Diverse rural communities were overlooked in the Covid-19 vaccine rollout, University of Otago research has found.
Researchers from the Otago University and the University of Waikato studied health providers in rural Māori and Pasifika communities during the Covid-19 vaccination rollout to uncover the challenges faced and improve future health promotion programmes.
Associate Prof Katharina Blattner of the Otago University’s department of general practice and rural health was the lead author of the study.
Prof Blattner said many studies had come out in recent years around disparities between rural and urban Covid-19 vaccination rates — but those studies did not explore the "how" or "why".
"The health outcomes for people living in rural areas are worse than that in the cities and those are exacerbated for our Māori and Pacific populations."
The purpose of the study was to determine barriers that impacted rural communities during the Covid-19 vaccination rollout.
Prof Blattner said the Covid vaccine rollout used "urban-centric" and "Pākehā" focused structures, policies and procedures, which did not translate well to rural communities.
"When you try to put the plan for a big city health service on to a small rural area, with a low-density population scattered across big geography and a very small team, you run into some problems — that’s what happened there."
She said the rural vaccine rollout was developed without considering challenges such as rural roads, workforce shortages, and limited infrastructure including phone and internet connectivity.
The needs of diverse rural communities could be met by allowing innovative local solutions, entrusting established ways of working and engaging the community, she said.
The overall consensus was that future health initiatives should be "geographically tailored, culturally anchored, and locally driven".
By translating "urban-centric" health initiatives into a rural context, there would likely be better overall health and mortality outcomes, Prof Blattner said.
There was a sense of "fragility" among those living in rural communities long pre-dating Covid, she said.
However, most rural communities had figured out how to get things done in their own respective places, she said.
"All of the places had quite strong established ways of working that worked well for them for a long time and they knew their community and their geography really well."
Most rural health providers took ownership of the rollout after realising the urban-centric initiative did not align with their context and hindered progress.
Rural places were not "miniature cities", so it was important the voices of rural health workers and their communities were heard, she said.
