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Morocco
>> Regional Overview >> Morocco Overview ACTIVITY DATA SHEET
PROGRAM: Morocco
TITLE AND NUMBER: Key Interventions Promote Sustainability of Population, Health and Nutrition Programs, 608-007
STATUS: Continuing
PLANNED FY 2001 OBLIGATION AND FUNDING SOURCE: $2,000,000 DA; $3,414,000 CSD
PROPOSED FY 2002 OBLIGATION AND FUNDING SOURCE: $2,000,000 DA; $3,100,000 CSD
INITIAL OBLIGATION: FY 1999 ESTIMATED COMPLETION DATE: FY 2004Summary: The goal of this objective is to help the Government of Morocco (GOM) maintain the current high levels of family planning, immunizations, and other priority public health services once USAID support to the sector ends in 2004. To accomplish this, USAID will help the GOM increase the effectiveness of the public health system and facilitate a shift to private sector providers by clients who are able to pay for these services. Until this year, USAID was the major donor for the Ministry of Health's (MOH) efforts to improve child health, expand family planning services, and assist in other aspects of reproductive health. With this assistance, Morocco achieved outstanding results in reducing fertility and the mortality of children under five, results that now serve as a model for other countries. Nonetheless, there remain significant challenges to sustainability. Rural Morocco is at least 10 years behind the rest of the country in health status indicators, and healthcare financing continues to be an issue.
Under this objective, USAID is helping the MOH consolidate the gains it has achieved and develop innovative solutions to unresolved problems, while progressively reducing USAID financial support. This program encourages greater involvement of partners at the local level and in the private sector to diversify the resource base and move problem solving from the central level toward the local level. The fact that the funding levels of this objective are 70% lower than in previous agreements highlights USAID's commitment to sustainability and phase-out.
Key Results: The program promotes sustainability with results in two main areas. The first expected result is a model of decentralized management of primary healthcare services in the regions of Souss-Massa-Draa and Tangier-Tetouan. The approach involves local women in collaboration with the MOH, local elected officials, NGOs and other community associations, and the private sector in the planning and delivery of quality reproductive and child health services. For this regional model, USAID will use DA funds to address relevant policy issues and reinforce the quality, management, and delivery of reproductive health service. Child survival funds will be used to strengthen primary healthcare services and systems and to address specific issues in child morbidity and mortality, including deficiencies in Vitamin A and other micronutrients.
The second key result is increased access to reproductive and child health services in the private sector. DA funds will be used to support relevant policy reform, social marketing of contraceptive products, and activities to improve the capacity of general practice physicians to provide quality reproductive health services at a reasonable price. Child survival funds will be used to support social marketing of oral rehydration salts and promote consumption of micronutrient-enriched food products.
Performance and Prospects: In FY 2001, $2,700,000 in CSD funds will be used to strengthen primary healthcare services and to address child mortality. Maternal and newborn care, including emergency obstetric care, will be a special focus of this activity. An additional $300,000 in FY 2001 CSD funds will be used to fight micronutrient deficiencies through promotion of Vitamin A and iron consumption, fortification of key foods, and community-level behavior change initiatives. Under this component, $1,400,000 in FY 2001 DA funding will be used to improve reproductive healthcare in the two regions, with improved counseling for family planning, outreach to remote areas, and management of reproductive health services.
The second main activity will be to promote the increased use of the private sector for reproductive and child health services. USAID will use $494,000 in CSD funds (including FY 2000 carryover funds) to support social marketing of oral rehydration salts, promote consumption of micronutrient-enriched food products, and increase the quality and availability of private medical services and products for child healthcare. A total of $600,000 in DA funds will be used in FY 2001 to increase the quality and availability of private medical services and products for reproductive healthcare. This will include working with private physicians to orient their services more toward preventive family practice rather than strictly curative care.
Possible Adjustments to Plans: No changes are anticipated in FY 2001. Based on performance results after two years, there may be some changes in indicators or activities proposed in FY 2002.
Other Donor Programs: Morocco is still donor dependent, with over 40% of the reproductive health program estimated to be donor funded. Beginning in FY 2000, The European Union overtook USAID as the largest donor in the sector. The World Bank plays a very significant role as a lender. The United Nations Children's Fund and United Nations Population Fund also play important roles. USAID is working with the MOH to facilitate expansion of successful models by these donors as well as to establish links with private U.S. foundations, including the Bill and Melinda Gates Foundation, which has begun funding several health activities in Morocco.
Principal Contractors, Grantees, or Agencies: USAID's principal counterpart is the MOH. Other partners in Morocco include local and international private voluntary organizations, NGOs, and professional associations. U.S. partners include John Snow Inc.; the Commercial Markets Strategy Project; Micronutrient Operational Strategies and Technologies; The Centre for Development and Population Activities; Catholic Relief Services; and the Near East Foundation. USAID also is working with Helen Keller International to implement community-level interventions to address micronutrient deficiencies and trachoma eradication.
Selected Performance Measures:
Baseline(1997) Actual(1998) Actual(1999) Actual(2000) Target(2001) Contraceptive use, modern methods 1 49% 49% 49% 49% 49% Percent of couple years of protection (CYPs) from private sector 2 32% 32% 33% 6% 41% Improved policy environment (completion of five reforms) 3 N/A N/A 0% 13% 36%
1 Baseline from 1997 PAPCHILD national survey; next survey planned 2002. Goal is maintenance of existing levels despite a reduction of over 70% in USAID support to the sector.
2 Based on annual data from USAID's social marketing program and NGOs, validated by independent market survey.
3 This indicator was revised in 1999 to reflect new targets when the performance-monitoring plan was finalized and approved. The five policy reforms concern host government financing of contraceptives and vaccines, co-financing of health activities in the two pilot regions, reducing barriers to private sector service delivery, and instituting quality standards for private sector care.
U.S. Financing
(In thousands of dollars)
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Last Updated on: May 29, 2002 |
