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In accordance with the health insurance schemes, public hospitals received only 9.8% of
the payments made while private practices get the more important share of 27.1% along
with 34.9% to private clinics. The share of direct expenditure of health coverage
organizations for the benefit of public hospitals moved from 6% in 2001 to
approximately 10% in 2006 (Ministry of Health/ WHO, 2006).
The share of direct payments by the households increased from 52% to 57% between
2001 and 2006 even with the implementation of the compulsory health coverage (AMO)
in August 2005. However, the effective starting of the AMO through the first
reimbursements of the managing organizations began only in March 2006 and many
reforms were needed at the administrative level in terms of information system, human
resources, communication and decentralization. In spite of the implementation of the
primary health insurance especially the AMO, the institutionalized solidarity in the field
of medical coverage in Morocco is still weak since the health insurance covers only 25%
of the total Moroccan population, the crushing majority of which is urban (Ministry of
Health/ WHO, 2006).
Besides this, the total health expenditure also benefits the national institutes and
laboratories at the level of 3.3% of that budget. These latter constitute an important
support for training and primary care network. However, their share is still inferior to that
of the central and local administration (13.1%). To illustrate the importance of the
medical education and training institutions related to the ministry of health, it is necessary
to describe the primary statistics (Ministry of Health/ WHO, 2006).
Concerning basic health statistics, Morocco’s performance is still weak in comparison to
other countries of the MENA region. It was ranked 18 over 22 MENA countries in terms
of life expectancy, child mortality, overweight, malnutrition, HIV/AIDS, expenses,
hospital accreditations, doctors and hospital beds (Kjeilen, 2008). The Moroccan health
system is defined by geographic differences, management of expenses and revenues and
capacity. There are major differences in quality between the rural and urban sides of
Morocco. The public services dominate the Moroccan health sector but private and semi-
public services also exist. By 2008, the Moroccan medical system included 122 hospitals,
2400 health centers and four university hospitals just before the inclusion of the 5 th
university hospital of Oujda (Teach Mideast, 2008). A portion of the Moroccan
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