Ravit M., Ravalihasy Andrainolo, Audibert M., Ridde Valéry, Bonnet Emmanuel, Raffalli Bertille, Roy F.A., N'Landu A., Dumont Alexandre. (2020). The impact of the obstetrical risk insurance scheme in Mauritania on maternal healthcare utilization : a propensity score matching analysis. Health Policy and Planning, 35 (4), p. 388-398. ISSN 1460-2237.
Titre du document
The impact of the obstetrical risk insurance scheme in Mauritania on maternal healthcare utilization : a propensity score matching analysis
Année de publication
2020
Auteurs
Ravit M., Ravalihasy Andrainolo, Audibert M., Ridde Valéry, Bonnet Emmanuel, Raffalli Bertille, Roy F.A., N'Landu A., Dumont Alexandre
Source
Health Policy and Planning, 2020,
35 (4), p. 388-398 ISSN 1460-2237
In Mauritania, obstetrical risk insurance (ORI) has been progressively implemented at the health
district level since 2002 and was available in 25% of public healthcare facilities in 2015. The ORI
scheme is based on pre-payment scheme principles and focuses on increasing the quality of and
access to both maternal and perinatal healthcare. Compared with many community-based health
insurance schemes, the ORI scheme is original because it is not based on risk pooling. For a
pre-payment of 16-18 USD, women are covered during their pregnancy for antenatal care, skilled
delivery, emergency obstetrical care [including caesarean section (C-section) and transfer] and a
postnatal visit. The objective of this study is to evaluate the impact of ORI enrolment on maternal
and child health services using data from the Multiple Indicator Cluster Survey (MICS) conducted
in 2015. A total of 4172 women who delivered within the last 2 years before the interview were
analysed. The effect of ORI enrolment on the outcomes was estimated using a propensity score
matching estimation method. Fifty-eight per cent of the studied women were aware of ORI, and
among these women, more than two-thirds were enrolled. ORI had a beneficial effect among the
enrolled women by increasing the probability of having at least one prenatal visit by 13%, the
probability of having four or more visits by 11% and the probability of giving birth at a healthcare
facility by 15%. However, we found no effect on postnatal care (PNC), C-section rates or neonatal
mortality. This study provides evidence that a voluntary pre-payment scheme focusing on pregnant
women improves healthcare services utilization during pregnancy and delivery. However,
no effect was found on PNC or neonatal mortality. Some efforts should be exerted to improve
communication and accessibility to ORI
Plan de classement
Médecine [050MEDECI]
;
Politiques de la santé [056POLSAN]
;
Famille, planification de la famille [108DEMOG2]
Localisation
Fonds IRD [F B010078441]
Identifiant IRD
fdi:010078441
