Geospatial Inequities in Access to Public Primary Healthcare Centers: Socioeconomic Vulnerability and Policy Drivers in Kaduna State, Nigeria
DOI:
https://doi.org/10.47514/kjg.2025.07.01.018Keywords:
Geographic Information Systems (GIS); Healthcare Policy; Income; Sustainable Development Goals (SDGs); Universal Health Coverage (UHC); Ward Health System (WHS).Abstract
This study evaluates the spatial justice of Public Primary Healthcare Centres (PPHCs) distribution across Kaduna State’s 255 electoral wards, critiquing the rigid "one PPHC per ward" mandate. Using a mixed-methods approach, Geographic Information Systems (GIS) mapping was integrated with a household survey (N=400). Results reveal a systemic mismatch: while 100% of wards have a facility, only 42% meet national population-to-facility standards. Severe overcrowding exists in the North (72.41%) and Central (83.95%) zones, with ratios exceeding 1:40,000. ANOVA results (F=18.42, p < 0.001) confirm significant zonal disparities in access quality. Furthermore, Pearson Correlation identified a "Proximity-Poverty Paradox," where household income (r = 0.64) and transport costs (r = -0.58) are stronger predictors of access than distance among the 87.96% living in poverty. The study concludes that current administrative allocation prioritizes territorial equality over equity of outcome. Policy must transition toward GIS-guided Maximum Coverage Location Models (MCLM) and aggressive expansion of the Kaduna State Contributory Health Management Authority (KADCHMA) to decouple healthcare access from income and achieve Universal Health Coverage.
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