Themes of Reported Rural Healthcare Challenges Related to Non-Communicable Diseases Before and After the COVID-19...

Non-communicable diseases (NCDs), including cardiovascular disease, cancer, and chronic respiratory disease, are major causes of death worldwide; addressing NCDs is thus essential. NCDs may contribute to health disparities between rural and urban areas. The COVID-19 pandemic has altered medical and social environments, and NCD management approaches may have changed accordingly. This scoping review aimed to examine themes of reported rural healthcare challenges related to NCD management before and after the COVID-19 pandemic. A literature search of original articles was conducted via PubMed. A thematic analysis was applied to compare the content of studies classified as pre-pandemic and post-pandemic. A total of 23 articles were identified, including 12 studies classified as pre-pandemic and 11 studies classified as post-pandemic. Before the pandemic, commonly reported challenges included low management rates of hypertension and diabetes, instability in pharmaceutical supply, and insufficient training of healthcare personnel. We integrated these into a theme related to "healthcare". After the pandemic, in addition to the low management rates, studies increasingly addressed mental and nutritional health, multimorbidity, and socioeconomic disparities. We integrated there into a theme related to "society". Namely, studies classified as pre-pandemic primarily reported healthcare-related aspects, whereas studies classified as post-pandemic more frequently reported broader societal aspects in addition to healthcare-related aspects. These findings may reflect changes in how rural healthcare challenges related to NCDs have been recognized and discussed following the COVID-19 pandemic. Further research is needed to clarify the significance and implications of these reported themes.