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56 pct of global rural population excluded from healthcare -- report

GENEVA, April 27 (KUNA) -- At least 56 percent of people living in rural areas worldwide do not have access to essential healthcare services, said a report by the International Labour Organization (ILO) on Monday.
New data on rural deficits in health coverage for 174 countries reveals major health access disparities between rural and urban areas around the globe, particularly in developing countries, the report added.
The highest number of people in rural areas, who are not covered by essential healthcare services, is in Africa where it amounts to 83 percent, it said, noting the most affected countries also face the highest levels of poverty.
The largest differences between rural and urban areas, however, exist in Asia, for example, in Indonesia the percentage of people that are not covered is twice as high in rural areas as in urban areas, it made clear.
"Decades of underinvestment in health interrupted efforts to develop national health systems and ultimately resulted in the neglect of health in rural areas. This has a huge human cost. Health is a human right and should be provided to all residents within a country," said Isabel Ortiz, Director of the ILO's Social Protection Department.
The report further finds that even if access to healthcare is guaranteed by law, people in rural areas remain excluded from healthcare because such laws are not enforced where they live.
The situation is worsened by the lack of health workers in the world's rural areas, it said, adding although half of the world's population lives in them, only 23 percent of the global health workforce is deployed to rural areas. The ILO estimates that 7 million out of the total 10.3 million health workers who are lacking globally are needed in these areas, it noted.
Africa and Latin America are the two regions where this problem is most acute, it added, indicating in Nigeria, for example, more than 82 percent of the rural population is excluded from healthcare services due to insufficient numbers of health workers compared to 37 percent in urban areas.
The report shows that financial resource gaps are nearly twice as high in rural than in urban areas, adding the largest gaps are found in Africa. However, significant inequities also exist in Asia and Latin America, it stated.
The extent of impoverishing out-of-pocket payments (OOPs) is also high in rural areas.
The report shows that rural populations in Africa and Asia are burdened with OOPs that amount to 42 and 46 percent of total health expenditure respectively. In many Asian countries such as Afghanistan, Bangladesh, Cambodia and Sri Lanka, OOPs are two to three times higher in rural than in urban areas, it mentioned.
"The lack of legal coverage, insufficient numbers of health workers, inadequate funding, and high OOPs have created life-threatening inequities in many countries," said Xenia Scheil-Adlung, Health Policy Coordinator at the ILO.
"Strengthening both the demand and supply side of services is crucial when moving towards universal health protection, particularly in rural areas. Legal health coverage is necessary, but not sufficient. Only when quality services are actually made available and affordable for all those in need can effective access to health care be ensured," she added.
The report explains that closing rural health access gaps requires a comprehensive and systematic approach that simultaneously addresses missing rights, health workers, funding, financial protection and quality. Such an approach needs to be based on the principles of universality and equity and calls for solidarity in financing and burden sharing.
"Addressing such inequities needs to consider the specific characteristics of rural populations, including high poverty rates and informality of work," she noted.
"This means moving from charity to rights, the provision of health workers with decent working conditions that enhance productivity, and the minimization of out-of-pocket payments by patients to avoid poverty. It also requires complementary socio-economic and labour market policies to trigger inclusive economic growth," she pointed out.
The report highlights the key role that national social protection floors can play in reducing and eliminating rural/urban gaps through human rights-based approaches. In this sense, it points to the importance of ILO Recommendation 202 on social protection floors. (end) Ta.hm