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Old Jewish man, Djerba / Photo HH

The World Health Organization’s 2008-2013 Tunisia Country Cooperation Strategy states that Tunisia has improved his health-care system over the past years, despite the country’s limited material resources. This has led to a generally effective system, with the public sector accounting for 90 percent of hospitalizations in basic health-care facilities. The number of communicable diseases, such as polio, and neonatal tetanus is either at a low level or has been decreasing constantly over recent years. The number of registered HIV/AIDS cases has risen slightly. In response to maternal- and child-health programmes, the number of maternal and infant deaths has decreased substantially. Due to regional disparities, however, maternal and child health continue poor in underdeveloped rural regions, in particular in Tunisia’s west and south. Some non-communicable diseases, such as cardiovascular disease, cancer, and injuries, are on the rise.

The death rate from hypertension is 11.3 percent among women and 6.4 percent among men. Diabetes accounts for 8.1 percent of deaths in women and 5.7 percent in men. Closely linked to diabetes, obesity and overweight are a greater problem for women (62.5 percent) than for men. Another main cause of death in women is stroke. For men, death is frequently caused by ischaemic heart disease (6.6 percent, compared with 3.4 percent for women), traffic accidents (6.2 percent, compared with 1.6 percent for women), and lung cancer (5.2 percent, compared with 0.6 percent for women). The high rate of lung cancer in men is due mostly to their high rate of smoking, estimated at 52.8 percent; only about 5.2 percent of women smoke.

According to a 2008 WHO-AIMS Report, Tunisia’s mental-health system faces persistent challenges, in part because no specific budget is allocated to mental hospitals, resulting in insufficient mental-health investment. Mental-health services are almost absent from rural and underdeveloped areas; most services are limited to Tunis and Tunisia’s coastal cities. There is also a shortage in psychologists and social workers qualified to provide mental-health services.

For years, mental health remained taboo, but Tunisians seem now to be increasingly open to it, and that facilitates treatment.

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