Health system challenges of NCDs in Tunisia

Romdhane, H. B., Tlili, F., Skhiri, A., Zaman, S. and Phillimore, P. (2015) Health system challenges of NCDs in Tunisia. International Journal of Public Health, 60(S1), pp. 39-46. (doi:10.1007/s00038-014-0616-0) (PMID:25399240)

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Objectives The objective of this study was to present a qualitative ‘situation analysis’ of the healthcare system in Tunisia, as it applies to management of cardiovascular disease (CVD) and diabetes. A primary concern was the institutional capacity to manage non-communicable diseases (NCDs).

Methods Research took place during 2010 (analysis of official documents, semi-structured interviews with key informants, and case studies in four clinics). Walt and Gilson’s framework (1994) for policy analysis was used: content, actors, context, and process.

Results Problems of integration and coordination have compounded funding pressures. Despite its importance in Tunisian healthcare, primary health is ill-equipped to manage NCDs. With limited funds, and no referral or health information system, staff morale in the public sector was low. Private healthcare has been the main development filling the void.

Conclusion This study highlights major gaps in the implementation of a comprehensive approach to NCDs, which is an urgent task across the region. In strategic planning, research on the health system is vital; but the capacity within Ministries of Health to use research has first to be built, with a commitment to grounding policy change in evidence.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Zaman, Dr Shahaduz
Authors: Romdhane, H. B., Tlili, F., Skhiri, A., Zaman, S., and Phillimore, P.
College/School:College of Social Sciences > School of Interdisciplinary Studies
Journal Name:International Journal of Public Health
ISSN (Online):1661-8564

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