CARBON FOOTPRINT IN PUBLIC PROCUREMENT

1
Kingdom of Morocco
M. Ahmed IDHAMMAD
Head of Sustainable Development and President of A2DS
Mohammed VI University Hospital of Marrakesh, Morocco
a.idhammad@a2ds.org
www.a2ds.org
CARBON FOOTPRINT IN PUBLIC PROCUREMENT
Policy evaluation from a case study in the healthcare sector
Nijmegen, Netherlands
10-12 October 2018
Parallel sessions C [C6 - Reducing the environmental impact of public procurement for healthcare]
Disclosure statement: I declare no potential conﬂict of interest on this work.

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Agenda
The Health System in Morocco
Public Procurement in Healthcare Sector
CHU Marrakech: At A Glance
CHU Marrakech: Sustainable Development
Our key Achievements
Our Carbon Footprint
Our GHG Reduction Plan

3
The Health System in Morocco
NationalHealth
SysteminMorocco
Private (fot-profit)Public
270 private units2 458 Basic Health
Facilities
124 Hospitals
7 Military hospitals
National Institutes
and Laboratories
Health care
establishments run
by mutual benefit
societies: 13 CNSS
the National Social
Security Fund
5 500 beds26 000 beds 1 800 beds
16%79% 5%
Private (non-profit)
 Regional hospitals
 National university hospitals
 Provincial hospitals
 Heathcare Center (local)
 Polyclinics
 Diagnostic Centers
PublicHospitalSystem
Morocco
Kingdom of Morocco in brief
Capital: Rabat
Population (2014): 33 848 242 inhabitants
Life expectancy at birth (2014) : 72 years
Population distribution % urban: 60.35
% population Under 15: 28.0
Total area: 710 850 km2
Coastline : 1 835 Km
Population density : 73,1 people /km2
Language : Arabic , Berber
To the north, the climate is Mediterranean, Atlantic to the
west, and Saharan to the south*
Thursday 11th October 2018 - Day 2 | CleanMed Europe - October 10 - 12 2018, Nijmegen, the Netherlands | M. Ahmed IDHAMMAD

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Public Procurement in Healthcare Sector | Morocco
Billion Dirhams
52
30,5
2006 2013
* Gross Domestic Product (GDP)
5,8
TotalHealthExpenditure(THE)
% of GDP* in 2013
2,9%
Average annual
growth rate: 2010/13
 Others
 Households out of pocket expenditures
 Tax-based financing
 Health Insurance
 Employers
 Foreign donors
50,7%
24,4%
22,4%
1,2%
0,6%
0,7%
Sourcesofhealthcare
financinginMorocco(**)
DistributionofNational
HealthExpenditures,by
TypeofService
 Collective Health Prevention
 Outpatient care
 Pharmaceutical
 Inpatient care
 Training, Education & Research
 Administration
 Others
38%
26,2%
23,2%
1,6%
2,2%
1%
7,8%
** CNS-Rapport 2015
About 88% of
THE is devoted
to medical
consumption

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The Marrakesh University Hospital | At A Glance
5
Hospitals
1 548
Beds
2 600
Professional Staff
160 000 m²
Constructed area
173 445
Outpatient consultations
225 470
Emergency Visits
57 812
Day-care admissions
57 096
Classic admissions
24 103
Surgical Interventions
15 635
Births
1 020 320 €
Electric consumption
50 million €
Operating budget
4 million €
Investment budget
83 %
Average occupancy rate
6 days
Average hospital stay
400 204 €
water consumption
150 000 €
Gas consumption
290 tons/year
Healthcare risk waste production
20 500 €
Diesel consumption
*Source: Rapport d’activité 2017

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The Marrakesh University Hospital | Sustainable Development
2016
Creation of the
Sustainable Development
Committee
2014
Integrating sustainability into
our strategic planning
2012
Commitment to sustainable
development
… 2011
Individual and Local
Initiatives
2017 …
A strategy for ongoing
project evaluation
A Timeline of Sustainable Development at Marrakesh University Hospital

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The Marrakesh University Hospital | Sustainable Development
Sustainable Development Policy
 Promotion of social progress
• Ensure the health, safety and well-being of employees in the workplace;
• Take into consideration the points of view of all stakeholders and create a work
environment based on the seven values of the institution;
• Include social responsibility in our management system;
 Preservation of the environment and natural resources
• Identify environmental aspects and impacts of the establishment's operational
activities;
• Reduce greenhouse gas emissions and improve the energy efficiency of
buildings;
• Promote products and processes that are more respectful of the environment;
• Promote source reduction, reuse, sorting, recycling, recovery and disposal of
waste safely;
• Support the implementation of renewable energy projects.
 Encouraging responsible economic
• Apply a responsible purchasing policy that aims to make suppliers aware of CSR;
• Continue to improve awareness and communication aimed to reduce
consumption and improve energy efficiency;
• Develop a sustainable economic development strategy;
• Ensure the integration of ecodesign principles in new investment projects.
Sustainable Development Committee
The mission of the
Sustainable Development
Committee is mandated
to develop, promote and
coordinate all activities
related to sustainable
development. Its mission
is also to oversee the
preparation of annual
action plans, monitor
their implementation and
capitalize on experience
The Sustainable
Development Committee,
consisting of managers of
various departments and
General manager
The Sustainable
Development Committee
meets at least twice a
year

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The Marrakesh University Hospital | Our Key Achievements
3
1
Greenhouse Gas
Balance
GHG Inventory - GHG Reduction
Analysis - Sustainbility Action Plan
Training and
Awareness
Increasing public awareness -
Promoting training
Digital Hospital
Dematerialization - Paperless office
Energy Audits
Conducting of two EA in
hospitals buildings
Energy Management
System
Counting system and energy
management
Environmentally
Responsible
Purchasing
Eco-friendly - Energy-efficient
appliances
2
4
6
5
Energy Efficiency
LED lighting - Motion and occupancy
detectors - Harmonic filtering - energy
Compensation
Green Building
Thermal insulation for buildings
- Natural lighting
Promotion of Sustainable
Development
At local / state / national level
Renewable Energy
Solar Thermal Energy - Solar Photovoltaic
Energy - Geothermal Energy
Reduction of Water
Consumption
Automatic faucets - Drip irrigation
Sustainable Waste
Management
Potentially infectious medical waste
treatment is done in-situ
8
7
9
10
12
11

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The Marrakesh University Hospital | Our Key Achievements
VIDEO

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The Marrakesh University Hospital | Our Carbon Footprint
Understanding the greenhouse effect01
Define the scope of the study02
Data Collection03
Analysis of results and ranking04
Establishing courses of action to reduce05
Launch of actions to reduce06
The Carbon Footprint ProcessBilan Carbone® tool
02
0304
01
Greenhouse Gases
EF are multiplier
coefficients to convert
activity data into GHG
emissions.
The Bilan Carbone® is a
French accounting
method and tool for GHG
emissions belonging to
the Association Bilan
Carbone®.
GHG Inventory
There are 7 Greenhouse
Gases (GHG) identified
in the Kyoto Protocol.
Emission factors
Bilan Carbone
It is calculated in
accordance with ISO
14064, Part 1 and the
GHG Protocol.
General principle (ISO 14 064-1)
Method of calculating the dataMethod used
Outil de Calcul Simplifié des Emissions
de GES Marocain (OCSEM)

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OVERVIEW OF GHG EMISSIONS (*)
40 336 tCO2(e)
ENERGY
21%
8 366 tCO2(e)
PROCUREMENT
35%
13 990 tCO2(e)
TRANSPORTATION OF PEOPLE
33%
13 373 tCO2(e)
WASTE
6%
2 408 tCO2(e)
OTHER
5%
2 199 tCO2(e)
BREAKDOWN OF GHG EMISSIONS BY TYPE
36%
27%
15%
12%
3%
1%
3%3%
 Hospital Linens
 Pharmaceuticals Products
 Purchased Services
 Food and Catering
 Medical consumables
 Business Furniture & Office Supplies
 Cleaners & Disinfectants Products
 Other Procurement
13 990 tCO2(e)
(Purchased Goods / Services)
(*) 2017 Results

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TRANSPORTATION OF PEOPLE
EMPLOYEE
COMMUTING
PATIENT &
VISITOR
TRAVEL
BUSINESS
TRAVEL
15,33%
84,64%
0,03%
CAR 82% REGIONAL BUS
14%
MOTORBIKE 2%
TRAIN 1%
CITY BUS 1%
13 373 tCO2(e)
9 395 tCO2(e)
GHG EMISSIONS BY ENERGY SOURCE
PROPANE GAS
8 366 tCO2(e)
10%
ELECTRICITY
80%
8 366 tCO2(e)

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The Marrakesh University Hospital | Our GHG Reduction Plan
-5,11%
ENERGYPROCUREMENT
TRANSPORTATION
OF PEOPLE
WASTE OTHER
-2,80%
-0,91%
-2,68%
+2,75%
NET CHANGE IN EMISSIONS* (%)
(*) 2016-2017
OUR TARGETS AND EMISSIONS PROJECTIONS
GHG emissions
reduction from 2016
baseline levels
annually
20%
100%
Renewable
electricity
commitment
2020
2030

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The Marrakesh University Hospital | Our GHG Reduction Plan
Telemedicine
Three Regional Hospitals
Focused on several specialties
including Neurology, Cardiology
and more
Sustainable Mobility
The Hospital of Marrakech
acquires its first 100% electric
utility vehicle
Waste Management
Potentially infectious medical
waste treatment is done in-situ
Building Design
New Buildings and
Refurbishments
Better building design and
operation
Online Appointment
200 805 Outpatient
consultations
Improve patient flow management
and avoid moving patients
Renewable Energy
800 Solar panels & 367
Solar water heaters
Installed at hospitals saving 312
tonnes of GHG per year
Procurement
Monitoring and Reporting
Highlight procurement
information, performance, and
trends
E-Procurement
Adoption of e-procurement
tools to improve inefficient and
ineffective procurement
management
CMMS
Computerized Maintenance
Management System
Improve maintenance operations
and reduce operating costs
Going Paperless
Hospital Information System
(HIS) - Electronic Document
Management System (EDMS) -
HR management software - …
Procurement
Include sustainability criteria in
tenders and procurement
contracts
Sustainability Criteria
Procurement
Training and Awareness raising
A number of sessions were
offered to key stakeholders

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M. Ahmed IDHAMMAD
Head of Sustainable Development and President of A2DS
Mohammed VI University Hospital of Marrakesh, Morocco
a.idhammad@a2ds.org
www.a2ds.org
Nijmegen, Netherlands
10-12 October 2018

CARBON FOOTPRINT IN PUBLIC PROCUREMENT

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