Kingdom of Morocco : Health Policy Note Towards a More Equitable and Sustainable Health Care System - Policy Challenges and Opportunities
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Washington, DC
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This note identifies three main issues
and proposes a set of short- and longer-term policy measures
for each. The publicly financed and run health care system
does not meet healthcare needs of the majority of the
Moroccans. Only half of the population uses health services
when experiencing an illness, indicating that people who
live outside big cities either cannot or will not pay for
poorer quality services in rural health facilities. While in
the short term limited use of healthcare services because of
inability or unwillingness to pay may not significantly
affect levels of morbidity and mortality resulting from
non-communicable diseases, the impact is likely to grow
exponentially in the next two decades. Despite recent
attempts by the government to expand population coverage,
improve system governance, and increase the quality of care,
Morocco's health care system remains predominantly
state owned and managed, yet highly fragmented. On one hand,
the system is not truly pluralistic because of negligible
participation of providers and consumers in system
governance. On the other hand, the execution of all main
healthcare functions are segmented across several government
agencies, or applicable to different population segments. In
addition, low and poorly allocated public outlays for health
care result in inefficiencies in the allocation and use of
public resources, as well as in high private out-of-pocket
expenditures. If a publicly funded health insurance scheme
is intended to provide universal coverage for an essential
package of services, a significant restructuring of the
existing institutional architecture and of the legislative
and regulatory framework will be needed to make it a reality.
Palabras clave
ABILITY TO PAY, ABORTION, ACCESS TO HEALTH CARE, ACCESS TO PRIMARY HEALTH CARE, ADOLESCENT FERTILITY, ADULT MORTALITY, ADULT POPULATION, AGED, AGING, ANTENATAL CARE, BABIES, BASIC HEALTH CARE, BEDS, BIG CITIES, BIRTH RATE, BOTH SEXES, BULLETIN, BURDEN OF DISEASE, CARDIOVASCULAR DISEASES, CERTIFICATION, CHILD CARE, CHILD HEALTH, CHILD MORTALITY, CHILDBIRTH, CHILDREN PER WOMAN, CITIES, CITIZENS, CLINICS, COMMUNICABLE DISEASES, CYCLE OF POVERTY, DEATH RATE, DEATHS, DEBT, DECISION MAKING, DEMOGRAPHIC TRANSITION, DEPENDENCY RATIO, DEVELOPMENT POLICY, DIABETES, DISABILITY, DISASTERS, DISPARITIES IN HEALTH, DISPENSARIES, DOCTORS, ECONOMIC GROWTH, ECONOMIC OPPORTUNITIES, ECONOMIC POLICY, ELDERLY, EPIDEMIOLOGICAL TRANSITION, EQUITY IN ACCESS, ESSENTIAL DRUGS, ESSENTIAL HEALTH CARE, ESSENTIAL HEALTH SERVICES, EXPANSION OF POPULATION, EXPENDITURES, FAMILIES, FERTILITY, FERTILITY RATE, GENERAL PRACTITIONERS, GENERIC DRUGS, GLUCOSE, GOOD GOVERNANCE, GOVERNMENT AGENCIES, GROSS DOMESTIC PRODUCT, HEALTH BEHAVIOR, HEALTH CARE, HEALTH CARE COVERAGE, HEALTH CARE DELIVERY, HEALTH CARE EXPENDITURES, HEALTH CARE FACILITIES, HEALTH CARE FINANCING, HEALTH CARE SERVICES, HEALTH CARE SYSTEM, HEALTH CARE WORKERS, HEALTH CENTERS, HEALTH EXPENDITURE, HEALTH EXPENDITURES, HEALTH FACILITIES, HEALTH FINANCING, HEALTH INDICATORS, HEALTH INFORMATION, HEALTH INSURANCE, HEALTH ORGANIZATION, HEALTH OUTCOMES, HEALTH POLICIES, HEALTH POLICY, HEALTH PROFESSIONALS, HEALTH PROGRAMS, HEALTH PROJECTS, HEALTH PROMOTION, HEALTH PROVIDERS, HEALTH SECTOR, HEALTH SECTOR REFORM, HEALTH SERVICE, HEALTH SERVICES, HEALTH SPECIALIST, HEALTH STATUS, HEALTH SYSTEM, HEALTH WORKERS, HEALTH WORKFORCE, HIGH BLOOD PRESSURE, HIV, HIV/AIDS, HOSPITAL, HOSPITAL AUTONOMY, HOSPITAL BEDS, HOSPITALS, HOSPITALS PUBLIC, HR, HUMAN DEVELOPMENT, HUMAN IMMUNODEFICIENCY VIRUS, HUMAN RESOURCES, HUMAN RESOURCES DEVELOPMENT, HUSBANDS, ILL-HEALTH, ILLNESS, IMMUNIZATION, IMMUNODEFICIENCY, INCIDENCE ANALYSIS, INCOME, INEQUITIES, INFANT, INFANT MORTALITY, INFANT MORTALITY RATE, INFANTS, INJURIES, INPATIENT CARE, INSTITUTIONAL CAPACITY, INSTITUTIONALIZATION, INSURANCE SCHEMES, INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES, INTEGRATION, INTERVENTION, LEVELS OF MORBIDITY, LIFE EXPECTANCY, LIFESTYLES, LIMITED RESOURCES, LIVE BIRTHS, LOW BIRTH WEIGHT, MATERNAL DEATHS, MATERNAL MORTALITY, MATERNAL MORTALITY RATES, MATERNAL MORTALITY RATIO, MEASLES, MILLENNIUM DEVELOPMENT GOALS, MINISTRY OF HEALTH, MORBIDITY, MORTALITY, MORTALITY DIFFERENTIALS, MOTHER, NATURAL DISASTERS, NEONATAL MORTALITY, NURSES, NUTRITION, OBESITY, OPPORTUNITIES FOR WOMEN, OUTPATIENT CARE, PATIENT, PATIENTS, PERI-NATAL CARE, PERINATAL CARE, PHARMACISTS, PHARMACY, PHYSICIAN, PHYSICIANS, POLICY DECISIONS, POLICY MAKERS, POOR HEALTH, POPULATION GROUPS, POPULATION GROWTH, POPULATION GROWTH RATE, PREGNANT WOMEN, PRIMARY CARE, PRIMARY HEALTH CARE, PROGRESS, PUBLIC ADMINISTRATION, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC HEALTH EXPENDITURES, PUBLIC HOSPITALS, PUBLIC INFORMATION, PURCHASING POWER, PURCHASING POWER PARITY, QUALITY OF CARE, QUALITY OF LIFE, QUALITY SERVICES, REPRODUCTIVE HEALTH, REPRODUCTIVE HEALTH POLICIES, REPRODUCTIVE HEALTH SERVICES, RESOURCE ALLOCATION, RESOURCE USE, RESPIRATORY DISEASES, RISK FACTORS, RURAL AREAS, RURAL COMMUNITIES, RURAL DEVELOPMENT, RURAL GIRLS, RURAL POPULATIONS, SANITATION, SERVICE PROVISION, SMOKING, SOCIAL SERVICES, SOCIOECONOMIC DEVELOPMENT, SOCIOECONOMIC DIFFERENCES, SURGERY, SUSTAINABLE ACCESS, SUSTAINABLE HEALTH CARE, TEACHING HOSPITALS, TECHNICAL ASSISTANCE, TRADE UNIONS, TUBERCULOSIS, UNDER FIVE MORTALITY, UNDER-FIVE MORTALITY, UNEMPLOYMENT, UNSAFE ABORTION, URBAN AREAS, URBAN POPULATION, URBANIZATION, USE OF HEALTH SERVICES, USE OF RESOURCES, USER FEES, VICIOUS CYCLE, WORKERS, WORLD HEALTH ORGANIZATION