Commentary
The Limerick Declaration on Rural Health Care 2022
AUTHORS
Liam Glynn1 MD, Professor of General Practice and General Practitioner * 
Andrew W Murphy2 MD, Professor of General Practice
Robert Scully3 MD, Deputy Director, Scottish Graduate Entry Medical Programme (ScotGEM) / Honorary Senior Lecturer, University of St Andrews
Roger Strasser4 MBBS, MClSc, FRACGP, FACRRM, Emeritus Professor of Rural Health, University of Waikato, New Zealand; Professor of Rural Health, Founding Dean Emeritus, NOSM University, Canada
Diarmuid Quinlan5 MICGP, FRCGP, BSc, LLM, GP Glanmire, Cork, Ireland; Medical Director, Irish College of General Practitioners
Jerry Cowley6 MRCGP, MICGP, LLB, BL, Chairman Rural Island & Dispensing Doctors of Ireland
Peter Hayes7 MD, General Practitioner and Senior Lecturer in General Practice
Patrick O’Donnell8 MB, BCh, BAO, MSc, Clinical Fellow in Social Inclusion
Andrew O’Regan9 PhD, General Practitioner and Senior Lecturer in General Practice
Shagun Tuli10 MBBS, MGHD, Student
Marcela A de Oliveira Santana 11 MD
Victoria M Sparrow-Downes12 MD, MSc, CCFP Family Physician at Pangnirtung Community Health Centre & Qikiqtani General Hospital; Clinical Assistant Professor of Medicine at Memorial University of Newfoundland
Ferdinando Petrazzuoli13 PhD, MD
Shelley Nowlan14 MHM, BN, ACN (Fellow), Deputy Australian National Rural Health Commissioner Australia; Chief Nursing and Midwifery Officer, Queensland Health Australia
Claire Collins15 PhD, Director of Research, Irish College of General Practitioners; Professor of Epidemiology and Public Health, Ghent University
Frank Fogarty16 MICGP, MRCGP, MMed Sc, FFSEM(Ireland), FFSEM(Malaysia), General Practitioner
Anne MacFarlane17 PhD, Professor of Primary Healthcare Research; Director, Public and Patient Involvement Research Unit and WHO Collaborating Centre for Migrants’ Involvement in Health Research
John Wynn-Jones18 BSc, MBBS, FRCGP, Senior Lecturer; Visiting Professor
Alan Bruce Chater19 MBBS, FACRRM, FRACGP, DRANZCOG Adv, Mayne Professor of Rural and Remote Medicine
AFFILIATIONS
1 SLÁINTE Research and Education Alliance in General Practice, Primary Healthcare and Public Health, School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland; and Health Research Board Primary Care Clinical Trials Network Ireland
2 Department of General Practice, National University of Ireland Galway, Galway, Ireland; and Health Research Board Primary Care Clinical Trials Network Ireland
3 School of Medicine, Medical and Biological Sciences Building, St Andrews KY69TF Fife, Scotland
4 Rural Health, University of Waikato; and Rural Health and Founding Dean Emeritus Northern Ontario School of Medicine (NOSM), Sudbury, ON, Canada
5 Woodview Family Doctors, Glanmire, Cork, Ireland; and Irish College of General Practitioners, Dublin, Ireland
6 Institute of Rural Health Ltd t/a Rural, Island & Dispensing Doctors of Ireland; and Mulranny Surgery, Mulranny, County Mayo, Ireland
7, 8, 9 School of Medicine, University of Limerick, Limerick, Ireland
10 University of Global Health Equity, Rwanda
11 Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil; and Rural WONCA Rural Seeds Ambassador – Ibero America
12 Department of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
13 European Rural and Isolated Practitioners Association Scientific Board; and Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
14 School of Nursing and Midwifery, University of Queensland, St Lucia, Qld, Australia; School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia; School of Nursing and Midwifery, University of Southern Queensland, Ipswich, Qld, Australia; School of Medicine, Griffith University, Brisbane, Qld, Australia; and Association Queensland Nursing and Midwifery Leaders
15 Irish College of General Practitioners, Dublin, Ireland; and Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
16 Rural, Island and Dispensing Doctors of Ireland
17 School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland; and Health Research Institute, University of Limerick, Limerick, Ireland
18 Rural and Global Health, Keele Medical School, UK
19 Rural WONCA (WONCA Working Party on Rural Practice); and Mayne Academy of Rural and Remote Medicine, Rural and Remote Medicine Clinical Unit, University of Queensland, Herston, Qld, Australia
ACCEPTED: 5 October 2022
early abstract:
The 19th World Rural Health Conference, hosted in rural Ireland and the University of Limerick, with over 650 participants coming from 40 countries and an additional 1600 engaging online, has carefully considered how best rural communities can be empowered to improve their own health and the health of those around them. The conference also considered the role of national health systems and all stakeholders, in keeping with the commitments made through the Sustainable Development Goals and the enjoyment of the highest attainable standard of health as one of the fundamental rights of every human being. This conference declaration, the Limerick Declaration on Rural Healthcare, is designed to inform rural communities, academics and policymakers about how to achieve the goal of delivering high quality health care in rural and remote areas most effectively, with a particular focus on the Irish healthcare system. Congruent with current evidence and best international practice, the participants of the conference endorsed a series of recommendations for the creation of high quality, sustainable and cost-effective healthcare delivery for rural communities in Ireland and globally. The recommendations focused on four major themes: rural healthcare needs and delivery, rural workforce, advocacy and policy, and research for rural health care. Equal access to health care is a crucial marker of democracy. Hence, we call on all governments, policymakers, academic institutions and communities globally to commit to providing their rural dwellers with equitable access to health care that is properly resourced and fundamentally patient-centred in its design.