Strengthening Health Systems in Resource-Limited Areas: Lessons from Rural South Africa and Rural North Carolina

Strengthening health systems
in resource-limited AREAS:
Lessons from Rural South Africa
and Rural North Carolina

In North Carolina, where you live matters when it comes to your health.If your home is in rural NC, not only does the data indicate that you are more likely to experience poor health, it also says you are less likely to have access to or the ability to pay for health services.

As a result, there are higher mortality rates in those living in rural areas, with an 8.2 year difference in life expectancy between those living in rural Swain (72.1 years) and urban Wake (81.3 years) counties. And while rural health care systems increasingly have to do more with less, there may be opportunities for improved health outcomes by cultivating and scaling smaller and simpler innovations, partnerships and low-risk experimentation. Undoubtedly, there is much to learn from rural health innovators–both from across the globe and right here at home. 

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Lessons from Rural South Africa and Rural North Carolina

The Institute for Emerging Issues, in partnership with Duke University’s Sanford School and Center for Child and Family Policy, hosted a webinar, Strengthening Health Systems in Resource-Limited Areas — Lessons from rural South Africa and rural North Carolina, on April 9 from 3-4 pm.

The webinar highlighted examples of rural health innovation and partnerships. View more information about the presenters and their projects below.

Interested in learning more about rural health data? Visit the Emerging Issues Commons

About The Presenters


Dr. Mosa Moshabela

Dr. Mosa Moshabela (MBChB, MFamMed, PhD) joined Rural Health at the University of KwaZulu-Natal (Rural Health at UKZN) in 2013. Previously, he was the regional health advisor for the Millennium Villages in West and Central Africa, based at the MDG Centre in Mali/Senegal, and concurrently worked with the Earth Institute at Columbia University, NYC, USA as a Public Health Specialist. His interests include strengthening health systems in resource-limited settings, primary health care for HIV/AIDS and TB, maternal and child health care, and the public health dimensions of controlling chronic infectious diseases in resource-limited settings. He has led several clinical and lay health care programs and research projects, translated into a number of scientific publications. His PhD investigated South African rural health systems and policy, with special reference to equity, access and utilization patterns for rural patients seeking and using antiretroviral treatment. He is now head of the Rural Health Department and chief medical specialist, and hopes to contribute to the transformation of rural health through the creation of platforms to achieve rural academic excellence and building scholarship in the trans-disciplinary field of rural health and development.



Dr. Bernhard Gaede

is the Director of the Centre for Rural Health at the University of KwaZulu-Natal. He trained as a family physician and worked for more than a decade in rural settings in South Africa with a wide scope of the clinical experience including HIV medicine, primary health care and the expanded scope of practice in rural district level services. His areas of interest and research have included health care systems (particularly around ARV provisioning, TB and HIV care integration as well as horizontal integration of vertical programs), health information systems, community-level care (including home- based care and traditional medicine) and medical anthropology. Recent interests include the development of rural health as an academic discipline and establishment of a rural teaching platform for health education. Over the past decade he has also been actively involved in the Rural Doctors Association of Southern Africa and the Rural Health Advocacy Project.


Dr. R.W. “Chip” Watkins

Dr. R.W. “Chip” Watkins (MD, MPH, FAAFP) is currently a Senior Physician Consultant with Community Care of NC and oversees much of CCNC’s PCMH and Quality Improvement efforts across the state as well as working directly with practices in Western NC. He is also Medical Director of High Country Community Health, an FQHC in Watauga County, NC and a Regional Medical Director for AccessCare, one of CCNC’s 14 networks. He serves as a reviewer for NCQA and is one of 19 physicians across the country to serve on NCQA’s Physician Review Oversight Committee. He was the first MD in the US to be certified as an NCQA Content Expert. He is an Associate Clinical Professor of Family Medicine at the UNC School of Medicine. Dr. Watkins has over 20 years experience in private practice, teaching, and corporate medicine. He is a past-president and Board Chair of the NC Academy of Family Physicians. He has lectured on a wide variety of topics at the local, national, and international levels. In addition, he has authored a number of journal articles and textbook chapters. He is a graduate of UNC Chapel Hill and the ECU School of Medicine and holds an MPH from Loma Linda University. Dr. Watkins completed his Family Medicine Residency at Florida Hospital Orlando.

Click the image below to view Dr. Watkin’s slides and learn more about his project.

 Rural Health and Rural Academic Excellence in South Africa

This webinar is part of the Rural Health and Rural Academic Excellence in South Africa series of events taking place with support from Duke’s Africa Initiative and and Duke’s Sanford School and Center for Child and Family Policy. For more information, please click here.
Health Webinar April 9