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Over the last 40 years, the Sahel has seen a long-term downward trend in rainfall. The importance of ecological variables as factors affecting child survival in rural subsistence societies has already been emphasized, but little empirical evidence has been gathered to support this. This paper presents a comparative event history analysis aimed at understanding how rainfall variations may influence child mortality in two neighbouring countries, Burkina Faso and Mali. These countries are similar in terms of population dynamics, economy, livelihood, child mortality and rainfall conditions (i.e. strong south-north decreasing rainfall gradient). Individual data for both countries came from two detailed nationally representative retrospective surveys conducted in 2000. Rainfall data for the 1960-1998 time period were obtained from the Climatic Research Unit. This study shows that child survival in each country is related to specific patterns of rainfall variation across livelihood regions, highlighting the complex nature of environmental causality of child mortality.