Abstract

Maternal health (MH) is a national priority of Morocco. Factors influencing the agenda set by the reproductive and maternal health policy process at the national level were evaluated using the Shiffman and Smith framework. This framework included the influence of the actors, the power of the ideas used, the nature of the political context, and the characteristics of the issue itself. Factors were evaluated by a review of documents and interviews with policy-makers, partners and individuals in the private sector, civil society and non-governmental organisations (NGOs) involved in MH, and decision-makers responsible for implementing health-financing strategies in Morocco. Evaluations showed that maternal mortality in Morocco was considered human rights and social development as well as a public health problem. The actors responsible for MH, including members of the government, researchers, national technical experts, members of the private sector, United Nations partners and NGOs, agreed on progress made in MH and universal health care (UHC). Stakeholders also agreed on the prioritisation process for MH and its inclusion in the health benefits package. Prioritisation of MH was found to depend on national health priorities set by the government and its close partners, as well as on the availability of human and financial resources. Interventions at the operational level were based on evidence, best practices, allocation of adequate financial and human resources, and rigorous monitoring and accountability. However, MH and health financing are experiencing difficulties in many areas, related to social and economic and health disparities, and gender inequality, and quality of care.

摘要

孕产妇健康 (MH) 是摩洛哥的国家优先事项。使用 Shiffman 和 Smith 框架评估了影响国家一级生殖和孕产妇健康政策进程制定的议程的因素。该框架包括行动者的影响、所用思想的力量、政治背景的性质以及问题本身的特征。通过审查文件并与私营部门的政策制定者、合作伙伴和个人、参与 MH 的民间社会和非政府组织 (NGO) 以及负责在摩洛哥实施卫生筹资战略的决策者进行访谈，对因素进行了评估. 评估表明，摩洛哥的孕产妇死亡率被视为人权和社会发展以及公共卫生问题。负责MH的演员，包括政府成员、研究人员、国家技术专家、私营部门成员、联合国合作伙伴和非政府组织成员，同意在 MH 和全民医疗保健 (UHC) 方面取得的进展。利益相关者还同意 MH 的优先排序过程及其包含在健康福利包中。发现 MH 的优先次序取决于政府及其密切合作伙伴设定的国家卫生优先事项，以及人力和财力资源的可用性。业务层面的干预基于证据、最佳做法、充足的财政和人力资源分配以及严格的监测和问责制。然而，MH 和卫生筹资在许多领域都遇到了困难，这与社会、经济和健康差距、性别不平等以及护理质量有关。