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Report: People in Rural Areas Lose Out on Health Care

FILE - Young schoolboys walk home in the village of Nyumbani, Kenya, which caters to children who lost their parents to HIV, and grandparents who lost their children to HIV.
FILE - Young schoolboys walk home in the village of Nyumbani, Kenya, which caters to children who lost their parents to HIV, and grandparents who lost their children to HIV.

A new report finds people who live in rural areas have far less access to health care than do city dwellers. The International Labor Organization reports 56 percent of the world’s rural populations have no health coverage compared to 22 percent who live in urban areas.

New data from 174 countries reveal a huge gap in access to health care between rural and urban areas worldwide. The report, by the International Labor Organization, for the first time presents comprehensive global evidence on the extent of the inequities between these populations.

The ILO finds inequities in health coverage exist in most countries - whether rich or poor, although the largest rural/urban divides exist in the developing world.

It says the highest number of people in rural areas or 83 percent who do not receive essential health care services are in Africa; but, the largest differences between rural and urban areas exist in Asia. For example, the report notes only 1 percent of the urban population in Vietnam has no access to health care compared to 56 percent in the rural areas.

ILO health policy coordinator Xenia Scheil-Adlung, says the situation is made worse by the lack of health workers. She says 7 million out of the total 10.3 million health workers lacking globally are needed in rural areas.

“Highest shortages are again found in Africa in countries such as Somalia, Guinea, Niger and Chad, where nearly 100 percent of the population do not have access to health care given the absence of the needed health workers…Globally, largest inequities in the distribution of health workers are found in Timor Leste, where 75 percent of the rural population remains without access or without health workers…while this compares to 18 percent of the urban population," said Scheil-Adlung.

Sheil-Adlung tells VOA all or most of the hospitals and health facilities are in capital cities and not in the countryside so, fewer jobs for health workers are available there. She says this is one explanation for the shortage of health workers in rural areas.

“But, then you have an additional problem and this is that health workers do not like to go in rural areas because the work is more demanding and often the salaries are lower than in urban areas and the working conditions are more indecent. So, there is not enough regulatory approaches, policies that try to balance this more demanding work with higher salaries or better career perspectives or whatsoever," she said.

The ILO says more people die in rural areas as a consequence of the rural/urban inequities. This observation is based on a maternal mortality ratio per 10,000 live births. The report finds maternal mortality in rural areas is 2.5 times higher than in urban areas. In Africa, for instance, it notes there are 29 maternal deaths in urban areas compared to 54.9 maternal deaths in the rural areas.

The U.N. agency is calling for more decent jobs and better working conditions for health workers in rural areas, as well as a better distribution of funds between the rural and urban areas to help close the gaps in health access between the two areas.