Rural Health Initiatives: Solutions to Rural-urban Health Disparity

By Jenny YC Lee, Key Correspondent for the Irish Forum for Global Health

 More than half (56%) of those living in rural areas worldwide do not have access to basic, essential healthcare

-Dr. John Wynn-Jones from Rural Wonca, speaking at the 4^th Global Forum on Human Resources for Health (HRH Forum 2017).

We will need 7 million more health care workers to make up the shortfall in rural areas around the world. We know about the concerning rural-urban divide, as well as the associated issues for rural health workers: shortage, skill imbalance, inefficient resources, barriers to professional collaboration, poor working conditions, lack of education and training, etc. At the Forum today, leaders from rural health initiatives across the Americas, Europe, Arctic, Africa and Australia convened—not to talk about the problems, but the solutions and the ways forward.

Starting with Making It Work (Recruit & Retain), an Arctic solution and a 7-year international collaborative which has built investment recommendations and practical tools for administrators. This initiative collects and utilizes evidence from health practices in Northern, rural and remote areas across Norway, Sweden, Canada, Iceland and Scotland. The success of Making It Work stems from tailoring organizational frameworks to community participation, on-going evaluation, and analysis of return on investment, and development of knowledge transfer tools. It is truly exciting to learn that this group will be holding a Recruitment and Retention Forum in September 2018, for countries involved to continue to facilitate dialogue, planning and knowledge transfers, both nationally and internationally.

In Queensland, Australia, Chief Nurse Shelley Nowland and colleagues have developed “a nursing pathway to rural practice using post graduate education and clinical practicum opportunities”. They call it the “Rural Generalist Programme”, which is championed through nursing leaders and supported by local clinicians. This initiative has given newly graduated nurses a clearer pathway to attain rural qualifications and recognition (i.e. credentialing). It also provides additional support through mentorship and virtual training such as telehealth. Furthermore, graduates are can take advantage of a career fast track—gaining more fellowship credentials in five years. In the steps moving forward, Queensland Health has commissioned the development of a formal Rural Generalist education program delivered at two universities: James Cook and Queensland University of Technology. This will be a unique online learning platform, as the program covers clinical and non-clinical capabilities with streams for seven medical professions, expanding beyond nursing to medical imaging, nutrition, physiotherapy, and more.

While Australia and the Arctic are physically thirteen thousand kilometers apart, rural health leaders from the two regions united in Dublin Ireland today, sharing the same vision and aspiration for more equitable healthcare across communities. We look forward to continued discussions surrounding innovative rural health initiatives such as these in the near future.

November 15^th, 2017

 Recently graduated with a BSc from the University of British Columbia in Canada, Jenny is a young professional working at the Swiss Research Institute for Public Health and Addiction. As a previous intern at the World Health Organization (WHO), she shares the same collective vision that universal health coverage is an ethical imperative and understands the importance of health workforce as health workers are the core of our health systems.

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