The role of contractual arrangements in improving health sector ...

INTRODUCTION
Morocco
During the past few years, public organizations have become increasingly open to
working with the private sector. As part of public sector reform, this openness is the result of
growing interest in resource efficiency and performance improvement. In the field of health,
contracting is considered a new mechanism that can enable the health sector to improve its
responsiveness to changes in the health system environment and the national context.
The contractual arrangement offers an opportunity to adapt interventions to a wide range
of health objectives, as well as to bring together different actors in the field of health. Given
their active roles, these actors (service providers, insurance agents, industry, technology, civil
society) are known as stakeholders
In the meantime, the systematic use of this new mechanism has become more difficult
due to the diversity of its forms and contents. This study attempts to document and analyse the
experiences of the Ministry of Health of Morocco in the area of contractual arrangements for
health.
OBJECTIVES AND METHODOLOGY
Objectives
This study is a part of a regional initiative by the WHO Regional Office for the Eastern
Mediterranean aimed at exploring the potential of the countries of the Region to contract with
the private sector for provision of health services. Such exploration responds to the need of
ministries of health to develop strategies for public–private mix as a way to improve health
system performance.
Specifically, the study aims at documenting the experience of the Ministry of Health in
undertaking contractual arrangements, and analysis two specific experiences of contracting
with the private sector that represent important potentials for outsourcing health services in
Morocco. The first is a traditional experience of subcontracting of hospital support services.
The second is an innovative experience recently started that consists of contracting for
equipment and supplies required for the care of end-stage renal disease.
Definition of contractual arrangements
The contractual arrangement is a type of a public–private mix that takes the form of a
partnership between two or more organizations belonging to different activity sectors and
seeking to reach common objectives.
The rationale for involving the private sector is the fact that this sector accumulates
resources, competencies and management styles sufficiently innovative to contribute to the
improvement of the health system performance. The growing need to modernize public
services and to respond with efficiency to population expectations is incentive for the public
sector to turn to the private or nongovernmental organization sector.
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