Archived: World Medical Association Recommendations Concerning Medical Care in Rural Areas

Adopted by the 18th World Medical Assembly Helsinki, Finland, June 1964,
amended by the 35th World Medical Assembly Venice, Italy, October 1983
and rescinded at the WMA General Assembly, Santiago 2005

1. Rural populations have the same entitlement to medical care as people living in urban areas. Although there may be economic and other factors affecting the quantity of medical services available in rural areas, there should be no disparity in the quality of medical services. Persistent efforts should be made to elevate the qualifications of all persons rendering medical service to the highest level in the nation.
2. Studies and analysis of factual data are useful for rural communities and regions in providing information for planning and developing suitable health services in rural areas.
3. Education and socio-economic levels in rural communities are mutually dependent. Health education of the public is most effectively achieved when agencies, organizations, the health professions and the community share in the development and maintenance of the highest level of health practices that can be mutually effected.
4. The physician-patient relationship should be preserved in the development of health services in rural areas.
5. It is the duty of the State to ensure that conditions offered in Public Health appointments are sufficiently attractive to enable rural health services to develop to the same extent as those in urban areas.
6. Proper integration of the program and facilities for preventive and therapeutic medicine, sanitation and health education should be ensured in both rural and urban areas.
7. Every effort should be made to ensure that only qualified physicians should have ultimate clinical responsibility in rural, as well as urban, health services. Medical auxiliaries should be employed only temporarily to perform the duties of qualified physicians. The number of rural health personnel should be adequate and should receive training well adapted to medical needs of the rural population. Their technical knowledge should be kept up to date.
8. The training of medical auxiliaries especially nurses, male nurses and mid-wives should be based on and correspond to the cultural and educational level of the country in order that a sufficient number may be available for the rural areas. The medical profession should in every way possible assist in providing basic as well as post-graduate and refresher courses to this group.
9. The special diseases of rural areas require cooperation of physicians with professionals of related fields.
10. The medical profession should provide leadership in health education of rural populations. It is essential that there be cooperation between the physician and the rural population in order to achieve the highest possible standard of health education.
11. National medical associations should do everything possible to ensure that rural physicians practice under conditions no less favourable than urban physicians.
12. National medical associations should take an active part in the development of plans for improving health conditions in rural areas.