Tunisia Way

Since 1990, the pyramid of health infrastructure has had four levels in the governorates: an extensive network of 1471 basic health centres (including maternal and child health centres, dispensaries and health posts) forms its base. At the secondary level are the 102 district hospitals, which provide primary health care and maternity and general inpatient and outpatient care. These two levels of the public health pyramid cover most of the health needs of the local communities. The third level-second-referral level-is made up of 23 regional hospitals. At the top of the pyramid, are 12 teaching hospitals, nine specialized institutes and 15 national specialized centres.

Community involvement in the field of health is carried out within the framework of local health councils (or committees) in each health district. Chaired and organized by the local political and administrative authority, these councils comprise locally elected representatives as well as the officers in charge of health-related sectors. It is also quite common that the community intervenes more directly in setting up a health centre managed directly by the people, in organizing health education, hygiene and first aid campaigns with nongovernmental organizations (for example, the Tunisian Youth Organization, the Red Crescent Society and the Tunisian Organization for Road Safety).