Mauritania - Islamic Development Bank

18
rooted harmful traditional practices (e.g.
female genital mutilation, food taboos etc)
negatively affect the health-seeking behavior
and ultimately, accessibility to health services.
• Chronic malnutrition rates have stagnated
and remain a serious problem in rural areas
among the poorest and the very young (0-3
years) who are the most vulnerable.
2.3 Government’s Strategy for the Health
Sector
64. The PRSP-III identifies the development and
implementation of a clear and coherent policy
as one of the top priorities of the health sector
for the next five years. The sector strategies and
poverty reduction plans highlighted the need to
increasing funding to address healthcare access
and quality, human resource needs, awareness
and monitoring and evaluation.
65. The forthcoming CSLP-III (2010-2015),
envisages developing a strategy whose objectives
focus on four strategic areas: (1) improving
universal access to health services and quality
nutrition, (2) strengthening of the fight against the
disease (3) developing mechanisms for financing
health and (4) leadership development, good
governance and sector performance. This strategy
will enable to (i) reduce the overall mortality
and morbidity, particularly IMR and MMR (ii)
reduce the total fertility rate; and (iii) mitigate the
impact of epidemics including endemic HIV/AIDS
and emerging diseases (iv) reduce hunger and
malnutrition in the population, especially among
vulnerable groups (v) strengthen community
participation in development and management
strategies for access to basic health services, and
(vi) enhance coordination and planning within
and across sectors.
66. Donors and specialized agencies remain
skeptical about the Government’s commitment
to implement the strategy in terms of the level,
equity and allocative efficiency of spending.
Inadequacy of financial support to the WHO for
preparing a health sector policy is worrying in
this regard. Also available PRSP III documents do
not specify the amounts of future funding to the
health sector.
2.4 Proposed Interventions (with Donors) to
Help Government Meet its Goals
67. Scaling up of direct IDB Group support
for primary health care, and a partnership
with donors on health initiatives, are the two
elements for IDB Group support to enhance
access to quality health services and ultimately,
impacting the high IMR and MMR in Mauritania
though a financing envelope of US$150 million.
Building partnership, and synergy with donors
68. Support to the initiative for preparation of
a national health sector policy and the proposed
five-year plan currently under preparation by
the WHO. In addition:
(i) Support the Expanded Immunization Program
to redress shortcomings in the coverage rates
with a direct impact on the infant mortality
rate in cooperation with UNICEF and GAVI;
(ii) Adopt and expand the successful AFD user’s
fees initiative to enhance access to quality
health services for pre- and post-natal care in
priority remote areas.
Scale up of the direct IDB Group support for
Health
69. Support for the extension of the Primary
Health Care (PHC) and secondary health care
services in the high poverty areas would enhance
access to quality services by investing in training
and retaining of basic health staff and community
volunteers (e.g. midwifes, nurses, community
promoter etc), procurement of equipment, other
essential health commodities and construction of
PHC facilities.
2.5 Suggestions and Recommendations for the
Government
70. The situation in Mauritania shows that
the implementation of interventions under
the human development pillar requires policy
and institutional reforms. In this regard, the
government strategy should be strengthened
through the following actions:
• Preparing and implementing at the earliest
opportunity a health system development
MCPS for Mauritania, 2011-2015