Maternal Risks Associated with Limited Access to Emergency Obstetric Care in Albasu Local Government Area, Kano State: A Binary Logistic Regression Analysis

Limited access to emergency obstetric care (EmOC) is a major contributor to maternal illness and death in rural areas of northern Nigeria. This study examined how geographic access to EmOC affects maternal complications among women in the ten wards of Albasu Local Government Area, Kano State, covering hospital use, complication and delay rates, and community priorities for improving maternal healthcare. A cross-sectional survey of 650 women aged 15–49 was conducted using multistage cluster sampling, with 65 respondents per ward; data were analyzed using descriptive statistics, chi-square tests, and binary logistic regression. Overall, 44.9% of respondents experienced obstetric complications, while 47.4% reported delays in accessing emergency care. The average distance to the most frequently used referral hospital was 43.4 km, with Sumaila General Hospital accounting for 50% of hospital utilization. Distance to hospital (OR = 1.048 per km), transport delay (OR = 2.252, 95% CI: 1.614–3.145), and lack of Caesarean section (CS) services (OR = 1.999) were the strongest independent predictors of maternal complications (all p < 0.01). Most respondents (91.4%) identified the establishment of CS-capable hospitals within the LGA as the highest priority intervention. Limited geographic access to EmOC substantially increases maternal risk in Albasu LGA; improving outcomes will require establishing at least three comprehensive EmOC facilities within the LGA, strengthening emergency referral and ambulance services, and expanding skilled maternity care, providing evidence to support policy decisions and resource allocation aimed at reducing preventable maternal complications and deaths in rural Kano State.