Hierarchical logics still largely prevail in the Moroccan health administration. Despite the positive interaction between learning and the RAMED policy, the opportunity to push forward a more structural transformation towards a learning system has not been fully seized. The policy decisions and the implementation strategy create a learning dynamic, though not structured in all cases. Our study also confirms that the learning changes in nature across the different stages of the policy process. Yet, our study also showed some major shortcomings, especially the lack of structure of the learning, and insufficient effort to systemise and sustain a transformation of practices within the health administration. There is evidence of a leadership encouraging learning, the introduction and adoption of knowledge management processes, and the start of a transformation of the administrative culture. The study confirmed the importance of learning during the different stages of the RAMED policy process.
We gathered data from key informants and document reviews. For the data collection and analysis, we developed a framework combining Garvin’s learning organisation framework and the heuristic health policy analysis framework. We conducted a retrospective analysis of the RAMED policy for the period between 19, along with a case study design. It specifically focuses on the development of a major health financing policy aligned with the UHC goal in Morocco, the RAMED, a health financing scheme covering hospital costs for the poorest segment of the population.
This study aims at documenting how, across time, learning can feed into a UHC policy process, and how the latter can itself strengthen (or not) the learning capacity of the health system. To progress towards universal health coverage (UHC), each country will have to develop its systemic learning capacity.
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