The relative failures of equity-promoting health policies in Africa are often attributed to shortcomings of content or implementation modalities, thereby sidestepping any in-depth understanding of the actors’ roles in this process. Yet any analysis of such failures cannot afford to neglect the social actors’ behaviour logic. Therefore, to this end, we conducted a study in a health district of Burkina Faso using a socio-anthropological field survey. This article empirically documents the recurrence of specific logics that provide a better understanding of these relative failures. The logics uncovered were: monopolizing, neutralization/domination, discourse construction, clientelism, opacity, connivance, avoidance, suspicion, substitution and disdain for public service. The study emphasizes the need, when analyzing the interpretation and implementation of health reforms by social actors, to take into account the concept of power.