Health reform framework and new Investment Charter in Morocco
Introduction
The healthcare sector is one of the most important domains impacting everyone and is closely linked to the development of any country. It also plays a crucial role in how a country is perceived in maintaining economic stability. As such, healthcare systems form a key part of government strategies across the world. To fulfill ideal healthcare to citizens, there are three important factors to be considered including accessibility, affordability and quality. It is important to note that the sustainability of healthcare depends on the aforementioned, thus, it has become so imperative that countries globally look into the ways in which these can be made accessible for the communities.
Moreover, quality health care helps prevent diseases and improve quality of life in countries. Improving health care quality and making sure all people get the health care services they need forms the integral part of what the countries are responsible for. However, the challenge of access to healthcare has been recorded globally particularly in developing countries. According to WHO (2020), at least half of the world’s population does not have access to the health services they need, which is an alarmingly high rate, particularly as this is a sector that impacts most people at some point in their life. In addition to this, it is estimated that 100 million people are driven into poverty each year through out-of-pocket health spending, given the lack of access to quality, affordable healthcare.
To also note is that, countries with robust healthcare frameworks often have long waiting lists to access the relevant specialist or have a simple surgery carried out. Some countries have systems in place that do not provide the best quality care due to lack of resources or budget constraints. The situation even exacerbates in less-developed countries who actually have a limited number of facilities that are understaffed and under-resourced, with those living in rural or remote areas having to travel long distances to obtain the healthcare assistance they require. Morocco is not an exception to these health challenges.
Health issues in Morocco
To begin with, the COVID-19 pandemic and a two-year drought which was experienced in Morocco pushed the northern Africa country’s economy into a deep recession in 2020 leading to an increase in poverty. Morocco gradually rebounded from the aforementioned crises with a notable growth rate that was registered in 2021. However, an unusually dry beginning of the agricultural season and the impact of the war in Ukraine on prices have put further pressure on the poor and vulnerable. This saw health issues arising in the nation including communicable and non-communicable diseases, especially for the vulnerable groups like the poor and vulnerable. Some of the health challenges notable in Morocco includes the following:
Ongoing institutional reforms- Morocco is undergoing a variety of health system reforms, including those affecting hospitals and institutions. Currently, the North African country’s health system has public and private sectors. The private sector is further divided into not-for-profit and for-profit divisions, which is often quite costly. The public sector, though more affordable, is unable to provide the same standard of care as the private sector. Due to the ongoing reforms, the World Health Organization has outlined the management of public hospitals and a “lack of a policy to manage and develop human resources” to be some of the Moroccan health system’s main challenges.
Lack of healthcare workers/professionals- There is a lack of skilled healthcare professionals in both sectors of its healthcare system. Notable in 2017, there was an average of 7.9 health workers per 10,000 people in the country’s 12 regions, as elucidated by the Moroccan Ministry of Health. This ratio falls far below the WHO’s standard of one physician per 650 people.
Limited accessibility to healthcare- Coinciding with cost barriers and limited healthcare personnels, many Moroccans lack access to healthcare outside of urban centers. Rural and remote areas of Morocco are often underserved, and citizens have to travel long distances to receive primary care. To attract and retain healthcare workers in these underserved areas, the Moroccan Ministry of Health proposed legislation in 2015 for new graduates to work in underserved areas for two years.
Gender inequality affecting women’s access to healthcare- Women’s health in Morocco is lower than men due to socio-economic factors limiting women’s standard of living and income. According to the Mohammed Bin Rachid Al Maktoum Foundation, Morocco’s estimated 2008 illiteracy rate was 43%. In the same report, women’s illiteracy rate sat higher at 54.7%. Moreover, according to a 2009 report by the High Commission for Planning for Morocco, women with higher education diplomas were more vulnerable to unemployment. The report found that, in general, 27.5% of women are unemployed, while 50.1% of women with credentials are unemployed. Furthermore, Morocco has one of the highest infant mortality rates in the world, with an estimated 21.90 deaths per 1000 live births in 2017.
Morocco new health reform and Investment Charter tackles health challenges
With the growing challenges to healthcare as mentioned earlier, the Moroccan government in April 2022 announced a change in its legislation with the Alawi kingdom carrying out a series of reforms in the health sector. Moreover, the Council of Ministers announced that a new Investment Charter has been approved to improve the health sector. The news was announced by the Royal Palace, where King Mohammed VI presided over a Council of Ministers that has taken this series of decisions.
Pertaining Morocco’s health reform, the Minister of Health and Social Protection, Khalid Ait Taleb, gave a presentation on the draft framework law on the national health system confirming that the Kingdom is ready for the overhaul of its health system and that social protection will eventually be incorporated into Moroccan law. The reform will be based on four fundamental pillars that will improve the entire health system in Morocco. The first of these will seek to strengthen the governance of the health system in order to promote mechanisms for regulating the actions of interest groups. This will consolidate good hospital management and impose equal planning of healthcare provision. This will be done through the creation of several institutions such as the High Health Authority, a Medicines and Medical Devices Agency and a Blood and Blood Products Agency.
Furthermore, at the central level, territorial health groups will be created to organize and fulfill the functions of the entire territory. These will be responsible for the development and implementation of the national regional programme, as well as for strengthening mechanisms to promote cooperation between the public and private sectors. The second area will develop the human resources of health professionals. With the creation of a law on public health administration, human capital in the public sector will be boosted to reduce staff shortages. It will also reform the training system and seek to provide better quality for Moroccan doctors working in other countries to return to the Kingdom to practise their profession.
According to the Head of Government, Aziz Akhannouch, Morocco seeks to increase the number of health professionals to more than 90,000 by 2025 from the current 68,000. He signed the framework agreement on the implementation of a program which aims at boosting the number of health professionals by 2030. The objective is also to reach the quota of 24 health professionals for every 10,000 inhabitants by the same deadline of 2025, and 45 health professionals for every 10,000 inhabitants by 2030. Reaching this goal requires doubling the number of medicine, pharmacy, and dentistry graduates, as well as tripling the number of nursing and health technology graduates by 2025. Under the framework agreement, three faculties of medicine and pharmacy as well as three university hospitals will be opened in Errachidia, Beni Mellal, and Guelmim for an estimated budget of more than MAD 3 billion ($294 million).
Moreover, the government on top of the above also announced its decision to reduce the duration of medical training from seven to six years, in a bid to meet the objectives of the kingdom’s New Development Model (NDM) and the national project to extend health insurance (AMO) to every Moroccan. According to the government, the goal of the health-related reforms is mainly to promote good governance among hospitals across the country while strengthening the exchange of expertise by encouraging foreign medical experts and experts from the Moroccan diaspora to contribute to revamp the country’s health sector.
The third area will focus on the facilitation of access to healthcare for Moroccans and improve the quality and distribution of hospital services throughout the country. The rehabilitation of all health structures will begin shortly, and a law will be implemented that will make it compulsory to respect the care pathway and a system of accreditation of institutions. Finally, the entire health system will be digitized by means of good computer equipment for the aggregation, processing and exploitation of patient and health system information.
The Investment Charter has been communicated by the Minister Delegate in charge of Investment, Convergence and Public Policy Evaluation, Mohcine Jazouli. Morocco will start to become more competitive in this sector and the main objective will be to improve the impact of the industry. To the citizens of Morocco, this entails the boosting of permanent job creation by the government and thus reducing the economic inequalities that exist between provinces where there is investment and those where there is not. Morocco will direct investments towards innovative and high value-added sectors. This will achieve sustainable development and strengthen the country's international attractiveness in terms of attracting foreign direct investment as the Minister of Health acknowledges.
He also adds that this Investment Charter will be supported by a mechanism dedicated to the search for strategic projects and three smaller ones that will be responsible for promoting the country's SMEs and companies that want to internationalize. In addition, processes will be made digital to facilitate procedures and the participation of the private and banking sectors in investment will be strengthened.
Conclusions & Recommendations
Morocco sets as an example of a country which has managed to create innovative and sustainable initiatives to tackle the health challenges its citizens have been facing. Through the stipulations of the new reform framework and the investment charter, the government of Morocco did not only tackle the root causes of health challenges which includes poverty, hunger and gender based inequalities, but it also went a step ahead in making sure that accessibility, affordability and quality health care is reached in its country. Some scholars have regarded how improving the Moroccan health system is a slow process; however, with support from international public health organizations like WHO and healthcare professionals, healthcare in Morocco could advance significantly. Equal healthcare to women and Moroccans living in rural and remote areas will ensure a brighter, healthier future for Morocco and the world. The new plan also aims to upgrade health care services to meet Moroccan expectations in terms of facilitating access to health services. Conclusively Morocco has taken commendable moves to tackle health challenges in the country through the introduction of the new health reform and investment charter, the effective implementation of the former will ensure effective access, affordability and quality healthcare to the citizens of Morocco.
Bibliography
Healthcare Industry in India. (2020). Retrieved September 27, 2022 from ibef.org
Health Promotion. (2020). World Health Organization. Retrieved September, 2022 from who.int
Reiling, J. (2006). Safe Design of Healthcare Facilities. Quality and Safety in Health Care.
Retrieved September 27, 2020 from ncbi.nlm.nih.gov
Sitanshu, K., Gautam, R. & Subitha, L. (2012). Health Promoting Hospital: A Noble
Concept. National Journal of Community Medicine, 3(3), 558-562. Retrieved September 27, 2020 from njcmindia.org
Training as a Doctor. (n.d.). Health Careers. Retrieved September 27, 2020 from healthcareers.nhs.uk