United in health, connected in care: Key takeaways from the Rural Health and Family Physicians Joint Congress 2026
A healthcare system can have policies and facilities, yet still leave people struggling to reach the care they need. This tension ran through the Rural Health and Family Physicians Joint Congress 2026, where conversations repeatedly returned to one question: what does it take to make healthcare work for people where they actually live?
Held under the theme United in Health and Connected in Care, the Congress, in collaboration with the South African Academy of Family Physicians (SAAFP), brought rural health practitioners, family physicians, researchers and advocates into conversation about the realities facing communities and the need to stop addressing these challenges in isolation.
One of the strongest messages was that where a person lives should not determine whether they live. Professor Mergan Naidoo from the University of Kwazulu Natal highlighted the continuing inequality created by geography, while the RUDASA Chairperson, Dr Asafika Mbangatha emphasised that advocacy must remain firmly on the side of healthcare and the patient.
This need for collective responsibility was further explored by the Chairperson of the People’s Health Movement SA and Head of Health Informatics at the Africa Health Research Institute (AHRI) in uMkhanyakude, KZN, Dr James van Duuren, who spoke about expanding the circle of responsibility by connecting primary healthcare, data and advocacy. His presentation challenged the idea that advocacy is a zero-sum game, where one group’s gain must come at another’s expense. Instead, better health outcomes require different parts of the system to recognise their shared responsibility.
The discussions also questioned how South Africa understands investment in healthcare. With the country facing the reality of not reaching its Universal Health Coverage targets by 2030, Dr van Duuren cautioned against viewing healthcare primarily through short-term calculations. Healthcare is an investment whose returns are measured not only today, but in the health, wellbeing and opportunities of communities in the future.
A further concern was fragmentation. When health professionals, institutions and communities operate within separate silos, accountability becomes harder and patients are left to navigate the gaps between them. The Congress therefore placed collaboration at the centre of the conversation, not as an abstract principle, but as a practical requirement for improving care.
In his RuReSA keynote address, Dr Lionel de Gouveia, senior doctor at Nurture Ilembe brought the discussion back to the patient experience. He described the distance between a patient and a healthcare service as a canyon that needs to be bridged. For people requiring rehabilitation, this distance can mean transport costs, long journeys, difficult environments and limited services once they arrive.
His presentation also highlighted the challenges within rural primary healthcare facilities, including shortages of equipment and medication, supply chain problems and limited access to specialised rehabilitation services. Keeping rehabilitation closer to home, he argued, requires the health system to think differently about how services are organised and delivered.
The Congress closed with a challenge to broaden responsibility beyond individual professions and institutions. Strengthening rural healthcare will require health workers, policymakers, researchers, advocates and communities to recognise that they are part of the same system.
The most important takeaway was therefore not simply that collaboration is needed, but that the gaps between people, services and institutions are themselves a health system problem. Closing those gaps will require sustained advocacy, better use of data, stronger accountability and a willingness to work across professional and institutional boundaries.