Defining Rural – What do we mean by Rurality

What do you mean by rurality?

RHAP envisages a health system in which rural communities access equitable, quality healthcare services.

When RHAP uses the term ‘rural’, we use it in relation to rural health access, characterised by:

  1. Geographical remoteness and long distances between levels of care;
  2. Typographical features that hinder physical access to healthcare, for instance, mountainous landscapes and poor road conditions;
  3. Low population densities;
  4. High cost of service delivery due to lower economies of scale and more expensive travel to facilities;
  5. Difficulties to recruit and retain health care workers because of distance from amenities like shopping malls, internet services, gyms etc;
  6. Often characterised by higher levels of deprivation than urban areas, compounded by intra-district variations in access to care.

For instance, the sub-district of NYANDENI in the OR Tambo District of the Eastern Cape is deeply rural according to the above factors.

Good rural health care is responsive to the needs of rural communities and ensures equitable access by way of appropriate, affordable, quality health care. Services are delivered at various levels of care by multi-disciplinary health care teams, based on Primary Health Care principles. Care begins at the household level and health care users experience a dignified pathway to higher levels of care. Investment in good rural healthcare can be more expensive at the outset because of the particular rural features mentioned above, like lower economies of scale and topographical features that make the provision of adequate healthcare more expensive. Access to good rural health care is implied by our Bill of Rights, and is an essential component of a society envisaged by the Constitution: one based on human dignity and equality.

How rural is your facility?

The purpose of this index is to rank South Africa’s District Health Facilities on a scale from most rural to most urban using a quantitative measure. In grading the rurality of a particular district, it may be helpful to consult the  RURALITY INDEX_SOUTH AFRICA

It may also be useful to consult the Facility-index-2018 that highlights the rurality of facilities across South Africa and the methodology that was utilised.