health care models.
Community Health Workers ; Data Collection ; Delivery of Health Care ; Health Personnel ; Humans ; Iran ; Nursing Care ; Rural Health ; Rural Population ; Statistics as Topic

PURPOSE: The aims of this study were to identify successful strategies and propose a community-based participatory global health project model for primary health care capacity development. METHODS: The study used case study methodology. A unit of analysis was an international cooperation health project entitled "Community-based Primary Health Care Improvement in San Lorenzo, Ecuador" using community-based participatory research conducted in 2007~2008. Data were collected through windshield surveys, focus group discussion, and provider surveys. RESULTS: Identified successful strategies for the international cooperation health project were reciprocal partnerships between researchers and community, partners' capacity building, south-to-south cooperation, and continuous monitoring and feedback. Community participation was found to be an essential tenet to guarantee the improvement of primary health care in the underserved rural community. Evidence from the activities of community health practitioners in Korea was applicable to the development of training programs for primary health care providers in Ecuador. CONCLUSION: Strategies for primary health care capacity development may be tailored depending on socio-cultural, political, and economical situations of each country. The model, however, would be applicable to the entire process of community-based global health projects in underserved rural communities of other countries.
Capacity Building ; Community-Based Participatory Research ; Consumer Participation ; Ecuador* ; Education ; Focus Groups ; International Cooperation ; Korea ; Primary Health Care* ; Rural Population*

OBJECTIVE: To explore the reliability and validity of the short-form of the UCLA loneliness scale (ULS-8) among Chinese rural community-dwelling elderly. METHODS: ULS-8 was used for 839 Chinese rural community-dwelling elderly during face-to-face interviews. RESULTS: After deleting item-3 (I am an outgoing person) and item-6 (I can find companionship when I want it), the exploratory factor analysis showed that the construction of the new scale (ULS-6) fit the original construction of ULS-8, a single-factor resolution. Cronbach's α coefficient of ULS-6 was 0.831. Test-retest reliability was 0.715. All item-total correlations reached statistical significance. The total score of ULS-6 was correlated to quality of life, social support, suicidal ideation, and current major depression episode. CONCLUSION ULS-6 shows satisfactory reliability and validity and meets the needs of psychometric properties, and can be used for the evaluation of loneliness among Chinese rural elderly.
Aged ; China ; Community Health Services ; Female ; Humans ; Loneliness ; psychology ; Male ; Middle Aged ; Reproducibility of Results ; Rural Population ; Sampling Studies ; Surveys and Questionnaires

Background: In 2020, Barangay Calumpang, a 2nd class municipality in Nagcarlan, Laguna recorded the highest prevalence of undernutrition among children under five years of age out of the 52 barangays. Objectives: This study was undertaken to describe the factors possibly causing undernutrition among children under five years of age in Barangay Calumpang and provide key recommendations to improve their nutritional status. Methods: The study used a descriptive research design wherein secondary data from the 2020 Barangay Management Information System (BMIS) and Operation Timbang (OPT) 2021 was merged to extract the children's data. The Statistical Package for the Social Sciences (SPSS) was used for the principal component analysis (PCA) and creation of the wealth index. The children’s nutrition situation and profile were also cross-tabulated. Results: We included 28 children. Undernutrition was more prevalent in boys than girls. Most of the children had improved water sources, sanitation facilities, and waste disposal methods. The wealth index showed that half of the subjects were in the lower quintiles, and all were partially immunized. The most prevalent forms of undernutrition were severe underweight (36%) and severe stunting (39%). Other forms of undernutrition were also present in the barangay, such as underweight (14%) and severe wasting (14%). There was also a prevalence of 11% for both stunting and wasting. Conclusion Undernutrition was more frequent in boys, lower quintile households (stunting), and partially immunized children. Conducting gender-targeted nutrition programs, developing nutrition-focused livelihood programs, increasing awareness on the advantages of immunization, and promoting proper infant and child feeding practices were some of the recommendations given to improve the nutritional status of children under five.
rural community ; Philippines

PURPOSE: We investigated the prevalence rate of benign prostatic hyperplasia (BPH) among Korean males in a rural area through a cross-sectional, community-based epidemiologic survey and analyzed the correlation with epidemiologic factors. MATERIALS AND METHODS: A total of 779 males who lived in Yangpyeong County participated in a prostate examination campaign. Targeting these men, we collected the International Prostate Symptom Score (IPSS), medical history, demographic information, serum prostate-specific antigen, and prostate volume as measured by transrectal ultrasonography. The data for 599 participants were analyzed, excluding 180 men who had a possibility of prostate cancer. BPH was defined as an IPSS of 8 points or higher and a prostate volume of 25 mL or more. RESULTS: The prevalence rate of BPH was 20.0%. The prevalence rate increased with age. There were 2 subjects (4.4%) in the age group of 40-49 years, 18 subjects (10.9%) in the age group of 50-59 years, 44 subjects (22%) in the age group of 60-69 years, and 56 subjects (26.6%) in the age group of over 70 years; this increase with age was statistically significant (p<0.001). In the BPH group, the average IPSS was 14.67+/-5.95, the average prostate volume was 37.04+/-11.71 g, and the average prostate-specific antigen value was 1.56+/-0.88 ng/mL. In the analysis of correlations between the epidemiologic factors and the risk of BPH, smoking was the only statistically significant factor. CONCLUSIONS: The total prevalence rate of BPH in this study was 20.0%, which was a little lower than the rate reported in other cities or rural areas.
Adult ; Age Distribution ; Aged ; Community-Based Participatory Research ; Cross-Sectional Studies ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Prostate/ultrasonography ; Prostate-Specific Antigen/blood ; Prostatic Hyperplasia/*epidemiology ; Republic of Korea/epidemiology ; Rural Population/statistics & numerical data ; Smoking/adverse effects

PURPOSE: The purpose of this study was to evaluate a self-care program for elders with osteoarthritis managed by primary health care workers, Community Health Practitioners (CHPs), in rural Korea. METHODS: The self-care program, consisting of 7 areas, was evaluated with a randomized experimental study for patients over age 60 with osteoarthritis in which 150 participants in the experimental group and 140 in the control group were compared. The self-care program was implemented for six weeks, 2 hours per week, at community health posts by CHPs. Data were collected using an interview questionnaire given by the CHPs and laboratory tests before and after the intervention for both groups. Propensity score matching analysis was done to test effectiveness after controlling for confounding variables. RESULTS: The intervention group showed a significant decrease in the number of painful joints (p<.001) and a significant increase in self-care ability (p<.05) compared to the control group. CONCLUSION: Study results indicate that training and utilizing primary health care workers in rural areas is valuable in increasing the generalization and continuity of intervention programs. As arthritis should be managed life-long, CHP directed self-care programs are useful interventions for rural elders with arthritis to learn self-care management.
Aged ; *Aged, 80 and over ; Asian Continental Ancestry Group ; Community Health Services ; Female ; Health Personnel/*utilization ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Osteoarthritis/*prevention & control ; Pain Management ; Program Evaluation ; Propensity Score ; Questionnaires ; Republic of Korea ; Rural Population ; *Self Care

OBJECTIVETo assess and analyze the risk and community treatment of hypertension in rural population of Changshu city, Jiangsu province.

METHODSA stratified cluster sampling technique was conducted to select a sample of 800 people, aged 35 - 74 years old, in a rural village according to the proportion of the national population in Changshu. Weight, height, blood pressure, serum lipid, blood glucose and other related factors were examined and analyzed.

RESULTSThe prevalence rate of hypertension in the rural area was 32.01%, and significantly higher with the increase of age (P < 0.01). The average systolic blood pressure of hypertension in females was significantly positively correlated while, the average diastolic blood pressure of male and female hypertensives was significantly negatively correlated to age. The proportions of risk factors of cardiovascular diseases (CVD) as senility, hyperlipemia, premature familial history of CVD and overweight of hypertension were significantly high than those without hypertension (P < 0.01). The percentage of medium-low risk on hypertension was 85.72%, but of high risk was 14.28%. The ratio of using medication, exclusive non-medication, comprehensive treatment or total cure were 42.05%, 2.84%, 14.20% and 59.09%, accordingly. The rates of blood pressure control under the above approaches were 35.14%, 40.00%, 36.00% and 39.77%.

CONCLUSIONAssessment on the risk of hypertension in the rural areas suggested that the priority should be given to medium-low risk groups, while the rate of medication and non-medicine intervention was at low level. It is necessary to strengthen a comprehensive intervention program for hypertension control.

Adult ; Age Factors ; Aged ; China ; epidemiology ; Community Health Services ; statistics & numerical data ; Female ; Heart Diseases ; epidemiology ; Humans ; Hypertension ; epidemiology ; therapy ; Male ; Middle Aged ; Prevalence ; Random Allocation ; Risk Factors ; Rural Health Services ; statistics & numerical data ; Rural Population ; statistics & numerical data ; Sex Factors

Background: People from rural communities are not spared from COVID-19. But implementing preventive measures and strategies can be made to control the spread. Objective: This study was conducted to describe the epidemiologic situation and the healthcare capacity of the locality, determine the responses and strategies implemented in the control of COVID-19, and explain the activities performed in relation to the epidemiologic situation in Tarangnan, Samar – a low-income class municipality in the Philippines. Methods: A mixed qualitative–quantitative design was employed in this study. Descriptive documentary research design through review of records from March to October 2020 was utilized. For the qualitative context, a case study design was employed whereby focus group discussions and key informant interviews using open-ended questions were performed. Results: A total of 66 individuals were recorded as having COVID-19 in the municipality from March to October 2020. The first recorded confirmed cases of COVID-19 in Eastern Visayas were two adults in Tarangnan, Samar, in March 2020. Since then, additional confirmed cases have been recorded every month, but confirmed COVID-19 dramatically reduced from August to October 2020. Qualitative analysis revealed stringent COVID-19 preventive measures reflected in the confirmed case numbers. The tailwinds of the COVID-19 response include: the SARS pandemic precedent, coordination and communication, outpouring of support from other government and nongovernment partners, and innovative community-based approaches. The headwinds of COVID-19 response were challenges in imposing minimum health and safety precautions, stigmatization, and discrimination. Conclusion Even if challenges have arisen in implementing measures against the spread of the disease, good outcomes have been achieved through persistent good practice, positive modifications, and community-based innovations.
Community Participation ; Community Health Services ; COVID-19 ; Rural Health ; Philippines

Adolescent ; Adult ; Aged ; Anxiety ; epidemiology ; etiology ; psychology ; China ; epidemiology ; Community Health Services ; Depression ; epidemiology ; etiology ; psychology ; Female ; Hepatitis B, Chronic ; complications ; psychology ; Humans ; Male ; Middle Aged ; Psychiatric Status Rating Scales ; Retrospective Studies ; Rural Population ; Severity of Illness Index ; Surveys and Questionnaires ; Young Adult

The Health Post Project in Gang Wha Gun is part of the Yonsei University Medical College's Community Health Teaching Project. Two townships, Son Won Myun and Nae Ga Myun, with a total population of 14,000 are being guided through a planned change process in order to raise health consciousness in the community based education of medical and other health manpower through demonstration of relevant community health principles and provision of entry points for applied teaching. The key to community access is provided through village based Family Health Workers (FHW) who, according to carefully designed selection procedures, functions, service package, training and implementation plan now serve as semi-independent village health representatives. The FHW is supervised by the government employed township health workers who in turn received re-orientation as multi-purpose workers. Their functions were re-designed according to project needs. Thus the government health services in the target area have been extended to the household level through FHW activities in MCH, TB care and Family Planning. The Health Post Project provides a statistically controlled environment with a base line survey and constantly incoming data. It also provides communication channels for reciprocal understanding of the health issues and problems between traditional villagers and city educated faculty and students. Moreover, the Health Post Project provides motivation for the communities to solve their health problems with existing resources to the highest degree possible. Finally, the development of grass-root level services in cooperation with the communities has potential for long term benefits. These include relevant training of health manpower regarding principles and practice of rural community health. It also includes the study and development of health manpower and service packages, streamlining of administrative and evaluation procedures, and information urgently needed for health planning.
Community Health Services* ; Delivery of Health Care* ; Human ; Korea ; Rural Health*