Morocco : 30 years of collaboration between USAID and the Ministry of Health -- a retrospective analysis : family planning

For the other three reports, see PN-ACP-901 through PN- ACP-903. Cooperation between the MOH and USAID began in the early 1970s, 5 years after the start of the Moroccan National Family Planning Program (NFPP). Between 1971 and 2000, five USAID/MOH projects, corresponding to five phases and totaling $126 million, were launched. A sixth and final project covering the 2000-2004 period is intended to ensure the sustainability of the population, health, and nutrition programs. The cooperation between USAID and the MOH evolved and adapted to the country"s needs and priorities. The NFPP benefitted from focused USAID technical support in five essential areas: contraceptive logistics; continued training of health providers; development of effective information, education, and communication (IEC) strategies; information systems; and involvement of the private sector. Project appropriations increased over time, growing from $3 million in 1971-1977 to $52 million in 1993-2000, attesting to the mutual interests and the relationships of trust between the two parties. Over the past 30 years, USAID supported a broad range of actions, facilitated by increased participation by both the MOH and USAID, and the involvement of institutional contractors. The support of the royal family over the years, as well high levels of political support, contributed political capital to FP as a program and legitimized contraceptive use at the individual level. The collaboration between the MOH and USAID led to important results in FP indicators. Contraceptive prevalence among married women of reproductive age rose from less than 20% in 1979-80 to 59% in 1997. The total fertility rate decreased dramatically from 7.0 children in 1979-80 to 3.1 children in 1997. Despite these advances, significant differences persist in FP indicators between rural and urban areas. While the Moroccan NFPP still faces challenges ahead, it is considered to be a success on both the national and international levels. Thanks to the commitment of political officials, use of the incremental approach adapted to the national context, the dedication of health care professionals, and the support of USAID, the NFPP stands today as an internationally recognized success. (Author abstract, modified)