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Ensuring financial access to emergency obstetric care: three years of experience with Obstetric Risk Insurance in Nouakchott, Mauritania

Renaudin P, A Prual, Vangeenderhuysen C, Ould Abdelkader M, Ould Mohamed Vall M, Ould El Joud Dahada.

Int J Gynaecol Obstet 2007 Nov; 99 (2) :183-90

Abstract

Introduction: The high cost of emergency obstetric care (EmOC) is a catastrophic health expenditure for households, causing delay in seeking and providing care in poor countries.

Methods: In Nouakchott, the Ministry of Health instituted Obstetric Risk Insurance to allow obstetric risk sharing among all pregnant women on a voluntary basis. The fixed premium (US$21.60) entitles women to an obstetric package including EmOC and hospital care as well as post-natal care. The poorest are enrolled at no charge, addressing the problem of equity.

Results: 95% of pregnant women in the catchment area (48.3% of the city’s deliveries) enrolled. Utilization rates increased over the 3-year period of implementation causing quality of care to decline. Basic and comprehensive EmOC are now provided 24/7.The program has generated US$382,320 in revenues, more than twice as much as current user fees. All recurrent costs other than salaries are covered.

Conclusion: This innovative sustainable financing scheme guarantees access to obstetric care to all women at an affordable cost.

PMID: 17900588 [PubMed – indexed for MEDLINE]

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