To a Blueprint for Rural Health
Addressing the issue of Rural and Remote Health has been a practical and policy challenge over centuries. Evidence on how to address this emerged in the 1970s and have been built on since then. Rural Wonca initially developed policies on Training for Rural Practice and Rural Practice and Rural Health. Although initially based on studies into the needs of rural doctors especially in high income countries, the evidence had been found to be generalisable to other professions and low income and middle income countries (LMIC). Rural Wonca in its literature review funded by WHO, found substantial evidence in LMIC. As the evidence for this has built through the literature, the WHO have published first, Increasing access to health workers in remote and rural areas through improved retention in 2010, and then the WHO Guideline on health workforce development, attraction, recruitment and retention in rural and remote areas in 2021. These have been complemented by other initiatives and publications internationally including substantial evidence from the World Bank.
During the last 2 decades, increasing evidence has emerged about not only about what to do but how to do it. These have been encapsulated in Blueprint for Rural Health(1) from the 17th International Rural Health Conference . The Blueprint outlines several important principles that should underline rural and remote health including the importance of advocacy, primary health care, universal health care, public health, community infrastructure, access and workforce. In this paper I will highlight some important new concepts and themes including, end to end planning and integrity, clinical courage, rural health education in rural for rural, immersive community engaged education (ICEE), rural exposure - any is good - more is better, grow your own, redundancy, stepladder education, engaging young doctors, the right health worker, rural generalism, rural origin, ruralisation, rural policy and localising economic benefit.
This provides a framework for further developments in Rural and Remote Heath for the benefit of rural people and communities.
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