Spatial Distribution of Healthcare Facilities and Accessibility Gaps in Sokoto State

Access to healthcare remains profoundly unequal across Nigeria's vast geographic landscape, with rural populations in the North West geopolitical zone particularly disadvantaged by distance, poor road networks, and sparse facility distribution. This study analyses the spatial distribution of primary healthcare centres, secondary hospitals, and tertiary facilities in Sokoto State, examining accessibility gaps using GIS-based network analysis and proximity modelling. Data on 312 registered health facilities were obtained from the Sokoto State Primary Healthcare Development Agency and georeferenced using GPS coordinates collected during field surveys conducted in 2023. A two-kilometre buffer analysis and travel time modelling using OpenStreetMap road networks were applied to delineate service catchment areas and identify underserved populations. Results indicate that 41 percent of Sokoto State's rural population resides beyond a five-kilometre radius from the nearest functional primary healthcare centre, with the highest service gaps concentrated in Gada, Tangaza, and Sabon Birni local government areas. The study identifies strong spatial correlations between healthcare inaccessibility, poverty incidence, and maternal mortality indicators from Sokoto State Health Management Information System records. Recommendations include priority siting of new facilities using spatial optimisation algorithms and improvement of feeder road infrastructure to reduce effective travel time to existing facilities. This research provides a spatial evidence base for Sokoto State's primary healthcare expansion strategy under the National Health Act implementation framework. Keywords: healthcare accessibility, spatial analysis, GIS, Sokoto State, North West Nigeria.