Introduction

The Second World Rural Health Congress issued the “Durban Declaration” on Health for All Rural People. This sets out the concerns and aspirations of rural doctors for the health of rural people around the world. Implementation of the following recommendations will facilitate achievement of that declaration. A combined effort to redress the historical inequities faced by rural and disadvantaged communities is needed through affirmative action for rural people with respect to health care.
The recommendations in this Policy present a matrix of measures designed to assist rural people through the enhancement of rural health services. The philosophy of the recommendations was set out in the WONCA “Policy on Training for Rural Practice”:
“The world-wide shortage of rural family doctors contributes directly to the difficulties with providing adequate medical care in rural and remote areas in both developed and less developed countries. WONCA believes there is an urgent need to implement strategies to improve health services around the world. This will require sufficient numbers of skilled rural family doctors to provide the necessary services.”
The WONCA Working Party on Training for Rural Practice was formed following the WONCA World Conference in 1992. At that conference the rural delegates met to discuss matters related to rural practice. The consensus that developed formed the basis for the “Policy on Training for Rural Practice” which was endorsed by WONCA Council on 9 June 1995.
At that 1995 WONCA World Conference, the WONCA working party was expanded and contributed to discussions regarding the organisation of the First International Conference on Rural practice in China.
In the triennium following the 1995 WONCA World Conference the Working Party was involved in the organisation of two international rural health conferences - The First International Conference on Rural practice in Shanghai/Fengxian County China in 1996 and the Second World Rural Health Congress in Durban South Africa in 1997. These Conferences each involved more than 300 delegates from around the world. Participants in both conferences developed a set of recommendations that enhance the Training Policy recommendations and reflect a developing world perspective.
This Policy on Rural Practice and Rural Health seeks to build on the seminal ideas of the Training Policy. Much experience was gained over the six years since the WONCA Working Party on Rural Practice was formed and met to discuss these issues. Many projects have been piloted and tested. Many of these have been the subject of lively presentation and discussion at the International Conferences. This policy seeks to distil from these a set of strategies which will benefit the health of rural people. The Working Party hopes that this document will provide a practical blueprint for Governments, Academies, Colleges and communities to tackle the parlous state of rural health.