Health in Morocco

Morocco became an independent country in 1956. At that time there were only 400 private practitioners and 300 public health physicians in the entire country. By 1992, the government had thoroughly improved their health care service and quality. Health care was made available to over 70% of the population. Programs and courses to teach health and hygiene have been introduced to inform parents and children on how to correctly care for their own and their families' health.

The first health care policy in Morocco was devised in 1959, with majority of the free healthcare services and management focused on the general public. The State provides funding and administration. The Ministry of Health runs the National Institutes and Laboratories, Basic Care Health Network and the Hospital Network. The Defence Department owns and runs its own hospitals, and local governments run city health services.[1]

The healthcare system is made up of AMO (Mandatory Health Insurance). AMO is split into two sections: CNSS (private)[2] and La CNOPS (public).[3] There is also RAMED, a health insurance program designed to support the low socioeconomic population from financial tragedy due to health related issues.[4]

The Moroccan health care system has four layers, the first being "primary healthcare". This includes clinics, health centres and local hospitals for public healthcare, and infirmaries and medical offices for private healthcare. The second section includes provincial and prefectural hospitals for public health, and specialised clinics and offices for private health. The third area includes hospitals in all major cities, and the fourth includes university hospitals. These centres have the most advanced equipment.

Background
[5]

According to the United States government, Morocco has inadequate numbers of physicians (0.5 per 1,000 people) and hospital beds (1.0 per 1,000 people), and poor access to water (82 percent of the population) and sanitation (75 percent of the population). The health care system includes 122 hospitals, 2,400 health centres, and 4 university clinics, but they are poorly maintained and lack adequate capacity to meet the demand for medical care. Only 24,000 beds are available for 6 million patients seeking care each year, including 3 million emergency cases. The health budget corresponds to 5 percent of the gross domestic product and 5.5 percent of the central government's budget.[6]

Health status

Diseases

In 2001 the principal causes of mortality in the urban population were circulatory system diseases (20.4 percent); perinatal diseases (9.3 percent); cancer (8.5 percent); endocrinological, nutritional, and metabolic diseases (7.6 percent); respiratory system diseases (6.9 percent); and infectious and parasitic diseases (4.7 percent).[6]

In 2004 the minister of health announced that the country had eradicated a variety of childhood diseases, specifically diphtheria, polio, tetanus, and malaria, but other diseases continue to pose challenges. According to estimates for 2013, 21,000 people or approximately 0.16 percent of the population between the ages of 15 and 49 was infected with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS).[7]

UNAIDS (Joint United Nations Programme on HIV/AIDS) have stated that around 270,000 people in the Middle East are currently living with HIV. Research from between 2001 and 2012 has shown that the number of adults and children living with HIV had increased significantly, by 73%. The predominant cause of HIV transmissions is the lack of knowledge and education to help prevent the spread. Treatment services are also lacking significantly in the Middle East to help treat the infection before passing in on. Research has shown that particularly in Morocco, 89% of HIV infections are amongst men having sexual intercourse with other men, female sex workers and people who share contaminated needles. New research is revealing that Morocco's newest HIV infections are amongst females, with three quarters receiving it from their husbands.[5]

Obesity

Adolescent girls are at a greater risk of becoming obese.[8]

Obesity is linked to a greater availability of food, particularly from the West, and an increasingly sedentary lifestyle in urban areas. A woman who has a low level of schooling or no education in urban areas is significantly more likely to be obese. The general public is not aware of the medical conditions that result from obesity. Rather, female fatness is embraced, as it "is viewed as a sign of social status and is a cultural symbol of beauty, fertility, and prosperity".[8] Being thin is a sign of sickness or poverty.[9]

Maternal and child health care

By 2001, 60% of births were taking place in both public and private health facilities, while the rest happened at home. Maternal mortality was 227 per 100,000 live births, and neonatal mortality was 27 per 1000 live births. A national population and family health survey showed that in 2003 the most common barriers in accessibility to emergency care were financial, for 74% of women; the distance to a health facility, for 60%; and transport, for 46%.

In 2007 the Ministry of Health recognised the problem of maternal and child mortality. This led the ministry to implement the Maternal Mortality Strategy action plan of 2008–12, whose aim was to reduce the maternal mortality rate (MMR) from 227 to 50 deaths per 100,000 births. There were three points of improvement to help them try and achieve their goal. The first was to reduce any barriers preventing women from accessing emergency services. The second was to enhance the health care quality and the third was to improve governance. The Ministry of Health also began the maternal mortality surveillance system. This allowed them to collect and analyse data in 2009 which discovered that the goal of reducing the MMR to 50 would not be achievable by 2015. Because of this information, a new action plan for 2012-16 was introduced to reinforce management and target specific actions for rural and disadvantaged areas.[10]

The 2010 maternal mortality rate per 100,000 births in Morocco was 110. This is compared with 124 in 2008 and 383.8 in 1990. The under 5 mortality rate is 39 per 1,000 births, and the neonatal mortality as a percentage of under 5s mortality is 54. In Morocco the number of midwives per 1,000 live births is 5 and the lifetime risk of death for pregnant women is 1 in 360.

Nutrition

Over the last 20 years nutrition has significantly changed with rapid changes due to demographic characteristics of the region, speedy urbanisation and social development of steady and significant economic growth. Morocco and the Middle East have the highest amount of excessive dietary energy intake. With a low rate of 4% of poverty prevalence and 19% of child malnutrition, Morocco has an 8% rate of child malnutrition. All these changes have significantly contributed to the dietary and physical activity of individuals living in the Middle East, reflecting changes with nutrition and the prevalence of these changes.[11]

Hospitals

Morocco has five university hospitals (CHU):

  • CHU Ibn-Rochd (Casablanca)[12]
  • CHU Hassan II (Fes)[13]
  • CHU Mohammed VI (Marrakech)[14]
  • CHU Cheikh Zaid (Oujda)[15]
  • CHU Mohamed V (Rabat)[16]

See also
  • The Stethoscope Revolution (Morocco)

References
  1. World Health Organisation (2006). "Health system profile: Morocco" (PDF).
  2. National Social Security Fund (2016). "Mandatory health insurance".
  3. Manager of Mandatory Health Insurance (2016). "National fund of social welfare organisations".
  4. Access Health International. "The RAMED project".
  5. Setayash, Hamidreza (2016). "Populations Reference Bureau". HIV in the Middle East: Low Prevalence but Not Low risk.
  6. Morocco country profile. Library of Congress Federal Research Division (May 2006). This article incorporates text from this source, which is in the public domain.
  7. Central Intelligence Agency (2011). "CIA World Factbook - HIV/AIDS adult prevalence rate". Retrieved 2011. Check date values in: |accessdate= (help)
  8. Mokhtar, Najat; et al. (2001). Diet Culture and Obesity in North Africa.
  9. Rguibi & R Belahsen, M. (2006). Fattening Practices Among Moroccan Saharawi Women.
  10. "Actions on social determinants and interventions in primary health to improve mother and child health and health equity in morocco". International Journal for Equity in Health. 15.
  11. Osman, Gala (2016). "Nutrition-health related patterns in the Middle East". Asian Pacific Journal of Clinical Nutrition. Retrieved 2016. Check date values in: |access-date= (help)
  12. http://www.chuibnrochd.ma/. Missing or empty |title= (help)
  13. http://www.chu-fes.ma/. Missing or empty |title= (help)
  14. https://www.chumarrakech.ma/. Missing or empty |title= (help)
  15. http://www.chuoujda.ma/. Missing or empty |title= (help)
  16. http://www.chisrabat.ma. Missing or empty |title= (help)
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