The mobility imperative: Integrating transport into inclusive and resilient health systems

Abstract

Transport remains a neglected yet critical component of health systems. While research on health system strengthening has expanded to include social care and social determinants of health, mobility is often treated as peripheral rather than central to equitable access and service delivery. This commentary reframes mobility as a structural determinant of health. Drawing on global evidence, with examples from Africa, South Asia, Latin America, and high-income contexts such as in Europe, we demonstrate how inadequate or unaffordable transport constrains both patients and frontline care workers, reinforcing inequities across diverse settings. We also highlight how community-driven innovations, such as bicycles, ambulances, and digital accessibility apps, provide resilience in the absence of formal provision. By reframing transport as a determinant of health and a structural enabler of inclusion, this commentary calls for interdisciplinary policy, practice, and research that integrates mobility into health system design and delivery.