Investigation of Disparities in Access to Surgical Care Between Urban and Rural Populations in Nasarawa State, North Central Nigeria

Surgical care access disparities between urban and rural populations represent a critical equity challenge in Nigerian healthcare, and their magnitude and determinants in North Central states like Nasarawa have not been empirically investigated. This study examines the disparities in access to and utilisation of surgical care between urban and rural populations in Nasarawa State. A cross-sectional population-based survey design is applied to 600 households (300 urban, 300 rural) selected through stratified multistage cluster sampling from six local government areas. Variables include household income, distance to nearest surgical facility, previous need for surgical care, actual utilisation, financial barriers, and health literacy. Among households reporting an unmet surgical need, the reasons for non-utilisation and estimated cost of surgical procedures foregone are documented. Logistic regression in SPSS examines predictors of surgical care utilisation adjusted for need. Available surgical access literature from North Central Nigeria identifies travel distance exceeding 50 kilometres and out-of-pocket surgical cost exceeding the household monthly income as the two dominant structural barriers to rural surgical access. The Lancet Commission on Global Surgery 2030 Goals and Bellwether surgical access indicators provide the analytical benchmark framework. Findings will inform Nasarawa State's health planning directorate on evidence-based surgical facility siting and financial protection policy. Keywords: surgical access, rural-urban disparities, North Central Nigeria, Nasarawa State, Lancet Commission.