Morocco's health and education outcomes have improved, with expanded access in recent years. However, persistent challenges include medical personnel shortages, weak learning outcomes, regional disparities, and outdated infrastructure. While public spending in these sectors is relatively high compared to peers, efficiency gaps remain, and budget under-execution is common, indicating potential for better results with existing resources.
Health Sector:
- Outcomes: Health-adjusted life expectancy (HALE) at birth is around 62.34 years, comparable to emerging market and regional peers. Infant mortality rates have declined significantly.
- Capacity Constraints: Density of health workers per 10,000 inhabitants is 16.09, below WHO's recommended critical density of 23. Hospital bed capacity is 7.3 per 10,000 inhabitants, below the desirable level of 20. Geographical disparities exist, with some regions having only three medical doctors per 10,000 inhabitants.
- Expenditures: Current health spending is around 5.7% of GDP, with government spending at 2.3% of GDP. Out-of-pocket spending remains high at 43% of total current health spending.
- Efficiency: Spending efficiency is better than in comparator countries in the MENA region and emerging markets, with an efficiency gap of around 0.27. Investment execution rate in the health sector is around 70%.
- Reforms: Key areas include universal health care coverage, strengthening human resources, more efficient infrastructure, and strengthening governance. The government has launched comprehensive social protection reforms and is working to modernize hospital infrastructure and expand training capacity.
Education Sector:
- Access: Enrollment has increased across all levels, with gross primary enrollment at around 115–117%, secondary enrollment up by 27 percentage points, and tertiary enrollment up by 34 percentage points since 2010. Preschool enrollment has also increased.
- Outcomes: Education attainment remains low compared to MENA peers and emerging markets. Morocco scores at the bottom of international PISA assessments in science, mathematics, and reading.
- Challenges: Regional inequities, skill mismatches, teacher-related constraints, governance and efficiency weaknesses, and limited decentralization.
- Expenditures: Public expenditure on education is around 6% of GDP, well above regional peers and emerging market comparators.
- Efficiency: Spending efficiency has improved, but an efficiency gap of around 37% persists, suggesting outcomes could be 37% higher if resources were used more efficiently. Investment execution rate is around 70%, particularly low in higher education, scientific research, and innovation.
- Reforms: Key areas include accelerating universal preschool education, improving quality and relevance of learning outcomes, scaling up the "Pioneer School" model, strengthening education infrastructure, and reforming student financial support and school services.
Recommendations:
- Health: Accelerate reforms, enhance governance and institutional capacity, fully operationalize key governance institutions, strengthen data and financial management systems, streamline decentralization arrangements, improve human-resource and infrastructure management, and link greater autonomy to clearer accountability.
- Education: Strengthen governance, accountability, and execution capacity across the education system. Clarify roles and responsibilities, streamline procurement and approval processes, enhance technical capacity, grant greater school level autonomy, and improve data systems to link resources to learning outcomes.
