@article{fdi:010078441,
  title = {{T}he impact of the obstetrical risk insurance scheme in {M}auritania on maternal healthcare utilization : a propensity score matching analysis},
  author = {{R}avit, {M}. and {R}avalihasy, {A}ndrainolo and {A}udibert, {M}. and {R}idde, {V}al{\'e}ry and {B}onnet, {E}mmanuel and {R}affalli, {B}ertille and {R}oy, {F}.{A}. and {N}'{L}andu, {A}. and {D}umont, {A}lexandre},
  editor = {},
  language = {{ENG}},
  abstract = {{I}n {M}auritania, 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. {T}he {ORI}
scheme is based on pre-payment scheme principles and focuses on increasing the quality of and
access to both maternal and perinatal healthcare. {C}ompared with many community-based health
insurance schemes, the {ORI} scheme is original because it is not based on risk pooling. {F}or 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. {T}he objective of this study is to evaluate the impact of {ORI} enrolment on maternal
and child health services using data from the {M}ultiple {I}ndicator {C}luster {S}urvey ({MICS}) conducted
in 2015. {A} total of 4172 women who delivered within the last 2 years before the interview were
analysed. {T}he effect of {ORI} enrolment on the outcomes was estimated using a propensity score
matching estimation method. {F}ifty-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%. {H}owever, we found no effect on postnatal care ({PNC}), {C}-section rates or neonatal
mortality. {T}his study provides evidence that a voluntary pre-payment scheme focusing on pregnant 
women improves healthcare services utilization during pregnancy and delivery. {H}owever,
no effect was found on {PNC} or neonatal mortality. {S}ome efforts should be exerted to improve
communication and accessibility to {ORI}},
  keywords = {{MAURITANIE}},
  booktitle = {},
  journal = {{H}ealth {P}olicy and {P}lanning},
  volume = {35},
  numero = {4},
  pages = {388--398},
  ISSN = {1460-2237},
  year = {2020},
  DOI = {10.1093/heapol/czz150},
  URL = {https://www.documentation.ird.fr/hor/fdi:010078441},
}