Intra-household differentials in women's status: household function and focus as determinants of children's illness management and care in rural Mali.

In West Africa, health-seeking behaviour can be better understood by assessing how women differ from each other, rather than how they differ from men, in terms of their socioeconomic and political power within the domestic environment. Anthropological and demographic data were collected among rural Malian Fulani and Dogon populations who possess similar health beliefs and who live in the same ecological area. However, real differences between the two ethnic groups were reflected in variations in maternal status defined according to women's support and/or autonomy in their households. When a child becomes sick, status obligations result in limited degrees of co-operation between marital female relatives. By contrast, on a day-to-day basis such assistance is rarely forthcoming and women rely on their own unmarried daughters or on external kin networks for surrogate child care. It is concluded that variations in health behaviour and mortality outcomes within these populations reflect not simply 'ethnic' differences in beliefs or culture, but rather real differences in mothers' social positions within their family environments and in their access to household resources for children's treatment and care.