Rabat/fr

Morocco / Rabat

INTRODUCTION

Au Maroc, il est possible d'acheter une contraception sans ordonnance. Vous pouvez également avoir accès à une contraception d'urgence (la pilule du lendemain). EllaOne, actuellement considérée comme la CU la plus efficace, est disponible. Il n'existe aucune restriction pour les voyageurs atteints du VIH ou d'une MST. Certains centres offrent un dépistage anonyme et gratuit, vous les trouverez sur cette page. Il n'existe actuellement pas de programme de vaccination contre le HPV. Il semble également que la PrEP ne soit pas encore disponible au Maroc. Vous pouvez trouver des serviettes et des tampons au Maroc, et il existe quelques petits fournisseurs de coupes menstruelles. L'avortement est légal dans certaines circonstances, qui se sont élargies ces dernières années. Cependant, l'avortement légal n'est toujours pas la norme et, chaque année, de nombreuses femmes ont toujours recours à des avortements clandestins présentant des risques.

Contraception

Note générale : il existe de nombreux moyens de contraception, comme les DIU (dispositifs intra-utérins ou stérilets), les contraceptions orales, les patchs, les injections, les préservatifs, etc. Pour une liste complète, cliquez ici.

Lois & stigmatisation sociale

Au Maroc, les moyens de contraception sont disponibles sans ordonnance, c'est à dire qu'ils sont en vente libre dans les pharmacies. D'autres formes de contraception sont également disponibles, tels que les préservatifs, les injections et les DIU (ou stérilets). On estime qu'environ 68 % des Marocaines ont recours à une forme de contraception et que 48 % d'entre elles utilisent des méthodes de contraception modernes. Selon un rapport de l'ONU datant de 2015, les besoins en planification familiale de 9,7 % des Marocaines ne sont pas satisfaits. Les méthodes de contraception les plus courantes sont la pilule (utilisée par 49,6 % des Marocaines mariées ou en couple), le DIU (4,3 %), le retrait (3,9 %), le calcul des cycles (ou méthode Ogino, 4,3 %) et la stérilisation féminine (3,0 %). L'utilisation du préservatif est assez peu courante, 1,2 % des Marocaines ayant recours au préservatif masculin.

Selon un rapport du Population Reference Bureau datant de 2012, " le pays se démarque des pays arabes par l'augmentation rapide de l'utilisation de moyens de contraception modernes chez les femmes des zones aussi bien rurales qu'urbaines, ainsi que le taux relativement faible de " besoins non satisfaits " en termes de planification familiale (définis comme la porportion de femmes désirant retarder ou éviter une grossesse mais n'utilisant pas de contraception)".

Cependant, des progrès peuvent encore être faits. D'une part, la planification familiale au Maroc met lourdement l'accent sur la pilule et néglige le préservatif (qui peut protéger des grossesses comme des infections et maladies sexuellement transmissibles). Pour cette raison, il est recommandé que la planification familiale au Maroc consacre davantage de ressources à la promotion d'autres moyens de contraception. En outre, comme l'indique le rapport, " les services marocains de planification familiale et de santé maternelle tendent à se concentrer sur les besoins des femmes mariées. Les hommes et femmes célibataires peuvent éviter les services de planification familiale et de santé procréative en raison d'un manque de confidentialité, ainsi que du jugement des prestataires. Selon Roudi-Fahimi, ces programmes doivent être étendus aux couples non mariés sexuellement actifs, une relation généralement tenue secrète car elle n'est pas socialement ou juridiquement acceptable."

Quoi et où

Birth control pills from Morocco

• " Contraception " se dit/s'écrit تنظيم النسل en arabe.
• Pour consulter une liste des options de contraception disponibles au Maroc, cliquez ici.
• Dans les villes du Maroc, les cliniques de quartier fournissent des services de planification familiale. Cependant, leur personnel pense souvent qu'il faut être marié pour y recevoir de l'aide. Les membres de leur personnel peuvent ne pas explicitement demander un acte de mariage, mais en général, ils savent déjà qui est marié ou célibataire en raison de leur rôle dans le quartier. En matière de services de planification familiale, de nombreuses Marocaines célibataires choisissent de consulter une ONG plutôt que les cliniques de quartier pour éviter tout jugement ou stigmatisation.
• Vous pouvez acheter la pilule en pharmacie. Vous pouvez trouver les marques Diane, Diane-35, Gynovlar, Jasmine, Mercilon, Microval, Minulet, Neogynon, Stediril, Microgynon, Microgynon-30, Minidril et Yasmin, entre autres.
• Vous pouvez acheter des préservatifs en pharmacie ou en ligne. Par exemple, les préservatifs Moods ici, qui coûtent 271,98 MAD les 10 boîtes.
• L'anneau contraceptif (Nuvaring) est disponible au Maroc, commercialisé par Cooper Pharma. En 2011, il était considéré comme une nouveauté assez rare, mais il commence à devenir plus courant. Il coûte 139 MAD. Cliquez ici pour plus de détails.
• Pour les progestatifs injectables, Depo-Provera SAS 150 mg/ml et Megestron sont disponibles au Maroc.
• Si vous souhaitez un DIU, Mirena est disponible au Maroc.
• L'AMPF (Association Marocaine de Planning Familial) fournit des services de planification familiale (ordonnance/ contraception hormonale sous forme d'injection ou d'implant et pose de DIU). Le coût est abordable (2 consultations coûtent environ 120 MAD, la procédure et la contraception sont gratuits).

Coûts

Certaines pilules coûtent environ 13 MAD par mois.

Contraception d'urgence ("pilule du lendemain")

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In the last few years, emergency contraception (the morning after pill) has become commercialized in Morocco. You can buy it at pharmacies without a prescription, according to locals. Technically, you may be required to have a prescription, according to Moroccan law, but this doesn't seem to be widely enforced. There are stories of many pharmacists, some of whom may even appear "religious," selling emergency contraception to locals without judgment, questioning or shaming.

What to Get & Where to Get It

• To say/write "emergency contraception," here it is in Arabic (وسائل منع الحمل في حالات الطوارئ) and French (contraception d'urgence).
• You can purchase dedicated emergency contraception at Moroccan pharmacies. Some brands you can expect to see are ellaOne, NorLevo 1.5mg and Postinor-2. For all of these pills, you should take one pill within 120 hours of unprotected sex to prevent pregnancy. Currently, ellaOne is considered the most effective EC on the market, since it can be effective for 5 days after unprotected sex, whereas the other pills are effective for 3-5 days after unprotected sex. For more information on ellaOne, check out the ellaOne website.
• You can have an IUD inserted to prevent pregnancy for up to 5 days after unprotected sex.
• If you can't access dedicated emergency contraception, you can use regular oral contraceptives (birth control pills) as emergency contraception. For progestin-only pills, you can take Microval (take 50 pills within 120 hours after unprotected sex). For combined pills (progestin-estrogen), you'll need to remember that, in 28-day packs, only the first 21 pills can be used. You can take Neogynon or Stediril (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Microgynon, Microgynon-30 and Minidril (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

• Here's how to say sexually-transmitted infection: مرض منقول جنسيا (Arabic), infection sexuellement transmissible (French)
• Note: Please visit the "Medications & Vaccines" section for information on PEP and PrEP access in Morocco.

There are no travel restrictions related to HIV or STI status in Morocco. In the 1990s, some people were deported due to their HIV status, but that has stopped. Furthermore, while the US Consulate website claims that there are restrictions on HIV+ visitors to Morocco, this has been confirmed by numerous sources to be incorrect, and more information can be found online at HIV Travel. In Morocco, some companies ask prospective or new employees for HIV test results. This is actually illegal and some NGOs in Morocco have worked to eliminate this practice, so it's become increasingly uncommon. However, there are still cases of employers asking for HIV tests. You can contact Association de Lutte contre le Sida (ALCS) for information if this is happening to you.

STI Tests at NGOs

Un dépistage effectué par une ONG ne coûte pas très cher. Les ONG ont également tendance à se montrer plus ouvertes en matière de décisions et pratiques sexuelles que les cliniques publiques.

• Association de Lutte contre le Sida (ALCS): You can provide free HIV and syphilis tests. Services for both Moroccan citizens non-citizens. Their testing site is 17 boulevard el Massira el Khadra. They also have vans that go around Morocco and offer free, anonymous tests for syphilis and HIV.
• OPALS (Organisation Panafricaine de Lutte contre le SIDA or Pan-African Organization for the Fights Against AIDS): They have testing facilities in many cities.

STI Tests at Private Laboratories

If you get tested at a private laboratory/clinic, it will be a bit more expensive than the NGOs. You can get the full range of STI tests, including HIV, Hepatitis B, Hepatitis C, syphilis, HPV, gonorrhea and chlamydia for around 200-500 Moroccan Dirhams.

Support

• Association Marocaine de Planification Familiale (AMPF): They give free medication for STI treatment.
• Association de Lutte contre le Sida: They offer treatment and education on HIV preventuin. Address: 17, Boulevard Al Massira Al Khadra, Casablanca. Phone: +212 2 994 242/43. Fax: +212 2 994 244.
• OPALS (Organisation Panafricaine de Lutte contre le SIDA or Pan-African Organization for the Fights Against AIDS): They offer support and education.

Costs

For STI tests, you can find very cheap (or free) options from NGOs. If you go to a private laboratory, you can expect to pay 200-500 Moroccan Dirhams for the full range of STI tests. If you are HIV positive, the Moroccan government and health services can provide free HIV treatment. For other STIs, you generally need to pay with your own money for medication but AMPF may be able to provide some free treatment services.

Medications & Vaccines

What to Get & Where to Get It

• In Morocco, you can get PEP (Post-Exposure Prophylaxis) in emergency rooms.
• There are no official providers of Pre-Exposure Prophylaxis (PrEP) in Morocco, as of February 2017. This may change in the future.
• If you have a yeast infection, this is how you say it in Arabic (الالتهاب المهبلي) and French (candidose vaginale). You should ask the pharmacist for Pevaryl or Gyno Pevaryl, which are two yeast infection medications that are commonly sold in Morocco. If those are not available, you can also ask for Fluconazole, and the pharmacist should be able to give you medication that contains the necessary active ingredients.
• If you believe that you have a UTI (urinary tract infection), here's how you say it in French: IVU (Infection des voies urinaires). You can get typically medication at the pharmacy without a prescription. While it is generally recommended that you visit a health professional to confirm your results before taking treatment, it's not enforced in Morocco.
• There is no national HPV vaccination program in Morocco, despite the fact that cervical cancer is the second most common form of cancer among Moroccan women.

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

• If you menstrual pain (dysmenorrhea), you can say عسر الطمث (Arabic) or dysménorrhée (French)
• In Morocco, you can find pads, tampons and some menstrual cups. Pads are very common and easy to find. Tampons are sold in large stores, especially ones that are in tourist areas. You can also find them in Marjane, a supermarket chain.
• Regarding menstrual cups, you can buy Girlies Menstrual Cup for 300 MAD from Nature & Eveil - click here for more details. However, there are no official sellers of major brands, like DivaCup, MoonCup or Lunette. However, there are some women and small boutiques that may sell menstrual cups. Also, if you're using a menstrual cup, nearly all washrooms have some kind of water, so you'll be able to rinse it out.

Gynecological Exams

What to Get & Where to Get It

• Here's how you say/write gynecologist: دكتور امراض نساء (Arabic), gynécologue (French)
• Zemmouri Najib: Very highly recommended by a Rabat local. 200 dh for the consultation. Address: Avenue Hassan II, résid. Mamounia entrée A, 1°ét. appt.2, RABAT. Phone: 0537202131

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Morocco, abortion is legal (for up to 6 weeks of pregnancy) under certain circumstances, which include: if the woman's life is endangered by the pregnancy, if the woman's physical or mental health is endangered by the pregnancy, and if the pregnancy is the result of rape or incest. In all other circumstances, such as risk of fetal impairment, social/economic reasons or upon request, are not permitted. If the woman's life is endangered by the pregnancy, spousal consent is not required. In all other cases, the spouse must generally approve of the abortion. If the husband refuses or cannot give consent, the physician is required to obtain the authorization of the chief medical officer of the province. This authorization will be a written notification, which will say that the intervention is the only way of safeguarding the health of the woman.

In the future, Morocco may seek to further liberalize its abortion laws. In 2015, the government (by the king's decree) began to allow abortions in cases of rape or incest. Furthermore, the Moroccan Health Minister told the Associated Press, “Morocco’s penal code on abortion is very restrictive; the law is not fair to women. It doesn’t take into account the reality that Moroccans live in these days - there is an urgent need to revise this law." However, these are also conservative and religious groups in Morocco, which are actively and vocally opposed to abortion.

As reported in USA Today in 2015, "Doctors, activists, and professors say some Moroccan women try to induce an abortion by ingesting harmful herbal infusions or pills, laying on the sweltering floor of a hammam (bathhouse) or even inserting a sharp device into their vaginas. But women with money can usually find doctors willing to provide a safe abortion, according to Imane Khachani, a gynecologist in Rabat. These abortions typically cost over $1,000, a huge amount in a country where the minimum wage is just $300 a month."

What to Get & Where to Get It

According to a Morocco local and sexual health professional, it's much safer to obtain a surgical abortion than a medical abortion. This is because, generally-speaking, you can only access part of the medication (one of the two pills) required to induce a medical abortion in Morocco. This typically means that the medicine isn't enough to fully complete the abortion -- and, a result, many women are brought to hospital emergency rooms. Since the abortion is already partially complete, the doctors usually complete the abortion in the emergency room. The doctors don't have legal proof that the woman induced the abortion herself, so women aren't typically prosecuted. However, this is a risky route, exposing women to potential medical providers, family members and community members to a decision that they probably wanted to keep personal and private. There is also the potential risk of doctors refusing to treat patients. For these reasons, if you want to obtain an abortion in Morocco, it's strongly recommended that you find a medical provider who you trust that can provide a safe surgical abortion.

Costs

Generally speaking, clandestine abortions in Morocco cost 2000-6000 Moroccan Dirham. There have been cases of abortion providers who provide especially low-cost services to women who cannot afford the typical rate, so this number varies.

Advocacy & Counseling

What to Get & Where to Get It

• If you have a crisis or need questions answered, you can send a direct message on Facebook to ALCS - Association de Lutte Contre le Sida. They can answer your questions in French, English and Arabic. Free help.
• ALCS Centre d'écoute "Allo Info Sida": 05 22 92 89 89.
• ALCS Palteforme SMS "Bilaharaje": 5808.
• For LGBTQI-friendly services in Morocco, you can check out the Marrakech, Rabat and Agadir chapters of ALCS.
• Association Marocaine de Lutte contre la Violence a l'égard des femmes (AMVEF): NGO that gives psychological counseling and legal guidance for victims of sexual violence. Email: amvef@gmail.com, ecoute@menara.ma. Tel: 00212522268667.
• Droit & Justice: This groups helps women victims of violence. "Co-founded 2009 by Reda Oulamine and Mourad Faouzi, “Droit et Justice” is a non-profit association, independent of any political organization, dedicated to legal assistance and the improve of the judiciary system and the rule of law in Morocco. Droit et Justice wants to change the atmosphere of the judicial system by denouncing cases of particular dysfunction while proposing solutions to present-day gaps."

List of Additional Resources

• Association Solidarité Féminine (ASF): "a non-profit organization founded by Aïcha Chenna in Casablanca, Morocco in 1985. The association helps single mothers gain work experience by training them at the association's restaurant, patisserie, and hammam."
• Association Démocratique des Femmes du Maroc (ADFM): "Association Démocratique des Femmes du Maroc (ADFM) is an autonomous, non-profit feminist NGO, which aims to promote women's rights in order to increase women's power and influence in the juridical, political, economic and social spheres to build an egalitarian society based on democracy and sustainable development."
• Amal Women's Training Center and Moroccan Restaurant: This is in Marrakesh. "Amal Women's Training Center and Moroccan Restaurant is a non-profit organization in Marrakesh, Morocco, that helps disadvantaged women gain work experience by training them in the preparation of Moroccan food and international food"