Collaboration and Governance in Integrated Care Systems: A Moroccan Perspective on Lessons From England’s ICS; Comment on “New Ways of Working to Manage and Improve Quality in Integrated Care Systems in England”

Document Type : Commentary

Authors

Interdisciplinary Research Laboratory in Economics, Finance and Organizational Management, Faculty of Law, Economic and Social Sciences, Sidi Mohamed Ben Abdellah University of Fez, Fez, Morocco

Abstract

Lalani et al explores how integrated care systems (ICSs) in England are redefining quality management through collaboration, co-production, and a focus on population health. This commentary examines the relevance of these principles for Morocco, where universal health coverage (UHC), the expansion of social protection, and Territorial Health Groups (GSTs, Groupements Sanitaire Territoriaux) aim to improve care coordination and reduce health inequalities. ICS-inspired strategies could strengthen Moroccan reforms by promoting decentralized governance, community engagement, and co-production, with GSTs serving as regional coordination platforms. However, financial constraints, centralized institutions, and political pressures to prioritize visible outcomes require local adaptation. Strengthening regional quality committees, addressing social determinants, and empowering community health workers (CHWs) could help align Morocco’s reforms with ICS principles.

Keywords


  1. Lalani M, Peters M, Sugavanam T, et al. New ways of working to manage and improve quality in integrated care systems in England. Int J Health Policy Manag. 2025;14:8424. doi:34172/ijhpm.8424
  2. Tinasti K. Morocco's policy choices to achieve universal health coverage. Pan Afr Med J. 2015;21:53. doi:11604/pamj.2015.21.53.6727
  3. Bouzaidi TD, Ragbi A. An analysis of the trend towards universal health coverage and access to healthcare in Morocco. Health Econ Rev. 2024;14(1):5. doi:1186/s13561-023-00477-0
  4. Boutayeb A. Social inequalities and health inequity in Morocco. Int J Equity Health. 2006;5:1. doi:1186/1475-9276-5-1
  5. Mourajid Y, Ghafili A, Chahboune M, Hilali A, Fihri Fassi C. Governance in Moroccan public hospitals: critical analysis and perspectives for action. Int J Health Gov. 2022;28(1):31-45. doi:1108/ijhg-04-2022-0043
  6. Loi n° 09‐21 relative à la protection sociale. Nº 7132. Rabat: Bulletin Officiel du Royaume du Maroc; 2021.
  7. Haut Commissariat au Plan (HCP). Les Indicateurs sociaux du Maroc, Edition 2023. HCP; 2023.
  8. Maroc. Loi n° 08.22 promulguée par le dahir n° 1.23.50 du 28 juin 2023 relatif à la création des Groupements Sanitaires Territoriaux. Rabat: Bulletin Officiel du Royaume du Maroc; 2023.
  9. Boutayeb A. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg. 2006;100(3):191-199. doi:1016/j.trstmh.2005.07.021
  10. United Nations International Children’s Emergency Fund (UNICEF). Morocco Country Brief. UNICEF; 2020.
  11. Mahdaoui M, Kissani N. Morocco's healthcare system: achievements, challenges, and perspectives. Cureus. 2023;15(6):e41143. doi:7759/cureus.41143
  12. Akhnif EH, Hachri H, Belmadani A, Mataria A, Bigdeli M. Policy dialogue and participation: a new way of crafting a national health financing strategy in Morocco. Health Res Policy Syst. 2020;18(1):114. doi:1186/s12961-020-00629-2
  13. Iroz CB, Ramaswamy R, Bhutta ZA, Barach P. Quality improvement in public-private partnerships in low- and middle-income countries: a systematic review. BMC Health Serv Res. 2024;24(1):332. doi:1186/s12913-024-10802-w
  14. Dove G, Craig A, Harris-Roxas B, Kelly-Hanku A. Governance of public-private partnerships for primary healthcare in low- and lower-middle-income countries, 2000-2023: a systematic review. Int J Health Policy Manag. 2025;14:8442. doi:34172/ijhpm.8442
  15. World Bank. Morocco Health Reform Program. World Bank; 2023.
  16. Belrhiti Z, Bigdeli M, Lakhal A, Kaoutar D, Zbiri S, Belabbes S. Unravelling collaborative governance dynamics within healthcare networks: a scoping review. Health Policy Plan. 2024;39(4):412-428. doi:1093/heapol/czae005
  17. Peters M, Lalani M, Hogan H, et al. Integrated care systems in England: progress towards forming new multi-stakeholder partnerships to develop quality. Int J Integr Care. 2023;23(S1):120. doi:5334/ijic.ICIC23120
  18. Roehrich JK, Lewis MA, George G. Are public-private partnerships a healthy option? A systematic literature review. Soc Sci Med. 2014;113:110-119. doi:1016/j.socscimed.2014.03.037

Articles in Press, Corrected Proof
Available Online from 11 November 2025
  • Received Date: 02 July 2025
  • Revised Date: 26 October 2025
  • Accepted Date: 08 November 2025
  • First Published Date: 11 November 2025
  • Published Date: 11 November 2025