Health workforce snapshot Tunisia

Health workforce snapshot TUNISIA TUNISIA AT A GLANCE1 Total population (2017) 11 446 000 Gross national income per capita (US$, 2018)2 12 060 Unemployment (% of total labour force) (2018)2 15.4 Per capita current health expenditure (US$ 2017) 257 Government health expenditure as % of general government expenditure (2017) 13.7 Out-of-pocket expenditure as % of current health expenditure (2017) 39.9 Universal health coverage index (2015)3 65 Number of refugees (2016) 636 Number of internally displaced persons (2016) 0 Maternal mortality per 100 000 live births (2017) 62 Under-5 mortality per 1000 live births (2017) 13 Births attended by skilled health personnel (%) (2017) 98.6 Raised blood glucose (%, 18+ years) (2017) 12.5 Raised blood pressure (%, 18+ years) (2017) 23.2 Hepatitis B incidence rate per 100 000 (2017) 800 Source: Eastern Mediterranean Health Observatory. 0 10 20 30 40 50 60 70 80 90 100 Density per 10 000 population Density of physicians, nurses and midwives in countries of the Region (2017) KEY FACTS ▪ The geographic distribution of health workforce is highly imbalanced in favour of coastal cities. ▪ There is a need to adapt health education to meet the new needs of the population resulting from ageing and increase in the burden of noncommunicable diseases. ▪ Motivation of health personnel is low due to difficult working conditions and poor career prospects. As a consequence, public services compete with private structures to attract and retain personnel. There is also emigration to higher-income countries that offer much higher salaries. ▪ Public services recruited many non-clinical health workers after the 2011 revolution. However, there has been very limited recruitment since 2017 due to wider public sector restructuring. There is significant unemployment of so-called “paramedical personnel”, in particular of care assistants. ▪ There are high rates of absenteeism and many days are lost to strikes. ▪ The Ministry of Public Health, with the support of WHO, has launched a planning process to address health workforce deficiencies. 0 5 10 15 20 25 30 35 40 45 2010 2011 2012 2013 2014 2015 2016 2017 D en si ty p er 1 0 0 00 p o p u la ti o n Density of selected health professionals (2010–2017) Physicians Nurses and midwives Dentists Pharmacists Source: Eastern Mediterranean Health Observatory. Source: Eastern Mediterranean Health Observatory. 12.3 12.3 12.8 16.8 16.8 13 13 13 32.5 32.5 32.5 32.5 32.5 40.9 40.9 40.9 0 10 20 30 40 50 60 2010 2011 2012 2013 2014 2015 2016 2017 D en si ty p er 1 0 0 00 p o p u la ti o n Density of physicians, nurses and midwives (2010–2017) Physicians Nurses and midwives © World Health Organization 2020 WHO-EM/HRH/647/E 2641 1706 1403 1342 1352 758 966 1445 1730 2598 0 500 1000 1500 2000 2500 3000 2012-2013 2013-2014 2014-2015 2015-2016 2016-2017 N o . o f p ro fe ss io n al s Trend in nursing and techniciens superieurs diploma qualification from public and private institutions (2012–2017) Public Private 2012–2013 2013–2014 2014–2015 2015–2016 2016–2017 Source: National Health Workforce Accounts. Source: National Health Workforce Accounts and Ministry of Public Health. 3458 7755 6752 14 507 3441 3539 3371 6910 0 2 000 4 000 6 000 8 000 10 000 12 000 14 000 16 000 Dentists Specialist physicians General physicians Physicians (total) No. of health professionals Total and professionally active health workforce (2016) Professionally active Total 000 40 000 80 1. Eastern Mediterranean Health Observatory [online data repository]. Cairo: WHO Regional Office for the Eastern Mediterranean (https://rho.emro.who.int/data-r. accessed 5 November 2019). 2. The World Bank, 2018 data [online]. Washington (DC): The World Bank; 2018 (https://data.worldbank.org/indicator/NY.GNP.PCAP.PP.CD?locations=OM, accessed 5 November 2019). 3. Tracking universal health coverage: 2017 global monitoring report. Geneva and Washington (DC): World Health Organization and International Bank for Reconstruction and Development/The World Bank; 2017 (https://apps.who.int/iris/bitstream/handle/10665/259817/9789241513555-eng.pdf?sequence=1, accessed 5 November 2019). 4. Santé Tunisie en chiffres 2017. Tunis: Studies and Planning Department, Ministry of Public Health, Republic of Tunisia; 2019 (http://www.santetunisie.rns.tn/images/docs/anis/cartesanitaire/Sante-Tunisie-en-chiffres- offre-de-soins-2017.pdf, accessed 10 February 2020). 5. Private higher education establishments for the 2018–2019 academic year [online]. Tunis: Ministry of Higher Education and Scientific Research, Republic of Tunisia (www.mes.tn/, accessed 12 February 2020). Source: Santé Tunisie en chiffres 2017 0 1 2 3 4 5 6 Medicine Nursing Dentistry Pharmacy Health Sciences and Technologies N o . o f in st it u te s Health professional education institutions by sector (2018–2019) Public Private Source: Ministry of Higher Education and Scientific Research, 2018–2019. 0 5 10 15 20 25 30 35 40 45 Greater Tunis North East North West East Centre West Centre South East South West D en si ty p er 1 0 00 0 p o p u la ti o n Distribution of health workfrorce by region (2017) General physicians Specialist physicians Nurses Dentists Pharmacists Techniciens superieurs 0 20 40 60 80 100 Pharmacists Dentists Specialist physicians General physicians Physicians (total) % of total Distrbution of health workforce by sector (2017) Public Private 1089 1475 1258 1569 1100 274 222 245 220 240 340 289 250 268 247 0 200 400 600 800 1000 1200 1400 1600 2012-2013 2013-2014 2014-2015 2105-2016 2016-2017 N o . o f p ro fe ss io n al s Trend in public sector diploma qualification among health professionals (2012–2017) Medicine Dentistry Pharmacy Source: Ministry of Public Health, 2019. Source: Ministry of Public Health, 2019. 2012–2013 2013–2014 2014–2015 2015–2016 2016–2017 Health sciences and technologies