Commentary

The Limerick Declaration on Rural Health Care 2022

AUTHORS

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Liam Glynn1
MD, Professor of General Practice and General Practitioner *

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Andrew W Murphy2
MD, Professor of General Practice

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Robert Scully3
MD, Deputy Director, Scottish Graduate Entry Medical Programme (ScotGEM) / Honorary Senior Lecturer, University of St Andrews

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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

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Diarmuid Quinlan5
MICGP, FRCGP, BSc, LLM, GP Glanmire, Cork, Ireland; Medical Director, Irish College of General Practitioners

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Jerry Cowley6
MRCGP, MICGP, LLB, BL, Chairman Rural Island & Dispensing Doctors of Ireland

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Peter Hayes7
MD, General Practitioner and Senior Lecturer in General Practice

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Patrick O’Donnell8
MB, BCh, BAO, MSc, Clinical Fellow in Social Inclusion

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Andrew O’Regan9
PhD, General Practitioner and Senior Lecturer in General Practice

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Shagun Tuli10
MBBS, MGHD, Student

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Marcela Araujo de Oliveira Santana11
MD

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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

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Ferdinando Petrazzuoli13
PhD, MD

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Shelley Nowlan14
MHM, BN, ACN (Fellow), Deputy Australian National Rural Health Commissioner Australia; Chief Nursing and Midwifery Officer, Queensland Health Australia

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Claire Collins15
PhD, Director of Research, Irish College of General Practitioners; Professor of Epidemiology and Public Health, Ghent University

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Frank Fogarty16
MICGP, MRCGP, MMed Sc, FFSEM(Ireland), FFSEM(Malaysia), General Practitioner

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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

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John Wynn-Jones18
BSc, MBBS, FRCGP, Senior Lecturer; Visiting Professor

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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; 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; 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; 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.