The aim of this paper is to evaluate the relative influence of neighbourhood and individual practices of care utilization in Dakar (Senegal). The data from a research program on urban malaria, made in Dakar, Senegal between 2008 and 2009. The sample was based on a two-stage sampling. A questionnaire survey covered 2952 households, of which we have selected those that have at least one case of fever (n = 1272) with one of their children under ten years two weeks before the passage of investigators. The analytical model of the use of health services developed by R. Andersen has been adapted for our conceptual framework. Our results showed's like many West African cities, self-medication is a common practice among all households in Dakar, espe...