More than half the population of rural areas worldwide do not have access to basic health care, with four in five rural Africans lacking services, the United Nations said Monday.

In the first report of its kind, the UN’s International Labour Organization found that the rural-urban divide was omnipresent from the richest countries down to the poorest.

Fifty-six percent of those living in rural areas worldwide were not covered by basic health care against 22 percent in cities and towns, according to the report, with data from 174 countries.”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,” the report’s author 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 percent of Africans in rural areas were left uncovered, the report said. “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 percent 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 percent of the rural population remains outside the purview of medical care, against 18 percent in cities.

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