26 PERSPECTIVES ON BUSINESS AND ECONOMICS | VOL 42 | 2024 dence of both communicable and noncommunicable diseases. Furthermore, it concentrates on expanding programs that meet the needs of diverse populations, such as women who need access to maternal and child health programs, victims of violence, individuals with disabilities, and prisoners. The third pillar of the health plan is dedicated to resource allocation and governance. It encompasses strategies aimed at enhancing the existing AMO and RAMED systems, at the same time addressing the pressing need for additional human health resources. This pillar seeks to restructure the Ministry of Health to establish a national health information system (Doukkali, n.d.). According to state estimates, the health plan will require an “investment of at least €2.2B to achieve the targets”; €179.9M of the total investment needed will come from government funds already put into place, the rest raised through public-private partnerships, international donors, and taxes (Morocco ramps up…, 2019). But 2025 is quickly approaching, and unfortunately, many changes still need to be made before UHC can be achieved. In 2021, under the guidance of King Mohammed VI, a developmental model was designed to foster comprehensive growth in all sectors, including social, political, economic, and cultural, through a citizen-centric approach. Regarding health care, the model calls for expanding the existing system to address significant disparities within the sector. Currently, Morocco falls below the health standards established by the WHO, making it imperative to undertake these upgrades. The model represents plans to effectively implement UHC, ensuring that all citizens have access to a progressively evolving range of basic health services. To achieve this access, Morocco is actively working to establish a new territorial structure for the health-care system, to enhance access by overcoming existing geographical and temporal barriers (Special Commission on the Development Model, 2021). Current health-care system demographics To properly analyze demand for and utilization of the Moroccan health-care system, it is necessary to understand the country’s current demographics and number of active health facilities. In 2023, the urban population of approximately 24.3 million people was served by 861 PHC facilities, whereas the rural population of 13.2 million had access to 2124 facilities. Even though rural areas are home to a population approximately half the size of the urban population, rural areas are vastly more decentralized, thereby requiring more facilities. Unfortunately, a greater number of facilities alone is not sufficient to provide services to that population. The optimal facilities are predominantly concentrated in urban areas like Casablanca and Rabat, leading to regional disparities in access to high-quality services (Morocco ramps up…, 2019). Along with a disproportionate number of quality facilities in urban areas, there is an unequal distribution of public physicians. In 2021, Casablanca, Marrakech, and Fez employed 57.4% of all physicians in the country (Ministry of Health and Social Protection, 2021), despite those regions being home to only 13% of the entire population (World- ometer, 2024). This disparity suggests fewer doctors per capita and the likelihood of fewer physicians in rural areas. Health-care spending plays a crucial role in understanding the evolution of a country’s health system over time. Health expenditure encompasses both private and public health insurance, research, and health-care facilities. From 2018 to 2020, Morocco witnessed growth in health expenditure both as a percentage of GDP (5.37% to 5.99%) and as spending per capita ($166 to $187). By way of comparison, in 2020, in Tunisia, Algeria, Egypt, and Spain, the health expenditures as percentages of GDP were 6.34%, 6.32%, 4.36%, and 10.89%, respectively. In 2020, the same four nations, respectively, expended $222, $215, $151, and $2900 per capita on health care. In sharp contrast, South Africa spent $490 per capita. Morocco’s rising spending trend signifies its dedication to achieving UHC (albeit COVID-19 likely playing a substantial role in this escalation). Despite these trends in health expenditures, Morocco consistently reports the second-lowest total health expenditure compared to its neighboring countries (World Bank, 2024). Furthermore, in 2023, to address the challenge of financial resources, the World Bank Board of Directors approved a $450M loan to support the Government of Morocco’s health-care reforms. The aim of this loan aligns with the UN Agenda for Sustainable Development, emphasizing inclusivity and ensuring that no one is left behind (Kasraoui, June 19). In 2022, the Ministry of Health and Social Protection allocated $604M to restructure the existing health sector. These funds will facilitate the construction of health-care facilities and a boost in health-care workers’ salaries. Looking ahead, the Moroccan government plans to augment the Ministry of Health’s budget by 9.1%, which will support the addition of 5500 new positions within the Department of Health and the modernization of hospitals and existing equipment (Zouiten, 2023). Even with the current increase in spending, continued investment is necessary to fully reach the goal of UHC.
RkJQdWJsaXNoZXIy MTA0OTQ5OA==