Assessing spatial accessibility to health services in rural nepal: a GIS-based study of Rohini Rural Municipality

Abstract Geographic and transport barriers continue to limit timely healthcare access in rural areas. This study analyses healthcare accessibility in the Rohini Rural Municipality of Nepal, employing GIS-based network modelling to quantify travel-time disparities across walking, cycling, and motorized transport modes. The analysis integrated spatial data, including road networks classified by surface type, geolocated health facilities, and population distribution from census data and satellite imagery. The study reveals distinct inequalities: while 41,668 residents (99%) can reach health facilities within 15 min by vehicle, only 3,707 people (9%) enjoy similar access when walking. Bicycle access shows moderate improvement, with 23,159 residents (55%) within the 15-minute reach. The most severe gaps occur in peripheral areas, where 28,180 people (67%) face walking times of 30–90 min to the nearest facility. Motorized transport covers 95% of the municipality’s area within 15 min, compared to only 6% for walking. The findings reveal how transportation poverty exacerbates healthcare inequities. While motorized and bicycle access serve approximately half the population relatively well, the poorest residents, those most vulnerable to health crises, face the greatest physical barriers to care. The study advocates for targeted placement of new health posts in identified underserved areas and community-based transport solutions to address mobility constraints.