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Cost Recovery in Mauritania: Initial Lessons from Reform


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  • Martine AUDIBERT

    (Centre d'Etudes et de Recherches sur le Développement International)


    (Centre d'Etudes et de Recherches sur le Développement International)


The analysis of the Mauritanian experience, where cost recovery was introduced in 1993, contributes on a number of key points to the discussion surrounding user fees contribution to health care systems. Initial results appear to be largely positive regarding the improvement of the quality of health care and the overall level of utilisation of basic health establishments. They suggest that users are globally willing to pay when the quality of health care improves, and that, contrary to a frequently-voiced concern, EPI activities have increased. Several elements tend to show that cost recovery accompanied by a fair supply of essential drugs and by a better motivated staff has contributed to improve the efficiency of the health system. But a coherent price structure is needed to guide more efficiently the patients to the different levels of the health pyramid. It is therefore vital that user fees are practically extended, as the Government intends, to the second and third levels of the health system. The analysis conducted here also suggests that cost recovery has probably had no major negative effects as far as equity is concerned, although further investigation is necessary before a more precise judgement can be made.

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Bibliographic Info

Paper provided by CERDI in its series Working Papers with number 199811.

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Length: 15
Date of creation: 1998
Date of revision:
Publication status: Published in Health Policy and Planning, 2000, pages 66-75
Handle: RePEc:cdi:wpaper:79

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Related research

Keywords: Mauritania; quality of health; cost recovery;


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Cited by:
  1. Deininger, Klaus & Mpuga, Paul, 2004. "Economic and Welfare Effects of the Abolition of Health User Fees : Evidence from Uganda," Policy Research Working Paper Series, The World Bank 3276, The World Bank.
  2. Ssewanyana, Sarah & Nabyonga, Juliet O. & Kasirye, Ibrahim & Lawson, David, 2004. "Demand for Health Care Services in Uganda: Implications for Poverty Reduction," Research Series, Economic Policy Research Centre (EPRC) 150529, Economic Policy Research Centre (EPRC).
  3. Margaret Grosh & Carlo del Ninno & Emil Tesliuc & Azedine Ouerghi, 2008. "For Protection and Promotion : The Design and Implementation of Effective Safety Nets," World Bank Publications, The World Bank, number 6582, August.


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