Barriers to access to healthcare service in rural Ontario

Qualitative study through the lens of the right to development

Bibliographic Data

ID7161273
AuthorsAmal Jawad (0000-0001-8336-9951, McMaster University, corresponding author), Bonny Ibhawoh (0000-0003-3627-5666, McMaster University), Lisa Schwartz (0000-0002-4959-225X, McMaster University), Andrew Kapoor (0000-0002-6078-5984, McMaster University)
Year2026
Volume123
Pages104024
Publication date2026-03-01
Open AccessYes
TypeARTICLE
VenueJournal of Rural Studies (JOURNAL)
Journal identifiersISSN: 0743-0167 • E-ISSN: 1873-1392
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.jrurstud.2026.104024
OpenAlexW7126097163
LanguageEN
References cited22

The Right to Development provides the central framework for this study, guiding an examination of barriers to healthcare access in Oxford County, a rural region of Ontario, Canada. The Right to Development emphasises that health is a collective entitlement shaped by structural conditions and shared social responsibilities. Using this perspective, the study argues that individual rights to healthcare are insufficient for understanding or addressing rural inequities. Drawing on twenty-five semi-structured interviews conducted between January and April 2025 and analysed through Braun and Clarke's reflexive thematic approach, three themes were identified. Structural barriers include infrastructure gaps, physician shortages, limitations in walk-in clinics, and prolonged wait times. Second, systemic inefficiencies arise from centralised service organisation and administrative shortcomings that leave some residents temporarily uninsured. Third, the individual appraisal highlights the importance of provider diversity, participation and inclusion, and community engagement for meaningful access. The primary contribution of this study is the development of the Collective Right to Development policy, which applies and extends the Right to Development to rural health systems. The Collective Right to Development policy identifies three collective entitlements required for equitable healthcare: structural provision and service diversity; institutionalised participation and community governance; and conditions that support dignity and well-being. These entitlements translate the Right to Development principles into concrete obligations and reveal rural health inequities as collective deprivations embedded in structural design. The absence of Right to Development–based collective principles in Canadian health policy undermines accountability, neglects rural system strengthening, and perpetuates inequitable access for underserved populations. • Identifies structural and systemic barriers to healthcare in rural Ontario. • Equity Gap: Healthcare framed only as an individual entitlement fails; the Right to Development (RTD) offers a stronger framework by embedding health in collective right to development (CRD) responsibility. • Collective Right Development (CRD) highlights healthcare as a communal good, requiring for equitable service diversity; institutionalised participation and community governance; and conditions that support dignity and well-being. • The study challenges libertarian views of healthcare as a service, affirming instead its role as a fundamental good tied to dignity, equality, and survival

Dignity · Entitlement (fair division) · Health care · Qualitative research · Reflexivity · Right to health · Service provider · Thematic analysis · Environmental and Social Impact Assessments · Healthcare Systems and Reforms · Human Rights and Development

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