Primary Health Care (PHC) is the cornerstone of equitable health systems, yet access remains uneven in Nigeria due to both structural and socio-economic constraints. This study assessed determinants of PHC accessibility in Taraba State, a region characterized by diverse geography and socio-economic conditions. Using a cross-sectional design, data were collected from eight Local Government Areas (LGAs) through household surveys, key informant interviews, and facility records, complemented by GIS mapping. Findings revealed marked disparities in utilization: while facilities such as Zing and Yorro achieved high outpatient attendance and full catchment coverage, others like Bali and Sardauna recorded low utilization despite wide coverage, underscoring the role of socio-economic barriers. Structural challenges, including poor roads, difficult terrain, long distances, and inadequate transport, were found to be systemic, affecting populations broadly across socio-demographics. Socio-economic determinants such as income, education, and occupation further influenced health-seeking behavior, with affordability and opportunity costs suppressing utilization even where facilities were physically accessible. The study concludes that PHC inequities in Taraba are multidimensional, shaped by the interaction of geographic constraints and socio-economic realities. It recommends expanding PHC services, improving rural transport, addressing affordability barriers, and strengthening community engagement to ensure equitable access and progress toward universal health coverage.
