When Healthcare Is Too Far Away: The Hidden Cost of Distance

Healthcare access is often discussed in terms of hospitals, doctors, medicines and infrastructure. But for many underserved communities, there is another barrier that comes before all of these: distance.

A healthcare facility may exist, but if reaching it requires significant travel, time away from work, transportation costs or navigating long queues, seeking care can become difficult—particularly for women, elderly people, children and daily-wage workers.

The Swaasth initiative, implemented by the Centre for CSR and Sustainability Excellence (CCSE) with Shahi Exports Pvt. Ltd. and the Indian Strokes and Paralysis Foundation (ISPF), offers a practical view of this challenge. The initiative deployed a Mobile Health Unit across underserved locations in Faridabad, while health camps were conducted in Noida and Ghaziabad. The project ultimately supported 9,242 individuals.

Distance is not just a geographical problem

The baseline assessment revealed that the communities faced two significant barriers: distance from healthcare facilities and high out-of-pocket expenditure. The assessment found that people often approached healthcare facilities only during a crisis or when a health issue became unavoidable.

The endline assessment further illustrated the scale of the distance barrier. Among the 104 respondents who provided feedback, 81.7% reported that their nearest government healthcare facility was more than 5 kilometres away. Nearly 77% said they accessed healthcare only occasionally, while another 21% reported doing so rarely.

For someone with limited income, poor mobility or household responsibilities, five kilometres can represent much more than a number on a map.

It can mean transport expenses.

It can mean lost working hours.

It can mean arranging childcare.

It can mean asking someone else for assistance.

And sometimes, it can mean postponing treatment altogether.

Bringing healthcare closer to the community

The Swaasth intervention attempted to address this access gap by taking primary healthcare closer to where people lived.

The Mobile Health Unit operated across 15 locations in Faridabad, providing health screening, consultations, medicines and explanations on medicine usage. The intervention also incorporated follow-up visits by maintaining a regular monthly visitation schedule.

The model was not limited to the presence of a doctor.

Local mobilisation, awareness sessions, trained medical professionals, community influencers and peer leaders became part of the delivery mechanism. This helped transform the mobile van from simply a vehicle carrying healthcare professionals into a recurring point of access within the community.

The financial distance matters too

Physical distance and financial burden can reinforce one another.

Before the intervention, 56.7% of respondents reported spending ₹1,000–₹3,000 on healthcare, while 19.2% reported spending more than ₹3,000. Following the intervention, these proportions fell to 13.5% and 2%, respectively.

The significance here is not simply the reduction in expenditure. It demonstrates how bringing primary healthcare closer can potentially reduce some of the costs associated with accessing care.

Designing healthcare around people's realities

The experience also highlights an important consideration for CSR healthcare programmes: access should be designed around the realities of the communities being served.

The project found that women constituted around 63% of the average MHU beneficiaries. The report also notes that elderly beneficiaries commonly sought support for conditions including joint pain, hypertension, diabetes and stomach-related concerns.

This suggests that a successful healthcare intervention cannot be designed solely around the question:

“Where can healthcare services be provided?”

It must also ask:

“What prevents people from reaching healthcare in the first place?”

That distinction can change how a CSR programme identifies locations, schedules services, mobilises communities and measures impact.

Access is an outcome

The most important lesson from the Swaasth experience is that healthcare infrastructure and healthcare access are not necessarily the same thing.

A facility can exist without being practically accessible to the people who need it.

For CSR programmes working in healthcare, therefore, impact measurement should go beyond counting consultations, camps or medicines distributed. It should examine whether the intervention has reduced the barriers that prevented people from seeking care in the first place.

Because sometimes, improving healthcare does not begin by building another facility.

It begins by bringing care closer to the people.