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Healthcare should be a basic human right. But in today’s world, it matters where you live. And it matters even within the same country. Over 50 percent of people living in rural areas in the world cannot access even the most basic healthcare facilities, compared to those living in cities in the same place. For example, four out of five Africans living in rural areas lack access to healthcare, according to a recent report from the United Nations. But even in the richest countries, the rural-urban healthcare divide is still a big problem.
Counting the Cost of the Rural-Urban Divide
The UN’s International Labour Organization recently put together its first-ever report into the division of healthcare access across the globe, looking at over 170 countries in all continents. The report shows that the invisible line is present in the wealthiest countries as well as the poorest places. Of those people living in rural areas across the globe, 56 percent do not have access to basic healthcare provision including clinics and doctors. This is compared to 22 percent of people living in the city or large towns.
Author of the report, Xelia Scheil-Adlung, said “The results that we found are really shocking. We find that the rural-urban divide is a consistent feature at global, regional and national levels. The place of residence can be considered as the entry door to access to health care or as the key barrier to be excluded from health care.”
Africans, Mexicans, Indians Uncovered by Healthcare
The report revealed one particularly shocking statistic – 83 percent of Africans living in rural areas have no healthcare provision. Other evidence states that the rural urban health divide in Mexico is prominent, and in India rural-urban healthcare is markedly divided. In India, large hospitals provide top-quality treatment but only to the richer portions of society that live in cities. The rural poor must experience average or poor facilities where they can find them. This results in poorer quality of life, more disease, increased problems with infection and epidemics, and lower life expectancy.
The biggest divide in the world, as reported by the UN, was experienced in East Timor, where a huge 75 percent of the rural people lack access to healthcare.
In Europe, the countries with the biggest inequality in healthcare are Italy, Greece, Cyprus and Andorra, according to Scheil-Adlung, ILO’s health policy coordinator. The lowest European gap was in Monaco, followed by in Switzerland.
Lack of Resources and Skills in the Countryside
The rural-urban healthcare divide is caused in part by negligence and underfunding in the rural parts of the world that house much of the world’s most vulnerable people, the report authors state.
The divide in healthcare provision is worsened by the lack of skilled professionals and knowledge in rural areas. The UN report states that although 50 percent of the global population lives in a rural area, only 23 percent of the health workforce in the world is deployed in these regions. Skilled healthcare graduates most often prefer to live and work in cities rather than in rural areas, resulting in a drain of capabilities and experience from the country to the city.
According to the report, an extra 7 million health workers are needed in rural areas to make up for the shortfall that contributes to the lack of health provision. In addition, there should be comprehensive steps taken by countries to move away from dependence on charity to provide rural healthcare and to ensure a more even coverage through bigger budgets and more resources in the countryside. “We have to ensure that everybody is included in legislation and people are just not waiting for Bill Gates to come and give some money,” Scheil-Adlung said.