1. Working Party on Rural Practice Ian Couper Chairperson

2. Chronology Formed in Vancouver 1992 Practising rural doctors from developed and developing countries Vision: Health for all rural people around the world 1995: Wonca Policy on Training for Rural Practice

3. Wonca believes there is an urgent need to implement strategies to improve rural health services around the world. This will require sufficient numbers of skilled rural family doctors to provide the necessary services. In order to achieve this goal, Wonca recommends: 1. Increasing the number of medical students recruited from rural areas. 2 Substantial exposure to rural practice in the medical undergraduate curriculum. 3. Specific flexible, integrated and coordinated rural practice vocational training programs. 4. Specific tailored continuing education and professional development programs which meet the identified needs of rural family physicians. 5. Appropriate academic positions, professional development and financial support for rural doctor-teachers to encourage rural research and education. …

4. First International Conference on Rural Medicine Shanghai, May 1996

5. Durban, September 1997 Second World Rural Health Congress

6. Adopted “Health for All Rural People: The Durban Declaration” Outlines a series of principles which was followed by a Call for Action renewing the “Health for All” initiatives and calling on WHO, UNICEF, Development Banks, such as the World Bank, and National Governments to work with local communities, doctors nurses and other health professionals working in poorer areas of the world, to make a success of the “Health for All” initiative. The Declaration called for a combined effort to redress the historical inequities facing rural and disadvantaged communities.

7. Kuching, July 1999 3 rd World Conference on Rural Health

8. Calgary, August 2000 4 th World Rural Health Conference

9. HARP meeting, May 200 WHO-Wonca Co-Sponsored Consultation Invitational Conference “Health for All Rural People” Action Plan

10. The implementation of the Action Plan involves three key elements – the pillars upon which action can be built. These are: 1. Action for equity 2. Action for a rural paradigm 3. Action Process

11. HARP The components of this local action process include the following mechanisms: 1. Community empowerment 2. Building unity of partners 3. Providing rural health services 4. Action oriented research 5. Education and performance of health professions

12. Melbourne, May 2002 5 th World Conference on Rural Health

14. Santiago de Compostela, September 2003 6 th World Rural Health Conference

15. Seattle, September 2006 7 th World Rural Health Conference

16. Calabar, February 2006 8 th World Rural Health Conference

18. Heraklion, Crete, June 2009 9 th Rural Health World Conference

19. More Policies Using information Technology to improve Rural Health Care Rural Health and Rural Practice Quality and Effectiveness of Rural Health Care (2002) Women in Rural Practice Health Care for Indigenous People

20. First Published 1998 Second Edition 2001 This Policy on Rural Practice and Rural Health contains strategies to assist governments and professional bodies to ensure that real progress is made toward the goal of improving the health of rural people. These strategies were developed over the six year period following the establishment of the Wonca Working Party on Rural Practice in 1992. The strategies have been used in many countries and the experiences derived have been presented at international rural health conferences. …

21. Mission (Revised 2006) Rural doctors REACHING TOWARDS RURAL HEALTH in partnership with like-minded groups Repositioning and relationship Education Activism Conferencing and communication Health for All Rural People vision

22. PRIORITIES (2006) 1. Promote rural medical education, rural medical schools, and rural clinical schools. 2. Be an international voice for rural medicine and health including political activism on issues impacting rural health, including determinants of rural health. 3. Maintain the HARP vision and move the Harp process forward. 4. Renew the vision and mission of the Working Party, in line with these priorities, and re- position our relationships with Wonca and other organizations. 5. Continue to organise conferences for educational and communication purposes and to promote rural health.

23. HARP: Guiding principles · Consider health, not just medicine, in policy and strategic development · Ensure equitable distribution of health resources and investment · Use a systems approach which leads to better, more efficient and effective solutions · Ensure all policy, planning and service delivery is people centred and guided by the community · Seek better results through a collaborative team approach and intersectoral cooperation · Ensure services are sustainable · Build capacity and self reliance at the local level · Support progress in Information Technology in rural environments · Ensure outcomes are supportable in a global context

24. Conclusion Retention is a much broader issue than rural doctors or even health professionals Multiple approaches required Broad strategy needed All our work can be said to support retention The Wonca Working Party on Rural Practice is ready to support any activities that can address these issues.