Spatial disparities and the paradox of healthcare access in Morocco: An econometric analysis of the relationship between the generalization of medical coverage and infrastructure density

Abstract

Introduction:  Health system reform in Morocco aims to achieve universal health coverage (UHC), primarily through the expansion of health insurance. However, financial coverage does not automatically guarantee physical access to services. This study examines the spatial efficiency of this reform by comparing the geography of financially solvent demand (coverage rate) with that of healthcare supply (infrastructure density).

Method:  Based on official data from the Ministry of Health (2023) and the Census (2024), this mixed quantitative approach combines inequality analysis using Lorenz curves and econometric modeling (OLS) to test the correlation between medical coverage and infrastructure density across the Kingdom’s twelve regions.

Results:  The analysis reveals a major structural asymmetry. While the distribution of coverage has become spatially homogeneous (CV=0.06), the supply of care remains highly concentrated and unequal. Linear regression (R2 = 0,137) confirms the absence of a statistically significant relationship between coverage and the local availability of infrastructure.

Conclusion:  These results highlight a “solvabilization paradox”: the administrative right to care does not correspond to an adequate supply in peripheral regions, risking the transformation of insurance into an “empty shell.” The success of the reform now requires moving beyond the simple solvabilization of demand toward a proactive policy of territorializing healthcare supply.