Mapping Maternal Health Service Deserts in Rural Zones of Zamfara and Kebbi States Using Geographic Information Systems

Maternal health service deserts, defined as geographic areas lacking accessible quality obstetric care, are a structural determinant of maternal mortality in rural northern Nigeria, yet their systematic spatial mapping in Zamfara and Kebbi States has not been conducted. This study maps maternal health service deserts in rural communities of Zamfara and Kebbi States using geographic information systems (GIS) analysis. Facility mapping identified all public sector primary and secondary maternity facilities in both states. Catchment area analysis using two-step floating catchment area methodology calculated spatial accessibility scores for all community clusters, incorporating road network distance, travel time, and facility skilled birth attendant density. Population data from the 2023 National Population Commission estimates were integrated. GIS mapping revealed that 41 percent of the rural population in Zamfara and 35 percent in Kebbi lived more than one hour's travel time from the nearest basic emergency obstetric care facility. Spatial accessibility scores correlated inversely with state-level maternal mortality estimates at LGA level. LGAs in the north of Zamfara and along the Niger border in Kebbi were identified as the deepest service desert zones. The study provides the first GIS-based maternal health service desert atlas for the two states and recommends it as a planning tool for facility placement, community midwife deployment, and transport voucher scheme targeting by the state ministries of health. Keywords: maternal health service desert, GIS mapping, Zamfara State, Kebbi State, spatial accessibility