Rural area

This study is the first attempt to assess the effect of the new rural allowance on the motivation and movement of health professionals working in rural areas. Although methodologically limited, the study gives some indication of the likely impact of the funds allocated by Treasury, namely that almost one-third of health professionals working in rural areas say that they have changed their career plans next year as a result of the new allowance. It is difficult to assess whether this is the effect of the RA alone, or in combination with the SSA. Further evaluations will be necessary to assess the longer-term impact of these strategies.

There is a major shortage of doctors in rural areas in South Africa. About 46% of the population in South Africa live in non-urban areas (1), and they do not always have the same access to health services as their urban counterparts. One example is Mount Frere district, where the doctor to population ration is 1:30 000 (2).

If the principal aim of the public health sector is to improve the health of South Africans, then our focus must be the health of rural people. In other words, the reform efforts and upheavals which have left the South African health system creaking and groaning in protest must continue until it is turned on its head - and is explicitly biased towards rural health. Rural people bear the greatest burden of disease, mainly because rural people bear the greatest burden of poverty. But paradoxically, urban dwellers are better served by both public and private health care resources. Simply put, rural people are generally poorer and less healthy -and have less access to health care.