The United Nations reported that worldwide, more than half the population in rural areas do not have access to basic health care, with four in five rural Africans lacking services.
According to the report, with data from 174 countries, the rural-urban divide was omnipresent from the richest countries down to the poorest with 56% of those living in rural areas worldwide were not covered by basic health care against 22% in cities and towns.
"The results that we found are really shocking. We find that the rural-urban divide is a consistent feature at global, regional and national levels," said, Xelia Scheil-Adlung, told a news conference.
"The place of residence can be considered as the entry door to access to health care or as the key barrier to be excluded from health care," she said.
An overwhelming 83% of Africans in rural areas were left uncovered. "The situation is worsened by the lack of health workers in the world's rural areas," the report said, adding that although half of the world's population lived in these areas, only 23% of the global health workforce was deployed there.
An extra seven million health workers were needed to make up for the shortfall in rural areas across the world, the report on iniquities in rural health protection said.
Scheil-Adlung, who is ILO's health policy coordinator, said the countries with the highest rural-urban divide in Europe were Italy, followed by Greece, Andorra and Cyprus. The lowest gap was in Monaco, a tiny principality in southern France, which is a tax haven for the world's rich and famous, followed by Switzerland, she said. The biggest divide globally was found in East Timor.
In the impoverished half-island nation that was occupied by Indonesia for over two decades, 75% of the rural population remains outside the purview of medical care, against 18% in cities.
The main reasons for this were under funding, negligence and investments in "prestige" projects in urban areas, said Scheil-Adlung.
She said this could be rectified with steps to ensure comprehensive national protection, moving away from depending on charities to meet the shortfall and revamping policies and budgets.
"We have to ensure that everybody is included in legislation and people are just not waiting for Bill Gates to come and give some money," she said.
"Investing in rural health, as part of a national health system, is affordable and yields significant economic and social returns," said Isabel Ortiz, the head of ILO's social protection department.