Geographical Locations - Tunisia

• (Statistical) Number of Inhabitants per Doctor: 1,870
• CIA World Factbook : Tunisia

Organisations and Networks

UN and Multinational

• WHO
  - WHO Country Profile - Tunisia
  - WHO - Tobacco control: Country Profile: Tunisia
  - WHO - Environmental Burden of Disease: Country Profile – Tunisia
• PNUD en Tunisie

Government

• Environmental Documentary Portal
• Ministry of Public Health
  - National Institute of Public Health
• The Tunisian Government Portal - Website also available in French and Arabic

Non-Government

Academic Institutions

National Policy and Related Documents

Reports, Guidelines, and Projects

• An overview of the health care system of Tunisia
  Provides an overview of: Tunisia: the Country; Economic Development; Overview of the Health Care System (involving Health Service Delivery; Health Care Finance and Expenditure; Health System Organization and Governance; Causes of death; Human Resources for Health; Physicians; Pharmacists; and Paramedical staff); The private sector; Health Facilities in the Private sector; and Conclusion. [Human & Health, No.5, October 2008, pp.2-4, 6]
• "Damm Sokkor": Factors Associated with the Quality of Care of Patients with Diabetes: A study in primary care in Tunisia
  Objective: To identify the organizational, physician, and patient factors associated with the quality of care of patients with diabetes in a low-/middle-income country. Research Design and Methods: Data from 2,160 randomly selected patients with diabetes were extracted from the manual medical records of a nationwide sample of 48 randomly selected health centers. Physician and organizational characteristics were collected from national reports, questionnaires, interviews, and observation at the centers. Univariate and multivariate regression analyses were undertaken to identify associations with four quality-of care scores, based on processes and intermediate outcomes of care and 53 potential explanatory factors. Results: The mean age of the study population was 62.4 years, mean duration of diabetes was 8.4 years, 62% were female, and 94% had type 2 diabetes. In the final multivariate models, factors independently and significantly associated with higher process-of-care scores were regional affluence, doctor motivation, and the use of chronic disease clinics (P < 0.05). Health centers with younger patients and increased availability of medication were independently and significantly associated with improved outcome-of-care scores (P < 0.05). The final models of the four quality-of-care scores explained 55–71% of the variations in scores. Conclusions: Use of chronic disease clinics, availability of medication, and possibly doctor motivation appear to be the most strongly related modifiable factors influencing diabetes care. These findings will be used to develop and implement culturally appropriate quality improvement interventions to improve the quality of diabetes care. We recommend our findings be taken into account in other low-/middle-income countries. [author abstract] [Diabetes Care, 30(8): 2013–2018 (2007)]
• Influence of socio-economic and lifestyle factors on overweight and nutrition-related diseases among Tunisian migrants versus non-migrant Tunisians and French
  Background: Migrant studies in France revealed that Mediterranean migrant men have lower mortality and morbidity than local-born populations for non-communicable diseases (NCDs). We studied overweight and NCDs among Tunisian migrants compared to the population of the host country and to the population of their country of origin. We also studied the potential influence of socio-economic and lifestyle factors on differential health status. Methods: A retrospective cohort study was conducted to compare Tunisian migrant men with two non-migrant male groups: local-born French and Tunisians living in Tunisia, using frequency matching. We performed quota sampling (n = 147) based on age and place of residence. We used embedded logistic regression models to test socio-economic and lifestyle factors as potential mediators for the effect of migration on overweight, hypertension and reported morbidity (hypercholesterolemia, type-2 diabetes, cardiovascular diseases (CVD)). Results: Migrants were less overweight than French (OR = 0.53 [0.33–0.84]) and had less diabetes and CVD than Tunisians (0.18 [0.06–0.54] and 0.25 [0.07–0.88]). Prevalence of hypertension (grade-1 and -2) and prevalence of hypercholesterolemia were significantly lower among migrants than among French (respectively 0.06 [0.03–0.14]; 0.04 [0.01–0.15]; 0.11 [0.04–0.34]) and Tunisians (respectively OR = 0.07 [0.03–0.18]; OR = 0.06 [0.02–0.20]; OR = 0.23 [0.08–0.63]). The effect of migration on overweight was mediated by alcohol consumption. Healthcare utilisation, smoking and physical activity were mediators for the effect of migration on diabetes. The effect of migration on CVD was mediated by healthcare utilisation and energy intake. No obvious mediating effect was found for hypertension and hypercholesterolemia. Conclusion: Our study clearly shows that lifestyle (smoking) and cultural background (alcohol) are involved in the observed protective effect of migration. [author abstract] [BMC Public Health 2007, 7: 265]
• Medicine prices in Tunisia: Report of a survey [translation of the French original]
  "The medicine price survey in Tunisia took place from 22 to 26 March 2004. The goal was to document and compare the prices of selected medicines in the various sectors of the Tunisian health system, and to compare them with those of other countries… Data on the prices of 30 medicines were collected in the public and private for-profit sectors in the capital, Tunis, and in 3 other areas of Tunisia. An estimate of the availability of the medicines was also obtained. The cost of the treatments was calculated for ten medicines and was compared with the minimum daily wages of an unqualified government worker to obtain an estimate of affordability. In addition, data was collected on the components of the prices of selected medicines." [World Health Organization (WHO) and Health Action International (HAI), March 2004]
• Oral health in Tunisia
  Current WHO methods were employed to estimate the prevalence of toothbrush possession, tea drinking, tobacco habits, fluorosis, dentofacial anomalies, periodontal diseases, dental caries as well as treatment needs in schoolchildren in Tunisia, the smallest country in North Africa. Fluorosis was endemic in some regions. Dentofacial anomalies were more frequent than in the other countries of the Eastern Mediterranean Region (EMR). The prevalence of periodontal disease was high despite the high percentage of toothbrush possession. Altogether 60% of 12-year-olds and 70% of 15- year-olds required oral hygiene instruction, 44% and 15% respectively required scaling. Dental caries was also relatively frequent, but indices were low and the dental therapeutic index was very low. Of the 6–12- and 15-year-olds, 52%, 44% and 52%, respectively needed restorative care. Moreover, 19% of 6-year-olds, 20% of 12-year-olds and 5% of 15-year-olds required extractions. None of 6-year-olds, 3% of 12-year-olds and 5% of 15- year-olds required other dental treatment such as pulpal treatment and prosthetics. A comparison with a survey carried out 13 years ago indicated that dental caries seemed to be decreasing. The DMF at age 12 was lower than WHO goals for the Year 2000 and of the Eastern Mediterranean Region countries. The findings showed an unequal distribution of oral health personnel, with the southern part of the country being particularly underserved. [author abstract] [International Dental Journal (2004) 54, 389–394]
• Survey on the [sic] Tunisia's Public Health System
  "A survey on the [sic] Tunisia's public health system was conducted in July 2005 by the World Bank Human Development Department, in collaboration with Tunisian experts from the health sector." Complete official report in French.

Educational Resources

• CDC - Travel Information : North Africa
• Tunisia Online - Portal with links to websites dealing with media and communications, government, the economy, the society, tourism and travel, history, culture, women and the environment.