Promotion Of Well-being Research Articles

Nurturing positive mental health and wellbeing in educational settings - the PRICES model.

This article presents a comprehensive framework for the implementation of social and emotional learning (SEL) programs as a means of health promotion in educational settings, to positively impact student, school, and adult mental health and wellbeing across education. It emphasizes the profound impact of education on life trajectories and success definitions. Drawing inspiration from the Greek myth of Icarus and Maya Angelou's poem "Still I Rise," it explores contrasting notions of success and their consequences. Schools play a pivotal role in shaping students' wellbeing across multiple dimensions and developmental stages. Because of this, holistic mental health and wellbeing promotion that takes a whole-school approach is critical. The paper introduces the PRICES framework (Preparation and Access, Restoration, Integration, Connection and Community, Educator Support, Strengths-Based Cultivation and Student Voice) as a comprehensive method for implementing SEL programs in educational systems. Each component of the PRICES framework is discussed in detail, emphasizing its role in fostering positive health promotion within schools. Examples of implementation plans that operationalize this model through a co-development process focusing on the Social, Emotional, and Ethical (SEE) Learning program are also presented. The PRICES model encourages a shift towards a more holistic approach to education, nurturing social and emotional development alongside academic achievement. By prioritizing wellbeing, fostering a sense of community, and integrating evidence based SEL interventions, schools can positively impact the mental health and overall flourishing of students and educators, contributing to thriving communities.

From historical pandemics to the COVID-19 crisis: lessons learned, challenges faced, and future directions in global health

This study aims to assess the coping strategies employed during major historical pandemics and their implications for mental health. An integrative literature review was conducted, encompassing the following databases: SciELO, PubMed, Lilacs, and Google Scholar. Scientific studies were identified using relevant Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) combined with Boolean operators AND and OR. Seventeen publications that met the eligibility criteria and were published between 2003 and January 2023 were selected for analysis. The findings revealed that 9 articles (52.94%) focused on COVID-19, 2 articles (11.76%) discussed the Black Death, 3 articles (17.64%) explored the Spanish flu, 4 articles (23.52%) addressed H1N1, 1 article (5.88%) examined Perinthus cough, and 6 articles (35.29%) investigated mental health in pandemic scenarios. The study demonstrates that coping strategies have significantly improved with advancements in scientific and technological knowledge, leading to a better understanding of the transmission and prevention of pandemics, as well as the promotion of mental well-being.

Mindfulness-Based Cognitive Therapy—Taking it Further (MBCT-TiF) compared to Ongoing Mindfulness Practice (OMP) in the promotion of well-being and mental health: A randomised controlled trial with graduates of MBCT and MBSR

ObjectiveTo evaluate the effectiveness and acceptability of Mindfulness-Based Cognitive Therapy-Taking it Further (MBCT-TiF), as an adapted programme for graduates of MBCT and Mindfulness-Based Stress Reduction (MBSR). MBCT-TiF sits within a global mental health approach, which aims to help shift a wider distribution of the population towards mental well-being and away from mental ill health using a family of MBCT curricula. The primary hypothesis was that MBCT-TiF, compared to Ongoing Mindfulness Practice (OMP), would help MBCT/MBSR graduates improve their mental well-being. MethodA parallel RCT with repeated measures was conducted. 164 graduates of MBCT/MBSR were randomly assigned (1:1) to either MBCT-TiF or OMP. Registration: ClinicalTrials.gov (NCT05154266). ResultsOf the 164 graduates recruited, 83 were randomly assigned to MBCT-TiF and 81 to OMP. MBCT-TiF was significantly more effective than OMP at improving mental well-being, with large effects post-intervention (B = 6.25; 95% CI = [4.20, 8.29]; Cohen's d = 0.78). No serious adverse effects were reported. ConclusionsThe findings support MBCT-TiF, in the context of the proposed global mental health approach, to help MBCT/MBSR graduates sustain mental health benefits and experience further gains in mental well-being after completing an introductory MBCT/MBSR programme. Future work should consider mechanisms and longer follow-up measurements.

Role of self-awareness in the promotion of health and well-being of college students

The quest for knowing self is the most basic of human nature, which is long believed to be necessary for promoting good health and well-being. This research provides a theoretical and empirical examination of the role of Self-Awareness (SA) in health and well-being. It was proposed that self-awareness is a positivistic construct that would promote health and well-being. In order to achieve the above-stated purpose, two series of studies were planned. The first study aimed to find out the contribution of SA to various dimensions of health and well-being. A total of 300 college students equally drawn from both genders participated in the study. The self-awareness scale (developed by the researcher), health scale for college students (adapted for the present study), and WHO spirituality form were given to participants. Study I demonstrated that self-awareness predicted most health and well-being factors. The findings further suggested that self-awareness may promote health and well-being. In study II, 60 experimental-control group participants were recruited. Students were allocated into experimental and control groups. A specifically designed Self-awareness Intervention Program (SAIP) was held for five days for the participants in a controlled setting. The results showed a substantial increment in the health and well-being of the treatment group in comparison to the control group. A brief follow-up interview was conducted to understand the Intervention's results. A major implication of the present study is that SA can be used as a positivistic construct and that an intervention program can be taken as a low-cost strategy to promote the health and well-being of college students.

Enabling pupils to flourish: six evidence-based principles of whole-school wellbeing promotion.

Schools have become increasingly important as health promotion settings, seeking to improve pupils' health and wellbeing through adopting a whole-school approach. A strong evidence-base highlights that focusing on the social, emotional and psychological aspects of pupils' wellbeing enables them to flourish, enjoy life and be better equipped to overcome challenges. However, it is acknowledged that further evidence is required regarding: (1) what happens in primary schools, (2) the impact of the English education system, (3) complexity and context, and (4) capturing children's voices. This article, therefore, addresses these gaps by asking the question: How do schools use whole-school wellbeing promotion to enable pupils to flourish? Taking an exploratory approach the study used a three-phase, mixed methods design to address the research problem by undertaking a systematic literature review, a secondary data analysis and a case study to capture multiple stakeholder voices including pupils. As appropriate for this research design, the findings from each phase were integrated into an overarching analysis which is presented in this article. Six broad principles formed consistent threads across the findings: (1) enabling children to flourish, (2) integrating wellbeing with key school goals, (3) promoting wellbeing and building capital, (4) building on virtuous cycles, (5) managing complexity and context, and (6) evaluating wellbeing promotion through listening to different voices. As well as presenting new knowledge addressing the identified research gaps, this study has demonstrated that schools can avoid 'reinventing the wheel' by adopting existing practices and resources and adapting them to their own setting. It is, therefore, hoped the six evidence-based principles of this study are equally transferable to schools within the English education system and more broadly. In addition, the paper highlights recognized challenges to staffing and resourcing and raises the question over whether schools receive sufficient funding to deliver the whole-school initiatives that government recommends. This article provides readers with an exploration of what has been achieved in schools and it is outside its scope to address specific issues about funding and other practical logistics for implementing whole-school wellbeing promotion, therefore further research is recommended.

Giving new meaning to the impact of touch in Shantala massage: mothers' perceptions of maternal and child well-being.

to understand maternal perceptions of maternal and child well-being based on Shantala massage and discuss its association with the third Sustainable Development Goal. a descriptive-exploratory study in the light of Symbolic Interactionism. Eight women, mothers of infants, participated in five online meetings to teach Shantala massage, collected in focus groups, between November and December 2021. The data was subjected to thematic content analysis and lexical analysis with IRAMUTEQ®. two categories emerged, 1) Maternal perceptions of Shantala massage and its promotion of child well-being and 2) Maternal perceptions of Shantala massage and its impact on their well-being, interconnected with subcategories. Shantala massage promoted mutual impacts on maternal and child well-being, working together to achieve the third Sustainable Development Goal.

Immersive virtual reality in the promotion of health and well-being for people in residential aged care without cognitive impairment: A scoping review.

Sustaining the health and well-being of older people living in residential aged care (RAC) requires new means of providing safe and stimulating recreational and therapeutic programs such as using virtual reality (VR). The aim of the scoping review was to investigate the utility of immersive VR interventions using head-mounted display technology to promote the health and well-being of people without cognitive impairment living in RAC. The following databases were searched from inception until January 2024: PubMed, PsycINFO, Scopus, Cochrane and CINAHL. The eligibility criteria were quantitative, qualitative or mixed methods studies published in English, conducted in RAC, using VR with head-mounted display with people without cognitive impairment. Of the 274 articles identified, 9 articles with a total of 310 residents and 50 staff met the inclusion criteria. Seven factors to either impede or enable the use of VR with head-mounted displays in RAC were: residents' agency; the nature of the VR experience; the content of the experience; the ease of use and comfort of the technology; the role of RAC staff; and the role of residents' family members. Immersive VR has potential as a tool to promote the health and well-being of people without cognitive impairment living in RAC. Small sample sizes, variations in study design, and selection bias mean that generalisability of the results is limited. Further research is recommended to inform the design and implementation of immersive VR programs tailored specifically for this population.

Autistic well-being: A scoping review of scientific studies from a neurodiversity-affirmative perspective

Background Historically, autism research has focused on the overrepresentation of physical and mental health problems and decreased psychological well-being in autistic people without intellectual impairment. There is a paucity of studies emphasizing what positively contributes to the well-being of autistic people. In line with a recent shift toward investigating autistic health more comprehensively, we conducted a scoping review to map emerging data on autistic well-being within a biopsychosocial context. Methods A Lived Experience Advisory Panel coproduced the review question. The research was collated using Preferred Items for Systematic Reviews and Meta-analyses guidelines for scoping reviews (PRISMA-ScR) with predefined selection criteria. Research based on the deficit-based view of autism and not within the core principles of the neurodiversity-affirmative movement was excluded. Results We collated 89 studies, with biological ( N = 8), psychological ( N = 70), and social ( N = 61) factors. Alongside an increase in affirmation-focused outputs, we identified several themes: ‘Impact of Diagnosis and Self-Identity’, ‘Self-empowering Characteristics’, ‘Cognition’, ‘Role of the Wider Community’, ‘Role of Relationships and Forms of Support’, and ‘Social Adaptations and Lessons from COVID-19’. Conclusions While neurodiversity-affirmative perspectives on autistic well-being are increasingly recognized as an important research area, there is a need for a more stringent exploration of interlinking biopsychosocial determinants. A focused approach within future research will enhance understanding of the promotion of autistic well-being. Lay abstract A lot of autism research focuses on the negative aspects of being autistic, for example, autistic people have a shorter life expectancy and are more likely to have physical and mental health conditions. There is not much research on what improves autistic well-being and quality of life. In this article, we summarize research that looks at positive factors which contribute to autistic well-being. We first asked four autistic adults which questions they think are most important to ask about autistic well-being. Together, we decided that we would look for research that is based on a neurodiversity-affirmative perspective and does not view autism as a deficit. We also decided we would look for biological, psychological, and social factors that positively contribute to autistic well-being for autistic people of all ages. We then used a specific method for searching different databases to see what other researchers had found that could answer our question. We found 89 studies that looked at biopsychosocial factors contributing to autistic well-being. Most of these were on psychological and social factors, with only a few on biological factors. We found that meaningful social connections, forms of support, and psychological factors like individual characteristics contributed to autistic well-being. Overall, we found that autistic well-being is a relatively new interest in autism research and that we need more research in the future to work out how we can improve the quality of life of autistic people of all ages.

Depression in the 1st year of MBBS – A longitudinal perspective

Background: Medical school is difficult, and studies have shown that medical students have a higher rate of depression than general people. This may be related to a competitive environment or intellectual burnout. Other contributing variables to this issue include the person’s social background, financial situation, and mental state. This may have long-lasting impacts and help to explain why a lot of doctors commit suicide. It is crucial to pinpoint the causes and deal with them to prevent the detrimental effects of depression among medical students. Aims and Objectives: The present study aims to measure the depression among medical students using patient health questionnaire-9 (PHQ-9) and to assess the correlates of depression among them. Materials and Methods: In this longitudinal study, data collected from 214 1st year medical students thrice: At the beginning, at midterm, and after completion of their university examination. PHQ-9 was used for screening of depression and multidimensional scale of perceived social support was used to find out the social support in the study participants. Results: It is found that depression affects the majority of the male younger students staying at hostels and coming from the rural background. Conclusion: The extent of depression is high among the study population which warrants its screening with the incorporation of mental health services for promotion of mental well-being among medical students.

A Review of different Honey from Indonesia and Malaysia

Indonesia and Malaysia share contiguous territories and are renowned for their honey production. In addition, they possess extensively published studies on honey. This study aims to present a comprehensive analysis of the many types of honey found in Indonesia and Malaysia, as well as their health-promoting components. The employed methodology entails conducting a comprehensive review of both primary and secondary literature. The literature search employed online tools, including NCBI-PubMed, Google Scholar, and Elsevier. Indonesia and Malaysia share similar species of bees, including Apis Dorsata, Apis Mellifera, Apis Trigona, and Apis Cerana. The phenolics and antioxidants have garnered the most focus among the components. Notable health advantages encompass the facilitation of diabetic wound healing, enhancement of reproductive health, and promotion of mental well-being.

SOWING SEEDS OF RESILIENCE: CULTURAL TRANSITIONS, ECONOMIC STRAINS, AND FEARFUL REALITIES: A DEEP DIVE INTO PSYCHOLOGICAL STRESS AMONG RURAL WOMEN

"Sowing Seeds of Resilience" examines the impact of psychological stress on the women living in rural areas. The article explores the interconnectedness amid cultural transitions, financial strains & fearful realities by employing the comprehensive approach to examine intricate experiences of women residing in the rural locations southern Punjab, aiming to comprehend their unique challenges. The study was quantitative in nature wherein findings reveal a complex scenario in which cultural shifts and financial difficulties synergistically contribute to heightened psychological stress. In this regard, actual terrifying occurrences exacerbate this situation. Study demonstrates the resilience exhibited by these groups. Thus, exerting specific efforts and comprehending the interconnections between these aspects are crucial for the promotion of mental well-being. This inclusive analysis of the thought processes of rural women provides valuable insights for policymakers and scholars to comprehend the situations by utilizing this knowledge to devise specific strategies that assist these resilient women in addressing wide range of challenges.

Exploring Smartphone Use Patterns and Their Associations with Demographic Characteristics, Socio-psychological Well-being, and Socio-cultural Factors among Nigerian Youth

The widespread adoption of smartphones has transformed communication and information access, particularly among Nigerian youths. As Africa’s most populous nation and rapidly digitizing economy, Nigeria offers a unique backdrop to investigate the complex interplay between smartphone use patterns, socio-psychological well-being, and socio-cultural factors among its youth population. This study employed a cross-sectional survey research design to explore these intricate relationships comprehensively. The methodological approach involved a quantitative research framework using a tailored measurement scale developed to gather relevant data, encompassing demographic details, smartphone use patterns, socio-psychological well-being indicators, and socio-cultural factors. This study focused on Nigerian youth aged 18 to 30 years, employing a snowball sampling technique to disseminate the research instrument through WhatsApp and Telegram platforms. A total of 1241 participants from different regions of the country were included in the study. The results showed significant variations in smartphone use patterns among Nigerian youth based on age groups, gender, and socioeconomic background. The results revealed significant variations in smartphone use patterns based on demographic characteristics, including age, sex, and socioeconomic background. Furthermore, smartphone use patterns exhibited significant correlations with various aspects of socio-psychological well-being, such as emotional well-being, stress levels, sleep quality, and life satisfaction. Sociocultural factors did not significantly predict smartphone use patterns; family dynamics and peer interactions emerged as significant indirect influencers through psychological well-being. The recommendations arising from the study’s findings suggest tailored interventions for demographic groups, promotion of digital well-being, and the incorporation of digital literacy education.

Quali oggetti di studio e quali prospettive di ricerca per la pedagogia nel tempo delle transizioni umane e digitali?

The pandemic crisis period we have been going through has made it abundantly clear that the training system needs to be strengthened in terms of life skills. The aim of this paper is to demonstrate the importance of strengthening individuals’ life skills, which in the digital-human ecosystem in which we are immersed are increasingly digital soft skills. This awareness requires the promotion of Digital Wellbeing as an educational territory that has not yet been responsibly presided over.

Intergenerational psychological intervention programme - PIN - Exploratory study with children and seniors

Intergenerational programs involving children and seniors are a form of psychological and social intervention that promote the development of cognitive, linguistic, motor, emotional and social skills and well-being, with significant results and benefits described for both children and seniors, such as intergenerational socialization and increased self-esteem and self-efficacy, intellectual development, increased happiness, and improved quality of life. In Portugal, programmes intervening in the psychological domain are scarce, which justifies our proposal. We present a P-IN Program: Intergenerational Psychological Intervention Program: Cri(activ)age, Health and Well-Being focused on the promotion of creativity, cognitive preservation/development and well-being associated with intergenerational coexistence. 
 The P-IN programme aims to: (i) Promote through an intergenerational psychological intervention, cognitive development/preservation, creativity and well-being, in children (5-6 years) and seniors (+60). (ii) To evaluate the effectiveness of the intervention on cognitive development/preservation, creativity and well-being. This paper presents the conceptual structure of the programme, its organization into three main components: Beliefs and attitudes; Emotions and well-being; Cognitive stimulation and creativity, and its operationalization in 10 90-minute sessions. Finally, we present the evaluation plan of the quality and effectiveness of the programme based on a qualitative methodological approach using semi-structured interviews to the participants (N= 23 children and 18 seniors; professionals= 4). Of the results we highlight: increase in autonomy, self-confidence and social participation in both groups. In specific terms, the increase in the emotional well-being and psychosocial and physical autonomy of the seniors is highlighted.

Exploratory Analyses of Existing Nexuses Between Cooperative Membership, Production, Wellbeing, And Determinants Among Layer Egg Production Enterprises: Evidences from South West Nigeria

Cooperatives have been evidently solicited to play a positively significant multifaceted role in the promotion of wellbeing among members hence, this study was conducted to examine the existing interrelationships between cooperative membership, farmers’ welfare, and farm production level along its determinants among layer egg producers in southwest Nigeria, using a multidimensional approach. A multistage sampling technique was employed in the collection of data from 185 poultry farmers; 94 Cooperators, and 91 Noncooperators, randomly from four local government areas, using well-structured questionnaires. Descriptive statistics, T-test, Variance inflation factor, Alkire-Foster multidimensional poverty measures, and multiple regression are employed in data analysis.: Many (54%) of the poultry farmers are medium scaled, within which a larger proportion of about 61% are cooperators. Also, the output of the cooperator category was found significantly higher than their non-cooperator counterpart by 128.1 % crates per day at 5 % probability level. Furthermore, there exists a veritable positive relationship between farmers’ multidimensional welfare and increased production scale, while years of farming experience, farming as a primary occupation, farm size, and cooperative membership, significantly influence increased output. The finding showed that farmers’ multidimensional poverty headcount indices are inversely proportional to their scale of production. There also exists a significant positive relationship between increased production scales, cooperative membership, and farmers’ welfare statuses.

Sailing into rough seas: The difficulties and challenges Chinese women seafarers face

The shipping industry has traditionally been male-dominated. Although tangible progress has been made toward gender diversity and inclusiveness, women seafarers worldwide still face difficulties and challenges. This paper aims to explore women’s struggles in their pursuit of a seafaring career on ocean-going cargo ships. Taking Chinese women seafarers as the research subjects, the study first analyses their current situation and points out that compared with global figures, only few STCW-certified Chinese women work as officers or ratings on the ocean-going cargo ships. Then five major types of difficulties and challenges Chinese women seafarers face, i.e., limited access to vocational education and training, employment difficulty because of stereotypes, prejudices and sexual distinction, safety and healthcare concerns, bullying, abuse and sexual harassment, as well as traditional ideas of family and childbirth, are presented by the data drawn from questionnaires and interviews given to current and future-to-be seafarers from both genders. At last, suggestions from the aspects of the provision of educational and training resources and guidance, the improvements in relevant legal system and policy, the establishment of support groups and report system, the promotion of occupational health, safety and well-being, as well as the creation of a friendly social and cultural atmosphere are given to advance gender equality, empower women seafarers in their careers and reach a barrier-free environment in the industry.

The Influence of Athletes’ Psychological Needs on Motivation, Burnout, and Well-Being: A Test of Self-Determination Theory

Sport provides a significant role in the lives of athletes; however, both positive and negative mental health effects may occur from sporting experiences, including burnout and/or well-being. A cross-sectional survey was conducted including 685 athletes (Mage = 23.39, SD = 6.22, 71% = male), testing multiple, complementary, self-determination theory hypotheses linked to well-being, and burnout. A multistage modeling approach encompassing confirmatory factor and path analysis was utilized, with results showing significant variance explained for well-being (R2 = .30) and burnout (R2 = .35). Several direct effects were found in line with self-determination theory, including between; needs-support and needs-satisfaction (β = 0.48), and needs-control and needs-frustration (β = 0.44); needs-satisfaction and motivational orientation (β = 0.25); needs-satisfaction and well-being (β = 0.37), and needs frustration and burnout (β = 0.25); and motivational orientation and burnout (β = −0.27), and motivational orientation and well-being (β = 0.18). Indirect effects were found for well-being and burnout via coach needs-support, needs-satisfaction, and motivational orientation in sequence (β = 0.24 and β = −0.22, respectively), in addition to burnout via coach needs-control, needs frustration, and motivational orientation in sequence (β = −0.12). To conclude, coach-based, sporting mental health interventions that promote the utilization of needs-supportive behaviors, while also highlighting the need to minimize needs-controlling behaviors, are recommended for the prevention of burnout and the promotion of well-being in athletes.

Health, Stress and Technologies: Integrating Technology Acceptance and Health Belief Models for Smartphone-Based Stress Intervention

Work-related stress significantly jeopardizes employees’ physical and mental health due to the considerable time they spend at work. Smartphone-based interventions provide a promising solution, eliminating traditional face-to-face interventions’ barriers. However, the elements that influence workers’ intentions to use this still remain unexplored. This study explores the link between health belief model (HBM) and technology acceptance model (TAM) factors. In this study, 336 Italian workers (64% female) answered an online questionnaire. We employed a structural equation model (SEM) to analyze the data. The results unveiled an indirect relationship: individuals perceiving health risks were more inclined to use stress-management apps, mediated by perceived utility (PU). This study underscores the significant potential of integrating the HBM with the TAM in predicting users’ preparedness for smartphone-based health interventions. These findings not only hold substantial value but also illuminate a path forward for professionals and organizations, offering insights to tailor and optimize smartphone tools for stress management and the promotion of workplace well-being. Ultimately, this research paves the way for the cultivation of healthier work environments, marking a noteworthy contribution to the field.

Emotional intelligence and leadership styles: a case study of school heads in Pakistan

ABSTRACT In the contemporary education system, school effectiveness anticipates teacher dedication, a sense of responsibility, and team spirit. Such a soft shift in perspectives urges school leaders to reshape their administrative roles to architects of a conducive environment for ensuring the fulfilment of school goals and the promotion of teacher well-being. Arguably, this shift stipulates extended competencies of leadership, namely interpersonal and intrapersonal, which are the essential traits and competencies of Emotional Intelligence (EI). Therefore, this paper presents school heads’ perceived levels of emotional intelligence and the influence of EI on practiced leadership styles. A phenomenological case study was employed with representative cases of five schools. The sample comprised both school heads (n = 5) and teachers (n = 10). Data were collected using four methods, namely semi-structured interviews with teachers and school heads; shadowing of school heads’ to observe their behaviours; a web-based emotional intelligence test to assess school head’ perceived EI; and a self-assessment questionnaire of leadership styles. The findings highlight weak levels of emotional intelligence among school heads. The frequently preferred leadership styles include authoritarian and transactional which underscores a notably weak emotional intelligence integration in leadership practices. However, the sentiments of school heads and teachers varied, because the former considered leadership as their right to rule the team, while the latter found a disconnection between school heads and teachers and a concern for teacher well-being. The findings imply the urgent need to improve the EI of school heads to ensure teacher well-being.

TERRITORIAL ACCESSIBILITY OF MEDICAL INSTITUTIONS FOR THE RESIDENTS OF THE NORTH OF RUSSIA

Access to health care is a key component that determines the possibility of the earliest-possible promotion of health and well-being in the context of everyday life. The article analyzes the spatial accessibility of health services for the population of certain areas of the North of Russia. Urbanized and rural areas in the Arkhangelsk and Murmansk regions and the Yamal-Nenets autonomous region were studied. OpenStreetMap data was used, including information about the location of medical institutions and settlements, and the configuration of road network. Using the ArcGIS Network Analyst toolkit, different accessibility zones were identified for each study area. It was revealed that large cities located in the north of Russia are sufficiently provided with medical care in terms of spatial accessibility. More relevant is the issue of providing specialized types of medical care. Even cities located close to each other show unequal possibilities of obtaining specialized health care. The concentration of specialized care in several centers, without taking into account their transport accessibility, requires additional time and carries risks for the population because of the untimely access to medical care. Rural population remains the most vulnerable in terms of the access to medical care.