SANTE ET PAUVRETE EN MAURITANIE

SANTE ET PAUVRETE EN MAURITANIEDR M. NEZHIR OULD HAMED / DPCS / MSAS26 MARS 2002COMBATTRE LA PAUVRETECOURS CMAP - IBM

INTERACTION PAUVRETE ET SANTE

Comportement du menage

Niveau deducation de la mere,

Acces a leau / assainissement

Travaux penibles

Fecondite leve

Acces faible aux services preventifs

Acces faible aux services curatifs

Problemes de Sante, Malnutrition

Fecondite

Bas revenu

Niveau de

Revenu

Poids des dpenses de sante sur les depenses du menage

Maladies graves augmentent la vulnerabilite des menages

Jours darrt de travail

Dveloppement psychomot et intellectuel des enfants

IMPACT DES POLITIQUES GOUVERNEM. SUR LETAT DE SANTE DES POPULATIONS

Mnages/ Communauts

Politiques gouvernementales et actions

Systme de sant et autres secteurs

Indicateurs de Sant Sant Fcondit et Etat nutritionnel

Facteurs Communautaires environnement, valeurs culturelles, capital social, cologie, gographie, etc.

Comportement des mnages et facteurs de risque Utilisation des services de sant publics et prives, pratiques alimentaires et sanitaires, style de vie, soins aux enfants et stimulation des enfants, etc.

Offre de services Disponibilit, accs , prix et qualit des services

Ressources au niveau mnage Revenu, possessions, terres, ducation, etc.

Offre dans les secteurs lies a la sant Disponibilit, accs, prix & qualit de la nourriture, nergie routes, eau & assainissement, etc.

Politiques de sant: e.g. financement et dpenses, provision de services, rgulation, coordination inter-sectorielle valuation & monitoring.

Autres politiques gouvernementales, e.g. infrastructure, transport, nergie, agriculture, eau & assainissement, etc.

Indicateurs de sant

Autres parties du systme Financement Approvisionnement.

Protection financire

Participation des populations

Key questions: Impacts of proximate determinants. What are the marginal impacts of different proximate determinants? Both at group level (e.g. health services, diet, etc.), and within groups (e.g. immunization, growth monitoring, etc.). Poor-nonpoor differences in proximate determinants. How are the various proximate determinants distributed across economic groups? Determinants of household choices. What are the key influences on households choices of proximate determinants, and do the poor and non-poor respond differently? Poor-nonpoor differences in determinants of proximate determinants. How are the various factors influencing household choices distributed across economic groups (e.g. assets, health insurance, prices, availability, quality, etc.)? Governments, markets, the public sector, and the poor. Government influence over the availability, quality and prices of goods and services that poor households use in producing health outcomes. What are the policy leverse.g. targeting of public health spending (geography, level of care, range of interventions, etc.). What factors influence the governments ability to exert an influence on the availability, quality and prices of goods and services households use in producing health outcomesthe efficiency and quality of government itself; the efficiency and motivation of providers; etc. Constraints facing governments. What are the constraints facing governmentsecology, geography, culture, religion, international trade, etc.

QUESTIONS CLEFSQuelles sont les conditions sanitaires et nutritionnelles des pauvres? Pourquoi les menages et les communautes pauvres souffrent plus que les plus riches et quelles sont les barrieres auxquelles elles font face?Pourquoi le secteur de la sante ne couvre pas les plus pauvres et les plus vulnerables?

Quel ensemble de politiques peuvent etre mises en oeuvre pour ameliorer les performances du secteur du point de vue de lequite?

Enqutes (EDSM)

Revues (RDPS)

Stratgies(CSLPCBMT)

Augmentation de la couverture sanitaire 75% (10km) 67% (5km)Diminution de la Mortalit Infantile (de 118 75 p1000) et de la Mortalit Infanto-Juvnile (de 182 116 p 1000)Diminution de la Mortalit Maternelle (de 940 700 p 100 000 NV)Augmentation du taux de prvalence contraceptive (de 2 8%)Diminution lindice synthtique ( 4,7)Diminition de la prvalence de la malnutritionEVOLUTION DE LA SITUATION SANITAIRE ENTRE 1996 ET 2000

CEPENDANT* Les indicateurs de sant sont encore levs: mortalit maternelle et infantile, volution des maladies mergentes (SIDA,TB), prvalence de la malnutrition * Un poids lourd de la maladie (dpense et morbidit) sur le revenu des mnages des plus pauvres* Une accessibilit et une utilisation insuffisantes des services de sante

QQUES RESULTATS DE LA REVUE DES DEPENSES PUBLIQUES EN SANTE (96 2000)8% de fonctionnement de letat alloue a la sante contre 12 % recommandeii) Augmentation annuelle (96-00) erodee par laugmentation de la population et la depreciation de la monnaie, donc depense par habitant en 2000 egale a 1995iii) Augmentation moins importante que dans dautres secteurs sociaux (Education)iv) Double desequilibre:investissement / fonctionnement (1,2)niveau tertiaire / niveaux primaire et secondaireNecessite dallouer 12 a 15% de la depense publique a la sante pour porter la depense de sante a 13 dollards par habitant, ce qui representerait 2,97% du PIB.

Resultats de la Revue des Depenses Publiques en Sante (suite)Fig1: Depense sante par habitant de 93 a 2000Figure 4: Dpense Totale et clate par habitant, par Rgion (classes de pauvre a plus riche), Mauritanie, 1999Figure 2: Evolution du ratio invest / fonctionn

Chart1

0.57

0.92

1.08

0.37

0.58

0.68

1.26

1.17

Ratio investissement/recurrent

Sheet1

19931994199519961997199819992000

Ratio investissement/recurrent0.570.921.080.370.580.681.261.17

Sheet1

0

0

0

0

0

0

0

0


93-01

0.57421399430.57421399430.92374608690.92374608691.08653327151.08653327150.374530230.374530230.5855432950.5855432950.68703828060.68703828061.26112645821.26112645821.17310309031.173103090300

MAURITANIEE V O L U T I O N D E S B U D G E T S O R D O N N A N C E S D E L A S A N T E D E 1 9 9 3 A 2 0 0 125-Jul-01

En millions UM

REPARTITION PAR199319941995199619971998199920002001

NATURE / NIVEAUMontant%Montant%Montant%Montant%Montant%Montant%Montant%Montant%Mont vot%

FONCTIONNEMENT1,34063.51,65152.01,77547.91,60272.81,73263.12,08259.32,28744.22,38746.0

SALARIAL66949.981749.582046.284652.893554.01,01248.61,05146.01,18649.7

Primaire31747.438747.339047.633539.637039.629328.931830.235429.9

Secondaire8713.010613.010713.09811.610911.6797.8858.1837.0

Tertiaire14121.117321.217120.815017.816617.721421.122321.222619.1

Administ/formation12418.515118.515318.626231.029031.042742.242640.552344.1

NON SALARIAL67150.183450.595553.875647.279746.01,06951.41,23654.01,20150.3

Primaire12118.010312.316317.1597.8627.7615.7705.724920.7

Secondaire487.1566.7606.3506.6617.7676.3685.515212.6

Tertiaire20830.936143.233535.127236.027534.530028.038230.942135.1


DONT MEDICAMENTS13410.016910.31558.81187.329216.834616.651022.354022.6

Primaire21.621.200.000.000.000.000.017832.9

Secondaire118.1116.500.000.000.000.000.08315.4

Tertiaire5238.65532.46542.100.015452.8154.412023.618434.0

Administration6951.710159.99057.9118100.013847.233195.639076.49617.8

INVESTISSEMENT76936.51,52548.01,92952.160027.21,01436.91,43040.72,88455.82,80054.0

Primaire42054.563441.665233.817128.529929.549534.654518.965123.3

Secondaire222.9302.01618.410.2262.51017.0923.256720.3

Tertiaire547.051433.755929.000.030.320.21,08337.695534.1

Administ/formation27435.634622.755728.942871.368667.683258.21,16440.462622.4

TOTAL SANTE2,1090.03,1760.03,7040.02,2020.02,7460.03,5120.05,1700.05,1860.0

00.000.000.0

Population2,147,7780.02,211,4730.02,277,7660.02,346,7520.02,418,5060.02,493,0730.02,570,4380.02,650,5630.0

Dp publique / hbt en UM9820.01,4360.01,6260.09380.01,1360.01,4090.02,0110.01,9570.0

Dp publique / hbt en USD46745688

BUDGET (1)National%SantNational%SantNational%SantNational%SantNational%SantNational%SantNational%SantNational%Sant

TOTAL37,4865.634,6249.236,65810.10---23,16411.90---0---0---

FONCTIONNEMENT19,4826.919,5738.420,2408.80---23,1647.50---0---0---

(1) Fonctionnement hors intret et Investissement hors amortissement de la dette

RECOUVREMENT1410.02800.02850.000.01220.05140.05110.04590.0

Primaire5035.620472.920772.80---00.018034.924848.425255.0

Secondaire00.000.000.00---00.0234.4377.200.1

Tertiaire9164.47627.17827.20---122100.031260.722744.420644.9

REPARTITION PAR199319941995199619971998199920002001

NIVEAU / NATUREMontant%Montant%Montant%Montant%Montant%Montant%Montant%Montant%Montant%

PRIMAIRE85740.631,12335.371,20532.5356525.6473226.6484824.1593318.051,25524.19

Fonctionnement43851.0449043.5855345.9339469.7143259.0635441.6938841.5860348.08

Salarial31772.4538778.9839070.5333585.0937085.7429382.7931881.8835458.71

Non salarial12127.5510321.0216329.475914.916214.266117.217018.1224941.29

% masse salariale3827421817212270

Dont medicament20.4820.4300000.0000.0017829.44

Investissement42048.9663456.4265254.0717130.2929940.9449558.3154558.4265151.92

Investissement20749.2647875.4346771.7315691.4028795.7035972.6445182.8258790.11

Fonctionnement21350.7415624.5718428.27158.60134.3013527.369417.18649.89

SECONDAIRE1577.431926.043288.851496.771957.122467.012454.7480215.46

Fonctionnement13485.7716284.2016750.8514899.1217086.8214659.1515462.6123529.25

Salarial8764.6110665.5810764.189866.3810963.977954.058555.438335.25

Non salarial4835.395634.426035.825033.626136.036745.956844.5715264.75


Dont medicament118.10116.7900.0000.0000.0000.0000.008335.39

Investissement2214.233015.8016149.1510.882613.1810140.859237.3956770.75

Investissement1985.122376.9115294.411100.0026100.00101100.0092100.00567100.00

Fonctionnement314.88723.0995.5900.0000.0000.0000.0000.00

TERTIAIRE40219.081,04833.011,06528.7542319.2144416.1851614.701,68832.651,60330.91

Fonctionnement34986.6153450.9250647.51423100.0044199.2851499.5260535.8464840.41

Salarial14140.4417332.4617133.7215035.5716637.5821441.6522336.8122634.94

Non salarial20859.5636167.5433566.2827264.4327562.4230058.3538263.1942165.06

% masse salariale147208197181166140172186

Dont medicament5214.875510.266512.9200.0015434.94152.9712019.8818428.39

Investissement5413.3951449.0855952.4900.0030.7220.481,08364.1695559.59

Investissement4990.6951499.84559100.000---00.002100.001,07298.9995199.54

Fonctionnement59.3110.1600.000---3100.0000.00111.0140.46

ADMINIST/FORMATION69332.8681225.571,10629.871,06548.381,37550.061,90154.132,30444.561,52729.44

Fonctionnement41960.5246657.3554949.6463859.8568950.121,06956.211,14049.4990159.01

Salarial12429.5315132.4415327.7726241.1329042.0842739.9442637.3352358.01

Non salarial29670.4731567.5639772.2337558.8739957.9264260.0671562.6737841.99

% masse salariale23920826014313815016872

Investissement27439.4834642.6555750.3642840.1568649.8883243.791,16450.5162640.99

Investissement14452.7714140.6329552.9032876.7948170.1154965.9961652.9525841.20

Fonctionnement12947.2320659.3726247.109923.2120529.8928334.0154847.0536858.80

TOTAUX2,1093,1763,7042,2022,7463,5125,1705,186

&A

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E V O L U T I O N D E S B U D G E T S D E L A S A N T E D E 1 9 9 3 A 2 0 0 125-Jul-01

En millions UM

MAURITANIE199319941995199619971998199920002001

Montant%Montant%Montant%Montant%Montant%Montant%Montant%Montant%Montant%

PRIMAIRE

Fonctionnement

Salarial

Non Salarial

Dont Medicaments

Investissement

Investissement

Fonctionnement

SECONDAIRE

Fonctionnement

Salarial

Non Salarial

Dont Medicaments

Investissement

Investissement

Fonctionnement

TERTIAIRE

Fonctionnement

Salarial

Non Salarial

Dont Medicaments

Investissement

Investissement

Fonctionnement

ADMINISTRATION/FORMAT

Fonctionnement

Salarial

Non Salarial

Dont Medicaments

Investissement

Investissement

Fonctionnement

TOTAUX

Fonctionnement Etat

Fonctionnement Sant

Investissement Etat (BCI)

Investissement Sant (BCI)

Budget Total Etat

Budget Total Sant

Population

Dpense sant/habt en UM

FONCTIONNEMENT

Salarial

Non Salarial

Dont Medicaments

INVESTISSEMENT

Investissement

Fonctionnement

RECOUVREMENT

Primaire

Secondaire

Tertiaire

GUIDIMAGHAEVOLUTION DES BUDGETS DE LA SANTE DE 1993 A 199625-Jul-01

En millions UM

199319941995199619971998199920002001


PRIMAIRE00.000.000.000.000.000.000.000.000.0

Fonctionnement0000000000000

Salarial000335000000

Non Salarial00059000000

Dont Medicaments000000000

Investissement000000000000000000

Investissement---------------------------

Fonctionnement---------------------------

SECONDAIRE00.000.000.000.000.000.000.000.000.0


Salarial000000000




Investissement---------------------------

Fonctionnement---------------------------

TERTIAIRE00.000.000.000.000.000.000.000.000.0

Fonctionnement0--0000000000000000

Salarial--00000000

Non Salarial--00000000

Dont Medicaments--00000000

Investissement0--0000000000000000

Investissement---------------------------

Fonctionnement---------------------------

ADMINISTRATION/FORMAT00.000.000.000.000.000.000.000.000.0


Salarial000000000




Investissement---------------------------

Fonctionnement---------------------------

TOTAUX

Fonctionnement Sant000000000

Investissement Sant (BCI)000000000

Budget Total Sant000000000

Population


FONCTIONNEMENT00.000.000.000.000.000.000.000.000.0

Salarial000000000000000000

Non Salarial000000000000000000


INVESTISSEMENT00.000.000.000.000.000.000.000.000.0



RECOUVREMENT010001000100010001000100010001000100

Primaire000000000000000000

Secondaire000000000000000000

Tertiaire000000000000000000

EVOLSTE.XLS&RPage &P

93-96

MAURITANIEEVOLUTION DES BUDGETS DE LA SANTE DE 1993 A 199625-Jul-0119931994-96BUDGET MSAS *1993199419951996

En millions UMVOTEEXEVOTEEXEVOTEEXEVOTEEXE

19931994Variation1995Variation1996VariationACEAEC

Montant%Montant%(%)Montant%(%)Montant%(%)260727NV

260827X07FONCTIONNEMENT00000000

PRIMAIRE00.000.0000.0000.00N27X08

Fonctionnement00000000000AECAECSALARIAL00000000

EFGEFGSalarial0000000000026F*27FNON SALARIAL00000000

SPF*PNon Salarial0000000000026X0927X09

EFGDont Medicaments0000000000026X1027X10

FMPInvestissement0000000000026X1127X11* = hors dpenses communes

EFGEFGInvestissement00000000000

IIPIFPFonctionnement00000000000

SECONDAIRE00.000.0000.0000.00


EFGEFGSalarial00000000000

SSF*SNon Salarial00000000000

EFGDont Medicaments00000000000

FMSInvestissement00000000000


IISIFSFonctionnement00000000000

TERTIAIRE00.000.0000.0000.00



STF*TNon Salarial00000000000


FMTInvestissement00000000000


IITIFTFonctionnement00000000000

ADMINISTRATION/FORMAT00.000.0000.0000.00



SAF*ANon Salarial00000000000


FMAInvestissement00000000000


IIAIFAFonctionnement00000000000

TOTAUX

Fonctionnement Etat19,48219,573020,240421,1429

Fonctionnement Sant00.0000.00000.00000.000

Investissement Etat (BCI)18,00415,051-1616,418-921,95122

Investissement Sant (BCI)00.0000.00000.00000.000

Budget Total Etat37,48634,624-836,658-243,09315

Budget Total Sant00.0000.00000.00000.000

Population2,147,7782,211,4732,277,7662,346,752

Dpense sant/habt en UM0000

FONCTIONNEMENT00.000.0000.0000.00


SF*Non Salarial00000000000


FM

INVESTISSEMENT00.000.0000.0000.00


IIIFFonctionnement00000000000

RECOUVREMENT0100010000100001000

EFGEFGPrimaire00000000000

RPRSSecondaire00000000000

EFGTertiaire00000000000

RT

Les budgets 1993-1995 sont les budget ordonnancs. Le budget 1996 est le budget vot (Loi de Finance Initiale).

Les variations sont calcules par rapport 1993.

Le fonctionnement Etat ne comprend pas le service de la dette.

Les investissements sont ceux du Budget Consolid d'Investissement.

CHAHODH EL CHARGUI241,146

GHBHODH EL GHARBI179,617

ASSASSABA186,839

GUIGUIDIMAGHAEVOLUTION DES BUDGETS DE LA SANTE DE 1993 A 199625-Jul-01GORGORGOL199,741

En millions UMBRABRAKNA211,045

19931994Variation1995Variation1996VariationTRATRARZA204,255

Montant%Montant%(%)Montant%(%)Montant%(%)ADRADRAR65,833

DAKDAKHLET NDB83,790

PRIMAIRE00.000.0000.0000.00TAGTAGANT70,106

Fonctionnement00000000000GUIGUIDIMAGHA130,829

EFGEFGSalarial00000000000TIRTIRIS ZEMMOUR38,731

SPGUIF*PGUINon Salarial00000000000INCINCHIRI13,874

EFGDont Medicaments00000000000NOUNOUAKCHOTT521,972

FMPGUIInvestissement00000000000TOTTOTAL2,147,778


IIPGUIIFPGUIFonctionnement00000000000

SECONDAIRE00.000.0000.0000.00



SSGUIF*SGUINon Salarial00000000000


FMSGUIInvestissement00000000000


IISGUIIFSGUIFonctionnement00000000000

TERTIAIRE00.000.0000.0000.00



STGUIF*TGUINon Salarial00000000000




IITGUIIFTGUIFonctionnement00000000000




SAGUIF*AGUINon Salarial00000000000




IIAGUIIFAGUIFonctionnement00000000000

TOTAUX




Population




SGUIF*GUINon Salarial00000000000


FMGUI



II*GUIIF*GUIFonctionnement00000000000

RECOUVREMENT0100010000100001000


RPGUIRSGUISecondaire00000000000


RTGUI






Nouakchott 93-01

NouakchottE V O L U T I O N D E S B U D G E T S O R D O N N A N C E S D E L A S A N T E D E 1 9 9 3 A 2 0 0 125-Jul-01

En millions UM

REPARTITION PAR199319941995199619971998199920002001


FONCTIONNEMENT54189.870339.672846.759083.062687.972981.480141.094947.9

00.000.000.000.000.000.000.000.0

SALARIAL29654.730843.834347.129650.232752.340555.539249.042945.3

Primaire13144.313543.715344.58729.49629.411428.110827.612930.1

Secondaire00.000.000.000.000.000.000.000.0

Tertiaire15652.916453.418052.515050.816650.721452.922356.722652.7


00.000.000.000.000.000.000.000.0

NON SALARIAL24545.339556.238552.929449.829947.732544.540951.052054.7

Primaire3313.4287.14010.3144.8124.0134.0122.86011.6

Secondaire00.000.041.100.051.651.661.4295.5

Tertiaire20884.736191.333587.027292.727592.330092.338293.542181.1


00.000.000.000.000.000.000.000.0


Primaire23.923.700.00---00.000.000.04919.1

Secondaire00.000.000.00---00.000.000.0238.9

Tertiaire5296.15596.365100.00---154100.015100.0120100.018472.0

00.000.000.000.000.000.000.000.0

INVESTISSEMENT6110.21,07060.483153.312117.08612.116618.61,15359.01,03152.1

Primaire2744.711911.214417.310082.78396.36840.9574.9737.1

Secondaire57.5171.6202.400.000.000.000.000.0

Tertiaire1727.090884.864277.200.033.721.51,08393.995592.7


00.000.000.000.000.000.000.000.0

00.000.000.000.000.000.000.000.0

TOTAL SANTE6020.01,7730.01,5600.07110.07110.08960.01,9540.01,9800.0

00.000.000.000.000.000.000.000.0

Population521,9720.0550,3690.0579,1300.0608,2280.0637,6290.0667,3010.0697,5420.0728,6350.0

Dp publique / hbt en UM1,1540.03,2220.02,6930.01,1700.01,1160.01,3420.02,8020.02,7170.0

Dp publique / hbt en USD50.0130.0110.050.050.060.0120.0110.0

00.000.000.000.000.000.000.000.0

RECOUVREMENT1020.0980.01030.000.01220.03270.02830.02500.0

Primaire00.000.000.00---00.0154.55720.04417.7

Secondaire00.000.000.00---00.000.000.000.0

Tertiaire102100.098100.0103100.00---122100.031295.522780.020682.3

00.000.000.000.000.000.000.000.0

REPARTITION PAR199319941995199619971998199920002001


PRIMAIRE19131.7628215.9133621.5720128.2919126.8219321.641779.0626213.25

Fonctionnement16485.6616357.6619357.2410150.2310856.6812564.7912067.7918972.20

Salarial13179.8713582.8115379.338786.019688.9211490.9110890.3012968.23

Non salarial3320.132817.194020.671413.991211.08119.09129.706031.77

% masse salariale250.00210.00260.00160.00120.00100.00110.00470.00

Dont medicament21.2721.2900.0000.0000.0000.0000.004925.77

Investissement2714.3411942.3414442.7610049.778343.326835.215732.217327.80

Investissement1660.0510991.2012587.219998.878399.936291.075291.756994.18

Fonctionnement1139.95118.801812.7911.1300.0768.9358.2545.82

00.0000.0000.009417.18

SECONDAIRE50.76170.99241.5700.005100.0040.4560.29291.45

00.0000.0000.00

Fonctionnement00.0000.00417.490---00.004100.006100.0029100.00

Salarial0---0---00.000---5100.0000.0000.0000.00

Non salarial0---0---4100.000------0.004100.006100.0029100.00

% masse salariale---0.00---0.00---0.00---0.0000.00---0.00---0.00---0.00

Dont medicament0---0---00.000---00.0000.0000.002379.47

Investissement5100.0017100.002082.510---0---00.0000.0000.00

Investissement372.7300.001154.550---0---0---0---0---

Fonctionnement127.2717100.00945.450---26100.000---0---0---

00.0000.0000.00

TERTIAIRE38163.201,43380.811,15874.2342359.4544199.2851657.841,68886.381,60380.97

00.0000.0000.00

Fonctionnement36495.6652536.6351644.53423100.0016637.5851499.5260535.8464840.41

Salarial15642.9316431.3118034.9515035.5727562.4221441.6522336.8122634.94

Non salarial20857.0736168.6933565.0527264.431660.0030058.3538263.1942165.06

% masse salariale1330.002190.001860.001810.0015434.941400.001720.001860.00

Dont medicament5214.245510.446512.6800.0030.72152.9712019.8818428.39

Investissement174.3490863.3764255.4700.0000.0020.481,08364.1695559.59

Investissement848.7790799.91642100.000---3100.002100.001,07298.9995199.54

Fonctionnement851.2310.0900.000---00.0000.00111.0140.46

00.0000.0000.00

ADMINIST/FORMATION264.28412.30412.648712.267110.0517920.07844.28864.32

Fonctionnement1350.471537.531638.866675.9371100.008346.457184.378397.19

Salarial965.60957.341062.445988.776590.997792.496187.087488.81

Non salarial434.40742.66637.56711.2369.0167.51912.92911.19

% masse salariale520.00740.00600.00130.00100.0080.00150.00130.00

Investissement1349.532662.472561.142124.0700.009653.551315.6322.81

Investissement1078.932492.312184.6021100.000---9497.59969.28144.06

Fonctionnement321.0727.69415.4000.000---22.41430.72155.94

00.0000.0000.00

00.0000.0000.00

TOTAUX6020.001,7730.001,5600.007117118961,9541,980

00.0000.0000.00

Pauvre

Riches

People living in remote areas, in areas with poor access to infrastructure such as schools or health centers are often among the poorest in a country.

In Mauritania, a large low populated country, we can see a correlation between the poverty level of a province and the level of access to primary carecenters.

Chart5

982.1271597903982

1435.97615120871362.406215568

1626.26515357151478.4228668832

938.3101659466808.8880740919

1135.5463627362923.2084249887

1408.64153415841043.4381734507

2011.49802085181457.2463768116

1956.63290486671417.8499310628

Dp publique / hbt en terme courant

Dep publique par habitant en terme constant

Annee

UM

Sheet1

19931994199519961997199819992000

Ratio investissement/recurrent0.570.921.080.370.580.681.261.17

Sheet1

0

0

0

0

0

0

0

0


93-01

668.6698686686671.2947833314769.426455

816.979185833.7701051524.873197042

820.4521451388954.86173286121928.9375957899

845.726756.262236599.9930225556

934.8199641503797.28391484971014.2218125556

1012.29542011861069.36817688141430.1825784889

1051.04390860111235.61764939892883.7693917222

1185.91646213881200.61494786122799.6473722222

200120012001

SALARIAL

NON SALARIAL

INVESTISSEMENT

concent

982.1271597903

1435.9761512087

1626.2651535715

938.3101659466

1135.5463627362

1408.6415341584

2011.4980208518

1956.6329048667

&A

Page &P


93-96

MAURITANIEE V O L U T I O N D E S B U D G E T S O R D O N N A N C E S D E L A S A N T E D E 1 9 9 3 A 2 0 0 125-Jul-01

En millions UM

REPARTITION PAR NATURE ET PAR NIVEAU199319941995199619971998199920002001

NATURE / NIVEAUMontantMontantMontantMontantMontantMontantMontantMontantMont vot%

FONCTIONNEMENT1,3401,6511,7751,6021,7322,0822,2872,387

SALARIAL6698178208469351,0121,0511,186

Primaire317387390335370293318354

Secondaire8710610798109798583

Tertiaire141173171150166214223226

Administ/formation124151153262290427426523

NON SALARIAL6718349557567971,0691,2361,201

Primaire12110316359626170249

Secondaire48566050616768152

Tertiaire208361335272275300382421

Administ/formation296315397375399642715378

DONT MEDICAMENTS134169155118292346510540

Primaire2200000178

Secondaire11110000083

Tertiaire525565015415120184

Administration691019011813833139096

INVESTISSEMENT7691,5251,9296001,0141,4302,8842,800

Primaire420634652171299495545651

Secondaire223016112610192567

Tertiaire545145590321,083955

Administ/formation2743465574286868321,164626

199319941995199619971998199920002001

TOTAL SANTE2,1093,1763,7042,2022,7463,5125,1705,186

0

Population2,147,7782,211,4732,277,7662,346,7522,418,5062,493,0732,570,4382,650,563

19931994199519961997199819992000

Dp publique / hbt en terme courant9821,4361,6269381,1361,4092,0111,957

Dp publique / hbt en USD46745688

100105.4110116123135138138

Dep publique par habitant en terme constant9821,3621,4788099231,0431,4571,418

BUDGET (1)NationalNationalNationalNationalNationalNationalNationalNational

TOTAL37,48634,62436,658023,164000

FONCTIONNEMENT19,48219,57320,240023,164000

(1) Fonctionnement hors intret et Investissement hors amortissement de la dette

RECOUVREMENT1412802850122514511459

Primaire5020420700180248252

Secondaire0000023370

Tertiaire9176780122312227206

199319941995199619971998199920002001

NIVEAU / NATUREMontantMontantMontantMontantMontantMontantMontantMontantMontant%

PRIMAIRE8571,1231,2055657328489331,255

Fonctionnement438490553394432354388603

Salarial317387390335370293318354

Non salarial12110316359626170249


Dont medicament2200000178

Investissement420634652171299495545651

Investissement207478467156287359451587


SECONDAIRE157192328149195246245802

Fonctionnement134162167148170146154235

Salarial8710610798109798583

Non salarial48566050616768152






TERTIAIRE4021,0481,0654234445161,6881,603

Fonctionnement349534506423441514605648

Salarial141173171150166214223226

Non salarial208361335272275300382421

% masse salariale147208197181166140172186


Investissement545145590321,083955

Investissement495145590021,072951


ADMINIST/FORMATION6938121,1061,0651,3751,9012,3041,527

Fonctionnement4194665496386891,0691,140901

Salarial124151153262290427426523

Non salarial296315397375399642715378

% masse salariale23920826014313815016872

Investissement2743465574286868321,164626

Investissement144141295328481549616258

Fonctionnement12920626299205283548368

TOTAUX2,1093,1763,7042,2022,7463,5125,1705,186

&A

Page &P

93-96

00

00

00

00

00

00

00

00


Dep publique par habitant en terme constant

Annee

UM

Depense de sante par habitant-1993-2000

Nouakchott 93-01

E V O L U T I O N D E S B U D G E T S D E L A S A N T E D E 1 9 9 3 A 2 0 0 125-Jul-01

En millions UM

MAURITANIE199319941995199619971998199920002001


PRIMAIRE

Fonctionnement

Salarial

Non Salarial

Dont Medicaments

Investissement

Investissement

Fonctionnement

SECONDAIRE

Fonctionnement

Salarial

Non Salarial

Dont Medicaments

Investissement

Investissement

Fonctionnement

TERTIAIRE

Fonctionnement

Salarial

Non Salarial

Dont Medicaments

Investissement

Investissement

Fonctionnement

ADMINISTRATION/FORMAT

Fonctionnement

Salarial

Non Salarial

Dont Medicaments

Investissement

Investissement

Fonctionnement

TOTAUX

Fonctionnement Etat

Fonctionnement Sant

Investissement Etat (BCI)

Investissement Sant (BCI)

Budget Total Etat

Budget Total Sant

Population


FONCTIONNEMENT

Salarial

Non Salarial

Dont Medicaments

INVESTISSEMENT

Investissement

Fonctionnement

RECOUVREMENT

Primaire

Secondaire

Tertiaire

GUIDIMAGHAEVOLUTION DES BUDGETS DE LA SANTE DE 1993 A 199625-Jul-01

En millions UM

199319941995199619971998199920002001


PRIMAIRE00.000.000.000.000.000.000.000.000.0


Salarial000335000000




Investissement---------------------------

Fonctionnement---------------------------

SECONDAIRE00.000.000.000.000.000.000.000.000.0


Salarial000000000




Investissement---------------------------

Fonctionnement---------------------------

TERTIAIRE00.000.000.000.000.000.000.000.000.0

Fonctionnement0--0000000000000000

Salarial--00000000

Non Salarial--00000000

Dont Medicaments--00000000

Investissement0--0000000000000000

Investissement---------------------------

Fonctionnement---------------------------

ADMINISTRATION/FORMAT00.000.000.000.000.000.000.000.000.0


Salarial000000000




Investissement---------------------------

Fonctionnement---------------------------

TOTAUX




Population


FONCTIONNEMENT00.000.000.000.000.000.000.000.000.0

Salarial000000000000000000

Non Salarial000000000000000000


INVESTISSEMENT00.000.000.000.000.000.000.000.000.0



RECOUVREMENT010001000100010001000100010001000100

Primaire000000000000000000

Secondaire000000000000000000

Tertiaire000000000000000000


MAURITANIEEVOLUTION DES BUDGETS DE LA SANTE DE 1993 A 199625-Jul-0119931994-96BUDGET MSAS *1993199419951996

En millions UMVOTEEXEVOTEEXEVOTEEXEVOTEEXE

19931994Variation1995Variation1996VariationACEAEC

Montant%Montant%(%)Montant%(%)Montant%(%)260727NV

260827X07FONCTIONNEMENT00000000

PRIMAIRE00.000.0000.0000.00N27X08

Fonctionnement00000000000AECAECSALARIAL00000000

EFGEFGSalarial0000000000026F*27FNON SALARIAL00000000

SPF*PNon Salarial0000000000026X0927X09

EFGDont Medicaments0000000000026X1027X10

FMPInvestissement0000000000026X1127X11* = hors dpenses communes


IIPIFPFonctionnement00000000000

SECONDAIRE00.000.0000.0000.00



SSF*SNon Salarial00000000000


FMSInvestissement00000000000


IISIFSFonctionnement00000000000

TERTIAIRE00.000.0000.0000.00



STF*TNon Salarial00000000000




IITIFTFonctionnement00000000000




SAF*ANon Salarial00000000000




IIAIFAFonctionnement00000000000

TOTAUX

Fonctionnement Etat19,48219,573020,240421,1429

Fonctionnement Sant00.0000.00000.00000.000

Investissement Etat (BCI)18,00415,051-1616,418-921,95122

Investissement Sant (BCI)00.0000.00000.00000.000

Budget Total Etat37,48634,624-836,658-243,09315

Budget Total Sant00.0000.00000.00000.000

Population2,147,7782,211,4732,277,7662,346,752

Dpense sant/habt en UM0000



SF*Non Salarial00000000000


FM



IIIFFonctionnement00000000000

RECOUVREMENT0100010000100001000


RPRSSecondaire00000000000


RT





CHAHODH EL CHARGUI241,146

GHBHODH EL GHARBI179,617

ASSASSABA186,839

GUIGUIDIMAGHAEVOLUTION DES BUDGETS DE LA SANTE DE 1993 A 199625-Jul-01GORGORGOL199,741

En millions UMBRABRAKNA211,045

19931994Variation1995Variation1996VariationTRATRARZA204,255

Montant%Montant%(%)Montant%(%)Montant%(%)ADRADRAR65,833

DAKDAKHLET NDB83,790

PRIMAIRE00.000.0000.0000.00TAGTAGANT70,106

Fonctionnement00000000000GUIGUIDIMAGHA130,829

EFGEFGSalarial00000000000TIRTIRIS ZEMMOUR38,731

SPGUIF*PGUINon Salarial00000000000INCINCHIRI13,874

EFGDont Medicaments00000000000NOUNOUAKCHOTT521,972

FMPGUIInvestissement00000000000TOTTOTAL2,147,778


IIPGUIIFPGUIFonctionnement00000000000

SECONDAIRE00.000.0000.0000.00



SSGUIF*SGUINon Salarial00000000000


FMSGUIInvestissement00000000000


IISGUIIFSGUIFonctionnement00000000000

TERTIAIRE00.000.0000.0000.00



STGUIF*TGUINon Salarial00000000000




IITGUIIFTGUIFonctionnement00000000000




SAGUIF*AGUINon Salarial00000000000




IIAGUIIFAGUIFonctionnement00000000000

TOTAUX




Population




SGUIF*GUINon Salarial00000000000


FMGUI



II*GUIIF*GUIFonctionnement00000000000

RECOUVREMENT0100010000100001000


RPGUIRSGUISecondaire00000000000


RTGUI






NouakchottE V O L U T I O N D E S B U D G E T S O R D O N N A N C E S D E L A S A N T E D E 1 9 9 3 A 2 0 0 125-Jul-01

En millions UM

REPARTITION PAR199319941995199619971998199920002001


FONCTIONNEMENT54189.870339.672846.759083.062687.972981.480141.094947.9

00.000.000.000.000.000.000.000.0

SALARIAL29654.730843.834347.129650.232752.340555.539249.042945.3

Primaire13144.313543.715344.58729.49629.411428.110827.612930.1

Secondaire00.000.000.000.000.000.000.000.0

Tertiaire15652.916453.418052.515050.816650.721452.922356.722652.7


00.000.000.000.000.000.000.000.0

NON SALARIAL24545.339556.238552.929449.829947.732544.540951.052054.7

Primaire3313.4287.14010.3144.8124.0134.0122.86011.6

Secondaire00.000.041.100.051.651.661.4295.5

Tertiaire20884.736191.333587.027292.727592.330092.338293.542181.1


00.000.000.000.000.000.000.000.0


Primaire23.923.700.00---00.000.000.04919.1

Secondaire00.000.000.00---00.000.000.0238.9

Tertiaire5296.15596.365100.00---154100.015100.0120100.018472.0

00.000.000.000.000.000.000.000.0

INVESTISSEMENT6110.21,07060.483153.312117.08612.116618.61,15359.01,03152.1

Primaire2744.711911.214417.310082.78396.36840.9574.9737.1

Secondaire57.5171.6202.400.000.000.000.000.0

Tertiaire1727.090884.864277.200.033.721.51,08393.995592.7


00.000.000.000.000.000.000.000.0

00.000.000.000.000.000.000.000.0

TOTAL SANTE6020.01,7730.01,5600.07110.07110.08960.01,9540.01,9800.0

00.000.000.000.000.000.000.000.0

Population521,9720.0550,3690.0579,1300.0608,2280.0637,6290.0667,3010.0697,5420.0728,6350.0

Dp publique / hbt en UM1,1540.03,2220.02,6930.01,1700.01,1160.01,3420.02,8020.02,7170.0

Dp publique / hbt en USD50.0130.0110.050.050.060.0120.0110.0

00.000.000.000.000.000.000.000.0

RECOUVREMENT1020.0980.01030.000.01220.03270.02830.02500.0

Primaire00.000.000.00---00.0154.55720.04417.7

Secondaire00.000.000.00---00.000.000.000.0

Tertiaire102100.098100.0103100.00---122100.031295.522780.020682.3

00.000.000.000.000.000.000.000.0

REPARTITION PAR199319941995199619971998199920002001


PRIMAIRE19131.7628215.9133621.5720128.2919126.8219321.641779.0626213.25

Fonctionnement16485.6616357.6619357.2410150.2310856.6812564.7912067.7918972.20

Salarial13179.8713582.8115379.338786.019688.9211490.9110890.3012968.23

Non salarial3320.132817.194020.671413.991211.08119.09129.706031.77

% masse salariale250.00210.00260.00160.00120.00100.00110.00470.00

Dont medicament21.2721.2900.0000.0000.0000.0000.004925.77

Investissement2714.3411942.3414442.7610049.778343.326835.215732.217327.80

Investissement1660.0510991.2012587.219998.878399.936291.075291.756994.18

Fonctionnement1139.95118.801812.7911.1300.0768.9358.2545.82

00.0000.0000.009417.18

SECONDAIRE50.76170.99241.5700.005100.0040.4560.29291.45

00.0000.0000.00

Fonctionnement00.0000.00417.490---00.004100.006100.0029100.00

Salarial0---0---00.000---5100.0000.0000.0000.00

Non salarial0---0---4100.000------0.004100.006100.0029100.00

% masse salariale---0.00---0.00---0.00---0.0000.00---0.00---0.00---0.00

Dont medicament0---0---00.000---00.0000.0000.002379.47

Investissement5100.0017100.002082.510---0---00.0000.0000.00

Investissement372.7300.001154.550---0---0---0---0---

Fonctionnement127.2717100.00945.450---26100.000---0---0---

00.0000.0000.00

TERTIAIRE38163.201,43380.811,15874.2342359.4544199.2851657.841,68886.381,60380.97

00.0000.0000.00

Fonctionnement36495.6652536.6351644.53423100.0016637.5851499.5260535.8464840.41

Salarial15642.9316431.3118034.9515035.5727562.4221441.6522336.8122634.94

Non salarial20857.0736168.6933565.0527264.431660.0030058.3538263.1942165.06

% masse salariale1330.002190.001860.001810.0015434.941400.001720.001860.00

Dont medicament5214.245510.446512.6800.0030.72152.9712019.8818428.39

Investissement174.3490863.3764255.4700.0000.0020.481,08364.1695559.59

Investissement848.7790799.91642100.000---3100.002100.001,07298.9995199.54

Fonctionnement851.2310.0900.000---00.0000.00111.0140.46

00.0000.0000.00

ADMINIST/FORMATION264.28412.30412.648712.267110.0517920.07844.28864.32

Fonctionnement1350.471537.531638.866675.9371100.008346.457184.378397.19

Salarial965.60957.341062.445988.776590.997792.496187.087488.81

Non salarial434.40742.66637.56711.2369.0167.51912.92911.19

% masse salariale520.00740.00600.00130.00100.0080.00150.00130.00

Investissement1349.532662.472561.142124.0700.009653.551315.6322.81

Investissement1078.932492.312184.6021100.000---9497.59969.28144.06

Fonctionnement321.0727.69415.4000.000---22.41430.72155.94

00.0000.0000.00

00.0000.0000.00

TOTAUX6020.001,7730.001,5600.007117118961,9541,980

00.0000.0000.00

Accocuhement Assiste et revenu

0.1917.4

0.3240.55

0.4651.57

1.3170.45

8.4481.57

Prive

Public

Quantile de richesse

Pourcentage

Accouchement Assist et statut socio-conomique des femmes

Accocuhement a domicile

82.41

59.14

47.97

28.24

9.98

A domcile

Quintile de richesse

%

Accouchement a domicile par niveau socio-economique: Mauritanie 2000

Vaccination

45.2522.2

54.6628.03

65.4745.34

71.4455.68

84.7157.85

Rougeole

DTC3

%

Taux de Vaccination Par Groupe socio-economique

Utilisation de la TRO

22.2

28.03

45.34

55.68

57.85

utilisation de la TRO

Utilisation de la TRO

Contraception

0.35

1.22

3.32

7.69

18.68

Contraception

Sheet1

HNP SERVICE INDICATORS

Immunization Coverage (children 21-23 months)

Measles

Wealth index12345Average

%45.354.765.571.484.761.6Q1Q2Q3Q4Q5

N230194221142125912Rougeole45.354.765.571.484.7

DPT3DTC322.228.045.355.757.9


%22.228.045.355.757.939.2

N222189217137125890Q1Q2Q3Q4Q5

utilisation de la TRO22.228.045.355.757.9

Medical Treatment of illness (children under 5)

Treatment of Diarrhea (%)

Prevalence


%17.421.218.015.220.418.4

N1,1679409857466594497

ORT use


%22.228.045.355.757.939.2

N222189217137125890

Seen Medically


%******

N******

Seen in Public Facility


%******

N******

*: no observation

Medical Treatment of illness (children under 5)

Treatment of Acute Respiratory Infection (%)

Prevalence


%14.617.423.820.017.718.6

N1,1639329867456594485

Seen Medically


%******

N******

Seen in Public Facility


%******

N******

*: no observation

Antenatal Care Visits

To a Medically Trained Person


%25.734.149.558.563.443.6

N1,2641,0491,0918117104925

To a DoctorQ1Q2Q3Q4Q5

Wealth index12345AverageCPN125.734.149.558.563.4

%7.310.613.615.425.913.4CPN219.730.044.753.561.1

N1,2641,0491,0918117104,925Accocuhement assiste21.248.055.278.893.9

To a Nurse or Trained Midwife


%19.125.541.049.244.533.9

N1,2641,0491,0918117104,925

2+ visits


%19.730.044.753.561.138.9

N1,245.91,042.31,078.2792.2688.94,848.0

Delivery Attendance (%)

By a Medically Trained Person


%21.248.055.278.893.954.4

N1,2641,0431,0928107104918

By a Doctor


%4.58.98.412.620.39.9

N1,2641,0431,0928107104,918

By a Nurse or Trained Midwife


%19.125.541.049.244.533.9

N1,2621,0481,0908107094,918

In a Public FacilityAccouchement

Wealth index12345AverageQ1Q2Q3Q4Q5

%17.440.651.670.581.647.9Prive0.20.30.51.38.4

N1260104110918087074908Public17.440.651.670.581.6

In a Private Facility


%0.20.30.51.38.41.7Q1Q2Q3Q4Q5

N1260104110918087074908A domcile82.459.148.028.210.0

At Home


%82.459.148.028.210.050.5

N1260104110918087074908

Q1Q2Q3Q4Q5

Contraception0.41.23.37.718.7

Modern Contraceptive Use (Mauritanie, female)


%0.41.23.37.718.75.3

N1,1279149736946984,406

Knowledge of HIV/AIDS Prevention (female)


%******

N******

*: no observation

Sheet2

Sheet3

LE CADRE BUDGETAIRE A MOYEN TERMEP1. Disponibilite des ress. humainesP2. Accessibilite GeographiqueP3. Disponibilite des ress. Mat. essent.P4.Qualite, Demande, lutte contre. MaladieP5.Action Sociale, Solidarite, ParticipationP6.Renforcement des Capacites InstitutionnellesUn Syst. de Sant Efficient, utilis par tous qui livre des prestations visant la rduction des indicateurs de sant et lattnuation du poids sur les plus pauvresImpact sur Indic. SanteEducation de baseAutres Fact.multi

REFORMES NECESSAIRESReforme des procedures budgetaires et de gestion financiere permettant une meilleure disponibilite des financements sur budget etat au profit des formations sanitairesMise en place rapide dune Centrale dAchat de MedicamentsMise en place de contrats de performance avec les DRPSS sur la base dobjectifs precisReforme de la formation, de la gestion et de lincitation a la performance avec la mise en place de contrats zones et de primes de technicite decentraliseeReforme du Systeme de Recouvrement des couts et du cadre dimplication des communautes dans la gestion de leur santeReforme du Systeme National dInformation Sanitaire pour aider a la decision et au suivi du Programme.

MONTANT: 14,269,909,000 UM

AUGMENTATION DE 58 % PAR RAPPORT A 2001

AVEC:Investissement: 6.962.872.000 soit 49 %Fonctionnement: 7,331,983,000 soit 51 %

PROPOSITION DE POAS 2002

PAR PROGRAMME:STRUCTURE DU POAS 2002

2. PAR NIVEAU:STRUCTURE DU POAS 2002 (Suite)

3. PAR SOURCE DE FINANCEMENT:STRUCTURE DU POAS 2002 (Suite)

JE VOUS REMERCIE

SANTE ET PAUVRETE EN MAURITANIE

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