Morocco: AN EXEMPLAR IN NEONATAL AND MATERNAL MORTALITY REDUCTION

Introduction to Morocco

Morocco is a nation of 38 million people located in northwest Africa.¹ Two mountain ranges cut through the country and divide eastern from Atlantic Morocco: the Rif Mountains in the north and the Atlas Mountains across the center. Population density is higher along the coastline, with lower density in the high elevations of inland Morocco. Nearly 65% of the population in 2022 was urban, steadily increasing from 53% in 2000.²

Since gaining independence from France in 1956 and becoming a constitutional monarchy, Morocco has modernized its economic, social, and political structures. In the early 2000s, Morocco revised its family code, known as Moudawana, to expand women’s rights, and introduced legislation for basic health care coverage.³ Morocco also revised its constitution in 2011, which ushered in a new era for the country. Reforms in the new constitution included strengthening the power of the elected parliament, enshrining the right of access to health services, regionalizing administration, and increasing the participation of civil society.⁴ In the early 2000s, Morocco’s political stability has acted as a foundation for important economic and institutional reforms, including policies to improve access to health care and accelerate reductions in maternal and neonatal mortality.

Morocco has experienced major demographic and socioeconomic changes since the early 2000s, such as decreasing fertility rates, increasing education rates, and higher life expectancy. Alongside these shifts, Morocco’s gross domestic product per capita grew from US$1,492 in 2000 to US$3,442 in 2022.⁵ While this economic progress is substantial, our country selection analysis suggests that Morocco’s improvements in maternal and neonatal mortality rates have outperformed what could be attributable to economic development alone. This narrative will highlight key indicators, interventions, policies, and programs that contributed to rapid and sustained neonatal and maternal mortality reduction in Morocco.

Exemplars in Global Health program

The Exemplars in Global Health program aims to learn from countries that have made rapid progress in improving health outcomes and disseminate this evidence to inform health policy and funding decisions. Our aim is to research success stories from low- and middle-income countries and share findings that can be useful for leaders looking to act in comparable contexts.

In selecting Exemplar countries, we review evidence to identify countries that outperformed their peers in vital areas of public health, controlling for factors such as economic growth. In this way, we aim to provide more actionable, policy-relevant insight for stakeholders about how health progress can be made despite resource limitations.

Together with research partners and technical advisers, we conduct quantitative and qualitative analyses to validate our initial assessments and assess factors that contribute to a country’s exemplary performance. Research in and across Exemplar countries could help ministries, nongovernmental organizations, and multinational bodies better deploy finite resources to address key public health issues in low- and middle-income countries.

By studying proven strategies to prevent disease, malnutrition, and other conditions that burden populations of low- and middle-income countries, we aim to create a list of data-driven narratives that can serve as resources for leaders looking to improve health within their own countries. The following narrative focuses on factors that contributed to rapid reductions in neonatal and maternal mortality in the Exemplar country of Morocco.