What type of study is this?

This is a Systematic Review study.

October 5, 2025

Challenges to universal health coverage: A systematic review with implications for the Moroccan health system

Key Points

Multiple barriers to universal health coverage were identified, particularly in financing and healthcare organization.
The systematic review included articles published from 2016 to 2023, emphasizing significant applicability to Morocco.
Analysis classified challenges into categories such as epidemiological, financial, and organizational barriers.
Efforts to achieve universal health coverage in Morocco will require coordinated stakeholder participation and strategic policymaking.

Abstract

In this study, we aimed to gather and analyze available data on the barriers to and challenges associated with achieving universal health coverage (UHC) in different countries. The findings from this current systematic review have the potential to be of significant merit and applicability for policymakers and researchers in the Moroccan context. A systematic review according to the recommendations of the PRISMA grid (“Preferred Reporting Items for Systematic Reviews and Meta-Analyses”), concerning observational studies providing comparative data on the challenges of progressing toward universal health coverage, published between 2016 and 2023. We selected eligible studies on the basis of an exhaustive bibliographic search across Cismef, LiSSa, PubMed and ScienceDirect. The following keywords were identified via the “HeTOP” tool, and the creation of search functions was developed via the medical bibliographic query builder CISMeF's CRBM (Universal health coverage, Universal health insurance, barriers). The studies included original studies analyzing UHC implementation challenges in different countries, articles published between 2016 and 2023, and publications in English or French. The exclusion criteria included articles published before 2016, after 2023, meta-analyses, systematic reviews, books, WHO reports, editorials, commentaries, or non-peer-reviewed sources. At the end of the analysis of the various selected articles, numerous challenges were identified and classified into three categories: epidemiological and demographic challenges; challenges related to healthcare financing and social protection; and challenges related to the organization of the healthcare system. This work was able to identify several likely challenges in establishing universal health coverage in Morocco, the most significant of which are epidemiological, related to financing, or linked to the organization of the healthcare system. Universal health coverage is therefore a political choice that can be achieved only through sustainable and coherent efforts, with the coordinated participation of all stakeholders.

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