In recent years, the National Sickness Insurance Fund (Caisse nationale d’assurance maladie – CNAM) has been working to design and implement new procedures with the aim of continuously improving its benefits in order to better meet the expectations of insured persons by significantly reducing, for instance, the reimbursement period for ambulatory care expenses – a key quality objective for the CNAM.

In order to achieve this objective, the CNAM has set up a system which operates mainly at the following four levels:

• the payment of data entry officers according to the number of claims input, exempting them from the time-logging system;
• the exemption from validation of claims for amounts below 3,000 MRO;
• the introduction of a payment system through pharmacies (reimbursement by SOLI);
• the periodic organization of paid additional work.

These combined measures have failed to reduce the reimbursement period in a significant and lasting way. It has therefore been decided to introduce a Third-Party (TP) reimbursement with a number of pharmacies in Nouakchott in an experimental pilot phase.