Territorial Health Groups in Morocco: A Reform Lever for Performant and Integrated Health System Governance

Abstract

The reform of the Moroccan health system introduced by Framework Law No. 06-22 established Territorial Health Groups (GST) to address the structural limitations of the previous model namely institutional fragmentation, territorial inequalities, weak coordination across levels of care, and underdeveloped information systems. This study examines the case of the Tangier–Tetouan–Al Hoceima GST, a pilot region characterized by pronounced socio-geographical heterogeneity and persistent deficits in specialized human resources, physical accessibility to care, and hospital infrastructure. The methodology is based on an in-depth qualitative documentary analysis of 43 sources, including legislative texts, the organizational decree, national institutional reports (Health Plan 2025, National Health Accounts, Health in Figures), international publications (WHO, World Bank, AfDB), and internal documentation from the TTA GST. A thematic coding procedure was used to identify organizational mechanisms, observed benefits, and constraints.

The results reveal progress in functional structuring, clarification of institutional responsibilities, and multi-level coordination, while also underscoring significant limitations: organizational complexity, insufficient managerial capabilities, and limited interoperability of information systems. These findings lead to three strategic areas for improvement: managerial strengthening, digital transformation, and participatory governance.

Classification JEL : I18, M12

Paper type : Theoretical Research