Healthcare Workforce Distribution and Primary Health Service Equity in Adamawa State, North East Nigeria

This study examines the distribution of healthcare workers and its implications for equitable primary health service delivery in Adamawa State, North East Nigeria. Skewed distribution of health professionals, with an overwhelming concentration in urban and semi-urban centres, constitutes one of the most persistent structural barriers to achieving universal health coverage in Nigeria. Drawing on health equity theory and current health workforce policy literature from 2020 to 2024, the study adopts a descriptive survey design. A sample of 230 respondents including primary health centre staff, community health extension workers, state health service commission officials, and rural household members is drawn from five local government areas using stratified sampling. Structured questionnaires and semi-structured interviews are used, with data analysed via descriptive statistics and equity analysis. The study expects to find significant disparities in doctor-to-population and nurse-to-population ratios between urban and rural local government areas in Adamawa, correlating with poorer maternal and child health outcomes in underserved zones. Incentive structures, rural posting policies, and the distribution of clinical infrastructure are also critically examined. Findings will generate evidence-based policy recommendations for rural health worker incentive packages, community health extension worker expansion, and telemedicine deployment to address health workforce inequity in the North East zone of Nigeria. Keywords: healthcare workforce, primary health, service equity, Adamawa State, health systems