While universal health coverage (UHC) and equity are high on the international agendas, until now policy makers had no evidence about coverage gaps and inequities experienced by rural as compared to urban populations. Against this background, ILO has developed for the first time the needed data and published in:
Global evidence on inequities in rural health protection - New data on rural deficits in health coverage for 174 countries
The results are shocking. We find extreme inequities at global, regional and national levels: 56 per cent of the global rural population lacks health coverage as compared to 22 per cent of the urban population. The situation is aggravated by extreme health workforce shortages in rural areas impacting on the delivery of quality services: in rural areas a global shortfall of about seven million missing health workers to deliver services is observed, compared to a lack of three million skilled staff in urban areas. Further, underfunding - deficits in per capita health expenditure - are twice as large in rural areas than in urban areas. The deficits observed result in unnecessary suffering and deaths, as reflected in rural maternal mortality rates that are 2.5 times higher than urban rates.
Globally, the highest levels in rural maternal mortality are found in Africa. Also in Africa we find the rural population that is globally most deprived of health coverage: As much as 83 percent of the rural population in Africa are lacking health coverage.
The sad conclusion of the new ILO study is that the place of living determines whether someone lives or dies! It is time for governments to act now and provide meaningful universal health protection that is not just a slogan to favor a few and leaving the rural population behind with charities rather than rights! Successful UHC requires a comprehensive social protection approach – it is challenging but feasible in the context of national social protection floor policies.
Health Policy Coordinator
Social Protection Department
International Labour Organization