Health insurance and medical deserts: The case of Morocco

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Published Oct 11, 2026
https://doi.org/10.62438/tunismed.v104i09.6742
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Vol. 104 No. 09 (2026): Tunis Med Sept 2026

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Abdelati Zouine
Multidisciplinary Research Laboratory in Economics and Management (LARPEG), Faculty of Economics and Management, Sultane Moulay Slimane University, Beni Mellal, Morocco
Fatima Touhami
Multidisciplinary Research Laboratory in Economics and Management (LARPEG), Faculty of Economics and Management, Sultane Moulay Slimane University, Beni Mellal, Morocco
Abdellatif Moustatraf
Multidisciplinary Research Laboratory in Economics and Management (LARPEG), Faculty of Economics and Management, Sultane Moulay Slimane University, Beni Mellal, Morocco
Nabil Tilaoui
Multidisciplinary Research Laboratory in Economics and Management (LARPEG), Faculty of Economics and Management, Sultane Moulay Slimane University, Beni Mellal, Morocco

Abstract

Introduction: Universal health coverage is a key objective in Morocco. However, it faces significant imbalances in the distribution of resources. The study explores ways in which these imbalances can be addressed.
Methods: The study adopts a mixed-methods approach, combining quantitative analysis using principal component analysis with an examination of concentration, and qualitative analysis through a review of the legislation governing health insurance.
Results: The PCA reveals a strong correlation between the nine healthcare provision indicators (coefficients ranging from 0.804 to 0.992), with a KMO index of 0.709, confirming the suitability of the data. Two axes account for 96.37% of the total variance, one corresponding to the overall level
of healthcare provision and the other contrasting public and private provision. The factor map shows six under-resourced regions. At the provincial level, Gini indices >0.5 indicate severe inequalities in distribution, with all values exceeding the 0.5 threshold that characterises critical inequality.
Discussion: The Moroccan health insurance system has an equity objective but contains no explicit territorial provisions; governance is centralised and Article 1 prohibits any discrimination based on area of residence. Fiscal incentives for private investment in underserved areas are low (0.5% of tax expenditure in 2024). International approaches exist, but their implementation in Morocco faces technological, financial and governance obstacles.
Conclusions: There are multiple levers that health insurance can mobilise, starting with positive discrimination in favour of insured persons residing in these regions.

Keywords:

health insurance , coverage , access to healthcare , medical desert

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