For the past three years, Hauora Taiwhenua Rural Health Network has been running an innovative programme aimed at addressing the critical health workforce shortages across Aotearoa New Zealand that are having a particularly profound impact on the health and wellbeing of rural communities.

The Rural Health Careers Promotion Programme provides advice and support to encourage rural youth throughout the country to pursue a career in health, and supports current tertiary health students to work in those traditionally underserved areas after they graduate. And it is raising awareness of, and generating interest in, paramedicine as a future career option.

The initiative had its origins at universities, where rural health clubs comprised of students from different health disciplines who were interested in working in rural areas started visiting high schools to engage with students from Years 9-13 and pique their interest in working .

“Some of those clubs got in touch with our organisation, which back then was known as the New Zealand Rural General Practice Network. We then came up with a proposal to run a nationwide programme to attract rural youth into health careers and took it to Health New Zealand | Te Whatu Ora. We’ve now been running this successful programme for more than three years,” said Samantha Hill, Hauora Taiwhenua Rural Health Network’s Rural Health Careers Coordinator.

Each year the programme aims to reach 90 different rural secondary and composite schools around Aotearoa New Zealand, during which they run interactive workshops where secondary school students learn about tertiary education and a wide range of health disciplines.

There are 14 planned five-day trips throughout the year, touring each region. Each trip is fronted by six to eight volunteer tertiary students studying towards a health career at various universities and Te Pūkenga. The volunteers speak to students about which National Certificate of Educational Achievement subjects they will need to apply for tertiary study, along with the various health disciplines on offer and tertiary support networks once they are studying

They run four to five interactive activities where students can try practical techniques used by health professionals, such as CPR and blood pressure. They also visit and talk with rural health professionals to learn about the rural health sector and potential job opportunities once they graduate.

“We also provide opportunities for tertiary students and local rangatahi to engage in Māori cultural competency and cultural safety training through noho marae; which includes an overnight stay at a rural marae to learn more about Māori health, tikanga, pūrākau (myths and legends) and traditional arts, crafts and waiata.

“During these experiences, our tertiary students learn how to better engage with Māori in rural communities so that they feel safe in utilising health options in their areas. The tertiary students follow up their visits to the regions with a range of online webinars to further engage with the rural students who have expressed an interest, to build a kind of big brother or big sister relationship.

“Oftentimes they won't know anyone else going to university, so they can join webinars and talk to current tertiary students, to dispel any anxieties they may feel. These different events and opportunities provide ‘bridges’ for our rural students to understand that there are health careers they can follow and hopefully inspire them to take those paths.”

The need to bolster the rural health workforce is pressing. According to the Network’s Rural Health New Zealand Snapshot 2024, the challenges facing the almost 900,000 people residing in rural areas of the country - who comprise 19% of the national population - include significantly higher mortality rates from preventable causes; significantly higher rates of suicide, particularly for males; twice as many people living in social and economic deprivation, particularly in more remote areas; very low vaccination rates to prevent disease; and far fewer rural people accessing hospital care, despite their poorer health. Many of these statistics are worse for Māori living in those areas.

Despite having poorer health outcomes, rural people are up to 37% less likely to have a hospital admission in a given year, and people living in remote communities also have poorer access to emergency department and specialist services than those living in the cities or other rural areas.

Building a better understanding of the health needs of rural communities and the differences between working in an urban area and a rural area are key components of the programme. And for aspiring paramedics, it raises awareness of the reality of professional practice in an environment where resources are often scarce and the nature of the work can differ markedly from that in cities.

“It’s especially interesting for our paramedic students hearing the differences about urban work and rural work. There's quite a bit more of going to pick someone up and take them to the hospital, because that's what needed in cities, but in rural communities there's a lot more hands-on community work and getting to know people, especially with some of the elderly.

“Some rural communities only have one or two ambulances and quite a large area to cover. Hearing about the issues they have if someone's been called out and it's going to take them three hours to get to a local hospital is quite interesting for them, particularly when many of them are studying in urban areas.”

With its multidisciplinary approach, the programme also enables students from different fields of health study to learn more about how others work and how they can work together. It also builds broader health literacy in the community.

“For many of our high school students, it's really interesting for them to learn about the different careers in health and what they do. Paramedicine is definitely one of the ones that gets quite a lot of attention, where they hear about the different scopes of practice, from being up in rescue choppers, to being at their local footy game, to community work or emergency work. A lot of the high school students don't know about this, and it's quite memorable for them to hear and to learn about.”

Since the programme began, 58 high school students have expressed an interest in pursuing a career in paramedicine. It’s been equally inspiring for the Auckland University of Technology (AUT) paramedicine students, who are able to take part in the School Health Careers Promotion programme thanks to funding from AUT to help cover their flights.

“Attending the Rural School Programme and being warmly welcomed into schools to share about Health Science careers was an absolute honour,” said third-year AUT paramedicine student Kelly Williams. “From interacting with engaged students and being welcomed through a pōwhiri, to visiting a regional hospital alongside a beautifully diverse team, was nothing short of an adventure.

“This is a wonderful space in which going into a rural health career becomes a possible dream or goal for the youth of rural New Zealand. It also personally opened my eyes to the endless opportunity that comes with being part of a tightly knit rural health community.”