Common Implementation Challenges and Facilitators

Rural community health programs may experience similar challenges that affect program viability and implementation. Common facilitators to rural program implementation can help address these barriers.

Securing Resources and Sustainability

Funding, technological, and human resources are typically limited in rural communities. It can be particularly difficult to generate enough start-up funds to sustain the program as it begins. Having a network of stakeholders and partners in the community can be beneficial for providing resources and support for a program.

Overcoming Geographic Limitations

Geography can present challenges to implementing rural community health programs. Geographic challenges include weather, distance, and isolation. Depending on the type of program, activities, setting, and frequency of participation, these challenges can become significant. Programs may need to tailor their design and approach to account for lengthy travel distances and times, availability of transportation, and opportunity to offer the program remotely or through other technologies. For example, the Rural Telehealth Toolkit discusses opportunities for overcoming challenges associated with limited access to local healthcare services.

Recruiting Staff

Rural communities implementing rural health programs often face challenges recruiting specific healthcare workers, such as physicians, dietitians, or physical therapists. Some programs work with volunteer or retired practitioners, or students. The Recruitment and Retention for Rural Health Facilities topic guide discusses approaches that rural communities have implemented to overcome recruitment challenges.

Engaging Communities

Program planners may face challenges in engaging community members due to lack of trust, lack of transportation options, and limited availability to participate in project activities during business hours. It is critical for program implementers to make a conscious effort to recognize and understand the population their program will serve. Involving members from the population of interest throughout the program design and implementation cycle can encourage participation from program onset.

Rural communities can also explore multiple other approaches to making it easier for community members to access program services. For example, many rural communities use mobile vans to provide traveling health services. See Resources by Topic: Community engagement and volunteerism in the Online Library for additional information.

Evaluation Support

Evaluation is a key to helping determine program effectiveness. Some rural community health programs will have staff with evaluation expertise. Other programs may consider establishing a relationship with researchers at a local university to provide external feedback on program implementation or evaluate the impact of the program. Organizations that specialize in program evaluation and technical assistance can provide similar service. Module 4 provides more in-depth information on program evaluation for rural health programs.

Business and/or Sustainability Plans

Sustainability is an important program component to address early in the planning and implementation stages, so that systems can be established to keep the program functioning and improving health in a community. Module 5 goes into more detail about how rural health programs can develop strong sustainability plans.