[Cross-sectional study on medical coverage for children with Down syndrome in Morocco: case study of the dysmorphology unit of the paediatrics 2 department at Ibn Sina University Hospital in Rabat].

Introduction: Down syndrome creates complex medical needs that require multidisciplinary care. In Morocco, there is a significant scarcity of data regarding the medical coverage for these patients. This study aims to describe the medical coverage of children with trisomy 21, as well as the medical specialities involved and the costs incurred during their care pathway, with a view to identifying areas for improvement in their care, particularly in the context of the public-private partnership that is part of the process of expanding compulsory health insurance (AMO). Methods: a descriptive cross-sectional study was conducted between January 2023 and December 2024 among children followed at the dysmorphology unit of the Rabat Children's Hospital. The data were collected via standardised forms and semi-structured interviews with parents. Results: among the 118 children included (52% boys, 48% girls), the majority were aged 6-10 (31%). 58% had no medical coverage, exposing families to direct financing. The most sought-after specialities were: endocrinology/genetics (39.8%), gastroenterology (36.4%), ophthalmology (31.4%), and cardiology (29.7%). Others, such as pediatric psychiatry (0.8%) and dentistry (2.5%), remained marginal. The highest costs were for haematology (702.5 MAD/month), developmental neurology (642 MAD/month), and cardiology (413.9 MAD/month). Conclusion: in our series, only 42% of patients had medical coverage. This finding highlights the need to provide other children with Down syndrome with better access to care, smoother check-ups, and, more generally, improved medical coverage.