Healthcare System in Mauritania: Organisation, CNAM, Hospitals, Emergencies and Vaccinations

The Mauritanian system rests on public general hospitals, private clinics and medical practices, with a strong concentration of resources in Nouakchott. France Diplomatie observes that the capital’s private facilities are better organised and equipped for a medical or surgical emergency. Outside the capital, the offer is more limited: the WHO notes that most peripheral and regional health facilities lack basic diagnostic capacity, and that transporting samples to the national reference laboratory, located in Nouakchott, delays confirmations.

Financial benchmarks give an idea of the scale: according to the WHO, health spending remains low, of the order of 4% of GDP, and life expectancy at birth is close to 70 years for men and 72 years for women. Under-five mortality remains high. The WHO also describes medicine stock-outs linked to logistics, and high out-of-pocket costs for vulnerable populations.

For a French resident, this translates into a pathway that is simple to describe: first-contact consultations in a practice or clinic in Nouakchott, tests and hospital stays in the private sector where possible, medical evacuation for serious situations. The page healthcare reimbursement in Mauritania explains who covers each step.

The CNAM (Caisse nationale d’assurance maladie), under the supervision of the Ministry of Health, covers employees and their dependants: the spouse, children up to 21 and disabled children with no age limit. Created in 2007 for the public sector, it extended to the parapublic sector and the liberal professions in 2010, then to the private sector and self-employed workers in 2012; in 2024, access was extended to widowers, widows and direct ascendants of insured people. To be reimbursed, you must consult a provider approved by the CNAM; care received abroad without prior evacuation is reimbursed only at the national rate.

The reimbursements indicated by the CLEISS (the French centre for international social security liaison) are as follows: 67% for medicines, with an out-of-pocket cost capped at 1,500 MRU per medicine; 80% in the private sector and 90% in the public sector for consultations, tests and rehabilitation, up to 10,000 MRU per service; 90% for hospitalisation and radiotherapy; 90% for devices and hearing aids; 100% for medical evacuations, haemodialysis and long-term conditions. An employee keeps their rights for six months after losing insured status.

Non-salaried people can join the CNASS (Caisse nationale de solidarité en santé), launched in September 2023: membership is as a family of at least six people or in a group, with a 2-month waiting period, and care must be received in approved facilities, following a coordinated pathway. For a foreign resident without a local employer, eligibility for these schemes is not established by the official sources consulted: enquire with both funds (contact details on the CLEISS page on Mauritanian bodies) before counting on them.

The first-contact doctor is, depending on the case, a general practitioner in a practice or private clinic in Nouakchott, or a health post or centre for the CNASS pathway. Specialist consultations, imaging tests and surgical procedures are concentrated in the capital’s clinics. France Diplomatie names no establishment; the list of public health facilities is kept by the Ministry of Health. The French embassy also publishes a list of French-speaking professionals that can be consulted on its website.

For emergencies, the numbers recorded by France Diplomatie are 101 (SAMU), 17 (police), 18 (fire brigade) and 119 (gendarmerie). The ambulance service is described as very little developed: in practice, it is often quicker to get to a clinic yourself, or to call an assistance transporter linked to your insurer. Once the emergency is stabilised, France Diplomatie recommends considering medical evacuation abroad.

The financial stakes are central: without an assistance contract, access to care may be compromised even in a life-threatening emergency, and the French embassy cannot under any circumstances cover these costs. The principle is detailed on assistance and repatriation.

France Diplomatie mentions a few quality pharmacies in Nouakchott, but overall irregular availability in the country. Bring only strictly necessary medicines, in their original packaging, with a prescription giving the names as international nonproprietary names (INN), and check that they are authorised in Mauritania. Never buy medicines in the street: the risk of counterfeits is real.

For a chronic treatment, build up before departure a reserve covering several months and a duplicate of the prescription. The WHO notes that national lists of essential medicines exist, but that stock-outs are frequent in remote areas.

Yellow fever is the only compulsory vaccination: required for travellers coming from endemic areas, it is strongly recommended for everyone, ideally at least ten days before departure; the international vaccination booklet may be required in all cases. The French vaccination schedule must be up to date (diphtheria, tetanus, polio, whooping cough, measles). Depending on the length and conditions of the stay, France Diplomatie also recommends vaccines against hepatitis A, typhoid fever, hepatitis B, ACWY meningitis (dry season or reported epidemic), rabies, tuberculosis for children under 15, as well as chikungunya and dengue in case of an epidemic.

The diseases reported are malaria (high prevalence in the Senegal River valley, cases possible in Nouakchott from August to November), dengue, chikungunya, Rift Valley fever, Crimean-Congo haemorrhagic fever (possible resurgences, no vaccine), rabies, cholera and diphtheria (epidemics have been reported, mainly in Hodh Ech Chargui). Occasional France Diplomatie alerts report rises in measles cases.

Prevention relies on protection against mosquito bites, food hygiene and a vaccination status checked before departure. Meningitis is regular in sub-Saharan Africa from November to June.

Depending on your status, three protections coexist: the French scheme maintained (secondment), the CFE (the Caisse des Français de l’Étranger, the French expatriate social security fund) and international insurance. The guide medical questionnaire and history explains how to prepare the declaration of your health status, and expat health insurance presents the comparison criteria. Finally, check that your contract covers evacuation from Nouakchott and direct payment in the private network, and register on Fil d’Ariane (the French foreign ministry’s traveller registration service).