Health leadership and rural contexts: keys to strengthening services

Health leadership in rural settings is a key element in ensuring equitable access and sustainability of health services in communities with structural constraints and scarce resources. This article analyzes the dynamics of leadership in rural areas between 2017 and 2022, employing a holistic approach to identify trends, areas of research, and international collaborations. Based on the analysis of 146 selected publications, three main lines are highlighted: adaptive leadership models, health promotion as a central strategy, and the impact of crises, such as the COVID-19 pandemic, on health management. The results show that adaptive leadership optimizes resource management and fosters community participation, strengthening trust and local commitment. Likewise, health promotion in these communities is presented as a strategic axis to address inequalities and improve health indicators. Finally, the importance of international collaboration in building knowledge and implementing sustainable solutions is highlighted. This study provides practical and theoretical inputs to strengthen public health policies in rural contexts, proposing interdisciplinary and participatory approaches as a basis for the transformation of health systems.