BRIDGING THE GAP BETWEEN HEALTHCARE ACCESS AND UTILISATION IN SOKOTO STATE
By Sani Umar
Across Nigeria, one of the most persistent challenges in maternal and child health is not only the availability of services but their utilisation. Over the years, governments and development partners have invested heavily in building health facilities, training personnel, and supplying essential medicines. Yet, a critical gap remains, many women, particularly in rural communities, still do not take full advantage of these services, especially when it comes to delivering in health facilities under skilled supervision.
Sokoto State reflects this national reality in a pronounced way. While progress has been made in expanding primary healthcare infrastructure and increasing antenatal care attendance, a significant proportion of expectant mothers continue to give birth outside formal health settings.
This disconnect between access and utilisation has continued to fuel preventable maternal and infant deaths, making it clear that addressing infrastructure alone is not enough, there must also be deliberate efforts to influence behaviour, build trust, and strengthen community engagement.
The recent distribution of sexual and reproductive health commodities, equipment, and essential medicines to selected health facilities across the state by the First Lady, Hajiya Fatima Aliyu, offers a timely intervention aimed at closing this gap.
By equipping high-burden primary healthcare centres with critical supplies, the initiative seeks to improve service readiness and ensure that women who choose to seek care are met with quality and reliable services. It also reinforces the message that healthcare facilities are safe, prepared, and capable of handling maternal and child health needs.
Driving the initiative, the Wife of the Governor, Hajiya Fatima Ahmed Aliyu, framed the effort as a practical step toward restoring confidence in the healthcare system. Her emphasis on protecting women and children, particularly in underserved communities, reflects a growing recognition that improving outcomes requires both compassion and sustained advocacy. By engaging directly with stakeholders and frontline workers, she highlighted the importance of not just delivering resources, but ensuring they are used effectively and reach those who need them most.
Her call for accountability and vigilance against the misuse of medical supplies further reinforces the idea that trust in the system is built through transparency. At the same time, her appeal to traditional leaders, community influencers, and security agencies underscores the role of society at large in encouraging women to seek proper care and in safeguarding the integrity of public health interventions.
From a systems standpoint, the Commissioner for Health, Dr Faruku Umar Abubakar, brought attention to the underlying dynamics shaping healthcare outcomes in the state. While acknowledging the progress made in infrastructure and service provision, he pointed to utilisation as the critical missing link.
The reality that only a fraction of women who attend antenatal care proceed to deliver in health facilities highlights deep rooted challenges, including cultural preferences, accessibility concerns, and perceptions about quality of care.
Addressing these issues, he noted, requires a combination of improved service delivery and sustained public enlightenment. By leveraging structured frameworks such as the Basic Healthcare Provision Fund, the state is working to standardise operations, enhance efficiency, and ensure that primary healthcare centres function optimally. These efforts are designed not only to expand access but to make services more responsive and trustworthy.
Providing further insight, the Special Adviser on Primary Healthcare, Dr Bello Marnona, emphasised the importance of aligning infrastructure, workforce, and supply chains to achieve meaningful impact. With an extensive network of healthcare facilities and a growing number of trained personnel, the state is positioning itself to deliver comprehensive services across both urban and rural areas. The deployment of nurses and midwives to underserved communities, in particular, is expected to bring care closer to the people and reduce barriers to access.
However, he stressed that true progress lies in ensuring that these resources translate into improved health seeking behaviour. The distribution of medicines and equipment, therefore, is not an end in itself but part of a broader strategy to rebuild confidence in the healthcare system and encourage greater utilisation of available services.
Ultimately, the emerging focus in Sokoto State is not just on expanding healthcare infrastructure but on making it work for the people. Bridging the gap between access and utilisation requires a balanced approach, one that combines investment in facilities and personnel with sustained community engagement, accountability, and behavioural change initiatives.
As these efforts continue to unfold, their success will depend largely on sustained commitment, effective implementation, and the active participation of communities in embracing safer health practices.
If effectively implemented, these efforts could mark a turning point in reducing maternal and child mortality and in building a healthcare system that truly serves all.
