Tunisia is among the nations that have implemented a health policy designed to let the population as a whole benefit from health cares without any discrimination, through a set of laws which states main principles and objectives of the country health policy:
- The right of access to medical cares guaranteed to every citizen.
- The obligation to insure health protection to population by Tunisian state.
- The setting up of public health structures which take into account the geographical distribution, the importance of equipment in quantity and in quality and the medical technological progress.
World reports on competitiveness worldwide and in Africa (2008-2009) published at Davos Forum has ranked Tunisia 27th on a Worldwide basis, first in Africa and second in Arab World with regard to health and primary school.
They are deemed by International Authorities to be the best on the southern border of the Mediterranean Sea and in Africa :
- Life expectation is of 74,2 year.
- Child death rate is of 18,70 for one thousand births
- The rate of obligatory vaccination is of 95%.
- The rate of country medical coverage is 1 physician per 968 inhabitants,1 dentist per 5447 inhabitants and 1 pharmacist per 5020 inhabitants.
- 95 % of the population lives less than 5 kms from the closest care center.
- The item “care and health” ranks fourth in household global expenses (10,30 %).
- Health expenses by inhabitant are around 256 Tunisian Dinars a year.
Tunisian health infrastructures are distributed into 3 different sectors:
1) Public sector:
It remains the main supplier of curative and preventive health cares. It holds more than 85 % of the total capacity in beds at a national level and uses 60% of the whole medical profession. Infrastructures of this sector comprise 3 levels of medical assistance:
- The first level is made up of basic health centers (more than 2050). They are primary health structures established throughout the country.
- The second level is made up of district hospitals (118) and regional hospitals (36). These structures are set up in department main towns and represent 18 % and 36 % respectively of available beds.
- The third level is made up of 30 academic hospital centers (so called CHU) totalling up to 196 departments with 40 medical specialities and offering 46% of total available beds.
2) The partly state-controlled sector:
This structure comprises 6 polyclinics belonging to National Social Security Fund (CNSS), where medical cares of a general type together with more specialized medical cares and diagnosis services are provided to Social Security beneficiaries.
3) The private sector:
It has experienced a great growth during the last ten years thanks to the State full support through fiscal incentives such as exemption of customs duties on equipments and lowering of VAT rate. It owns 104 clinics offering 2700 beds.
The private sector is also present with its 990 dentists rooms, 4974 medical rooms, 107 X-rays rooms, 200 analysis laboratories, 100 dialysis centers and 1800 pharmacist shops.
Health budget is the second in importance after the national education one. The state is allocating to it 8 % of global budget i.e. 2 % of G.D.P. Health expenses amount to 1,6 billions Tunisian Dinars i.e. about 1 billion Euros. Those expenses are covered 30 % by the State, 50 % by households and 20% by insurance companies and funds.
Every year, a great number of a high calibre physicians, dentists, pharmacists, veterinary surgeons, middle level technicians and medical and medical related staffs are graduated in Tunisia:
- Four Medecine faculties.
- One Dentistry faculty.
- One Pharmacy faculty.
- One Veterinary faculty.
- Four Sciences and health technics high schools.
- Twenty public health professional schools.
State has allocated for the time period of the eleventh development plan (2006-2011) investments amounting to near 549 millions Tunisian Dinars in the fields of prevention and safety, infrastructures and above all equipments with the objective to provide public hospital structures with a performing and up to date material.
For the same time period, private investments are estimated to equal 200 millions Tunisian Dinars.