title: Transforming rural health systems through clinical academic leadership: lessons from South Africa.
abstract: BACKGROUND
  Under-resourced and poorly managed rural health systems challenge the achievement of universal health coverage, and require innovative strategies worldwide to attract healthcare staff to rural areas. One such strategy is rural health training programs for health professionals. In addition, clinical leadership (for all categories of health professional) is a recognised prerequisite for substantial improvements in the quality of care in rural settings.
  
  
  OBJECTIVE
  Rural health training programs have been slow to develop in low- and middle-income countries (LMICs); and the impact of clinical leadership is under-researched in such settings. A 2012 conference in South Africa, with expert input from South Africa, Canada and Australia, discussed these issues and produced recommendations for change that will also be relevant in other LMICs. The two underpinning principles were that: rural clinical leadership (both academic and non-academic) is essential to developing and expanding rural training programs and improving care in LMICs; and leadership can be learned and should be taught.
  
  
  CONCLUSIONS
  The three main sets of recommendations focused on supporting local rural clinical academic leaders; training health professionals for leadership roles in rural settings; and advancing the clinical academic leadership agenda through advocacy and research. Byadopting the detailed recommendations, South Africa and other LMICs could energise management strategies, improve quality of care in rural settings and impact positively on rural health outcomes.
authors.affiliation: Centre for Rural Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. dohertyj@telkomsa.net
authors.forename: J E
authors.initials: JE
authors.lastname: Doherty
authors.forename: I D
authors.initials: ID
authors.lastname: Couper
authors.forename: D
authors.initials: D
authors.lastname: Campbell
authors.forename: J
authors.initials: J
authors.lastname: Walker
mesh_terms: D057191:Capacity Building; D002983:Clinical Competence / Q000592:standards; D006801:Humans; D007857:Leadership; D009936:Organizational Innovation; D011204:Poverty Areas; D016730:Program Development; D011787:Quality of Health Care; D012423:Rural Health / Q000193:education*; D019035:Rural Health Services / Q000592:standards*; D013019:South Africa; D019472:Universal Health Insurance; D000078329:Workforce