As one of eight African countries supported by phase II of the Global Fund’s BIRCH project, Mauritania received technical assistance from ICHESS to assess the maturity of its community health system. The Ministry of Health’s National Community and Mobile Health Program (PNSCM) held the assessment workshop in Tiguint on 7–9 October 2024, with 55 stakeholders involved in community health.

Method. Mixed methods with an in-depth document review, preceded by an inventory of the 16 foundational elements of the community health system. The maturity analysis used an Excel tool based on the CHW Assessment and Improvement Matrix (7 domains, 28 components). The “5 whys” technique identified the root causes of each bottleneck.

Key findings

Domain	2024 status	Key finding
Service delivery	Functional	The only domain rated functional
Leadership, governance and planning	Partially functional	National Community and Mobile Health Program (PNSCM) attached to the Minister’s office
Financing	Partially functional	Fragmented funding; foundational activities mainly supported by UNICEF and the World Bank
Information systems	Partially functional	Shortage of data to measure the performance of community interventions
Supply chain	Partially functional	Weaknesses in supplying community actors
Community engagement	Partially functional	Progress made, but civil society and communities are not yet involved enough in decisions
Human resources	Non-functional	Insufficient coverage and management of community health workers

Overall, the system is partially functional. Only 7 of the 16 foundational elements (44%) were available in the second quarter of 2024. The assessment identified 29 bottlenecks with mitigation strategies and priority actions, and documented 7 good practices to build on in the 2025 operational action plan.

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