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Tunisian Health Care System - Coggle Diagram
Tunisian Health Care System
General Organization
•Dominated by public sector (but growing private sector)
•Pyramidal structure
Administrative Organization
•Central (Ministry of Health)
→ policy, planning, regulation
•Regional (Governorate)
→ adapt national programs
•Local (Health district)
→ implementation of care
Technical Organization
Public Sector
1st line (Primary care)
•Basic Health Centers (BHC)
•District hospitals
→ preventive + curative care
•2nd line (Secondary care)
•Regional hospitals
→ specialized care
•3rd line (Tertiary care)
•University hospitals
→ highly specialized + training + research
Parapublic Sector
•Military and interior hospitals
•CNSS polyclinics
•Occupational medicine
Private Sector
•Clinics, private practices
•Labs, imaging centers
•Strong growth since 1990s
Health District
•Covers ~50,000 inhabitants
•Includes BHC + district hospital + mobile teams
•Functions:
•prevention
•treatment
•coordination
Service Delivery Characteristics
•Public system with 3 levels
•Strong primary care network
•Expanding private sector
Primary Health Care
•Preventive + curative
•Based on Alma-Ata principles:
•vaccination
•maternal/child care
•disease control
•health education
•essential medicines
Resources
A. Infrastructure
•Basic health centers
•District hospitals
•Regional hospitals
•University hospitals
B. Pharmaceutical System
3 components:
•Regulation: Ministry structures
•Supply: Central Pharmacy (monopoly import)
•Distribution: hospitals + private pharmacies
•Growth of local production (generics)
Main Problems
•Regional inequalities
•Poor coordination between levels
•Weak referral/feedback system
•Difficult management of chronic diseases