WP on Rural Practice report

Dr John Wynn-Jones, Chair WONCA Working Party on Rural Practice (WWPRP), reports on past year's activities.

The WONCA Working Party on Rural Practice (WWPRP) continues to work on a triennium schedule and we will provide a further report after our 16th WONCA World Rural Health Conference in Albuquerque, New Mexico in October.

The current chair of WWPRP is John Wynn-Jones and he will be handing the chair over to Professor Bruce Chater who has been the secretary for the last six years.

Our success in attracting rural practitioners from around the world, meant that we needed to change our structure and as a result we established three tiers of membership
· The executive: Each executive member has a portfolio to manage. Executives are chosen by the Council and meet at least once (video/audio) during the year in addition to face to face meetings.
· The Council: The council aims to be gender, age, geographically and demographically equitable. We try to ensure that each WONCA region is represented in this way. The membership of the council is limited to approximately 60.
· The Assembly: Everyone who is either a rural health professional, rural academic or a rural health stakeholder is entitled to join the assembly. Assembly meetings take up a day during our annual conferences.
We communicate with each other through a number of media vehicles. The Google Group remains the backbone with over a thousand members. We also run Facebook and Twitter pages.

Rural Seeds

Rural Seeds has been in existence for two years following its launch at the 14th World Rural Health Conference in Cairns in 2017. It has three joint chairs/coordinators Mayara Floss (Brazil), Amber Wheatly (British Virgin Islands +UK) and Veronika Rasic (Croatia + UK)

Rural Seeds has its own social media platforms in addition it’s own google Group. Its achievements over the last two years include:
• Rural Family Medicine Café (global discussion group using a number of social media platforms on a regular basis)
• Rural Success Stories Rural (an extensive blog gathering success stories in rural health care)
• Global mentoring programme for rural medical students and young doctors

Rural Seeds aims to expand its reach and we will be launching a new plan after the New Mexico Conference.

WWPRP achievements over the last triennium

• Equity: Working to achieve equity has been our driving force over the last three years. Our Delhi Declaration: Alma Ata revisited, endorsed at the WONCA World Rural Health Conference in April 2018 identifies six major themes. This document (see attached) is our manifesto for the future:
o Equity and access to care
o Rural Proofing of Policy
o Health System Development
o Developing and educating a workforce fit for purpose
o Realigning the research agenda
o People and communities

• Working in partnership: We have continued to work with other WONCA groups and will continue to do so. We released a joint declaration with the environment group on climate change at our Cairns conference. We have shared workshops and other activities with Education, Indigenous, Research, Women and Family Medicine, Emergency and Family Violence. We continue to work with WONCA Regional Groups, WHO, Towards Unity for Health, ICOH, Darwin International Institute for the Study of Compassion, American Association of Family Medicine and other organisations. We have just signed a Memorandum of Understanding with the National Rural Health Association of America - along with the University of New Mexico are the hosts of the 16th WONCA World Rural Health Conference this October.

• Priority areas: We signalled our intention to prioritise certain areas. We have now a permanent and productive link with China. Attempts to develop a establish a rural network in Asia Pacific has not moved on any further from a rural meeting at the last Asia Pacific Conference. Links with South America continue to grow. Finally we are delighted that we have established a rural network in Africa (WoRA). A rural day is being held at this year’s WONCA Africa conference and the Chair will be giving a Keynote Lecture at the main conference.

• Conferences:
15th WONCA World Rural Health Conference, New Delhi, India 2018. This conference attracted over a thousand delegates from around the world. We were honoured by the participation of the Vice-President of India and two Health Ministers. The timing was perfect as it coincided with major changes in India, aimed at securing access to health care for its poor and rural inhabitants. We were delighted to host a National Consultation on Strengthening Rural Primary Care in India. We launched the Delhi Declaration: Alma Ata revisited. See below for further details.

Working with WHO

Our recent activities to date with WHO include
• In a response to the lack of emphasis on rural health care in the draft Astana declaration we launched our own rural response to the 40th anniversary of Alma Ata, called the Delhi Declaration: Alma Ata Revisited. We were honoured and delighted when WHO put this on their website. https://www.who.int/hrh/news/2018/delhi_declaration/en/
• We contributed to the Astana declaration. After further lobbying and close working with WONCA Executive, acknowledgment of rural appeared in the final declaration. “We will strive for the retention and availability of the PHC workforce in rural, remote and less developed areas.”
• We were approached by WHO in October 2018 to undertake a rapid response project to carry out a comprehensive literature review into “Pathways and Pipelines for Rural Training” across all professional groups in LMICs and use the information gained and our extensive rural network to develop a check list to help LMICs to introduce their own training pathways. We were fortunate to be able to commission an excellent team at Monash University to help us with this work and together with our global expert panel and information gathered using our contacts and Google groups, the project finished on time and has been highly valued by WHO.

Finally: As I finish as chair, I would like to thank all those that have helped me with my work across WONCA. A special thanks to Garth, Nongluck, the WONCA secretariat, Karen Flegg and the three WONCA Presidents (Michael, Amanda and Donald). I would also like to thank my colleagues in WWPRP, the Executive and a very special thanks to Bruce Chater, who as secretary made it all possible. It has been a great honour and a rich and rewarding experience.

Note: For purposes of space requirements in WONCA News the original comprehensive report has been edited to show highlights. Please contact the chair for the unedited version.

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