Overhauling Morocco's healthcare system: Perception of healthcare professionals

Abstract

Introduction: Healthcare systems in low- and middle-income countries have faced multiple performance challenges (quality, responsiveness, equity and resilience). At various times during the COVID-19 pandemic, healthcare systems were unable to respond in time to the needs of the population, prompting many countries to consider drastic changes to their healthcare systems. Like other countries, Morocco is resolutely embarking on a new era of progress in the healthcare sector, driven by an ambitious overhaul dictated by the enlightened vision of His Majesty King Mohammed VI. In order to implement this overhaul under the right conditions, we need to reconsider the human factor as the cornerstone of the healthcare system, and to examine how public establishments perceive this overhaul. Hence the importance of taking stock of healthcare professionals' knowledge in order to overcome any barriers to the success of the future healthcare system.

Aim: to describe healthcare professionals' perceptions of the Moroccan healthcare system overhaul.

Method: This is a descriptive study. We adopted a mixed-methods approach. For the qualitative approach, we conducted fifteen interviews, including six interviews with strategic-level managers, four interviews with intermediate-level managers and five interviews with operational-level managers, all selected on a purposive basis. For the quantitative approach, we interviewed 71 healthcare professionals by means of a questionnaire distributed to all doctors and nurses in charge of health programs.

Results: The description of healthcare professionals' perception of the Moroccan healthcare system revealed that it has made considerable progress but has not met national requirements and needs to be overhauled. However, in order to support and carry out this overhaul, it would be necessary to allocate the necessary resources, establish a transparent institutional communication process, a continuous training approach, an approach to integrating the various stakeholders, and finally the adoption of leadership to facilitate the motivation, commitment and involvement of healthcare professionals in this process of change. For managers, the study showed a positive perception justified by an awareness indicating that this change is part of a natural evolution of the Ministry of Health and Social Protection to ensure the generalization of social protection in Morocco. Managers focused more on participation in the redesign process and on communication. On the other hand, health professionals expressed more negative attitudes to the redesign than did managers. Lastly, participants stated that the redesign could have a more positive impact if it were carried out in a way that valued human resources, both financially and in terms of career advancement.

Conclusion: If the redesign is to become a reality, a gradual approach to implementation is required. To reduce any reluctance to implement it, the redesign should be conceived collectively, based on simple, explicit communication, involvement of healthcare professionals, training and support.

Keywords: healthcare professionals; healthcare system; overhaul; perception.