Join us   Log in   jmsr2014@yahoo.com  


JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Vol. Xl, n 2, December 2024

Pages: 1377-1398
Print Article   Download XML  Download PDF

Benchmarking of Governance Models for Basic Health Coverage: Research of Good Practices for Morocco

Author: Karsi Mohammed, Abouqal Redouane

Category: JMSR Public Health

Abstract:

Background: The benchmarking is a concept with multiple aims. The reflection on improving the governance of Basic Health Coverage (BHC) in Morocco leads us to analyze successful solutions that have been implemented in other countries. Objectives: This study aimed to make an international benchmark of BHC’s governance models and look for good practices in other countries in order to study the possibility of their implementation at the Moroccan level. Methods: We benchmarked BHC's governance models by determining the criteria for selecting the benchmark countries. We have selected five countries, namely: Turkey, Malaysia, France, Chile, Rwanda. We analyzed governance models based on the five dimensions of the World Bank study "Governing Mandatory Health Insurance: Learning from Experience", which are: Coherence of the decision-making structure, stakeholder involvement, transparency and access to information, supervision and regulation, coherence and stability. Results: Our analysis based on the five dimensions showed that there are relative common factors with the governance model between the benchmark countries that allowed them to achieve universal health coverage, however, each country has introduced innovative rules and solutions adapted to its context and constraints. There are several good governance practices that we have drawn from this benchmark. Morocco can use these good practices to improve its governance model for BHC. An adaptation effort is necessary, taking into consideration the existing situation. Discussion: There is not a governance model suitable for all countries. Each country is trying to find a formula that will allow it to overcome its challenges. Morocco can draw inspiration from these models to instaure good practices to adopt, but this cannot happen without repositioning the governance of health coverage in the government's strategic vision in relation to the social protection agenda and the objectives of the health system. Conclusion: Improved governance has a direct impact on the performance of the basic health coverage system. In this sense, Morocco must take this aspect into consideration in the process of achieving universal health coverage as many other countries that have made this great step forward.

Keywords: Benchmarking, Governance, Social Security, Health Insurance, Morocco

References:

  1. Karsi M, Bennana A. The governance of basic health coverage: A systematic review. Ethiop J Health Dev. 2020;34(3):[217-225].
  2. Savedoff, William D., and Pablo Enrique Gottret, eds. Governing mandatory health insurance: learning from experience. World Bank Publications, 2008.
  3. World Health Organization. Universal health coverage (UHC) data portal. [Internet]. 2019. Available from: http://apps.who.int/gho/portal/uhc-overview.jsp. Accessed September 19, 2019.
  4. Menon, Rekha, Salih Mollahaliloglu, and Iryna Postolovska. Toward universal coverage: Turkey's green card program for the poor. Washington, DC: World Bank, 2013.
  5. Social Security Institution of Turkey. Social security system in Turkey. [Internet]. 2019. Available from: http://www.sgk.gov.tr/wps/portal/sgk/fr/detail/sosyal_guvenlik_sistemi. Accessed September 19, 2019.
  6. OECD. Universal health coverage and health outcomes: OECD report for the G7 Health Ministers. [Internet]. 2016. Available from: https://www.oecd.org/els/health-systems/Universal-Health-Coverage-and-Health-Outcomes-OECD-G7-Health-Ministerial-2016.pdf. Accessed September 22, 2019.
  7. Social Security Institution of Turkey. History of the social security system in Turkey. [Internet]. 2019. Available from: http://www.sgk.gov.tr/wps/portal/sgk/fr/detail/tarihce. Accessed September 22, 2019.
  8. Cleiss. Social security system in Turkey: Overview. [Internet]. 2019. Available from: https://www.cleiss.fr/docs/regimes/regime_turquie.html. Accessed September 22, 2019.
  9. Chabra, Sheena, Rekha Menon, Iryna Postolovska, Owen Smith, Ajay Tandon, and Val Ulep. Preventing, Detecting, and Deterring Fraud in Social Health Insurance Programs: Lessons from Selected Countries. World Bank, 2018.
  10. Smullen A, Hong PK. Comparing the Health Care Systems of High?Performing Asian Countries. Asia & the Pacific Policy Studies [Internet]. 2015 Mar 9;2(2):347–55. Available from: http://dx.doi.org/10.1002/app5.76
  11. Chua HT, Cheah JCH. Financing Universal Coverage in Malaysia: a case study. BMC Public Health [Internet]. 2012 Jun;12(S1). Available from: http://dx.doi.org/10.1186/1471-2458-12-s1-s7
  12. Rannan-Eliya RP, Anuranga C, Manual A, Sararaks S, Jailani AS, Hamid AJ, et al. Improving Health Care Coverage, Equity, And Financial Protection Through A Hybrid System: Malaysia’s Experience. Health Affairs [Internet]. 2016 May;35(5):838–46. Available from: http://dx.doi.org/10.1377/hlthaff.2015.0863
  13. Vignier N, Chauvin P, Dray-Spira R. Un système de protection sociale universaliste, mais des barrières à l’accès aux soins encore trop nombreuses. Parcours [Internet]. 2017 Jul 1;113–36. Available from: http://dx.doi.org/10.3917/dec.desgr.2017.01.0113
  14. French Social Security. Organization of the French social security system. [Internet]. 2019. Available from: http://www.securite-sociale.fr/L-organisation-de-la-Securite-sociale?id_mot=&type=part. Accessed September 22, 2019.
  15. Lafore R. Le principe d’égalité dans la Sécurité sociale : incertitudes et ambiguïtés de sa construction contentieuse. Le Droit Ouvrier [Internet]. 2016 Jul 10;N° 816(7):433–41. Available from: http://dx.doi.org/10.3917/drou.816.0433
  16. Polton D. La gouvernance des systèmes de santé et d’assurance maladie, une perspective internationale. Regards [Internet]. 2018 Feb 6;N° 52(2):175–85. Available from: http://dx.doi.org/10.3917/regar.052.0175
  17. Tabuteau D. Loi de santé publique et politique de santé. Santé Publique [Internet]. 2010 May 17;Vol. 22(2):253–64. Available from: http://dx.doi.org/10.3917/spub.102.0253
  18. Legifrance. Public health law and policy in France. [Internet]. 2019. Available from: https://www.legifrance.gouv.fr/affichSarde.do?reprise=true&page=1&idSarde=SARDOBJT000007110329&ordre=null&nature=null&g=ls. Accessed September 22, 2019.
  19. Haute Autorité de Santé. Choix méthodologiques pour l’évaluation économique à la HAS. Saint-Denis La Plaine: Haute Autorité de Santé; 2011.
  20. Legifrance. French social security code. [Internet]. 2019. Available from: https://www.legifrance.gouv.fr/affichCode.do?cidTexte=LEGITEXT000006073189. Accessed September 22, 2019.
  21. Tuppin P, Rudant J, Constantinou P, Gastaldi-Ménager C, Rachas A, de Roquefeuil L, et al. Value of a national administrative database to guide public decisions: From the système national d’information interrégimes de l’Assurance Maladie (SNIIRAM) to the système national des données de santé (SNDS) in France. Revue d’Épidémiologie et de Santé Publique [Internet]. 2017 Oct;65:S149–67. Available from: http://dx.doi.org/10.1016/j.respe.2017.05.004
  22. French Ministry of Solidarity and Health. Missions of the Ministry of Solidarity and Health. [Internet]. 2019. Available from: https://solidarites-sante.gouv.fr/ministere/missions-du-ministere/article/missions-du-ministere-des-solidarite-et-de-la-sante. Accessed September 22, 2019.
  23. Legifrance. Law on the organization of the health system in France. [Internet]. 2019. Available from: https://www.legifrance.gouv.fr/affichTexte.do?cidTexte=JORFTEXT000026785322&categorieLien=id. Accessed September 22, 2019.
  24. Lautman A, Brouard C. La gestion de l’Assurance maladie complémentaire. Regards [Internet]. 2019 Apr 5;N° 54(2):179–87. Available from: http://dx.doi.org/10.3917/regar.054.0179
  25. Legifrance. Law on the financing of social security in France. [Internet]. 2019. Available from: https://www.legifrance.gouv.fr/affichTexte.do?cidTexte=JORFTEXT000000815414. Accessed September 22, 2019.
  26. Moatti S. Un système en souffrance. L Economie politique [Internet]. 2018;N° 80(4):5. Available from: http://dx.doi.org/10.3917/leco.080.0005
  27. French Social Security. High Council for the Future of Health Insurance (HCAAM). [Internet]. 2019. Available from: https://www.securite-sociale.fr/hcaam. Accessed October 22, 2019.
  28. Cour des Comptes. Rapport sur l’application des lois de financement de la sécurité sociale. [Internet]. 2018. Available from: https://www.ladocumentationfrancaise.fr/var/storage/rapports-publics/184000642.pdf. Accessed October 22, 2019.
  29. Busquets C M, Serra T R. Validación del cuestionario International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) en una población chilena usuaria del Fondo Nacional de Salud (FONASA). Revista médica de Chile [Internet]. 2012 Mar;140(3):340–6. Available from: http://dx.doi.org/10.4067/s0034-98872012000300009
  30. Bossert TJ, Leisewitz T. Innovation and Change in the Chilean Health System. New England Journal of Medicine [Internet]. 2016 Jan 7;374(1):1–5. Available from: http://dx.doi.org/10.1056/nejmp1514202
  31. Health Insurance Scheme Performance and Effects on Health and Health Inequalities in Chile. MEDICC Review [Internet]. 2017;19(2–3):57. Available from: http://dx.doi.org/10.37757/mr2017.v19.n2-3.10
  32. Arellano O. P, Gamonal C. S. Flexibilidad y desigualdad en Chile: el derecho social en un contexto neoliberal. Boletín Mexicano de Derecho Comparado [Internet]. 2017 Jun 22;1(149):555. Available from: http://dx.doi.org/10.22201/iij.24484873e.2017.149.11350
  33. Sekhri N, Savedoff W. Regulating private health insurance to serve the public interest: policy issues for developing countries. The International Journal of Health Planning and Management [Internet]. 2006;21(4):357–92. Available from: http://dx.doi.org/10.1002/hpm.857
  34. World Health Organization. WHO country cooperation strategy: Rwanda 2014–2018. [Internet]. 2014. Available from: https://apps.who.int/iris/bitstream/handle/10665/205893/CCS_Rwa_2014_18.pdf?sequence=1. Accessed September 22, 2019.
  35. Nyandekwe M, Nzayirambaho M, Kakoma JB. Universal health coverage in Rwanda: dream or reality. Pan African Medical Journal [Internet]. 2014;17. Available from: http://dx.doi.org/10.11604/pamj.2014.17.232.3471
  36. Saksena P, Antunes AF, Xu K, Musango L, Carrin G. Mutual health insurance in Rwanda: Evidence on access to care and financial risk protection. Health Policy [Internet]. 2011 Mar;99(3):203–9. Available from: http://dx.doi.org/10.1016/j.healthpol.2010.09.009
  37. World Health Organization. Republic of Rwanda health financing systems review 2008: options for universal coverage. 2009. Available from: https://apps.who.int/iris/bitstream/handle/10665/75833/WHO_HSS_HSF_2009.1_eng.pdf. Accessed September 22, 2019.
  38. Letourmy A. Traité d’économie et de gestion de la santé. Traité d’économie et de gestion de la santé [Internet]. 2009 Jun 1;505–10. Available from: http://dx.doi.org/10.3917/scpo.bras.2009.01.505
  39. mondiale de la Santé, Organisation. De la mutualisation du risque maladie à l'assurance maladie universelle: expérience du Rwanda. No. HSS/HSF/DP. F. 09.1. Organisation mondiale de la Santé, 2009.
  40. Rwanda. Loi N° 62/2007 du 30 décembre 2007 instituant et déterminant l’organisation, le fonctionnement et la gestion du système mutualiste d’assurance maladie à Rwanda. [Internet]. 2007. Available from: https://www.ilo.org/dyn/natlex/natlex4.detail?p_lang=fr&p_isn=96255&p_count=3&p_classification=15. Accessed September 22, 2019.
  41. Chemouni B. The Political Path to Universal Health Coverage: Elite Commitment to Community-Based Health Insurance in Rwanda. SSRN Electronic Journal [Internet]. 2016; Available from: http://dx.doi.org/10.2139/ssrn.2893122
  42. Mohammed K, Ahmed B. Évaluation du modèle de gouvernance de la couverture médicale de base au Maroc [Evaluation of governance framework of basic health insurance coverage in Morocco]. Pan Afr Med J. 2021 Feb 24; 38: 210. French. doi: 10.11604/pamj.2021.38.210.25351. PMID: 33995816; PMCID: PMC8106775.
  43. Mohammed K, Ahmed B. la gouvernance de la couverture medicale de base: une analyse conceptuelle- The governance of basic medical coverage: a conceptual analysis. Journal Marocain Des Sciences Médicales.;22(1) (2020).
  44. Mohammed, Karsi, Bennana Ahmed. Couverture Médicale De Base CMB La. "Etude du contexte de la gouvernance du systeme la couverture medicale de base au maroc ; Study of the context of system governance basic medical coverage in morocco." Journal Marocain des Sciences Médicales 21.3 (2017).
  45. Sninate I, Bennana A. L´ impact du vieillissement démographique sur la consommation médicale: assurance maladie obligatoire au Maroc. Pan African Medical Journal. 2020 Mar 27;35(1). doi:10.11604/pamj.2020.35.93.20716