Urban-Rural Disparities in Primary Healthcare Service Delivery and Implications for Sustainable Development Goal 3 in Southern Nigeria

Rationale: Urban–rural inequities in primary healthcare (PHC) service delivery remain a major barrier to achieving Sustainable Development Goal 3 (SDG 3) in low- and middle-income countries. In Nigeria, limited empirical evidence exists on how structural capacity, governance, and utilisation pathways jointly shape these disparities at the frontline health system level, particularly in underserved riverine states such as Bayelsa. Objectives: This study assessed urban–rural disparities in PHC service delivery in Bayelsa State, southern Nigeria, with a focus on service readiness, governance and performance management, utilisation pathways, and prospects for strengthening PHC systems to advance SDG 3. Methods: A cross-sectional facility-based assessment was conducted across 34 government-owned PHC facilities (17 rural and 17 urban). Standardised indicators were used to evaluate human resources, infrastructure and utilities, equipment readiness, infection prevention and control, medicine availability, health information systems, governance practices, and service utilisation pathways. Urban–rural differences were analysed using chi-square or Fisher’s exact tests, with statistical significance set at p