The paper addresses problems of geographical accessibility of health care in rural areas of Nigeria. It provides analyses of the location, distribution and accessibility of government-provided health care facilities to people and presents a framework for measuring improvements in accessibility and for assessing the efficiency of decisions about location of new facilities. It shows that while accessibility in the study area improved between 1979 and 1982 through the establishment of more dispensaries and maternity and child-welfare centres, the relative efficiency of locations has remained low. It identifies alternate locations for the new facilities introduced in the 1979-1982 period that could have increased the utilization of maternal and child health centres by an estimated 12% and the utilization of dispensaries by 16%.