In the dense literature on health-seeking behaviour in the African rural environment, contextual aspects, and, more especially, differences between villages, are rarely studied. This article therefore considers the village or group of villages as an aggregate level of analysis, based on a study conducted in the Fatick region in Senegal. The descriptive results show significant variations in therapeutic practices, disease management and health care planning strategies from one village to the next. At different levels, individual health-seeking behaviours appear to be conditioned by a set of collective norms developed by the village community. The spatial analysis shows that these variations in behaviour describe two distinct geographic sets, distinguished by different levels of access to health facilities and different historical, social and cultural characteristics. These results challenge the validity of a unified approach to the African rural environment and call for further research to analyse the impact of numerous contextual, quantitative and qualitative factors on health-seeking behaviour.