An Examination of the Effect of Increase in Transportation Cost on Access to Healthcare in Ijebu North Local Government Area

Abstract Access to healthcare is a critical component of healthcare systems, yet transportation costs can create a significant barrier, particularly in rural or resource-constrained areas like Nigeria which previous studies have not covered. Thus, this study investigates the impact of transportation costs on access to healthcare in Ijebu North Local Government Area, Nigeria, with a focus on identifying the factors that influence healthcare access and informing policy interventions to improve health outcomes. This study drew on several theoretical frameworks to explore the impact of transportation costs on access to healthcare: Accessibility theory, Central Place Theory (CPT), Anderson framework, demand and supply concept, Location and allocation, Shortest route and closest facility methods, and Spatial interaction model. Accordingly, the research employed a mixed-methods approach, combining primary and secondary data, with a stratified random sampling technique selecting 100 respondents who completed a well-structured questionnaire and secondary data for the network analysis include locations of PHCs, Settlements and road network. Data analysis utilized descriptive and inferential statistical tools in SPSS, including Student t-test, Chi-square analysis, Binary logistics, and Multiple regression analysis, to examine the impact of transportation costs on access to healthcare. The study's findings revealed significant socio-economic disparities among respondents, the analysis shows that 60% of female respondents and 54% of married individuals face challenges in accessing health facilities due to transportation costs. Furthermore, 55% of respondents with tertiary education and 42% of self-employed individuals also experienced difficulties in accessing healthcare services. Statistical analysis chi square showed that there is no Significant relationship between the transportation cost as a barrier to access health facility and the annual income of the respondents (t⁹⁸ = 8.13) at 5% level of significance. Chi square showed there is no significant relationship between encountered delayed medical care due to increased transportation cost and the annual income (t⁹⁸ = 0.308) at 5% level of significance. Student t test showed that there is no significant difference in the frequency of visit to health facilities before and after increase in transportation cost among the residents in Ijebu North. (t⁹⁸ = 0.000) at 5% level of significance. Multiple regression analysis was used to test the hypothesis that the gender, age, marital status of the residents is not a determinant of the frequency of visit to health facility after increased transportation cost. Additionally, Geographic Information Systems (GIS) analysis demonstrated the potential for finding nearest health facilities and the shortest routes to a particular health facility, thereby reducing transportation costs and enhancing healthcare access. The findings highlight the need for targeted interventions to address the socio-economic disparities and transportation-related barriers to healthcare access in Ijebu North Local Government Area. Finally, the study recommends developing transportation infrastructure to reduce travel time and costs, enhancing access to healthcare services for vulnerable populations, engaging with local communities to raise awareness, considering health facility location, and fostering collaborations among healthcare providers, transportation services, and local government agencies to address transportation barriers and improve healthcare access.