28 PERSPECTIVES ON BUSINESS AND ECONOMICS | VOL 42 | 2024 Between 2011 and 2020, the number of health workers per 10,000 citizens in the private sector grew by 1.3, while in the public sector, the number of doctors per 10,000 citizens decreased by 0.3 (Rahhou, 2023). As of 2021, the public sector employed 12,896 doctors, whereas the private sector employed 14,199 doctors (Ministry of Health and Social Protection, 2021). Individuals who can afford private health care opt for it due to the obstacles to care in the public sector, including language, long wait times, inadequate equipment, and a shortage of health professionals. These barriers contribute to the reluctance of doctors to work in public institutions and even prompt some to leave the country to practice medicine (Rahhou, 2023). Although acknowledging the need for an increased physician workforce is essential, it is equally crucial to devise strategies to attract and retain doctors in public health-care facilities. The unattractiveness of a medical career Currently, the path to becoming a doctor in Morocco spans seven years, including five years of education in medical school, one year as a trainee doctor, and another year working at a regional hospital. The latter serves the dual purpose of providing practical experience and addressing the existing shortage of doctors in remote rural areas. Medical students in Morocco face significant financial challenges, leading to a situation where 70% of students in their final year plan on leaving Morocco to pursue their careers elsewhere (Sawahel, 2022). This exodus is part of a larger issue of workers going abroad, mainly to France and Spain, with a total of 27,000 Moroccans leaving the country in 2022 (Sahnouni, 2022). The migration of talent has an impact on the Moroccan health-care workforce, impeding its growth and development, thus preventing the country from reaching the minimum number of health-care workers needed to sustain the system. Initiatives have been put into place to reduce the duration of medical training from 7 to 6 years (Latrech, 2022). Although these initiatives seemingly make it easier for students to become doctors, they do not address the problem of students not being able to support themselves. The change in training time also does not address the stress that students will be encountering now that they must take exams, complete internships, and write a thesis within one year instead of two (Tachfine, 2023). In 2022, the National Commission of Medical, Dental and Pharmacy Students of Morocco conducted a study about the problems relating to “social conditions, the economic and financial situation of students” due to the rising number of uncertainties with the change of training and availability of funds for students. The survey revealed that 92% of students need to go to their families for financial support because they are unable to pay rent, buy appropriate clothing and equipment, or afford transportation to classes and internships. Students can apply for limited funding (living stipends) and scholarships, but these payments can be delayed, forcing students to adjust their lifestyle to support themselves. This reduced lifestyle includes skipping meals and never taking time off thus decreasing their quality of life in general. The overall decrease in quality of life “creates an environment that is poorly adapted to studies,” often leading students to investigate different locations for studying (National Commission of Medical, Dental and Pharmacy Students of Morocco, 2022). Morocco needs to add to the funds available for medical stipends and scholarships to better support its doctors in training and to reduce the number of those leaving the country. Lack of generalists In Morocco, the absence of general practitioners and family medicine–oriented training is problematic. General practitioners play an essential role in providing continuous care to patients and conducting routine examinations. This practice not only ensures the well-being of patients but also directly aligns with general practitioners’ mission to decrease the chances that their patients need further specialized care. A greater number of general practitioners in the medical workforce is crucial for Morocco to adopt the PHC approach recommended by the WHO. Integral to PHC is that individuals receive consistent quality care throughout their lives instead of just receiving care for life-threatening issues. This approach aligns with the primary goal of increasing the number of health professionals; more broadly, a PHC approach works to address the social determinants of health that affect individual health outcomes (WHO, 2023). Lack of funding As discussed previously, the World Bank approved a loan to support Morocco in implementing health reforms. While this loan will help establish the new health-care system, steps still need to be taken to establish standard quality-of-care practices that lead to better health outcomes (Kasraoui, 2023, June 19). In addition, the availability of funding influences health professionals’ decisions when it comes to
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