Abstract It is suggested that environmental or geographical factors (e.g. population density, climate and disease environment) play an important role in determining infant and child survival above and beyond that played by individual and household level factors. Only recently, however, have relevant spatial data become available and have demographic survey data systematically recorded geographical location of surveyed households, or has the technology to integrate these data become accessible. This study estimates the risk of infant and child death in ten West African countries attributable to individual, household and spatially explicit geographical factors; 120,000 births occurring in the 10 years prior to the 1997–2001 Demographic and Health Survey dates are evaluated. Results from a generalised linear model show that spatial variables explain away a good deal of the country‐specific variation in mortality, and that they are associated with (and may be mediated by) the household characteristics. Implications for research and policy are addressed. Copyright © 2004 John Wiley & Sons, Ltd.