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“They Are After Quantity, Not Quality”: Health Providers’ Perceptions of Fee Exemption Policies in Morocco

نویسندگان

  • Bruno Marchal Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
  • Fahdi Dkhimi Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
  • Karen Van der Veken Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium | Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
  • Peter Decat Department of Public Health and Primary Care, Ghent University, Ghent, Belgium

چکیده

Background A free obstetric care policy (FOCP) has been implemented in Morocco in 2008 in order to further decrease maternal mortality.   Methods Through in-depth interviews we explored the perceptions of health professionals in public Moroccan hospitals with regard to fee exemption policies. We tried to understand what drives health professionals to ignore, modify or apply a health policy as formulated.   Results Respondents express significant influences of such policies on their work environment (higher workload and scarcity of resources) and on the patient/provider relationship, both of which may cause a negative effect on health workers’ motivation. A mix of motivational determinants incites health workers in their turn to influence policy implementation.   Conclusion Understanding the motivational determinants of health workers may optimize policy implementation at the point of service delivery.

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