Closing gaps between urban and rural healthcare

September 17, 2022

When striving to improve healthcare in South Africa, where people live and what access to proper medical services they have are questions that must be asked.

The gaps between urban and rural healthcare are complex, encompassing uneven socio-economic conditions, health status, beliefs about and access to healthcare, and making use of available healthcare as a whole. This was the finding of a study exploring the differences in healthcare-seeking behaviour among a rural and urban Black community, published in the International Journal for Equity in Health in 2012.

The study also found that urban communities rated their health significantly better than rural communities, although both reported difficulty in receiving the care they requested. Financial constraints affect access to healthcare in rural environments as transport to distant facilities is a challenge, and once there, the facilities may only offer limited services.

A 2011 case study in the SA Health Review found that health outcomes can also be quite different in urban versus rural areas. Review. Deprivation – usually a result of poverty – is often a cause of disease, which is worsened by lack of staff and poor infrastructure at rural facilities.

Positive examples of rural healthcare are cited, however, and are a result of innovation, good practices and sound leadership, even when resources are limited. The key is taking into account the rural healthcare context – also described as finding “rural-proof” solutions – when designing and implementing health policies and strategies, the study notes.

Urban areas are not necessarily better when it comes to healthcare, when unplanned and unmanaged urban growth and poverty are present. This was the finding of a 2017 study on, a leading global scientific, technical and medical website. Together with other factors, increased urbanisation puts pressure on access to adequate municipal services like water, sanitation, housing, and healthcare.

Most of these challenges in access to adequate healthcare in rural communities are not new, and many are self-evident.

Pple Healthcare understands the need to boost the quality and availability of healthcare in rural areas across South Africa, and earlier this year embarked on a call to registered nurses, midwives, pharmacists and doctors to take their skills “back home” and serve communities where they were raised.

Pple Healthcare has clients looking for skilled workers in many smaller cities and towns around the country, such as Rustenburg in the North West; Mbombela, Emalahleni and Middelburg in Mpumalanga; Bloemfontein in the Free State; Kimberley in the Northern Cape; Polokwane in Limpopo; and a growing number of other areas in South Africa. With Pple Healthcare as their ongoing employer, healthcare professionals continue to enjoy all the benefits of working in the city while being closer to family back home.

Dr Joe Phaahla, Minister of Health, said recently in an address to the WHO, “It is our view that the health system needs to be properly reset, recalibrated so that it can properly recover from the pressure of the Covid-19 pandemic. In this regard, a holistic approach to resetting health systems is more likely to yield desired results, not only for the recovery, but also for building back better.”

He listed key lessons learnt from the pandemic as:

  • The power of committed leadership and partnerships
  • Technology and analytics
  • The need to capacitate communities to play a central role in disease control and health emergencies

“We cannot afford to regress on these,” he added.