HEALTH INFRASTRUCTURE AND HEALTHCARE UTILIZATION IN NIGERIA

Abstract

Health infrastructure remains a critical determinant of healthcare utilization in sub-Saharan Africa, yet Nigeria continues to face significant infrastructural deficiencies that limit access to quality healthcare services. This study investigates the effect of health infrastructure on healthcare utilization in Nigeria, focusing on facility availability, health workforce density, and adequacy of medical equipment. A mixed-methods approach was adopted using secondary data from the Nigeria Demographic and Health Survey (NDHS 2018), National Health Management Information System (NHMIS), and World Health Organization (WHO) databases, analyzed through descriptive statistics, multiple regression, binary logistic regression, and GIS mapping across the six geopolitical zones. The findings reveal that number of health facilities per population, skilled health worker density, and availability of diagnostic equipment significantly and positively influence healthcare utilization. Regional disparities were evident, with the South-West recording the highest utilization due to better infrastructure, while the North-East and North-West exhibited the lowest levels, reflecting severe infrastructural gaps. Proximity to healthcare facilities and adequate drug supply significantly enhanced the likelihood of healthcare use. The logistic regression model demonstrated that the presence of skilled health workers tripled the odds of facility-based delivery (OR = 3.12, 95% CI: 2.46–3.95), while adequate infrastructure perception nearly tripled them (OR = 2.87). The study concludes that strengthening health infrastructure is essential for improving healthcare utilization and reducing regional inequalities in Nigeria.