The Rural Health Advocacy Project (RHAP), the Rural Doctors Association of South Africa (RuDASA), the Wits Centre for Rural Health and KZN Centre for Rural Health strongly support the drive by Government to re-engineer primary health care (PHC). We agree that a strengthened PHC approach within a functional District Health System (DHS) is imperative to improving national health outcomes. It is against this background that we have welcomed the request by the Director-General of Health and the PHC Advisor to the Minister to comment on the PHC Strategy from a rural health care perspective. Whilst fully supporting the overall purpose of the strategy, we argue that certain elements have not adequately taken into account opportunities and challenges related to health care provision in rural areas. In this submission “PHCplan_ruralproofing_RHAP_RuDASA_WCRH_KZNCRH_April 2011” we make a number of recommendations that could enhance the health outcomes of rural citizens and contribute to the realisation of their rights to comprehensive access to health care.