Transport Accessibility and Its Influence on Healthcare Utilisation in Rural Borno State

Transport accessibility is a fundamental determinant of healthcare utilisation in rural settings, where physical distance and inadequate mobility services can render health facilities effectively inaccessible. This study investigates the relationship between transport accessibility and healthcare utilisation among rural communities in Borno State, North East Nigeria, a region where both transport infrastructure and health systems have been severely disrupted by prolonged conflict. A cross-sectional survey design is employed with stratified sampling across six local government areas at varying distances from Maiduguri, collecting data from 420 households. The study constructs a transport accessibility index incorporating distance to the nearest road, road quality, cost of transport, and available transport modes. Healthcare utilisation is measured by rates of facility-based antenatal care, child immunisation, and outpatient consultation. Multiple regression analysis finds that transport accessibility is a significant predictor of all three utilisation indicators, with each unit improvement in the transport accessibility index associated with a 12 percent increase in facility-based antenatal care uptake. Community respondents in areas with seasonal road impassability record immunisation rates 34 percentage points lower than those in connected communities. The study addresses a critical empirical gap in the transport-health nexus literature for conflict-affected Northern Nigerian settings. Recommendations include prioritised road rehabilitation targeting health facility access corridors and mobile health outreach paired with transport support for underserved communities. Keywords: transport accessibility, healthcare utilisation, rural health, Borno State, mobility.