Proximity to healthcare clinic and depression risk in South Africa: geospatial evidence from a nationally representative longitudinal study

Abstract

Proximity to primary healthcare facilities may be a serious barrier to accessing mental health services in resource-limited settings. In this study, we examined whether the distance to the primary healthcare clinic (PHCC) was associated with risk of depression in KwaZulu-Natal (KZN) Province, South Africa. Depressive symptoms and household coordinates data were accessed from the nationally representative South African National Income Dynamics Study (SA-NIDS). Distances between households and their nearest PHCCs were calculated and mixed-effects logistic regression models fitted to the data. Participants residing <6 kms from a PHCC (aOR=0.608, 95% CI:0.42–0.87) or 6–14.9 kms (aOR=0. 612, 95% CI:0.44–0.86) had a lower depression risk compared to those residing ≥15 kms from the nearest PHCC. Distance to the PHCC was independently associated with increased depression risk, even after controlling for key socioeconomic determinants. Minimizing the distance to PHCC through mobile health clinics and technology could improve mental health.

Prevalence of depressive symptoms and associated factors among adolescents living with HIV/AIDS in South Western Uganda

“…Furthermore, longer transportation time to a clinic was associated with higher prevalence of depressive symptoms in this population. Similar findings have been reported in the general adult population of SSA, with one study showing that individuals living less than 6 km from a clinic had significantly lower rates of depression than those living 15 km or more from a clinic (Tomita et al, 2017). This could be related to the increased burden of attending clinical visits with long travel times.…”

Determining factors for the prevalence of depressive symptoms among postpartum mothers in lowland region in southern Nepal

“…In the current study, PPD was likely to be higher among mothers who live at more than one-hour walking distance from the nearest health facility. This result is supported by the findings from the studies conducted in South Africa and Canada where depressive symptoms among participants were positively associated with increasing distance to reach the nearest health facility [ 57 , 58 ]. This might be due to the reason that people whose residence is at a far distance from healthy facility lives in greater isolation and have difficulty in reaching health facility for receiving the health services.…”

Depression among female heads-of-household in rural Mozambique: A cross-sectional population-based survey

“…Finally, mental health services in Mozambique are becoming more accessible due to the Ministry of Health’s focus on training and employing psychologists and Psychiatric Technicians (dos Santos et al, 2016). As found in South Africa, the expansion of services may be partially responsible for lower depression rates among people living in close proximity to health facilities, although few provisions are available in rural areas (Tomita et al, 2017). Continued expansion of services should improve well-being.…”