The availability and access of the population to quality health care remains highly insufficient in Tunisia. The "Essaha Azziza" (precious health) support programme aims to improve basic health care to improve the living conditions and promoting the well-being of all people at all ages.
The specific objective aims at improving the performance of the first-line health services in terms of (i) quality, (ii) accessibility, (iii) decentralization and (iv) governance in 13 governorates located in 4 geographical areas, which are partly remote areas where a large number of vulnerable people live. The areas covered are the north-western zone (Jendouba, Kef, Siliana), the west-central zone (Kasserine, Sidi bouzid and Gafsa), the southern zone as well as the peri-urban pole of Greater Tunis (Tunis South, Ettadhamen, Douar Hicher).
The underlying intervention logic is to allow for a qualitative reform of the health sector from its primary care base, in accordance with the new principles of participatory governance and within the context of the decentralization process.
The role of the TA is to support the Tunisian authorities, in particular the MoPH and especially the health authorities in the governorates and districts, in implementing the Health Sector Support Programme by acting as a facilitator for change.
Services are provided in the following areas:
Decentralisation of health management structures allowing for a more rational, effective and efficient functioning of the first-line health system.
Improvement of PHC services.
Improvement of access to and coverage with quality PHC services.
Establishment of viable governance structures at decentralised level.
Activities planned under each of these areas include:
At national level to initiate a strategic oversight process to improve efficiency and effectiveness for health services.
Design and implementation a regional model for health care, including models to optimise the use of the existing resources and identifying gaps in financing.
Design and operationalisation of the PHC mobile units at regional level to improve accessibility of the healthcare services in remote areas.
Development and operationalisation of referral protocols between PHC, SGC and THC, at both regional and national levels.
Development and implementation of an effective human resources management model adapted to the context and needs of the MoPH and its regional departments.
Implementation of a computerized information system including a hospital information system (HIS), a decision-making information system (DIS), a human resources information system (HRS) and a health management information system (SIS) and digitalising services.
Update, development and/or creation of standards and procedures and professional guides for management of health facilities (manuals including guidelines and reference to protocols), and monitoring their application.
Capacity building in terms of strategic planning, management of PHC, quality management, financial resources and fixed assets planning;
Promotion of intersectoral and multi-stakeholder collaboration at regional and local level.
Development and implementation of an EU communication and visibility strategy to raise awareness among health staff and the population.