Strategic measures for accessing effective healthcare delivery in rural Nigeria OnyemeAzuka 2021 Healthcare as a system has been and will always be a vital public provision to support human existence. The onus rests with every nation’s healthcare system to provide health services; and individuals to consciously embrace healthy living. The health status of people in rural areas is generally not as good as those in urban areas, especially in middle and low-income countries. Research within the last decade shows significant barriers such as geographical location (terrain and transportation concerns); local health issues and availability of healthcare facilities are common concerns that affect effective delivery practices in rural settings. These barriers have affected the actualisation of a healthy environment and have regrettably led to high mortality rate from preventable and or curable causes. Consequently, in this study, findings were generated from literatures and field study and divulge that health polices, infrastructures and health service schemes are available in Bayelsa State (focus region of study), created to improve health status of the people especially those situated in the remote and riverine communities but economic, topographical and social challenges which are still prevalent have dawdled progress in attaining this goal. In response to these challenges, the study investigates and proposes strategic measures to improve the delivery practices hence, making healthcare services available and accessible to the rural poor. Therefore, the study is aimed at developing a framework for effective healthcare delivery to meet current challenges, especially where access issues are prevalent for various demographic and geographic rural settings. Review of several literatures, survey of 1637 completed questionnaire carried out between August 2016 and July 2017 within seven selected states in the Niger Delta region of Nigeria and, 13 semi - structured interviews conducted across respondents from the public and health sector within Bayelsa State, Nigeria which is the focus state for the study formed source data for evaluation. The mixed method approach was employed to evaluate existing healthcare strategies, assessment of the rural and health needs in different settings and, the required improvements to the healthcare policies. A framework which serves as strategic approach is developed and proposed for the desired improvement in the healthcare system in these rural settings following results from analysed data sets that established health and rural needs, government neglect and, accessibility issues (terrain and transportation) as the significant factors of concern.