BackgroundMajor health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level community participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level community participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level community participation in rural healthcare.MethodsA scoping review was designed to map the existing evidence base on higher level community participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies.ResultsWe identified six articles that most closely demonstrated higher level community participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level participation, little detail was provided about how groups were established and how the community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from community participation were not rigorously measured.ConclusionsIn an environment characterised by increasing interest in community participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for research, policy and practice.

This paper reports on a study that explored the experiences, perceptions and motivations of a new type of autonomous volunteer emerging in modern society, in particular, those working to assist in the rural resettlement of refugees in Australia.The volunteers filled a gap left by under resourced government and community services. In‐depth semi structured interviews revealed that their motivation was due in part, to the lack of bureaucratic' red tape'. Their drive to address social issues was based also in part on values to see social justice expressed in their community. Some challenges and tensions due to cultural differences were identified. Questions for community development and social capital are raised.Implications are raised for volunteer groups' and resettlement organisations' policy and practice to enhance the resettlement process for both the host community and those with a refugee background.