Geographic distance remains a barrier to healthcare access at community-scales

What is it about?

Geographic distance is known to reduce healthcare access, particularly in countries where most transport is by foot. Community health workers are one potential solution to this problem because they are located closer to otherwise remote communities. However, we still do not know much about how geographic distance acts at these much smaller spatial scales. In this study, we explored the relationship between geographic distance to community health sites and monthly consultation rates of children in a rural health district of southeastern Madagascar. We found that healthcare use dropped by about 28.1% per km that communities lived from the community health site. We explored some potential ways to combat this negative effect of distance via optimizing the location of a community health site or adding another health site and predicting the effect on consultation rates. Most community sites are already in the best place, and further optimizing their locations would increase consultation rates by only 7%. Adding a second health site, however, could increase consultation rates by over 30%, especially in larger community health catchments.

Featured Image

Photo by Stephen Monroe on Unsplash

Photo by Stephen Monroe on Unsplash

Why is it important?

One goal of community health programs is to reduce geographic barriers to care, but we find even short distances (<4 km) limit access and may reduce the benefits of community health programs. We recommend alternative community health strategies, such as home visits (e.g. pro-active care), be used in areas that suffer from geographic barriers to care.