Application of Spatial Statistical Methods to Analyse Distribution of Healthcare Facilities in Kano State

Spatial statistical analysis of healthcare facility distribution provides evidence on geographic access equity and facility clustering that is essential for rationalising facility placement and investment decisions by the Kano State Ministry of Health and development partners. This study applies spatial statistical methods to analyse the distribution and spatial accessibility of primary, secondary, and tertiary healthcare facilities in Kano State, North West Nigeria. Facility coordinate data from the Health Facility Registry and LGA population data from the 2023 NBS estimates were used. Kernel density estimation mapped facility distribution intensity. Average nearest neighbour analysis tested for clustering or dispersion. Two-step floating catchment area analysis measured population-to-facility accessibility ratios, and Local Moran's I identified spatial clusters of high and low accessibility. Kernel density estimation revealed strong concentration of all facility types in Kano Metropolitan Area with sparse coverage in Dawakin Kudu, Karaye, and Doguwa LGAs. Average nearest neighbour analysis confirmed significant clustering (z = -8.2, p < 0.001). Population-to-primary-facility ratios ranged from 3,200 in urban LGAs to 42,000 in remote rural LGAs. Local Moran's I identified a statistically significant low-accessibility cold spot cluster in seven southern Kano LGAs (p < 0.05). The study provides a statistically grounded spatial equity assessment for Kano State health system planning and recommends prioritising new facility construction in the identified low-accessibility cluster zone. Keywords: spatial statistics, healthcare facility distribution, Kano State, kernel density, two-step floating catchment area