Rural Research Articles

Effect of Polycystic Ovarian Disease and Polycystic Ovarian Syndrome among Indian Female Age Groups 15-45 Years Old in the Rural Area of Mohali, Punjab

Effect of Polycystic Ovarian Disease and Polycystic Ovarian Syndrome among Indian Female Age Groups 15-45 Years Old in the Rural Area of Mohali, Punjab

Long-term phenobarbital treatment is effective in working-age patients with epilepsy in rural Northeast China: a 10-year follow-up study.

Effective management of epilepsy in working-age patients is essential to reduce the burden on individuals, families, and communities. This study aimed to assess the long-term efficacy of phenobarbital (PB) in working-age patients with epilepsy in rural Northeast China and identify the risk factors for seizures during treatment. Patients aged 18-65 years diagnosed with convulsive epilepsy in rural areas of Jilin Province between 2010 and 2024 were included, and demographic and clinical data were recorded. Seizure frequency, self-efficacy, adherence, and adverse events (AEs) were assessed monthly. Of the 3,568 participants, 288 (8.1%) withdrew from the study and 159 (4.5%) died. During the first year of treatment, 75.2% of patients experienced a ≥50% reduction in seizure frequency compared with baseline (considered as treatment effectiveness); 53.7% of patients were seizure-free. By the tenth year, 97.7% of patients showed treatment effectiveness, and 89.6% were seizure-free. Self-efficacy was improved in 37.8% of patients in the first year and in 72% of patients by the tenth year. The independent risk factors for seizures during treatment were higher baseline seizure frequency [odds ratio (OR) = 1.431, 95% confidence interval (CI): 1.122-1.824], presence of multiple seizure types (OR = 1.367, 95% CI: 1.023-1.826), and poor adherence (OR = 14.806, 95% CI: 3.495-62.725), with significant differences observed in the first, third, and fifth years. The most commonly reported AEs were drowsiness (43.3%), dizziness (25.0%), and headaches (17.0%), most of which were mild and decreased over time. Age at enrollment was the only factor influencing withdrawal (hazard ratio = 0.984, 95% CI: 0.973-0.996, p = 0.010), with a substantial number of patients who withdrew (32.6%) relocating for work. Cardiovascular disease was the primary cause of death, and age at enrollment was the only risk factor (hazard ratio = 1.026, 95% CI: 1.009-1.043, p = 0.002). Working-age adults with epilepsy demonstrated a favorable response and tolerability to PB monotherapy. Baseline seizure frequency, seizure type, and adherence consistently predicted prognosis throughout the treatment period. Withdrawal was mainly explained by work-related pressures in this age group. Therefore, it is essential to implement interventions that support patient adherence to therapy and maintain stable regimens.

The Understanding America Study (UAS)

PurposeThe Understanding America Study (UAS) is a probability-based Internet panel housed at the Center for Economic and Social Research at the University of Southern California (USC). The UAS serves as...

13 Child maltreatment in Canada in the time of COVID-19: Experiences of child protection teams

Abstract Background At the onset of the COVID-19 pandemic, there were many fears regarding the effect on children’s wellbeing – specifically with regards to increased exposure to violence and potential for abuse and neglect within their homes. Early experiences of child protect teams (CPT) in the literature from one Canadian tertiary care center revealed a number of adaptations in their child abuse programs such as a move toward virtual assessments. Objectives Our descriptive study seeks to understand the perspectives, practices, and experiences of child protection teams in Canada during the COVID-19 pandemic with regards to: clinical practice, interactions with child welfare organizations and the justice system, team modes of operating and medical education. These lessons can be applied to child maltreatment and neglect clinical practice in the event of future pandemics, natural disasters, and to provide care to rural areas of Canada. Design/Methods Using a web-based, bilingual, mixed methods survey, we asked both quantitative and open-ended qualitative questions to members of CPTs across Canada. Thematic analysis was completed on qualitative responses. We received a total of 11 responses. Results Respondents unanimously reported a decrease in referrals during the COVID-19 pandemic. 64% endorsed the use of new virtual tools. Virtual tools were used to collaborate amongst members of the CPT as well as with external partners (such as child welfare and justice system). Interestingly, there was minimal adaptation of these tools in patient-facing contexts. 57% of respondents foresee these tools to continue being used in a post-COVID-19 context, and 71% see relevance of these tools for use in rural contexts. Respondents reported that virtual clinical discussions changed the way medical education and case discussion in child maltreatment was delivered. Conclusion These findings describe not only the adaptation of child protection teams to the pandemic, but also robust changes to clinical practice, interactions with partner organizations and the justice system, team modes of operating and medical education in child maltreatment and neglect in Canada.

Hepatitis A, B, and C in Brazilian Afro-Descendant Communities from Northeast Brazil: A Seroepidemiological Survey

Background: Viral hepatitis is a disease that is more prevalent among individuals residing in remote regions and in contexts of social vulnerability. The objective of this study was to ascertain the seroprevalence of hepatitis A (HAV), B (HBV), and C (HCV) in vulnerable communities in the rural area of São João do Piauí (SJP), northern Brazil. Methods: Immunoenzymatic assays were employed to detect the presence of anti-HAV (total and IgM), HBsAg, anti-HBc, anti-HBs, and anti-HCV serological markers in serum samples. Samples that yielded positive results were subjected to further analysis using real-time polymerase chain reaction (PCR). Results: A total of 492 individuals, ranging in age from 3 to 101 years, were consecutively recruited from eight rural communities. The majority of individuals were female (51.2%), over 30 years of age (57.1%), self-identified as Black/Brown (92.2%), and resided in Afro-Brazilian communities, designated as “quilombos” (68.1%). The seroprevalence of anti-HAV was 69.5% (95% CI: 65.4–73.6%), while that of anti-HBc was 4.7% (95% CI: 2.8–6.6%), and that of anti-HBs was 35.2% (95% CI: 30.1–39.4%), and 0.2% (95% CI:0.0–0.6%) for anti-HCV. Conclusions: The seroprevalence rates observed were higher than the national average, and a significant proportion of individuals in the target age groups were susceptible to HBV, despite the availability of vaccination. These findings highlight potential shortcomings in the management of vaccine-preventable diseases, which could have implications for public health.

Everyday reality of children in rural Catalonia (Spain): experiences and emotions

ABSTRACT The pandemic has been the catalyst for many families with young children to leave the urban environment and settle in rural areas, attracted by discourses that are in tune with the imported and classic ‘ideal of rural childhood’: natural environment, freedom, autonomy, mutual help, peace and quiet. However, we do not know to what extent this ideal construction of childhood in rural areas corresponds nowadays to the everyday reality of children. In this article we analyse the daily experiences and emotions of children in rural areas of Catalonia (Spain). By applying a qualitative methodology that allows children to express themselves, we provide a critical reading of the current rural areas based on children’s lived experiences. The use of the relief map as a methodological tool makes possible to graphically capture children’s emotions related to places. The research fills a gap on the current rural childhood experiences in non-Anglo-Saxon contexts, places the concept of the rural ideal in the Catalan environment and provides insight into the diversity of rural childhoods based on children’s experiences and emotions.

Simulated GP clinic closure: effects on patient access in the Irish Mid-West.

Rural communities can experience more barriers to accessing health care than their urban counterparts, largely due to fewer healthcare staff and services, and geographical isolation. The purpose of this study is to examine the availability of GP practices in rural communities across the Mid-West of Ireland and the potential impact of practice closure on patient access. GP clinic locations were identified in Ireland's Mid-West, specifically counties Limerick and Clare. Administrative subdivisions of both counties, Small Areas (SAs), were identified and their XY geographic centre coordinates recorded. SAs were indexed into six levels of rurality according to Irish Central Statistics Office urban/rural classifications (1, cities; 2, satellite urban towns; 3, independent urban towns; 4, rural areas with high urban influence; 5, rural areas with moderate urban influence; 6, highly rural/remote areas). The direct linear distance from the centre of each SA to its respective closest GP clinic was calculated. Simulated closure of each GP clinic was assessed programmatically by removing practices from the overall dataset and calculating the new direct linear distance from each SA to the next closest GP clinic. The majority of the SAs in County Clare (63%) and County Limerick (66%) are classified as rural (rurality index ≥4), with the exception of Limerick City, where all SAs were defined as urban. Rural SAs have longer travel distances to GP clinics than their urban counterparts, and these distances are greater with increasing rurality of a population. Simulated closure of GP clinics revealed increasing travel distances to the next closest clinic with increasing level of rurality in a stepwise fashion (r2=0.31). Rural community dwellers across the Mid-West of Ireland face longer travel distances to GP clinics than their urban counterparts. Thus rural communities will be, on average, more adversely affected should their local GP clinic close. While these findings are unsurprising, our methodology calculates a discrete number that can be used to rank vulnerability of local communities. Rural areas are particularly vulnerable to GP clinic closure, and maintaining a solid foundation of primary care in these areas will require careful service and workforce planning.

Factors Promoting Physical Activity and Physical Development in Early Childhood

This research explored factors promoting physical activity and development in early childhood in urban and rural areas. A sample of 488 urban and 387 rural students was selected through random sampling. Data was collected and analyzed using descriptive statistics and the chi-square test. The findings revealed that urban schools have more environmental factors promoting physical activity than rural schools. Urban students had better physical development scores than those in rural areas. The study also found that school location correlates with students' physical development in the form of good hygiene habits, consuming nutritious food and clean water, regular exercise, good body coordination, and good hand-eye coordination.

Utilization of Biomass Waste Through Small-Scale Gasification Technology in the Eastern Cape Province in South Africa: Towards the Achievement of Sustainable Development Goal Number 7

Despite being resource-richly endowed with various energy sources, and despite the connection of 89.8% of the households to the grid in South Africa, the Eastern Cape province, as compared to other provinces, has the lowest level of grid connection of about 64.5%. Some of the rural poor households in the Eastern Cape province supplement their free basic electricity with unclean energy alternatives. Using unclean energy alternatives is not only detrimental to the environment and health of the people, but it is a sign of energy poverty and among the contributing factors to depesantization, deagrarianization, and deindustrialization which prolongs the underdevelopment in rural areas. Innovation in energy technologies is a key ingredient in meaningful rural development. The utilization of small-scale biomass gasification technologies can be a solution to the South African energy crisis in rural areas, and it is in line with sustainable development goal number 7, which is about ensuring access to affordable, reliable, sustainable, and modern energy for all. Alternative renewable energy sources cannot be ignored when dealing with the energy crises in South Africa. Renewable energy sources in the country include biomass, solar, wind, and hydropower. Despite its low utilization in the Eastern Cape province, small-scale biomass gasification technology remains pivotal in reducing energy crisis by producing electricity. However, the affordability of biomass gasification technology also plays a role in whether people will accept small-scale biomass gasification technology. The purpose of this paper is to determine the possibilities of using small-scale biomass gasification technology. This paper gives a comprehensive review of small-scale biomass gasification technology potential in the Eastern Cape province and the link between acceptance of small-scale gasification technology and affordability by evaluating the availability of biomass sources in the province and achievements with regards to small-scale biomass gasification. This paper also covers the impact of biomass gasification technology integration in the energy grid, what needs to be taken into consideration before its installation, its benefits and the barriers to its development in Eastern Cape province.

Do Teachers Still Teach Agriculture in Rural Areas? Students' Perceptions Towards Agricultural Material in School and Its Correlation with Students’ Interest in Farming in Rural Areas

Do Teachers Still Teach Agriculture in Rural Areas? Students' Perceptions Towards Agricultural Material in School and Its Correlation with Students’ Interest in Farming in Rural Areas

Making green cocoa: Deforestation, the legacy of war, and agrarian capitalism in Côte d'Ivoire

AbstractThis article examines the legacy of war on environmental policy, contributing to recent literature on the linkages between armed violence, conservation, rural livelihoods and global value chains. It argues that environmental norms reshape agricultural practices, but also the means by which people claim control over land and labour. Using the case of cocoa in Côte d'Ivoire, this paper examines the impact of ‘zero‐deforestation’ policies on the country's last agricultural frontier: its western forestlands, where migration and deforestation have driven the development of the cocoa economy for years. The region is now feeling the effects of global trade policies such as the European Deforestation‐Free Regulation (EUDR), competition for the last remaining forests and social fault lines inherited from the war. This article traces the origins of the zero‐deforestation policy, its national and local impact and its implications for social struggles over the control of land and labour.

Preparedness, Challenges, and Opportunities for Digital Intervention for Chronic Disease Management: A Qualitative Study in Rural Areas of South Korea

ABSTRACT Motivated by the prevalence of an aging population and the associated increase in chronic diseases, coupled with rising medical expenditure, the Korean government initiated a pilot project in Pyeongchang-gun, Gangwon-do, a rural area, to implement a “smart online-to-offline (O2O) digital health care model” aimed at managing and preventing chronic diseases. However, there is limited understanding regarding perspectives and levels of preparedness for digital health among stakeholders at various levels. In-depth focus group interviews were conducted with elderly and non-elderly community members, health care providers, and staff members at Pyeongchang Health and Medical Center. The study found the presence of both positive and negative perceptions and a lack of preparedness across different levels. At the end-user level, it was observed that community members, especially the elderly, have low levels of health and digital literacy, compounded by limited access to social support. At the health care provider level, there was uncertainty about the acceptance of the digital health program. At the area level, the need to bolster health staff members and enhance their capacity was observed. Recommendations include: customizing the design of the online and offline service components by considering end-user factors (such as age, occupation, and household type) that may contribute to disparities in health; establishing a platform for providers to share their experiences to facilitate the effective incorporation of digital health into their practices; and preparing an appropriate provider payment mechanism.

Occupational Exposure to Unburnt Tobacco Dust and Thyroid Function: A Case-Control Study

Beedi rolling is one of the most common home-based occupations used to meet daily expenses. The process of making beedis is mainly done by women, especially in rural areas. Due to a lack of awareness regarding safety measures, beedi-rolling women are exposed to toxic components present in unburnt tobacco dust. This exposure leads to many health complications among women beedi-rollers. In this study, we investigated how unburnt tobacco dust disrupts thyroid gland homeostasis by altering levels of thyroid hormone and TSH. We included 421 beedi rolling women (BR) and 426 control subjects (NBR) who were not exposed occupationally to any chemical agents. Levels of thyroid hormones (T3, T4) were analysed using competitive ELISA, and TSH levels were analysed using sandwich ELISA. Serum nicotine metabolites were analysed using LC-MS. We observed a statistically significant increase in the levels of T3, T4, anabasine, nornicotine, and cotinine in BR compared to the NBR group. Additionally, significantly lower TSH levels were observed in the BR group. However, the Correlation between nicotine metabolites, and hormones did not show a significant difference in the BR group. We conclude that prolonged exposure to unburnt tobacco dust must have disrupted thyroid function by altering the thyroid hormone, and TSH levels.

Parent-teacher partnerships to enhance education for sustainable development: Early childhood development education learning centres in Zimbabwe

Education is one of the fundamental tools necessary to achieve the global Sustainable Development Goals. In particular, Goal 4 advocates for quality education for all since it is important for all children to have a sound educational foundation. In this study, I focus on the second target of Sustainable Development Goal 4 that advocates for early childhood development and universal pre-primary education. The aim of this study was to explore how parent-teacher partnerships could be used to enhance education for sustainable development in early childhood development education learning centres in rural areas. The study was conducted in two primary schools in Bulilima district of Matabeleland, South province in Zimbabwe. The study called on Epstein's notion of parental engagement as the theoretical framework. A participatory action research methodological design was deemed suitable for this qualitative study because it allowed participants to have an opportunity to express their views in their natural settings. Data was generated by means of discussion meetings and reflections and Fairclough's (1992) critical discourse analysis was employed in its analysis. The findings, from early childhood development centres, highlight the importance of teacher-parent partnerships in promoting sustainable learning outcomes and children's well-being. Furthermore, it was found that such partnerships promote alignment between the school culture and the needs of communities and enhance communication and decision making as well as providing a basis for change in the parents' perceptions regarding early childhood development education. The study concluded that teachers and parents should work together at this level of education.

Assessment of microplastic and heavy metal pollution in agricultural soils of Ernakulam District, Kerala, India.

Microplastics (MPs) and heavy metal pollution pose significant environmental threat, potentially leading to agroecosystem toxicity and jeopardizing food security. Therefore, this study aims to evaluate the abundance and risk assessment of these pollutants in five different farmlands of Ernakulam district, India. Results showed that MPs content in agricultural fields near commercialized areas such as Kakkanad Nedungapuzha, Nedumbassery, and Kadamakuddy was dominant compared to Nechoor, a rural area. The average microplastic abundance was found to be 45.6 ± 26.4 items kg⁻1 dw. Polypropylene (PP) and polyethylene (PE) were the dominant polymers found in the soil samples, constituting 45% and 25% of the microplastic content, respectively. The pollution load index of MPs indicates that the sampling sites are considered to be polluted as PLI > 1 with hazard level I. The heavy metal pollution status follows the order: Cu (80.3 to 724mg/kg) > Zn (77 to 543.5mg/kg) > Cr (171.65 to 334.65mg/kg) > As (10.25 to 79.5mg/kg) > Pb (2.05 to 30.3mg/kg) > Cd (0.3 to 14.35mg/kg). Calculated pollution load index (PLI) geo-accumulation index (Igeo), ecological risk assessment values indicate that commercialized regions exhibit high levels of trace metals, namely Cu, Zn, As, Cd, and Cr, posing a significant concern for the agricultural ecosystem. Our results indicate heightened microplastics and heavy metals prevalence in farmlands adjacent to commercial zones, necessitating immediate preventive action to mitigate increasing concentrations.

Twelve Tips for Engaging Medical Students in Rural-Focused Research

Background The future of rural healthcare depends on training the future rural health workforce, and on rural health research that can guide clinical and policy decisions in rural spaces. Promotion of rural healthcare careers usually focuses on clinical aspects of care, and research may be seen as a lower priority. Supporting students to be involved in rural focused research offers the opportunity to broaden the pool of potentially rural interested students, and to develop research and scholarship skills and capacity in the future rural workforce. Aim and method We identify twelve tips that medical schools can adopt to foster medical student participation in research and promote student interest in rural healthcare and rural medical practice. These recommendations are based on a review of literature and our personal experience of conducting rural-focused research activities with medical students. Conclusion Through these twelve tips, we provide a practical framework for enhancing undergraduate medical student exposure to rural-focused research to foster research capacity. This has potential to inspire student interest in future rural medical practice and could contribute to alleviate workforce and research gaps in rural areas.

Development and Evaluation of a Rural Longitudinal Neonatal Resuscitation Program Telesimulation Program (MOOSE: Maine Ongoing Outreach Simulation Education).

Neonatal resuscitation is a high-acuity, low-occurrence event and many rural pediatricians report feeling underprepared for these events. We piloted a longitudinal telesimulation (TS) program with a rural hospital's interprofessional delivery room teams aimed at improving adherence to Neonatal Resuscitation Program (NRP) guidelines and teamwork. A TS study was conducted monthly in one rural hospital over a 10-month period from November 2020 to August 2021. TS sessions were remotely viewed and debriefed by experts, a neonatologist and a simulation educator. Sessions were video recorded and assessed using a scoring tool with validity evidence for NRP adherence. Teamwork was assessed using both TeamSTEPPS 2.0 Team Performance Observation Tool and Mayo High-Performance Teamwork Scale. We conducted 10 TS sessions in one rural hospital. There were 24 total participants, who rotated through monthly sessions, ensuring interdisciplinary team composition was reflective of realistic staffing. NRP adherence rate for full code scenarios improved from a baseline of 39 to 95%. Compared with baseline data for efficiency, multiple NRP skills improved (e.g., cardiac lead placement occurred 12× faster, 0:31 seconds vs. 6:21 minutes). Teamwork scores showed improvement in all domains. Our results demonstrate that a TS program aimed at improving NRP and team performance is possible to implement in a rural setting. Our pilot study showed a trend toward improved NRP adherence, increased skill efficiency, and higher-quality teamwork and communication in one rural hospital. Additional research is needed to analyze program efficacy on a larger scale and to understand the impact of training on patient outcomes. · Optimal newborn outcomes depend on skillful implementation of NRP.. · Telesimulation can deliver medical education that circumvents challenges in rural areas.. · A longitudinal NRP TS program is possible to implement in a rural setting.. · A rural NRP telesimulation program may improve interprofessional resuscitation performance.. · A rural NRP telesimulation program may improve interprofessional resuscitation teamwork..

Effects of Table Banking on Socio-Economic Empowerment of Households in Turkana County, Kenya.

Table banking is a concept that has gained popularity in the recent past in Kenya. The aim of this type of informal banking is to enhance the socio-economic status of citizens, particularly those from poor areas of the country. However, measuring and tracking changes in the levels of socio-economic empowerment of households through table banking is not well documented, although it is becoming popular, especially among women groups in Kenya. The main objective of this study was to investigate the effects of table banking on the socio-economic empowerment of households in Turkana County, Kenya. The specific objectives were: to establish the effect of table banking financial accessibility, table banking awareness, table banking group participation, table banking group credit risks management strategies on socio-economic empowerment in Turkana County. The study is guided by the theory of change by Loiseau and Walsh 2015, vulnerable group theory of financial inclusion and public good theory of financial inclusion. The study adopted descriptive survey design where questionnaires were used to get primary data. Secondary data was used to validate the primary data collection. The study involved a sample of 398 members drawn using simple random sampling method from a population of 60,500 Table banking members from Kalobeyei ward, Kakuma ward in Turkana West Subcounty in Turkana County. A total of 398 questionnaires were administered with a return rate of 97.0%. The data collected was analysed using descriptive statistics. The study relied on Pearson’s correlation, linear regression and factor analysis to draw inferences from the responses. Statistical analysis was done with the aid of statistical package of social sciences (SPSS) software version 24. The findings of the study revealed a strong, positive and statistically significant relationship between access to finance and socio-economic empowerment of households. The findings of the study also showed a fairly, strong, positive and statistically significant relationship between table banking awareness on socio-economic of households. Besides, the findings revealed a very strong, positive and statistically significant relationship between Table banking and active group participation on socio-economic empowerment of women. The results of the study also revealed a very strong, positive and statistically significant relationship between table banking credit risk management strategies and socio-economic empowerment of women. According to the findings, this study recommends continuous, operative and thorough training of all groups involved in table banking to enhance their capacity in leading the groups and enhancing financial management capability and performance. Additionally, the study recommends creating a functional system for financial access through the use of several financial products at affordable prices, this focuses on government considering increasing the avenues and mechanisms for socioeconomic empowerment of women and special interest groups, especially in the rural areas. As shown in this study, findings provide evidence of active participating of women in the table banking compared to men involvement, based on this it will also be pivotal to further research the basis of men’s involvement in table banking and how affects their contribution to socio -economic empowerment at the household level.

Rural Economic Development Strategy through Village Tourism Development with the Exploitation of Local Potential (Empirical Study in Kebon Ayu Village, West Lombok)

This study aims to examine and analyze the appropriate strategies developed by stakeholders in building and developing rural tourism areas, especially Kebon Ayu Village as one of the mainstay tourist villages in West Lombok. The development of rural areas is important to create community welfare as well as to play the role of residents to take responsibility for maintaining the preservation of the surrounding natural environment. The research approach used is a qualitative descriptive approach based on field observation with the support of secondary data. The collected data is then analyzed using a SWOT analysis approach by systematically identifying various internal and external factors to formulate the desired development strategy. The logic built is how to maximize strengths and opportunities but at the same time minimize weaknesses and threats. The results of the study show that the tourist attraction of Kebon Ayu Village has enough potential to be developed because of the support of the beautiful rural nature and the surrounding hills that surround it. It has a natural rural atmosphere, supporting agro-tourism and culinary tourism potential, with an attractive green expanse of hills, a strategic position as a buffer for the district capital (Gerung) and its safe and comfortable environment. But on the other hand, several things need to be improved, such as the arrangement of the residential environment, waste handling, and concern for tourist facilities such as garbage cans, ATMs, toilets, mini markets, prayer rooms, and others. Supporting facilities and infrastructure need to receive attention so that they are more organized, such as the construction of environmental roads, street lighting, waterways, folk craft coaching, water game spots, outbound, and camping grounds. If all of these things can be overcome properly, then the Kebon Ayu Village tourist attraction will have its own attraction and become a mainstay tourist destination that can compete with other village tourist attractions.

Opportunities and challenges in utilizing community assets to extend chronic care management in podoconiosis endemic areas: Evidence from Northwestern Ethiopia.

Community-based chronic care intervention is important in the control and prevention of lifelong conditions such as podoconiosis and similar 'intensive disease management' neglected tropical diseases (NTDs). Despite a call for such interventions, few efforts have been made to identify opportunities and challenges related to their implementation. Employing a qualitative approach, this study explored the possibility of engaging community actors, physical places and networks to promote chronic care management in rural Ethiopia. We gathered data from affected individuals, community members, local leaders, health professionals and community health workers between April and May 2022. The study revealed that affected individuals, family members, religious leaders, traditional leaders, and health professionals have the potential to extend chronic care management in rural areas. Houses, churches, schools, and healthcare facilities are suitable venues at which to perform interventions. Strong community solidarity and political will are vital to chronic care interventions, while lack of understanding about chronic conditions, financial constraints, and limited resources at healthcare facilities could pose challenges. Using community assets has great promise for expanding chronic care management with minimal costs and efforts in under resourced areas. Achieving this will require a successful plan to coordinate the collaboration among the agents and settings.