"They Are After Quantity, Not Quality": Health Providers' Perceptions of Fee Exemption Policies in Morocco

A free obstetric care policy (FOCP) has been implemented in Morocco in 2008 in order to further decrease maternal mortality. Through in-depth interviews we explored the perceptions of health professionals in public Moroccan hospitals with regard to fee exemption policies. We tried to understand what drives health professionals to ignore, modify or apply a health policy as formulated. Respondents express significant influences of such policies on their work environment (higher workload and scarcity of resources) and on the patient/provider relationship, both of which may cause a negative effect on health workers' motivation. A mix of motivational determinants incites health workers in their turn to influence policy implementation. Understanding the motivational determinants of health workers may optimize policy implementation at the point of service delivery.