**5. Conclusions**

Inadequate access to health services is one of the components of rural poverty which is prevalent in Nigeria. Inadequate access to health services determines, to a large extent, the decision of rural households to either patronize OM or TM. This study assessed the distribution of OM infrastructure in Ekiti State Nigeria, focusing attention on the ruralurban dichotomy. It further looked at the extent of patronage of TM and OM among farming households with special emphasis on the rural-urban dichotomy.

Result of the analyses indicates that inequality exists in the distribution of OM infrastructure in Ekiti State. There was a distinct rural-urban dichotomy in the provision of OM infrastructure in the state. This was caused largely by the concentration of private investment in OM infrastructure in the urban LGAs because of their profit motive. This emphasizes the need for the public sector to continue to moderate the distribution of OM infrastructure through its investment. In doing this, attention should be paid not only to the population of the LGAs but also to their land areas. In addition, the existence of private OM infrastructure in the respective LGAs should be considered in citing new public OM infrastructure.

The results from primary data analysis with respect to the urban LGA seem to establish an indirect nexus between poverty and utilization of TM. The fact that the use of TM increases with household size and age of household heads; two independent variables that are positively correlated with poverty in several studies, is an indication that as poverty increases in Nigeria, urban households have the tendency to revert to the use of TM. Similarly, for rural households, the use of TM increases with household size and the number of elderly people in the household. These two variables are also positively correlated with poverty, implying that increases in poverty among rural households will lead to increases in the use of TM. This is a justification for a welfare oriented health policy in Nigeria.

Given the tendency for the use of TM in Nigeria, steps that will improve the practice of TM, ensure sustainable use of TM resources and re-orientate farming households on how to properly and safely use TM, should be given important considerations in Nigeria's national health policy. Overall, the findings of the study clearly indicate the need for government in Nigeria to continue to play active role in the provision of health services in a sector that is increasingly being dominated by private entrepreneurs who are driven by the profit motive. In the current circumstances, farming households that are unable to access OM either because of the cost or distance to such facilities are being compelled to patronize TM; which is at the moment largely unregulated.
