08.10.07

Foreign Agencies in Morocco…

Posted in Uncategorized at 8:13 pm by nadia

. UNICEF

A 1994 UNICEF document entitled Note on the health sector in Morocco was dis­tributed to the participants. This presented the work of UNICEF in the health sector in Morocco and reviewed the cooperation of the country with UNICEF. It included:

•    the programming process

•    the thrusts of this cooperative pro­gramme during the period 1992–1996. The principles of the programme are in line with the priority problems affecting children and women as shown by na­tional surveys, the priorities defined by the economic and social policy of the Government, the Convention on the Rights of the Child, the Declaration of the World Summit, the National Plan of Action, and the UNICEF medium-term plan.

The country programme is structured into specific programmes covering the fol­lowing areas: basic health, education, inte­grated basic services in rural areas, children in particularly difficult circum­stances in the periurban environment, plan­ning, advocacy and social mobilization.

The basic health programme consists of five projects which have been conducted using an integrated primary health care ap­proach: Expanded Programme of Immuni­zation, Diarrhoeal Disease Control Programme, Acute Respiratory Infection Control Programme, Promotion of Safe Motherhood and Iodine Deficiency Disor­ders Control Programme.

The education, integrated basic services in rural areas, children in difficult circum­stances, planning, advocacy and social mo­bilization programmes aim at protecting children and mothers in difficult circum­stances and at facilitating their access to the minimum services required for human de­velopment.

The health system has made major pro­gress over the past 20 years and the main indicators have significantly im­proved. However, such progress conceals great disparities:

•    population policy—levels remain high;

•    persistence of waterborne diseases;

•    persistence of tuberculosis, rheumatic fever and measles;

•    high maternal mortality rate resulting from pregnancy and delivery.

The main bottlenecks have been identi­fied and the Government’s efforts are fo­cused on improving health coverage, developing human resources, ensuring a better distribution of public and private fa­cilities, increasing the share of the national budget allocated to health and improving the distribution of financial resources. Moreover, the managerial process is mov­ing towards greater decentralization of health programmes, and the vertical nature of health activities is moving towards the development of a dynamic planning–pro­gramming process for a better strategy aimed at reducing inequities and making optimal use of national resources and exter­nal assistance. The effective mobilization of intersectoral support, mobilization of the community and the establishment of a co­ordination mechanism between govern­ment and donors are complementary elements which are essential for the suc­cess of national plans to meet basic health needs and ensure equitable access to health care.

E. UNFPA

UNFPA, in collaboration with the Moroc­can Government, has established a cooper­ation programme which aims at supporting action taken by the Government to improve the social and economic status of the popu­lation (particularly the rural population), to promote the quality of maternal and child health and family planning services (MCH/ FP), to ensure higher rates of contraceptive use, and to better inform the public and raise people’s awareness about the impor­tance of improving the health of the nation. The focus is on the interdependence be­tween population increase, its distribution and the environment.

In the area of MCH/FP, the programme objective is to strengthen the Government’s plan to improve the quality of MCH/FP ser­vices and facilitate access to these services in order to reduce maternal and infant mor­tality rates as well as fertility rates of high-risk groups.

Activities are being undertaken by the Ministry of Public Health in some of the provinces that are the poorest and most dif­ficult to reach; they aim to enhance the quality of MCH/FP services provided from established facilities. They also seek to im­prove supervision by standardizing proce­dures for reporting and follow-up methods, to encourage more frequent and well orga­nized supervision visits, and to integrate family planning into preventive health care.

In order to establish effective services for information, education and communi­cation (IEC) in family planning within the Ministry of Public Health, it is planned to develop an integrated community strategy through: the production of improved adver­tising materials on MCH/FP services in­tended for illiterate or semiliterate women, including traditional birth attendants; the production of IEC materials and visual aids that can be used in health facilities; and the integration of postnatal counselling and family planning into the programme on breast-feeding and nutrition.

To assist this governmental programme, UNFPA provides support to the Moroccan Family Planning Association in the devel­opment of IEC strategies intended for young and newly married people, combin­ing awareness-raising, information about MCH/FP and the promotion of women’s status.

UNFPA also collaborates with the Min­istry of Public Health in improving and ex­tending the decentralized computerized system on MCH/FP and in the analysis of data on health and population derived from the 1992 population and health survey. Moreover, support is currently provided to the National Institute of Health Adminis­tration to improve the quality of training provided by the Institute in the field of lo­gistics of management in health and family planning services.

Finally, UNFPA contributes to the na­tional programme on acquired immunode­ficiency syndrome (AIDS) by integrating modules on sexually transmitted diseases and AIDS into the training of health work­ers, either pre-employment or during in-service training and by designing information materials on AIDS.

Thus, during 1992 and1993, UNFPA supported a comprehensive programme amounting to US$ 17 million, out of which US$ 12 million were provided from UNFPA’s regular budget and distributed over a five-year period starting in January 1992 in order to assist the Moroccan Gov­ernment in achieving its objectives in the areas of population and development. If UNFPA financial situation allows, the bal­ance (i.e. US$ 5 million) will be provided by the Fund. Otherwise, UNFPA will try to secure the funds that are not available through multibilateral and other sources.

F.1 UNDP

The strategy proposed by UNDP is to im­prove the living conditions of underprivi­leged populations in rural and periurban areas in order to ensure sustainable devel­opment of the health sector in Morocco. Particular attention is given to the funda­mental relationship between good health and safe water supply and adequate sanita­tion.

The basis for action in this strategy is outlined below.

a)  Institutional reforms and strengthening of national capacities in the field of hu­man, technical and managerial resourc­es are needed. This requires plans for strengthening the action of the Govern­ment including:

•   capacity building;

•   sectoral policies defining the roles and responsibilities of the agencies concerned with the management of health, water and sanitation services;

•    involvement of the private sector and better coordination with public sector agencies;

•    assistance to local communities, non­governmental organizations (NGOs) and sanitation services in the evalua­tion of the roles, responsibi-lities and existing expertise (support on a mul­tidisciplinary, intersectoral and de­centralized basis);

•    establishment of sound programmes for human resources management.

b)  promotion of an economic and social environment likely to give households the individual opportunity to improve their health.

c)       encouragement of public policies aimed at achieving a more satisfactory distri­bution of governmental public health expenditure through:

•   an intervention taking place before the thinking exercise at the national level but at a later stage in sectoral planning (better cost–effectiveness ratio);

•    enlargement of the base level to a maximum in order to ensure access of the poor to basic health care while improving the quality of care and en­couraging projects of a preventative nature;

•   greater participation of all providers and recipients in the sector;

•    encouragement of the decentraliza­tion of public services and effective reduction in the concentration of these services;

•    establishment of an effective and ef­ficient health insurance system;

•    enhancement of the capabilities of women in the field of education/in­formation and prevention and care

•    (MCH/AIDS);

•   extension of the initiatives and pro­grammes of technical cooperation among developing countries within the Arab Maghreb Union.

•   more extensive cooperation in the field of resource mobilization for pri­ority areas of the Ministry of Public Health.

Since 1986, UNDP has cofinanced the fol­lowing nine projects in the areas of drink­ing water supply, sanitation and health within the framework of its fifth program-

ming cycle for Morocco: strengthening the capacities of the public corporations and the National Office for Drinking Water, ex­ploration of groundwater, hospital mainte­nance I and II, wastewater reuse, drinking water economy, masterplan for drinking water in rural areas, management support to the National AIDS Programme, master-plan for liquid waste disposal.

F.2 WFP

Although WFP does not have any specific project with the Ministry of Public Health, it has launched important interventions in the health sector. These involved:

•    provision of food to 840 000 schoolchil­dren, mainly in underprivileged rural ar­eas. This figure is currently decreasing but 1 400 000 children were covered during the 1991/1992 school year;

•    provision of food aid to 10 000 trainees in the OFPPT and food rations to the workers involved in WFP-supported ru­ral projects which represent a signifi­cant nutritional input.

WFP is currently collaborating with WHO/Rabat with a view to implementing a project to combat malnutrition targeted at the vulnerable groups of the population, es­pecially women and children.

Discussion

Following the presentation by the various agencies of their collaborative programmes in the field of public health, a general dis­cussion was initiated, the main lines of which are summarized below.

Morocco’s assets

In view of Morocco’s economic perfor­mance, its political stability, its many com­petent executives, the presence of a United Nations system for development adequate­ly represented by the health sector, and a political commitment at the highest level towards an overall improvement of the health status of the Moroccan population, Morocco presents the ideal profile for a joint, organized action of NGOs, donors, development banks (including the World Bank and the AfDB) and bilateral coopera­tion agencies in order to find new and appropriate means to:

•    stimulate the eradication of epidemic, endemic and other diseases;

•    foster the improvements in nutrition, housing, drinking water supply and sanitation, working conditions and all other environmental health factors;

•    promote cooperation between the scien­tific and professional groups contribut­ing to progress in the field of health;

•    participate in the implementation of rec­ommendations of international conven­tions and agreements on health matters;

•    strengthen national capacities in plan­ning, management, implementation, monitoring and evaluation of national health programmes;

•    reduce the risks of environmental pollu­tion, with its devastating effects on hu­man health;

•    stimulate and guide health research; help impart a clear and informed view on health to the underprivileged seg­ments of the population;

•    increase women’s involvement in deci­sion-making on population matters, MCH and economic development;

•    face the AIDS pandemic through IEC activities.

WHO and the United Nations system

In the field of health, WHO, UNICEF, UNFPA, UNDP, WFP, FAO, and UNESCO have committed themselves, either directly or indirectly, to reach a consensus on inter­agency cooperation and, through the note on the national strategy (in preparation), to consolidate their efforts for strengthening their support to deal with the thorny health-related problems in Morocco.

WHO and the United Nations agencies concerned have the unifying moral and technical strength to galvanize, guide and support Morocco in the institution of its policy for health for all by the year 2000.

Statement for the press

The ongoing escalation of violence resulting from the military occupation of Palestinian territories and the ongoing assaults on several cities in the West Bank has caused serious humanitarian situations. The targeting of civilians and health workers, as well as health facilities, and prevention of safe passage of ambulances and medical personnel performing medical duties represent serious violations of international humanitarian law, including the Geneva Conventions.

The WHO Regional Office for the Eastern Mediterranean draws the attention of the international community to the serious consequences of cutting off the electricity and water supply, which not only cripples the population but prevents hospitals and other medical facilities from carrying out their vital functions and increases the risk of epidemics.

The WHO Regional Office for the Eastern Mediterranean is deeply concerned and disturbed by this unprecedented situation and calls upon the international community to take appropriate measures to ensure the protection of health facilities, safe and free access for medical personnel and emergency medical and other humanitarian supplies, and the strict application of the Geneva Conventions.

Source: WHO EMRO Press release No. 6

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