October 15 is the United Nations’ International Day of Rural Women and this year’s theme is ‘Building rural women’s resilience in the wake of COVID-19’.
Rural women account for a quarter of the world’s population and are less likely to have access to quality health services, essential medicines, and vaccines. COVID-19 has aggravated all these issues.
Health inequities are typically the result of adverse social and environmental determinants, as well as weaker health systems in rural areas. Poor rural health system performance both compounds and contributes directly to health inequities.
An Australian perspective on rural women’s health
The Australian Longitudinal Study on Women’s Health (ALSWH) was launched by the Department of Health and Ageing in 1996 to conduct ongoing population-based surveys on the health and wellbeing of more than 57,000 Australian women across four age cohorts. The health data collected is used to inform government policy.
In 2011, the ALSWH published a major report, Rural, remote and regional differences in women’s health. Women’s health is particularly important because it directly impacts the health of their children and communities. The report’s key findings include:
- Australian women who live in regional and remote areas have higher death rates compared to women living in major cities.
- Older rural women have particularly higher rates of lung cancer, chronic obstructive pulmonary disease, and ischaemic heart disease – diseases often associated with tobacco smoking.
- The obesity rate increases with distance from major cities and is thought to account for higher rural rates of diabetes and hypertension.
- The use of medical and health services is much lower in remote and regional areas due to limited access. Rural women are, however, more likely to have mammograms than women in major cities; and Pap test rates are highest in regional areas.
- Country women experience more difficulty accessing GPs. Access issues relate to GPs who bulk bill, female GPs, after-hours service, hours when GPs are available, waiting times for appointments, and choice of GPs.
- Country women also have more difficulties accessing specialists, hospitals, and screening tests.
- Country women tend to have higher levels of resilience and adaptability when dealing with adversity. They also report higher rates of neighbourhood connectedness, feeling safe, life satisfaction, perceived control, and optimism.
Telehealth – helping deliver rural health services
Telehealth is one solution to improve the disparity between healthcare access for women in rural areas compared to women in metropolitan areas.
Telehealth services can efficiently and effectively improve access to healthcare for people living in rural and remote areas of Australia, according to the 2016 review article, Telehealth services in rural and remote Australia: a systematic review of models of care and factors influencing success and sustainability.
The review says escalating costs of health care, issues with recruitment and retention of health practitioners in rural areas, and poor economies of scale are dilemmas for health authorities around the world.
The review has found the use of telehealth services in rural and remote areas provides many benefits for patients and providers alike, including:
- Reduced length of stay in care
- Reduced demand on emergency services
- Improved access to healthcare
- Improved quality of services
- Improved clinical outcomes
- Decreased costs
- Reduced inconvenience
- Reduced travel
- Improved management of chronic and complex conditions
- Provision of peer support, networking, and education
However, the review has also found that, while telehealth services continue to become more commonplace in rural areas, there are still barriers and challenges associated with telehealth adoption and sustainability, including:
- Clinician preference for face-to-face consultations
- Ethico-legal concerns
- Change management practices
- Resources (including time)
- Funding models
- Service coordination and administration personnel
Visionflex – bringing clinical telehealth services to rural Australia.
Credits: Photo courtesy of UN Women/Rosendo Quintos featuring beekeeper and entrepreneur Oralia Ruano Lima, Guatemala.