national rural health alliance national rural health alliance the national rural health alliance (nrha) is australia's peak non-government organisation for rural and remote health. the alliance began in 1991 and was incorporated in 1993. it brings together a number of disparate organisations for the common purpose of improving the health of people who live and work in australia's non-metropolitan areas. member bodies as of august 2020 the alliance comprises 44 member bodies, each of which is a national organisation. they represent health consumers, health care professionals, service providers, health educators, students and some indigenous health organisations. the following are current members: australian chiropractors association – aboriginal and torres strait islander rural and remote practitioner network australasian college of emergency medicine – rural, regional and remote committee australasian college of health service management (rural members) australian college of midwives – rural and remote advisory committee australian college of nursing – rural nursing and midwifery community of interest australasian college of paramedicine australian college of rural and remote medicine australian general practice accreditation limited australian healthcare and hospitals association allied health professions australia rural and remote australian indigenous doctors' association australian nursing and midwifery federation (rural nursing and midwifery members) australian and new zealand college of anaesthetists australian physiotherapy association (rural advisory council) australian paediatric society australian psychological society (rural and remote psychology interest group) australian rural health education network council of ambulance authorities (rural and remote group) congress of aboriginal and torres strait islander nurses and midwives cranaplus country women's association of australia exercise and sports science australia (rural and remote interest group) federation of rural australian medical educators isolated children's parents' association national aboriginal community controlled health organisation national aboriginal and torres strait islander health worker association national rural health student network rural special interest group of pharmaceutical society of australia royal australian college of general practitioners royal australasian college of medical administrators royal australasian college of surgeons – rural surgery section royal australian and new zealand college of obstetricians and gynaecologists royal australian and new zealand college of psychiatrists rural doctors association of australia rural dentists' network of the australian dental association royal flying doctor service royal far west rural health workforce australia regional medical specialists association rural optometry group of optometry australia rural pharmacists australia services for australian rural and remote allied health society of hospital pharmacists of australia speech pathology australia – rural and remote member community mission and support the alliance has core operational support from the australian (federal) government department of health. the alliance's work has remained independent of government and is controlled and managed by its member bodies, through its council. current members of council at any given time are listed on the alliance's website. the alliance's interests and constituency are the communities of rural and remote australia. rural and remote areas are defined (arbitrarily) by the alliance as all those places except the nine capital cities and the regional conurbations of townsville, the gold coast, newcastle, the central coast, wollongong and geelong. australia has various formal classification systems of the geographic continuum from 'metropolitan' to 'remote', the latest and most widely used of which is the australian standard geographic classification system – remoteness areas (asgc-ra). despite australia's general affluence, for a number of reasons the health status of its people deteriorates with increasing remoteness (i.e. distance from its capital cities). the proportion of aboriginal and torres strait islander people in local communities increases with remoteness and this contributes to the urban-remote health gradient. across australia as a whole there is a 12–17 year difference in life expectancy between indigenous and non-indigenous people. between remote and metropolitan areas the difference is estimated to be 3–4 years. against this background, the alliance’s vision is good health and wellbeing in rural and remote australia. the alliance takes a broad view of health and a long-term view of the development of rural australia. its operation is based on the view that all australians, wherever they live, should have access to comprehensive, high quality health services and the opportunity for equivalent health outcomes. this aspiration requires action relating to the social and economic determinants of health, as well as to factors in the health sector more narrowly defined. these broader issues include education, housing, employment, rural and regional development, telecommunications, transport, cultural safety, illness prevention, health promotion, and health infrastructure. the alliance works with consumers, communities and governments to make the diverse communities of rural and remote australia healthy and health-promoting places in which to live and work. in 1998–99 the nrha was a participant with commonwealth, state and territory governments in development of a national strategic framework for rural and remote health in australia: healthy horizons. it worked with governments on the updated healthy horizons 2003–07 and on its review in 2008. the nrha is manager of the biennial national rural health conference. the conference has become a key event on the calendar of people interested in improving health in rural, regional and remote australia, whether as community representatives, policy makers, researchers or other stakeholders. the nrha is the national manager for the australian government of the rural australia medical undergraduate scholarship scheme (ramus). the ramus scheme is part of the national strategy to increase the medical workforce available to people in rural australia. ramus supports around 580 rural students each year to study medicine. the alliance also managed stream 2 of the rural health continuing education program (rhce2) on behalf of the department of health. rhce2 was designed to foster inter-professional, team-based training and joint continuing development projects in order to better enable practising health professionals to provide health care services, both as members of multi-disciplinary teams and as individual practitioners. the program is also designed to support the retention of rural and remote health professionals. the alliance is owner and manager of the australian journal of rural health (ajrh) partyline is the alliance’s flagship magazine. friends of the alliance is a support network for individuals and organisations interested in rural health and in supporting the work of the alliance. alliance chairs chairpersons of the alliance have been: bruce chater (1993–1994) sabina knight (1994–1995) sue wade (1995–1997) john lawrence (1997–1999) steve clark (1999–2000) nigel stewart (2000–2003) sue mcalpin (2003–2005) john wakerman (2005–2008) jenny may (2008–2011) lesley barclay (2011–2013) tim kelly (2013–2015) geri malone (2015–2017) tanya lehmann (2017 – present)