The Healthcare System in Mayotte: Hospital Centre, Dispensaries, Emergencies, Health Insurance and Medical Evacuations

Mayotte comes under the French health system: the Regional Health Agency (ARS) organises the healthcare offering, the CSSM provides health insurance and the Mayotte hospital centre (CHM) is the public reference establishment. The ARS describes three levels in its page "Where to get care in Mayotte": the main CHM site in Mamoudzou, four care and childbirth centres, and thirteen consultation centres providing primary care and prevention. The private practitioner sector is reached through 15, which directs either to the SAMU for a life-threatening hospital emergency, or to an out-of-hours private-practice service organised by an association of private doctors.

Routine care follows the coordinated care pathway, which has applied in Mayotte since the law of 24 July 2019: affiliated people over 16 declare a referring doctor (CLEISS, the French centre for European and international social security liaison). For specialities not available on the island, the patient is directed to a medical evacuation (see below). The guide healthcare reimbursement in Mayotte presents the role of supplementary health insurance.

The CSSM has been the single social security body in Mayotte since 2015; it issues the certificate of entitlement and the Vitale card (CLEISS, CSSM). The CSSM specifies that universal health protection (PUMa) came into force in Mayotte on 1 July 2026: it covers healthcare costs on a personal and continuous basis for anyone who works or lives in Mayotte on a stable and lawful basis, allows 16-year-olds to apply for individual affiliation and provides for a temporary continuation of rights of 3 to 6 months in the event of a change of situation.

Reimbursements follow the mainland rates: the CSSM gives the example of a GP consultation reimbursed at 70%, the remaining 30% being payable by the insured person or their supplementary insurance. It requires no upfront payment for consultations and hospital stays at the CHM and in dispensaries. The order of 22 July 2026 also provides, with the application of the social security code in Mayotte on 1 January 2028, for full coverage of hospital and outpatient care at Mayotte's public health establishment, with a proportional contribution from the insured person remaining for certain examinations prescribed in private practice. The page social protection and healthcare in Mayotte details the applicable scheme.

According to the ARS, the four care and childbirth centres (Kahani, Dzoumogné, Mramadoudou and Dzaoudzi) offer GP consultations without appointment in the morning and by appointment in the afternoon, with medical cover 24 hours a day and 7 days a week. Each has a maternity unit for physiological deliveries (68 beds in total) and a dental surgery; the Petite-Terre centre has 14 medical beds.

• Jacaranda centre (Mamoudzou): care Monday to Friday from 6:30 a.m. to 7 p.m. and Saturday from 6:30 a.m. to 12 noon; consultations by appointment in the afternoon.
• Other dispensaries: care Monday to Friday from 7 a.m. to 2 p.m. (Labattoir, Pamandzi, Mtsapéré, Passamainty, Dembeni, Boueni, Sada, Mtsangamouji, Acoua, Mtsamboro, Koungou, Bandrélé).
• France Santé: 21 labelled structures, including one mobile structure; the label requires a referring doctor, a nurse, opening at least five days a week and application of regulated tariffs, with no extra-billing.

The ARS specifies that on-call dental care in town may have been suspended after Cyclone Chido and recommends contacting 15 for any dental emergency.

The main CHM site brings together a medicine, surgery and obstetrics facility, a medico-technical facility (laboratory, radiology, MRI, scanner), an imaging department, 5 operating theatres, a SAMU, SMUR (mobile emergency unit) outposts, a level 2b maternity unit and an emergency department open 7 days a week and 24 hours a day for adults, children, gynaecology and maternity. It has more than 2,600 professionals, including more than 220 doctors and 170 midwives, and 411 beds and places across 5 sites (ARS). The CHM website shows other figures without specifying the period; they are not used here.

The law of 11 August 2025 on programming for the rebuilding of Mayotte includes €407 million of investment for health: €122 million for works at the CHM, €122 million for the extension of the Mamoudzou hospital centre, and the programming and construction of a second hospital site at Combani (€10 million then €153 million). Progress on the sites can be followed with the ARS and the CHM.

Emergency numbers: 15 for the SAMU-Centre 15 (available 24 hours a day, free), 17 for the police, 18 for the fire brigade, 112 for the European number and 196 for sea rescue (Ministry of the Interior, ARS). The ARS strongly recommends not going to the CHM emergency department without an invitation from the regulating doctor at 15.

Medical evacuation (Evasan) is governed by the decree of 3 September 2004: it concerns patients whose diagnosis, treatment or follow-up cannot be carried out in Mayotte, and the CSSM bears the costs of transport, health measures, accompaniment and, where applicable, accommodation. A liaison unit between the CSSM and the La Réunion university hospital supports insured persons and a medical commission gives the opinions (CLEISS).

• Conditions: be a social security member, have been referred by a doctor outside Mayotte, not be in a life-threatening emergency (the CHM then arranges the transfer directly), with a medical appointment more than 15 calendar days after the file is filed (CSSM).
• File: filed at the CSSM EVASAN one-stop desk (Monday to Thursday from 7:30 a.m. to 2:30 p.m., Friday from 7:30 a.m. to 12 noon) or in the Evasan letterbox, at least 15 calendar days (excluding Saturdays, Sundays and public holidays) before the appointment, with the application form, an identity document, a valid CSSM, MGEN or MSA certificate of entitlement, proof of the admission or examination date, the agreement of the receiving doctor and the opinion of the prescribing doctor.
• Destination: the CSSM page only describes La Réunion; it gives no information on the mainland. For any question about coverage, the CSSM refers to its one-stop desk.

An assistance and repatriation policy usefully complements this scheme, particularly for a visitor from the mainland whose fund is not the CSSM: the CSSM page cites certificates of entitlement from the CSSM, the MGEN or the MSA.

CLEISS indicates that CSSM reimbursements are aligned with mainland rates. For medicines and medical devices, the order of 22 July 2026 provides, with the application of the social security code in 2028, for reimbursement under mainland rules, with possible price increases set by order to take account of costs specific to Mayotte. The glossary explains the notion of ticket modérateur and that of out-of-pocket cost.

The opening hours and supplies of each pharmacy are to be checked on the spot. For dental care, each of the four care and childbirth centres has a dental surgery (ARS).

Santé publique France publishes a regional surveillance bulletin. It regularly reports cases of malaria (acquired locally or imported, mainly from the Comoros), confirmed cases of mpox (imported or local) and laboratory-confirmed cases of chikungunya. It also reports seasonal epidemics, such as acute gastroenteritis linked to rotavirus A and influenza, with vigilance recommended for young children and older people.

On water, the ARS publishes a newsletter on tap water quality: the number of analyses carried out on the distribution network has increased, and the ARS recalls the importance of following the health recommendations issued during supply interruptions and when the network is refilled. For vaccinations, the ARS section refers to pages on compulsory vaccinations, strengthened recommendations against whooping cough and seasonal influenza; the personalised schedule is to be confirmed with your doctor or the ARS.