Health-related Research on Remote Islands in the South Atlantic Ocean: Facilitators and Barriers identified within a scoping review

Abstract

Introduction: The objective of this scoping review is to characterise the nature of health-related research in the remote South Atlantic United Kingdom Overseas Territories (UKOTs) and explore facilitators and barriers to research in this context.

Methods: A review of the published academic research covering human health in the South Atlantic UKOTs between 1950 to 2025 was carried out on 23rd September 2025. The following databases were searched: CINAHL, Embase, Global Health, Medline, and Global Index Medicus.  Data on bibliographical information, study design, country of study, objectives, lead research organisation and collaborators, population group and sample, and health topic were extracted and charted; and unique contextual factors and explicit or implied barriers or facilitators were narratively summarised.

Results: The search yielded 179 records, leading to 68 included studies meeting the search criteria. Thirty-eight studies were carried out on Tristan da Cunha, nineteen on St Helena, eight in the Falkland Islands, and three covered multiple territories. Health topics included genetics of disease, dental health, infectious diseases, and non-communicable diseases. Most were descriptive or analytical observational studies, and many were led by researchers from other countries.

Discussion: Research has focused extensively on the small Island of Tristan da Cunha. Barriers to research identified included the small population size and resulting close-knit social structures, and a lack of research skills and capacity. Research facilitators included the geographical and social isolation, enabling novel research, although this poses risks of research without explicit benefit to local populations. Collaborations with external institutions and agencies have been successful and highlight future opportunities for research support. There is scope for health-related research that would build skills in local researchers, deliver locally relevant evidence, strengthen collaboration with overseas experts and funders and potentially enable learning on other remote, resource-limited contexts.