We, the delegates at the 15th WONCA World Rural Health Conference call on the international community
\nto reaffirm the principles of the Declaration of Alma-Ata. We call on the United Nations, its specialized
\nagencies and national governments to continue to strive to achieve the goals set 40 years ago.
\nThe Declaration of Alma-Ata defined health as \u201ca state of complete physical, mental and social wellbeing,
\nand not merely the absence of disease or infirmity.\u201d As rural healthcare practitioners, we base our work on
\nthis understanding. We strive for the highest possible level of health for the communities we serve, with the
\ngoal of \u201cHealth For All Rural People\u201d.<\/p>\n
We recognise that:
\n\uf0b7 the realization of this goal requires the action of other social and economic sectors in addition to the
\nhealth sector: health and wellbeing is driven as much by socio-economic development as by healthcare;
\n\uf0b7 primary health care in rural and other areas must be delivered by teams of health workers with a broad
\nrange of skills and levels working together in partnership with communities;
\n\uf0b7 teams of health workers must focus on delivering comprehensive care that responds to the needs of
\nindividuals, families and communities, moving away from a narrow medical model and siloed thinking.
\n\uf0b7 family doctors, working to their maximum scope, have an important role in delivering patient and
\ncommunity centred care in rural areas
\n\uf0b7 rural populations are becoming older, poorer and more vulnerable \u2013 in the era of the Sustainable
\nDevelopment Goals we must promote equitable access to health and ensure no-one is left behind.<\/p>\n
WHO\u2019s Global strategy on human resources for health: Workforce 2030 and the High-Level Commission on In this context, we believe that the needs of people living in rural and isolated parts of the world must be Equity and access to care: True universal health coverage will be achieved only when people in the rural <\/p>\n 15th WONCA World Rural Health Conference\u00a0<\/em>New Delhi, India, April 2018<\/em> We, the delegates at the 15th WONCA World Rural Health Conference call on the international community to reaffirm the principles of the Declaration of Alma-Ata. We call on the United Nations, its specialized agencies and national governments to continue to strive to achieve the goals set 40 years ago. The Declaration of Alma-Ata defined health …<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[20],"tags":[],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/p13bms-1QP","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"http:\/\/kohom.hr\/mm\/index.php?rest_route=\/wp\/v2\/posts\/7119"}],"collection":[{"href":"http:\/\/kohom.hr\/mm\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/kohom.hr\/mm\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/kohom.hr\/mm\/index.php?rest_route=\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"http:\/\/kohom.hr\/mm\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=7119"}],"version-history":[{"count":2,"href":"http:\/\/kohom.hr\/mm\/index.php?rest_route=\/wp\/v2\/posts\/7119\/revisions"}],"predecessor-version":[{"id":7121,"href":"http:\/\/kohom.hr\/mm\/index.php?rest_route=\/wp\/v2\/posts\/7119\/revisions\/7121"}],"wp:attachment":[{"href":"http:\/\/kohom.hr\/mm\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=7119"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/kohom.hr\/mm\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=7119"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/kohom.hr\/mm\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=7119"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nHealth Employment and Economic Growth reinforce the need for an expanded and more socially
\naccountable health workforce. Further, the Dublin Declaration on Human Resources for Health: Building
\nthe Health Workforce of the Future, emphasizes:
\n\u201cthe fundamental importance of a competent, enabled and optimally organized and distributed<\/em>
\nhealth and social workforce, especially in rural and under-served areas, for the strengthening of<\/em>
\nhealth system performance and resilience\u201d<\/em><\/p>\n
\ngiven special priority if nations are to achieve universal health coverage.
\nIn the spirit of Alma Ata, the conference is committed to working with the international community and
\nidentifies the following six areas as priorities to achieve \u201cHealth For All Rural People\u201d.<\/p>\n
\nareas of the world have equitable access to healthcare which overcomes the current geographic, social,
\neconomic, political, ethnic and cultural barriers. Despite the fact that nearly 50% of the world\u2019s population
\nlive in rural areas, only 38% of the world\u2019s nurses and 24% of the world\u2019s doctors provide care for them.
\nThis inequity must disappear. Rural people deserve the same quality of care that their urban counterparts
\nreceive – accessible, affordable, and effective care that meets the population\u2019s health needs. According to
\nthe International Labour Organisation, the rural-urban divide is omnipresent from the richest countries down
\nto the poorest countries. Worldwide (174 countries), 56% of those living in rural areas are not covered bybasic health care against 22% in cities and towns. Gender, cultural, age and geographical issues are paramount in achieving equity for rural people.
\nRural proofing of policy: Policies that affect the health of and determine the healthcare provided to rural
\npeople are often developed in urban centres of power. These often do not take the needs of rural people or
\nthe implications of policies for these people into account. Comprehensive research data needs to be gathered
\nand the voices of rural people need to be heard in developing policies that affect them. A process of rural
\nhealth impact assessment or \u201cRural Proofing for Health\u201d mitigates against the possible negative health
\neffects of fragmented policy development.
\nHealth system development: A health system which features comprehensive primary health care is the
\nmost effective and efficient in terms of cost and health outcomes. In this context, governments must invest
\nin expanding their health systems with the development of multidisciplinary teams of health workers that
\nhave the skills to address the specific needs of rural and isolated communities. New and emerging
\ntechnologies will play an increasingly important role in sustaining the health workforce and the health of
\nrural and isolated communities. We call on the international community to invest in digital health and digital
\nhealth education technologies in support of an appropriately trained rural health workforce.
\nDeveloping and educating a workforce fit for purpose: Evidence is clear that recruiting students from
\nrural backgrounds, giving students substantial rural experience during training and implementing specific
\nrural training programmes after qualification are the most effective interventions in achieving rural
\nrecruitment and retention. Rural health training schools must develop socially accountable curricula with a
\ncommitment to community engagement throughout. Isolation and rurality impose additional challenges for
\nrural health care professionals to provide the services that are needed in rural areas. Rural health care thus
\nneeds generalist health practitioners and family doctors who are appropriately trained to have an extensive
\nand comprehensive range of certified skills to meet the specific challenges that they will face in their
\neveryday work. Conversely, sending newly trained health care workers without appropriate skills to work in
\nunsupported rural environments puts patients at risk and dissuades young professionals from choosing a
\nrural health career. Those health professionals working in rural communities must have a safe, fair working
\nand living environment.
\nRealigning the research: Urgent action is required to reverse the 90\/10 research gap: where less than 10%
\nof worldwide resources for health research are dedicated to addressing the 90% of all preventable deaths in
\nlow- and middle-income countries. This inequity is even greater in rural areas. Rural data and rural research
\nmust be expanded to inform government decision-making on rural health services.
\nPeople and communities: Rural people deserve health systems that are sensitive to their cultures, languages
\nand traditions. Rural populations are aging more than in urban areas and as a result have a large number of
\nvulnerable individuals. The burden of disease, especially as a result of non-communicable conditions, is
\nimposing increasing pressure on fragile rural health systems. The original Alma Ata declaration emphasises
\nthat health and well-being is not just about health services but is also dependent on economic, and social
\nfactors. We call on governments and policy makers to invest in the infrastructure, services and the
\neconomies of rural areas. These together will have a lasting impact on the well-being of their rural
\npopulations.
\nHealth for All Rural People is synonymous with the aspirations of Alma Ata and Universal Health
\nCoverage. We call upon the United Nations, its specialized agencies and national governments to prioritise
\nrural health, health workers and the enabling infrastructure to eliminate the inequity that exists and to leave
\nno-one behind.<\/p>\n
\nDocument Status: Endorsed by the 15<\/em>th WONCA World Rural Health Conference, Awaiting endorsement by WONCA Executive<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"