Rural Health Advocacy Project » Press Room and Downloads

PRESS ROOM AND DOWNLOADS

IST Reports
IST Consolidated Report
IST DoH Limpopo
IST DoH Mpumalanga
IST DoH Gauteng
IST DoH North West
IST DoH Free State
IST DoH Kwazulu-Natal
IST DoH Eastern Cape
IST DoH Western Cape
IST DoH Northern Cape

Press Releases
Current OSD Offer still Disadvantages Rural Communities (9 June 2010)
Rural Health in Focus. Making Expenditure Control, Equity and Efficiency work for Rural Health (12 February 2010)
Rural communities disadvantaged by KZN Community Service Medical Officer placements for 2010 (11 December 2009)
Launch Rural Health Advocacy Project (13 August 2009)

RHAP in the Media
Healthcare needs help
Healthcare sick as a dog
Lack of Rural Doctors Hits Aids Pledge
Provinces face drug stock outs due to overspending.

Useful Rural Health Resources

Health systems and services
Access challenges in TB, ART and maternal health services. Phase 1 Results. Researching Equity in Access to Health Care Project. University of the Witwatersrand Centre for Health Policy in collaboration with University of Cape Town Health Economics Unit, Mc Master Institute of Environmental Health and Mc Master University Centre for Health Economics and Policy Analysis, 2009.
A strategy to enhance health services in rural and other deprived areas: 2008-2013. National Department of Health (unpublished).
A Rural Health Strategy for South Africa. RuDASA, 2006.
Couper ID. Rural hospital focus: defining rural. Rural and Remote Health 3 (online), 2003: 205
Couper ID, Hugo J.
Management of district hospitals. Suggested Elements for Improvement. Durban, Health Systems Trust (2002). Rural_hospital_beats_odds_2.pdf”>Baleta, R. Rural Hospital beats odds. The Lancet. Vol 374 September 5, 2009.

Health Financing
Health budgeting and HIV. A Budget and Expenditure Monitoring Forum fact sheet. BEMF, 2010.
Consolidated Report of the Integrated Support Team. Review of health overspending and macro-assessment of the public health system in South Africa. National Department of Health, 2009.
Limpopo Department of Health: Report of the Integrated Support Team. National Department of Health, 2009.

Health Outcomes
The Lancet South Africa Series. August, 2009.
Couper et al. Evaluation of mental health care in North West Province. University of the Witwatersrand, Faculty of Health Sciences, Chair of Rural Health, 2006. Available at:
Gaunt CB. Are we winning? Improving perinatal outcomes at a deeply rural district hospital in South Africa. South African Medical Journal, 2010, 100 (2).

Health and Human Rights
Hassim, A, Heywood M, Berger, J. Health & Democracy. A Guide to human rights, health law and policy in post-apartheid. Cape Town, 2007.
Public Inquiry: Access to Health Care Services. SA Human Rights Commission, 2009.

Human Resources for Health
A National Human Resource Plan for Health. Pretoria, National Department of Health, undated. Available at: http://www.doh.gov.za/docs/factsheets/guidelines/hrplan/index.html
The government’s OSD proposal is anti-rural. RuDASA, 2009. Available at: http://www.rudasa.org.za/papers.php.
De Villiers MR, De Villiers PJT. Doctors views of working conditions in rural District Hospitals in the Western Cape. South African Family Practice, 2004, 46(3).
De Vries E, Reid S. Do South African rural origin medical students return to rural practice? South African Medical Journal, 2003, 93(10). Available at: ftp://ftp.hst.org.za/pubs/research/ruralorigin.pdf
George G, Quinlan T, Reardon C. Human Resources for Health: A needs and gaps analysis of HRH in South Africa. Durban, University of Kwazulu Natal, Health Economics and HIV ; AIDS Research Division, 2009.
Increasing access to health workers in remote and rural areas through improved retention. Global Policy Recommendations. WHO Final Draft, unpublished.
Sanders D and Lloyd B. National Health Insurance: Human Resources Requirements. Undated.
Reid S. Monitoring the effect of the new rural allowance for health professionals. Durban, Health Systems Trust; 2004.

Website links
Africa Health Placements
Budget Expenditure Monitoring Forum
Capacity Plus-HRH and MDGs
Ndlovu Care Group
Physicians for Human Rights
Rural Doctors Association of Southern Africa
Rural Rehab
SECTION27, incorporating the AIDS Law Project
Treatment Action Campaign
WHO Health Workforce Advocacy Initiative
Wits Centre for Health Policy
Wits Centre for Rural Health

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Rural Health Facts
Rural areas, home to 43,6% of the population, are served by only 12% of South Africa's doctors and 19% of its nurses
There are 30 generalist doctors and 30 specialists per 100 000 people in urban areas, but only 13 generalists and a mere 2 specialists per 100 000 people in rural areas
The ratio of professional nurses to the population is 82% greater in Gauteng than in Mpulamanga
Of the 1200 medical students graduating in SA yearly, only about 35 end up working in rural areas in the longer term
Three out the four Districts with the highest HIV prevalence are rural
There is a shortage of pharmacies in rural areas but an oversupply in urban areas
Despite this, there are some remarkably successful initiatives in rural areas:
The perinatal mortality rate at deeply rural Zithulele District Hospital in the Eastern Cape dropped from 42 per 1000 to 24•6 per 1000 in 2008, due to a hospital turn around strategy implemented by a multi-disciplinary team of health workers
Some of the most successful ARV programmes are based in rural areas, with some rural projects exceeding the NSP 2011 targets of 80% of people in need on ARV treatment
This is in a context of enormous challenges:
40% of poor women are not accessing PHC services in the Eastern Cape
The burden of non-communicable diseases is rising in rural communities
Poor rural households in a Limpopo District spend up to 80% of monthly income on health expenditure, travel costs being a significant contributor
21.3% of households in metropolitan areas belong to a medical aid, but only 5,4% of households in rural districts
There is a critical shortage of ambulances in rural areas