Financial barriers to emergency obstetric care are one of the causes of a high
maternal mortality ratio in low-income countries, particularly in Mauritania.
Risk sharing through the introduction of obstetric risk insurance provides all
women with care throughout their pregnancies for a flat-rate ticket of 22
US$, i.e. between two and ten times less than in other public sector
maternity wards. Pregnancy-related complications and surgical procedures
are included in the package. Besides facilitating access, this strategy aims to
improve the quality of emergency obstetric care and ensure better working
conditions for health staff.
After five years of implementation in the capital and over two years in
three rural regions, the scheme has had a highly positive impact: the
population’s massive adherence in all four areas has led to a growing number
of services delivered and a consequent twofold increase in assisted deliveries
in rural areas. Less than 0.1% of services go unpaid and the scheme is
completely autonomous following an injection of initial investment. It is
managed by a committee made up of users, health staff members and locally elected representatives, guaranteeing exemplary transparency.
These initial results have encouraged the Ministry of Health to prioritise
expansion of this Obstetric Risk Insurance scheme, aiming to cover 80% of
the country by 2010.