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WELCOME TO THE CENTRE FOR RURAL HEALTH, UNIVERSITY OF THE WITWATERSRAND
Background The Wits Faculty of Health Sciences has a long-standing history of involvement in rural areas in South Africa.
While there were links established with rural hospitals all over the country in the apartheid era, a particular focus was around Tintswalo Hospital in the Bushbuckridge area of the then Gazankulu Homeland, now Limpopo and Mpumalanga provinces. In the early 1980 s, a training programme for primary health care nurses was initiated and the Health Systems Development Unit (HSDU) was established by the Department of Community Medicine. The MRC/Wits Unit in Rural Public Health and Health Transitions Research in Agincourt grew out of this.
In 2001 the Faculty of Health Sciences decided on a new initiative to take forward rural health in and on behalf of the faculty, and the then dean, Professor Max Price, began to explore possible ways to fund a post to do this. This led to an agreement with North West Province and, in July 2002, to the appointment of Wits-alumnus Professor Ian Couper as the first Chair of Rural Health in the Faculty and principal specialist, rural medicine, in North West Province. This was the first such Chair on the African continent.
Starting as a single person-position, the chair has developed into a division within the Department of Family Medicine. This resides within the School of Clinical Medicine but is also closely affiliated to the School of Public Health.
Developments
In 2003, the Wits Initiative for Rural Health Education (WIRHE) scholarship scheme was launched to attract disadvantaged rural students into health science careers, to support them through their studies and to place them back into their rural health districts on completion of their studies. (See WIRHE.)
As part of development, a series of strategic planning workshops were held in 2003-05, leading to the submission of a proposal for the establishment of a Centre to the University. (See Centre for Rural Health proposal.) In 2007, the University Senate approved the formation of the Centre for Rural Health. The Health Sciences Faculty Board subsequently approved an Advisory Board for the Centre, which held its first meeting in December 2007. The Advisory Board is assisting the director, Prof Ian Couper, with the finalisation of a strategic plan for the future development of the Centre.
The development of family medicine in North West province, overseen by the chair of rural health, has meant there has been an ongoing influence in the province in many ways, and a steadily increasing number of joint appointment family physicians in that province.
Focus areas
The current aims of the Division of Rural Health include the following:
1. Nurturing rural students: This is done through the Wits Initiative for Rural Health Education (WIRHE) scholarship scheme.

| Gathering of WIRHE students, August 2008 |
2. Undergraduate Education: In addition to teaching medical students in years 3 to 6 of the curriculum, the Division coordinates the Integrated Primary Care block during which students spend 6 weeks in primary care sites in Gauteng and North West provinces (for more information about the block see the current IPC students guide.) It also actively supports elective opportunities for students from Wits and abroad. (For more information for overseas elective students, see Rural Electives). As part of the Centre we are aiming to develop district educational campuses as key training sites for undergraduate training sites for undergraduate students from a range of disciplines and professions
3. Postgraduate Education and Training: The division is actively involved in training of Family medicine registrars in Northwest Province, and has developed a Masters in Public Health in the filed of rural health. (See Master of Public Health). The Division also runs regular skills training courses for doctors in Johannesburg and in the various sites in Northwest province.
4. Development of primary health care in North West: Through our involvement in North West province, we are actively supporting the development of primary care through training of doctors and nurses, quality improvement activities, research, health service development, etc.
 North West Family Medicine Forum meeting, Vryburg, June 2007
5. Centre for Rural Health: As noted above, the Centre for Rural health was formed as a co-ordinating focus for rural health activities in the faculty.
6. Research: Members of the division are engaged in research in health service development, human resources for health, and education. We are also linked to the Collaboration for Health Equity through Education and Research (CHEER).
7. Policy: The Division aims to work with other bodies, such as the Rural Doctors Association of Southern Africa (see www.rudasa.org.za), other centres for rural health, the World Organisation of Family Doctors (Wonca) Working Party on Rural Practice (currently chaired by Professor Couper), etc, to contribute towards and advocate for rural health policy development.
8. Clinical associate: The Division has been at the forefront of the development of the Bachelor of Clinical Medical Practice (BCMP) degree in South Africa, a 3 year programme to train Clinical Associates (physician or medical assistants), and has launched the degree in 2009.
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