RESEARCH ARTICLE


Universal Health Coverage in Morocco: The Way to Reduce Inequalities: A Cross-sectional Study



Kawtar Zahidi1, Abdellatif Moustatraf2, Ahmed Zahidi1, *, Saida Naji3, Majdouline Obtel1
1 Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
2 National Health Insurance Agency, Rabat, Morocco
3 Faculty of Legal Economic and Social Sciences Souissi, Mohammed V University in Rabat, Rabat, Morocco


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Creative Commons License
© 2022 Zahidi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco;
Tel: +212667323273; E-mail: ahmed.zahidi@fmp.um5.ac.ma


Abstract

Background:

Morocco launched an appeal in 2002 to develop a fundamental law on Basic Medical Coverage. Two systems have been put in place: Compulsory Health Insurance (AMO) based on solidarity and social security contributions; and a Medical Assistance Scheme based on the principle of social protection. The objective of these systems is to achieve Universal Health Coverage (UHC) to attain equity and equality in access to health care.

In the international trend, access to economic and social rights has become a significant concern in public policies. This concept, based on the value of “equity” is now essential in evaluating equal opportunities in social and health systems. More importantly, there is a need to clarify the difference between the terms equality and equity in health. In most cases, reference is made to the definition used in Anglo-Saxon literature (equity, equality, fairness). Therefore, not all inequalities are inequities. The difference between equality and equity lies in that the first term gives the result of comparison without value judgment, while the second makes a judgment that qualifies the result as fair or unfair.

Our study aims to analyze the specific problems related to the healthcare policy focused on allocating the supply of care, and efforts to improve financial accessibility specifically by developing medical coverage. We will present results that reflect the availability and quality of care in Morocco and shed light on the problem of not seeking healthcare for financial, geographical, and other reasons. In addition, we will discuss the difficulties related to the use of care by Moroccan citizens.

The findings of this paper can potentially inform national healthcare policy and add to the small but growing literature on this subject in Morocco.

Methodology:

The methodology is based on research & data taken from official institutional publications from Morocco & United Nations organizations (gray literature) and data derived from articles published in scientific journals.

Results:

Morocco continues to suffer from disparities in the distribution of health practitioners due to an imbalanced distribution of health infrastructure and human resources between rural and urban areas. The Health Map developed by the Ministry of Health and Social Protection in 2016 is a very good tool to monitor the distribution of public health needs in each region, plan the delivery of care, regulate spending, and consolidate regionalization policy to ensure equity in supply and access to health care. At the end of 2021, the national average ratios were 7.3 physicians and 10 beds per 10000 inhabitants. In 2018, more than 60% of the Moroccan population enjoyed basic medical coverage and the Moroccan Government is committed to reaching 100% of Universal Health Coverage (UHC) by 2030.

Conclusion:

The health map will make it possible to control health expenditure by allocating human and financial resources according to needs and will determine the future location of health facilities to establish equity in the offer and access to health care.

Keywords: Accessibility, Health equity, Health expenditures, Health cost universal health coverage, Financial resources, Health care.