Case Study: Respecting Human Rights

Public Private Partnership for Access to Mental Healthcare in Mauritania, Sanofi


In Mauritania, a 2005 study in the capital city of Nouakchott revealed that 34% of the population had at least one mental disorder. As in many other developing countries, available mental health care systems are not aligned with needs in Mauritania, resulting in large numbers of neglected patients. In addition, some symptoms of mental disorders are traditionally attributed to possession by evil spirits, which leads to the stigmatization of patients: patients often live on the edges of society, are rejected, excluded and sometimes even chained. In October 2008, Sanofi launched a pilot program focusing on schizophrenia in Nouadhibou, the economic capital of the country. The aim of this pilot project was to test the feasibility of setting up one mental health clinic in each of the 13 Mauritanian provinces, working in a close collaboration with specialists from the Nouakchott neuropsychiatric center; to assess the impact of the project on access to mental health care and to learn from this experience for preparing an extension of the project to the rest of the country./p>

Lessons Learned

The partnership is developed around a comprehensive approach that includes awareness of the medical nature of mental disorders among communities, and training on diagnosis and treatment for heathcare professionals. The results of this pilot program indicate that access to care for patients with mental disorders can greatly be improved by a simple, assessable, replicable and scalable program. Launched in 2008, the program was extended to other provinces of Mauritania in 2011 to include 2 to 3 provinces per year in order to cover the whole country in 5 years. In addition to schizophrenia, the expanded program also includes other major mental disorders (mood disorders, anxiety disorders, addiction …) and epilepsy.

Results to Date

As of end 2012:

  • 37 healthcare professionals have been trained, and outpatient facilities have been opened in seven centers.
  • Through information tools specifically designed for awareness campaigns and used by several NGOs, more than 1000 people (patients, patient families, teachers, woman associations…) were informed about mental disorders.
  • 452 patients with schizophrenia (of a total estimated population of 1,000 patients with schizophrenia in Nouadhibou) have been reached by the program.
  • The treatment gap (number of patients with mental disorders, not treated) has gone from 93% in May 2009 to 48% in December 2012 – an improvement of 48% in 3.5 years.

This pilot program has a positive impact on the Nouadhibou population management of mental health disorders, addressing the needs of neglected patients and reducing their stigmatization. It indicates that access to care for patients with mental disorders can greatly be improved by a simple, assessable, replicable and scalable program.

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