- A recent study examines how different countries deliver health services to remote communities.
- The experiences of Australia, Canada, New Zealand, Scotland, and the Nordic countries show that distance does not have to be a barrier to guaranteeing the right to health.
- The study explores how the digital transformation of health care, combined with strong primary care systems, can expand access in isolated territories.
In Latin America and the Caribbean, millions of people living in rural or remote areas face major obstacles in accessing health care: long distances, lack of transportation, shortages of professionals, and limited infrastructure. Yet this challenge is not unique to our region. Countries with universal health systems in other parts of the world also face these barriers and have implemented innovative solutions to ensure that no one is left behind.
In a recent study by the Inter-American Development Bank, we examined the experiences of Australia, Canada, New Zealand, Scotland, and the Nordic countries, exploring how the digital transformation of health care — combined with strong primary care networks — has become an essential tool to reach the most remote communities. The lessons from these systems provide valuable insights into how to narrow gaps in our region. This blog post highlights the main findings.
Across all the countries studied, one common principle emerges: technology as a bridge and primary care as the foundation.
- In Australia, for example, service delivery in remote areas is supported by initiatives such as the Royal Flying Doctor Service, which provides primary and emergency care by aircraft. This is complemented by targeted programs for Indigenous communities and a significant expansion of telemedicine during the pandemic. In addition, a point-of-care approach was implemented, a screening strategy that enables decentralized detection of Human Papillomavirus (HPV) through self-collection. Among Aboriginal women, this system achieved adherence rates of 81%. Of those women, one-fifth had never undergone the test before, one-third were overdue for screening, and another quarter did not remember when they had last been tested.
- In Canada, the public Medicare system has promoted virtual clinics, online care portals, and mobile stroke units. A notable example is the Integrated Virtual Care (IVC) model, which connects patients in remote areas with family physicians through virtual consultations. Where it has been implemented, nearly 70% of consultations were conducted virtually, meaning that more than half of users did not need to travel to receive care.
- Scotland established a National Centre for Remote and Rural Health and Care, with a focus on training local teams and using telemedicine to bring specialist services closer to communities.
- Nordic countries have strengthened coordination between primary and specialized care by decentralizing services and leveraging digital solutions to address access challenges in regions with extreme climates. In Norway, for example, the use of telemonitoring for patients with pacemakers has shown clinical outcomes comparable to traditional outpatient follow-up, with similar levels of quality of life, safety, and hospital visits.
- In New Zealand, the public system ensures almost free care for children, subsidies for chronic conditions and vulnerable populations, and a strong emphasis on primary care as the entry point to the health system.
Despite their differences, these experiences share a common approach: leveraging digital tools and network models to expand access. This includes everything from general and specialized consultations to mental health support, remote diagnostics, mobile apps for monitoring chronic diseases, and systems to coordinate care across different levels.
The study identified clear strengths in these strategies: wider coverage in remote areas, better service integration, shorter emergency response times, and high levels of satisfaction when technologies are well adapted.
But we also noted challenges that limit their impact, including inadequate connectivity, gaps in digital and health literacy, cultural preferences for in-person care, unequal infrastructure, and high turnover among health personnel in remote areas.
Even so, these experiences reveal important opportunities: investing in training, combining in-person and virtual care to build acceptance, strengthening digital infrastructure, and designing culturally appropriate solutions that foster community trust.
In Latin America and the Caribbean, where barriers to accessibility in isolated areas remain significant, these experiences show that distance does not have to be an obstacle to guaranteeing the right to health.
The cases of Australia, Canada, Scotland, New Zealand, and the Nordic countries demonstrate that technological innovation, combined with strong primary care systems and well-coordinated networks, can transform the way we reach people living farthest away.
The lesson is clear: if effective ways of delivering care have been found in places as dispersed as the Arctic, the Australian desert, or Indigenous communities in Canada, then our region can also take firm steps toward health systems that are closer, more inclusive, and more resilient. Because in the end, it does not matter where people live — everyone deserves timely, quality care.
Learn more in the publication: O que sistemas universais de saúde pelo mundo têm a ensinar sobre o atendimento a populações remotas?: estratégias de países selecionados para atender às necessidades de saúde de populações remotas (available in Portuguese).