This study examines high incidence of under-five mortality among agro-pastoralists resulting from lack of access to healthcare facilities. A proportional sampling method was adopted, and descriptive statistics and binary logistic regression were used in data analysis. The results revealed low dependence of agro-pastoralists on formal healthcare facilities, which could be explained by prevalence of informal healthcare facilities in villages where they reside. Education, income, accessibility,

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... duration of stay in a particular area accounted for the choice of healthcare facilities. Level of education and income determined preference for formal health facilities, possibly due to influence of education on understanding benefits of treatment in formal health facilities and income to meet associated costs. Accessibility of health facility influenced the decision to patronize formal health facilities. This was evident in villages which were connected to reliable road networks. Additionally, the length of time one resides in a particular area played a role in adhering to traditional values influencing the choice of informal healthcare facilities. The government and private sector should invest in rural road networks and promote education among agro-pastoralists on importance of using formal healthcare facilities and rational use of household income to improve accessibility to formal health facilities.