{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:52:59Z","timestamp":1791298379736,"version":"4.1.0"},"reference-count":12,"publisher":"CAIRN.INFO","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,5]]},"abstract":"<jats:p>Introduction\u00a0: \u00a0La r\u00e9forme du syst\u00e8me de sant\u00e9 au Maroc vise la couverture sanitaire universelle (CSU) principalement par la g\u00e9n\u00e9ralisation de l\u2019assurance maladie. Toutefois, l\u2019\u00e9quit\u00e9 financi\u00e8re ne garantit pas automatiquement l\u2019acc\u00e8s physique aux services. Cette \u00e9tude interroge l\u2019efficacit\u00e9 spatiale de cette r\u00e9forme en confrontant la g\u00e9ographie de la demande solvabilis\u00e9e (taux de couverture) \u00e0 celle de l\u2019offre technique (densit\u00e9 infrastructurelle). M\u00e9thode\u00a0: \u00a0Bas\u00e9e sur les donn\u00e9es officielles du minist\u00e8re de la Sant\u00e9 (2023) et du Recensement (2024), l\u2019approche quantitative mixte combine l\u2019analyse des in\u00e9galit\u00e9s par les courbes de Lorenz et une mod\u00e9lisation \u00e9conom\u00e9trique (MCO) pour tester la corr\u00e9lation entre la couverture m\u00e9dicale et la densit\u00e9 des infrastructures dans les douze r\u00e9gions du Royaume. R\u00e9sultats\u00a0: \u00a0L\u2019analyse r\u00e9v\u00e8le une asym\u00e9trie structurelle majeure. Alors que la distribution de la couverture est devenue spatialement homog\u00e8ne (CV\u00a0=\u00a00,06), l\u2019offre de soins demeure fortement concentr\u00e9e et in\u00e9galitaire (CV\u00a0=\u00a01,05). La r\u00e9gression lin\u00e9aire\u00a0( R 2 = 0,137) confirme l\u2019absence de lien statistique significatif entre la d\u00e9tention d\u2019une couverture et la disponibilit\u00e9 locale des infrastructures. Conclusion\u00a0: \u00a0Ces r\u00e9sultats mettent en lumi\u00e8re un\u00a0\u00ab\u00a0paradoxe de la solvabilisation\u00a0\u00bb\u00a0: le droit administratif aux soins ne rencontre pas d\u2019offre ad\u00e9quate dans les r\u00e9gions p\u00e9riph\u00e9riques, risquant de transformer l\u2019assurance en une \u00ab\u00a0coquille vide\u00a0\u00bb. La r\u00e9ussite de la r\u00e9forme n\u00e9cessite d\u00e9sormais de d\u00e9passer la simple solvabilisation de la demande pour engager une politique proactive de territorialisation de l\u2019offre.<\/jats:p>","DOI":"10.3917\/spub.263.0029","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:31:15Z","timestamp":1791297075000},"page":"29-37","source":"Crossref","is-referenced-by-count":0,"title":["Disparit\u00e9s spatiales et paradoxe de l\u2019acc\u00e8s aux soins au Maroc\u00a0: analyse \u00e9conom\u00e9trique de la relation entre g\u00e9n\u00e9ralisation de la couverture m\u00e9dicale et densit\u00e9 infrastructurelle"],"prefix":"10.3917","volume":"vol. 38","author":[{"given":"Aazelarab","family":"Boughaleb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mounir","family":"Jerry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2273","reference":[{"key":"rb1","doi-asserted-by":"publisher","DOI":"10.2174\/18749445-v15-e221226-2022-160"},{"key":"rb2","unstructured":"2. World Bank. Morocco Health Reform Program (P179014): Program Information Document (PID) [en ligne]. Washington, DC : World Bank Group ; 2023 [visit\u00e9 le 16\/07\/2025]. Disponible sur : https:\/\/documents1.worldbank.org\/curated\/en\/099111924080513425\/pdf\/P179014-555dfd4f-8ee9-481a-af61-7b78ddfad9a4.pdf"},{"key":"rb3","unstructured":"3. Minist\u00e8re de la Sant\u00e9 et de la Protection Sociale. Sant\u00e9 en chiffres 2023 [en ligne]. Rabat : MSPS ; 2024 [visit\u00e9 le 16\/07\/2025]. Disponible sur : https:\/\/www.sante.gov.ma\/Documents\/2025\/01\/Sante%20en%20chiffre%202023%20VF.pdf"},{"key":"rb4","unstructured":"4. Haut-Commissariat au Plan. R\u00e9sultats pr\u00e9liminaires du Recensement g\u00e9n\u00e9ral de la population et de l\u2019habitat 2024 [en ligne]. Rabat : HCP ; 2024 [visit\u00e9 le 16\/07\/2025]. Disponible sur : https:\/\/www.hcp.ma\/Recensement-general-RGPH_r518.html"},{"key":"rb5","unstructured":"5. Organisation mondiale de la sant\u00e9 (OMS). Le financement des syst\u00e8mes de sant\u00e9 : le chemin vers la couverture universelle [en ligne]. Gen\u00e8ve : OMS ; 2010 [visit\u00e9 le 16\/07\/2025]. Disponible sur : https:\/\/iris.who.int\/server\/api\/core\/bitstreams\/4ac2e625-119b-4075-9ea5-9be77ade0545\/content"},{"key":"rb6","doi-asserted-by":"publisher","DOI":"10.1186\/1476-072X-3-3"},{"key":"rb7","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(17)30429-1"},{"key":"rb8","doi-asserted-by":"publisher","DOI":"10.1002\/9780470996249.ch15"},{"key":"rb9","doi-asserted-by":"publisher","DOI":"10.1080\/15481603.2018.1446713"},{"key":"rb10","doi-asserted-by":"publisher","DOI":"10.1016\/j.apgeog.2021.102584"},{"key":"rb11","unstructured":"11. World Bank. Morocco\u2019s Subsidized Health Insurance Regime for the Poor and Vulnerable Population: Achievements and Challenges [en ligne]. Washington, DC : World Bank Group ; 2018 [visit\u00e9 le 20\/07\/2025]. Disponible sur : https:\/\/openknowledge.worldbank.org\/entities\/publication\/c973913b-f17a-52dd-9824-1a9e12fc6cf6"},{"key":"rb12","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16020170"}],"container-title":["Sant\u00e9 Publique"],"original-title":[],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:31:18Z","timestamp":1791297078000},"score":1,"resource":{"primary":{"URL":"https:\/\/stm.cairn.info\/revue-sante-publique-2026-3-page-29?lang=fr&ref=doi"}},"subtitle":[""],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,10,5]]}},"URL":"https:\/\/doi.org\/10.3917\/spub.263.0029","relation":{},"ISSN":["0995-3914"],"issn-type":[{"value":"0995-3914","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,5]]}}}