Morocco
Context: HIV, viral hepatitis and sexually transmitted infections (STIs) remain significant public health challenges in Morocco, despite the progress made in prevention, screening and care as part of efforts to improve access to and the quality of health services. However, certain population groups remain particularly at risk, notably men who have sex with men (MSM), sex workers, people who inject drugs (PWID), transgender people and prisoners. The social, legal and structural vulnerabilities faced by these groups can limit their access to prevention and care services.
In response to these challenges, Morocco has placed the acceleration of the fight against HIV, STIs and viral hepatitis at the heart of its 2024–2030 Integrated National Strategic Plan (PSNI). In particular, the plan provides for the strengthening of combined prevention strategies to offer the most at-risk populations a range of services tailored to their needs. This approach is based on the coordination of several complementary interventions,
including screening, the use of condoms and lubricants, pre-exposure prophylaxis (PrEP), self-testing, STI prevention and harm reduction. It also involves addressing the barriers that hinder access to care, notably stigma, discrimination and difficulties in ensuring the confidentiality of care.
In this context, primary healthcare centres (ESSPs) are a key lever for bringing prevention services closer to key populations and facilitating their referral to appropriate facilities. Healthcare professionals must therefore be able to provide care that respects users’ rights, is tailored to their needs and is free from stigma or discrimination.
However, the lack of a harmonised practical framework governing the provision of combined prevention services is a barrier to standardising practices within PHC facilities. With this in mind, the Directorate of Epidemiology and disease control (DELM) of the ministry of Health and Social Protection, with support from the global fund, wishes to develop a National Guide to the Combined Prevention of HIV, STIs and Viral Hepatitis for these facilities.
The technical assistance mobilised in this context is intended to help update the minimum package of services and formalise the applicable technical and organisational standards. It also aims to strengthen the skills of healthcare professionals and provide them with practical tools to improve and assess the quality of services, thereby supporting the implementation of national guidelines and promoting more equitable access to integrated, confidential prevention services tailored to the needs of key and vulnerable populations.
Overall objective: to develop a national guide serving as a framework of best practice for the combined prevention of HIV, STIs and viral hepatitis, aimed at professionals working in primary healthcare settings.
Specific objectives:
SO1: Update the minimum package of combined prevention services that must be available in a social care center;
SO2: Describe the minimum organizational, technical and functional standards applicable to ESSPs offering combined prevention services;
SO3: Define best practices relating to reception, counselling, screening, prevention, guidance and referral of service users to promote the concept of ‘welcoming ESSPs’;
SO4: Define measures to prevent stigmatization and discrimination in health services;
SO5: Define recommended information materials and displays (charter of users’ rights, services offered, patient pathways, prevention messages, etc.);
SO6: Propose a self-assessment grid enabling establishments to assess their level of compliance with best practice.