Assessment of the Distribution and Accessibility of Primary Health Care Facilities Using GIS-Based Health Mapping in Taraba State, Nigeria

Abstract

Anger, R.T., Emeka Daniel Oruonye, Ibrahim Abdullahi, Yusuf, M.B and Linda Sylvanus Bako

Equitable access to Primary Health Care (PHC) is fundamental to achieving Universal Health Coverage, yet significant spatial inequities persist in regions characterised by difficult terrain and dispersed populations. Taraba State, Nigeria, exemplifies these challenges, with mountainous topography, poor road networks, and uneven facility distribution limiting physical access to essential services. This study assesses the spatial distribution and accessibility of PHC facilities across eight Local Government Areas (LGAs) in Taraba State, integrating Geographic Information System (GIS) modelling with Electronic Immunization Register (EIR) data. A mixed-methods design combined quantitative spatial analysis with facility and community surveys.

Eight high-patronage PHC facilities were purposively selected across Ardo-Kola, Bali, Gassol, Jalingo, Kurmi, Sardauna, Yorro, and Zing LGAs. GIS-based buffer analysis (0–3 km, 3–5 km, 5–10 km) and network analysis (15, 30, and 45-minute isochrones) were used to delineate catchment areas and measure physical accessibility against WHO thresholds. Kernel density estimation mapped immunization coverage, while EIR data validated theoretical access against actual service uptake. Statistical analyses included one-way ANOVA, correlation tests, and one-sample t-tests. Approximately 65% of the sampled population resided beyond the WHO-recommended 3 km radius of a PHC facility. The mean catchment population per facility was 11,352, exceeding the national benchmark of 10,000, with Turaki-A PHCC (20,956) and Gassol PHC (18,364) serving nearly twice the recommended standard (t = 1.42, p = 0.098).

Village coverage ranged from 35.2% (Gassol) to 100% (Zing-Z, Baissa, and Kofi). One-way ANOVA confirmed significant disparities in spatial distribution across LGAs (F = 3.42, p = 0.001). EIR validation demonstrated high completeness (94.2%) and accuracy (91.7%), revealing that communities within 3–5 km of a facility still exhibited low immunization rates due to stockouts and follow-up failures. The correlation between facility altitude and immunization uptake was not significant (r = 0.008, p > 0.05), indicating that terrain impedance, rather than elevation alone, is the more relevant barrier.

PHC facilities in Taraba State are unevenly distributed, with mountainous and dispersed rural LGAs experiencing the most severe service gaps. The integration of GIS and EIR proved effective in quantifying accessibility inequities and identifying priority communities. The study recommends targeted facility construction in underserved wards, rural road upgrades, expansion of digital health monitoring, and financial protection mechanisms to advance health equity.

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