Morocco has been experimenting with an innovative community health system since 2022 to improve maternal and child care in rural areas. Initiated by IndH, the Ministry of Health and UNICEF, this pilot program, deployed in three key regions, is focusing on a single tripartite approach coordinating health centers, specialized reception houses (Dar Al Oumouma) and community relays to bring the care of isolated populations closer and overcome geographic barriers.
Despite notable advances in recent decades, Morocco has faced persistent challenges in maternal and child health, particularly marked by important disparities between urban and rural areas.
According to 2018 data cited by the World Bank in its article on the occasion of World Health Day, the maternal mortality rate in rural areas amounted to 111 deaths per 100,000 living births, almost twice and a half times the rate observed in urban areas (45 deaths). Similarly, infant mortality was 37%greater, reaching 26 deaths per 1,000 living births against 19 in cities. These differences are partly explained by more limited access to essential health services.
Indeed, only 73.4 % of rural women give birth in health facilities, compared to 96 % in urban areas. The geographic obstacles and the distance of health centers also contribute to these inequalities, as local actors underline such as Najate Nadifi, president of the Riaaya Association, which evokes the risks linked to the deadlines for access to care for pregnant women. The growth retardation rate in children under the age of 5 also illustrates this gap, reaching 20.5 % in rural areas against 10.4 % in urban areas.
Launch of a tripartite pilot initiative in 2022
Faced with this situation, the National Initiative for Human Development (INDH), in collaboration with the Ministry of Health and Social Protection and UNICEF, launched in 2022 a Community Health Pilot system.
This program specifically aims to improve maternal and child health and nutrition in the most affected rural regions. The pilot phase was deployed in three regions deemed priority-Béni Mellal-Khénifra, Draa-Tafilalet and Marrakech-Safi-covering a total of 14 provinces and 56 rural health centers.
The singularity of this model lies in its tripartite approach, based on close coordination between three key players, in particular rural health centers, community structures called Dar Al Oumouma (maternity houses) and community relay. This synergy aims to create a continuum of care and support for pregnant women and young children in often isolated areas.
-The central role of community actors and host structures
The device is strongly based on local involvement. Health centers provide medical care during childbirth and postnatal follow -up. The Dar Al Oumouma play a leading role by offering safe accommodation and support to pregnant women before and after childbirth, reducing the risks linked to the distance or difficult transport conditions just before the term. These structures also serve as awareness places.
At the same time, community relays, chosen within their own community for their reliability, constitute an essential link between populations and the formal health system.
Trained for this mission, they ensure proximity follow -up, sensitize pregnant women to the importance of prenatal consultations (targeting at least four recommended visits) and orient them towards health centers or Dar Al Oumouma at the right time. Since 2022, around 1,000 of these voluntary relays have been trained in the pilot regions. Their work, although having encountered initial resistances, has gradually gained the confidence of communities thanks to dialogue and continuous awareness.
First encouraging results and extension prospects
The first results of the pilot phase are deemed positive. Between January 2023 and December 2024 (reference period indicative of the potential), the system made it possible to orient around 285,000 beneficiaries (women and children) to adapted health and nutrition services.
Local testimonies, such as that of Najate Nadifi, report a decrease in complications and mortality, as well as a significant improvement in the quality of care thanks to this global approach. Building on these initial successes, the INDH, in coordination with the Ministry of Health and with the technical support of the World Bank, has developed a strategy of national scope.
This strategy, resulting from an in -depth diagnosis of the pilot phase, plans to strengthen the programmatic model, in particular by the integration of digital tools for the collection and analysis of data in order to improve monitoring and decision -making. It also emphasizes governance, financial sustainability and progressive deployment prioritizing areas according to human development indicators, with the objective of extending this promising model to other rural localities in Morocco.
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