The paramedicalization of family planning services in Morocco.

Morocco has made great strides in family planning services provision since 1966 when His Majesty King Hassan II first issued a decree establishing a High Commission and Area Subcommittees on population. At that time there was no distribution through the public sector; today 12% of the total 21% prevalence of modern methods is attributed to public sector distribution alone. The greatest increases have occurred in concert with paramedicalization of FP services first through clinical facilities and subsequently through community based distribution (CBD). The Ministry of Public Health conducted a pilot operational research project in the late 1970s to ascertain the acceptability of CBD primarily providing FP services. Utilizing nursing and practical nursing personnel the Moroccan Ministry of Public Health has expanded this concept strengthening the primary health components into an extensive outreach system presently extending to 13 provinces. This paper highlights the history of FP services in the Moroccan public sector and the paramedicalization of service delivery in this setting. A discussion follows addressing factors which may influence the success of present programming. (authors)