National Cancer Prevention and Control Plan Strategic

Objectives

Morocco’s National Cancer Prevention and Control Plan for 2010–2019 provides a multisectoral roadmap to reduce cancer incidence, mortality and exposure to risk factors, while improving the quality of life of patients and their families.[1][2][3]It seeks concrete, sustainable action suited to Morocco’s socioeconomic and cultural context, founded on equity, solidarity, quality, excellence, equal access to care and respect for the rights of people affected by cancer.[4][3]

• Reduce behavioural and environmental cancer risks by 30% during 2010–2019, recognising prevention as a priority because an estimated 40% of cancers could be avoided by reducing exposure or vulnerability to major risks.[5][6][3]
• Prevent tobacco use and passive exposure, harmful alcohol use, unhealthy diet, physical inactivity, overweight and obesity, virus-related infections, occupational exposures, pollution, radiation exposure and food-related carcinogenic hazards.[7][8][9][10]
• Expand nationwide early detection, screening at least 50% of women in the target population for breast and cervical cancer, and improve early diagnosis for symptomatic patients.[5][6][11][12]
• Provide diagnosis, treatment and follow-up through standardised, quality-assured services; ensure infrastructure and skilled personnel nationwide; manage all patients in accordance with international standards; and cure 50% of treated patients.[13][14][6]
• Establish a national palliative-care network and support all patients requiring palliative care, including pain management and physical, psychological, social and spiritual support for patients and families.[15][6]
• Support the four core components of prevention, early detection, diagnosis and therapeutic management, and palliative care through communication, social mobilisation, legislation, regulation, training, research and patient-rights measures.[3][5][16]

Implementation

The plan combines coordinated national leadership with decentralised, patient-centred delivery across prevention, screening, diagnosis, treatment, follow-up and palliative care.[2][3][17][18]It was developed through partnership between the Association Lalla Salma against Cancer and the Ministry of Health, informed by a national situation analysis and structured around 78 measures.[1][19]

• Coordinate implementation through the Association Lalla Salma against Cancer, the Ministry of Health, civil-society organisations and other relevant stakeholders, supported during plan development by a steering committee, a joint Association-Ministry panel and an ad hoc follow-up commission.[2][19]
• Use situation analysis, including 15 studies of incidence, risk factors, service capacity, legal arrangements, patient and professional needs, and public knowledge and attitudes, to identify gaps and guide component-specific action plans.[19][6]
• Deliver services through three levels: primary healthcare centres and general-practitioner offices for information, screening, triage, referral and follow-up; provincial hospitals and private specialist providers for diagnosis and principally surgical management; and university medical centres, regional oncology centres and specialist private clinics for advanced care, multidisciplinary decisions, education and research.[17][18]
• Integrate breast screening based on clinical examination for women over 45 years and cervical screening using visual inspection with acetic acid for women aged 30 to 50 years, initially through a pilot before wider generalisation.[12]
• Strengthen prevention through public education, school and community action, tobacco cessation services, immunisation and infection control, occupational and environmental protection, food controls, consumer protection, inspection, and legislative or regulatory measures.[8][9][10]
• Expand oncology capacity through new and proximity centres, specialised oncogynaecology and paediatric haemato-oncology services, equipment, medicines access, generic medicines, standardised protocols, referral arrangements and public-private coordination.[13][14]
• Develop the workforce through core curricula and continuing training for general practitioners, surgeons, non-oncology specialists undertaking chemotherapy, nurses and multidisciplinary diagnostic, therapeutic, supportive and palliative-care teams.[20][21][22]
• Organise palliative care through regional reference centres, proximity oncology centres and primary-care teams, using residential units, hospital outreach teams and home-based outreach care, with family, volunteer, civil-society and community involvement.[15][5]
• Monitor delivery through cancer and hospital registers, mortality-register linkage, occupational-risk records, information systems, traceable patient records, quality control and maintenance, programme indicators and periodic external reviews.[10][23][14][22]
• Finance capital and operating expenditure through a provisional 2010–2019 budget of 8,197,700 thousand Moroccan Dirhams, covering early detection, management, infrastructure, medicines, operations, organisation and supporting measures; the supplied material does not identify funding sources or financing gaps.[6][24]

Monitoring & Evaluation

The plan establishes a broad monitoring and evaluation architecture spanning cancer and risk-factor surveillance, early detection, patient management, palliative care, information systems and research. It combines population and hospital cancer registers, routine service data, quality assurance, external review, traceable patient records and continuous monitoring of component-specific indicators.[10][23][14][22][6]

• Strengthen cancer surveillance through the Grand-Casablanca-Region population cancer register, hospital registers in public and private oncology units, possible development of a second population-based register, and analysis through the Regional Health Observatory.[10]
• Improve mortality measurement by completing and verifying death certificates and linking cancer and mortality registers.[10]
• Monitor occupational and behavioural risks through medical records, workplace exposure monitoring, reporting by exposed people, centralised occupational-risk databases and regular risk-factor studies.[10][11]
• Assess public and occupational knowledge, attitudes and practices, including the effects of information, education and communication activities.[11]
• Apply early-detection quality assurance through protocols, quantitative and qualitative indicators, standardised forms, computerised information collection, stakeholder feedback and periodic external programme reviews. Indicators are to cover tests, examinations, treatment, procedural and time-limit compliance, patient satisfaction and cost trends.[23]
• Track cancer-management performance through time from first consultation to diagnosis and from diagnosis to treatment, adherence to chemotherapy and radiotherapy, treatment intervals, loss to follow-up, diagnosed cases against expected cases, treated cases against diagnosed cases and patient satisfaction.[14]
• Maintain traceability through standardised patient records, documented multidisciplinary consultation decisions, information systems linking levels of care, archived patient files and recording of severe adverse events.[14][22]
• Monitor palliative care through proximity-centre records, outreach-team activity records, a palliative-care information system and evaluation of protocols, patient and family needs, clinical practice and supportive-care development.[15][5]
• Track 2010–2019 outcomes through indicators for a 30% reduction in behavioural and environmental risk-factor prevalence, numbers of women screened and functional screening structures, patients managed and cured, operating diagnosis and treatment structures, and patients receiving palliative care.[6]

Accountability is supported by an ad hoc follow-up and monitoring commission, a proposed structure to manage the National Cancer Control and Prevention Plan, and quality-control and maintenance requirements for diagnostic and therapeutic equipment.[2][14][5]However, the extracts do not set out reporting lines, reporting intervals, full indicator definitions or a unified formal accountability framework across all components.[12][6]

Costing & Financing

The 2010–2019 National Cancer Control and Prevention Plan provides for capital and operating expenditure across prevention, early detection, treatment management, infrastructure, medicines, organisation and supporting measures. Its consolidated provisional budget is 8,197,700 thousand Moroccan dirhams, while the extracts do not identify financing sources, financing commitments, resource-mobilisation mechanisms, funding gaps or detailed economic assumptions.[6][24]

• Allocate 146,000 thousand Moroccan dirhams to early detection and 7,237,000 thousand Moroccan dirhams to management, including 789,000 thousand Moroccan dirhams for infrastructure, 4,629,000 thousand Moroccan dirhams for medicines and 1,782,000 thousand Moroccan dirhams for operating expenditure.[6]
• Allocate 37,000 thousand Moroccan dirhams to organisation and 150,000 thousand Moroccan dirhams to supporting measures.[6]
• Provide a provisional palliative-care budget of 86,000 thousand Moroccan dirhams and treat palliative care as equivalent to intensive care for pricing purposes, at a similar price.[5][25]
• Present separate budget-table totals of 578,700 thousand Moroccan dirhams and 146,000 thousand Moroccan dirhams, although the supplied extracts do not fully identify the programme headings for these tables.[26][27]
• Recognise substantial financial barriers: cancer treatment exceeded the capacity of most patients, more than two-thirds of the population lacked medical coverage, and patients could incur up to 90% of the cost for certain cancers.[2]
• Reduce economic barriers to diagnosis and treatment, assess screening efficiency and possible costs, monitor the cost evolution of early detection and management, and undertake prevention cost-benefit and palliative-care medico-economic research.[11][23][5]
• Increase taxes and prices on alcoholic beverages as a proposed policy measure, without specifying rates or expected revenue.[9]

Resource requirements include oncology infrastructure, diagnostic and treatment technologies, anticancer medicines, staffing, training, palliative-care networks, information systems and patient-support services.[18][13][28]The source specifies no unit costs for these inputs, nor quantified funding requirements beyond the provisional budget tables.[17][14]