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