GIP SPSI’s activities in Morocco are an outgrowth of an administrative agreement signed by the French Ministry of Health and Solidarity and the Moroccan ministries of Health, and Employment and Professional Development. They focus primarily on providing assistance to the Moroccan authorities in setting up a compulsory health insurance system under a law establishing a Medical Coverage Code. .

Background to the mission

The Act establishing a Medical Coverage Code – published in the official bulletin of Morocco of 21 November 2002 – provides for the creation of a compulsory health insurance system (AMO).

In a first stage, this comprises three components:

1. a compulsory health insurance system for public and private sector employees, which has already entered into force,
2. a medical assistance scheme for low income individuals, which should come into effect by the end of 2006,
3. a scheme for the self-employed, which is in the process of creation.

Given the proximity of the French and Moroccan systems, the Moroccan Government called upon France for assistance in implementing the AMO. To that end, the GIP led a first in-country mission in the spring of 2005.

The partnership was formalised in an administrative agreement between the two countries, signed on 26 September 2005 by the French Ministry of Health and Solidarity and the Moroccan ministries of Health and Employment and Professional Development.

Three priority areas

In November 2005, in the wake of the agreement, the GIP conducted a second mission to Morocco, meeting with French Embassy and senior Moroccan officials in Rabat and Casablanca. The following week a Moroccan delegation visited Paris, where two meetings were held to establish the exact requirements of the Moroccan authorities and identify priority areas for cooperation. The three priorities singled out were as follows:

1) Information systems

The AMO is administered by several different players who are coordinated by the National Health Insurance Agency (ANAM). High-quality, reliable information and data are thus crucial to the proper operation of the system.

2) Insurance management
This covers the various techniques for ensuring control of health expenditure, including effective medical controls and medicalisation of information.

3) Training
Training must be provided alongside the implementation of the AMO. The training needs formulated by the Moroccan authorities and organisations focus on professional practices and the transfer of know how.
Another aspect addressed in the course of the meetings were the practical arrangements for conducting the cooperation process. Possibilities discussed included in-country operations involving local resources (the favoured approach) and twinning initiatives between French and Moroccan organisations (CNAMTS and ANAM, for example).

The 2006 Programme

A further subject raised was the development of a prioritised time schedule for the implementation of the AMO.
Three priority actions were thus identified, each pertaining to one of the above-mentioned priority areas:

1. hands on training for medical-inspectorate doctors,
2. an in-country mission to assist information system decision-makers,
3. the transfer of know-how to ANAM representatives to guide them on negotiations practices with health-sector professionals.

Other, less urgent actions are also planned, such as the organisation of a workshop on the medically-driven control of health expenditure and identification of a resource person for Moroccan health insurance system actuaries.