Public health discourse surrounding women in Africa has yet to benefit from longstanding, rigorous problematizations and theorizations of gender in African settings. In a word, the African woman, from the public health perspective, is still primarily a ‘wife’. Yet, targeting women solely as wives obscures the other important and varied positions which women in Africa occupy and limits the opportunities available for addressing their myriad health issues. We draw on data emerging from our years of ethnographic work among the Ubang community in Obudu, Cross River State, Southeast Nigeria, examining indigenous/local gender constructions and the attendant implications for women’s decision-making and action related to illness. We conclude by advancing a new public health approach to women in African contexts, and by demonstrating that in engaging with women exclusively as wives, public health interventions have unwittingly overlooked other critical entry points for improving the health status of women in Africa.