Abstract
This study is about the distribution of health care facilities in Kogi State within the context of the geography and politics of the state. Hence, the study analyses the spatial patterns of health care facilities among the three senatorial districts (which corresponds to the division along major ethnic lines) in the state. Also, the ownership structure of facilities and the relationship between population and distribution of health care facilities in the state are analysed. The list of health care facilities and ownership in Nigeria obtained from the Department of Health Planning and Research, Federal Ministry of Health served as database for the analysis of the spatial patterns of distribution and ownership of health care facilities in Kogi State. Also, the National Population Commission's census figures provided information on the population of the State. Kogi State was stratified into the three existing senatorial districts - Kogi Central, Kogi East, and Kogi West. The total number of health care facilities and their ownership in each stratum were determined and used for the analyses. Data show that there exist inequalities in the distribution of HCFs among the various senatorial districts in the state. Kogi east senatorial district recorded the highest concentration of HCFs having 66.3% of all HCFs in the state, followed by Kogi west (19.6%) and Kogi central (14.1%). It is observed that the facility-population ratios for both PHC and SHC (1:2575 and 1:29024 respectively) are high. These proportions vary among the various senatorial districts; for example PHC-population ratios were 1:6850, 1:2746 and 1:1689 for Kogi central, west and east respectively; the ratios for SHC were 1:41,859, 1:27804 and 1:23736 for Kogi central, west and east respectively. Although, the government dominates the ownership of health care facilities in the state, her impact is heaviest in Kogi east where she owns 93% of HCFs as opposed to 70% in Kogi central where the impact is least. Kogi east which has produced the civilian Chief Executives of the state since its creation in 1991 ranks far ahead of the two other districts in the distribution of HCFs. Appropriate authorities should endeavour to achieve a more equitable distribution of health care facilities in the state, so as to engender equity and social justice.
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