Health care in Tunisia

What does the healthcare system in Tunisia look like?

In the World Health Organization's health systems ranking, Tunisia takes the 52nd spot. The country has one of the most developed healthcare systems in Africa and is a popular destination for medical tourism from neighboring countries.

With that, the country's healthcare system is still coping with a number of challenges. One of the most pressing issues is the disparity in the quality of services provided in public and private hospitals in the country.

In total, Tunisia hosts around 2,000 basic health care centers, 180 hospitals, as well as more than a hundred private healthcare institutions such as clinics. In general, emergency services in hospitals and clinics are available 24/7, providing quality health care to patients.

Tunisia's constitution of 2014 defined healthcare as an essential human right. However, the Tunisian government is still working on ensuring universal healthcare coverage for its people.

Currently, over 90% of the population is covered by health insurance. Some Tunisian citizens use private healthcare insurance, while others are covered by social security programs. With that, the country is still facing challenges when it comes to universal coverage. One of the main complaints in this regard is the gaps in payments for serious medical procedures.

Prices for standard check-ups and consultations in public hospitals in Tunisia are as follows:

For a visit to a general practitioner, you will need around 25 to 30 dinars, while a visit to a specialist doctor can cost around 35 to 40 dinars. Note, moreover, that most hospitals and doctors prefer cash payments.

When it comes to buying medication, you will need a prescription for controlled drugs. However, standard medicine is readily available in pharmacies, some of which are often on call at night.

Public healthcare in Tunisia

The Caisse Nationale d'Assurance Maladie is responsible for all health-related issues in Tunisia. As a social protection system, it applies to the whole population and is compulsory. Services depend on each social and professional category: the non-agricultural sector includes a general scheme, a supplementary scheme, and another one for the self-employed. Agricultural workers and farmers are also covered.

To be eligible for the Tunisian social security system, you must:

• have worked for at least 50 days during the last two quarters
• have worked for at least 80 days during the last four quarters.

Moreover, the social security system also applies to the spouse or partner and children of the persons covered.

While public hospitals in Tunisia are well-equipped and provide all the essential services, most expats living in the country prefer to go with private healthcare. There are several reasons for that.

First, the wait times in public hospitals can be quite long. You will need to allocate quite a bit of time for an appointment and be prepared to wait in crowded halls to see a specialist.

Second, while the quality of care in a public hospital is generally not lower than in a private one, the level of comfort won't be the same. Hospital rooms are typically minimally equipped, and the personnel in a public hospital are often too busy to pay you any additional attention.

Thus, if you are used to the western-style hospital experience, you would definitely be advised to turn to private health care in Tunisia. Here, you will experience a short-term wait time and a more personalized approach. However, be mindful that the price you pay in a private hospital may not always reflect the quality of the care you will receive. Private hospitals located in expensive areas will often charge higher prices compared to hospitals in more “modest” areas.

You will also find that some doctors work in several hospitals at different times. If you want to work with a specific doctor, it may be best to talk to them directly and inquire about their schedule and the hospital they are affiliated with.

Private health care in Tunisia

The public health care system only covers some services provided by the private health care system. In fact, most opticians and dentists are available in the private sector. Thus, Tunisians do not hesitate to seek private health services to access a broader range of health services.

With that, private healthcare isn't cheap, especially for Tunisians making an average salary.

As we've mentioned above, expats living in Tunisia generally prefer private healthcare facilities to public hospitals. This is because the wait times in private hospitals are shorter, you have more say in what doctor you want to treat you, and hospital personnel has more time to tend to your needs.

However, the higher price doesn't always mean higher quality medical service. When choosing a private hospital to attend in Tunisia, make sure to inquire with your local friends and colleagues about the best options within your budget.

Important:

Note that whether you choose to seek treatment in a private or public hospital and even if you have valid insurance, you will probably be asked to pay for your medical procedure in advance. You will then be able to present your receipts to the insurance company for reimbursement.

Private health insurance in Tunisia

Having valid health insurance is essential for anyone coming to Tunisia — whether you are here for the short term or are considering becoming an expat.

Valid health insurance will let you receive treatment in both public and private hospitals in Tunisia.

Public hospitals provide a variety of services and are a good option for emergencies and basic treatments. However, as we've mentioned above, public healthcare does have its limitations, and the faculties at public hospitals in Tunisia are generally not as good as those in private clinics.

In most cases, you would do better by getting international healthcare insurance for your stay in Tunisia.

International healthcare policies tend to take into account the specific needs that expats in Tunisia might have. Having an international policy will make managing healthcare issues in Tunisia easier and will provide you with access to English- speaking medical personnel.

With some healthcare providers, you will also be able to benefit from the waiver of advance payments in parent establishments, which you would be required to make otherwise.

Another benefit of having international healthcare insurance in Tunisia is that it will also keep you covered outside of Tunisia and offer additional guarantees such as repatriation assistance.

Depending on the type of international health insurance you get, you will also have coverage outside of Tunisia, which can be very useful if you plan to travel.

Important:

If you are a resident in Tunisia, having an international health policy won't exempt you from the requirement to join Caisse Nationale d'Assurance Maladie (CNAM) and make regular contributions.

Alternatively, there are many insurance companies to choose from in Tunisia, according to your needs and budget. Some of the leading health insurance providers are:

• Allianz Care
• Regency for expats
• Cigna

Consider having a look at their offers according to your needs and get a free quote on Expat.com's Health Insurance for expatriates in Tunisia page.

Social security affiliation in Tunisia

In general, employers are responsible for affiliating their employees to the social security scheme within a month following the signing of the employment contract and once the employee has started working. Otherwise, the employee has to register at the social security scheme by himself to obtain his affiliation number.

Good to know:

The social security system only applies to expatriates who are working for Tunisian companies operating within the country. As regards assigned employees, they have to refer to their home countries' health and social security systems for more information.

Read also Work in Tunisia

Pharmacies in Tunisia

You will find no shortage of pharmacies all across Tunisia. Many of these are open till late, and you shouldn't have any trouble purchasing most non-prescriptive drugs.

However, when it comes to more specialized medication, it's best to inquire with your healthcare professional ahead of time about the availability of such medication in Tunisia or possible alternatives.

Another important thing to consider is the medication you plan to bring into Tunisia. If you are traveling with any prescription medication, make sure the medication packaging is clearly labeled and keep the prescription signed by your doctor within hand's reach. This especially concerns any medication containing morphine.

Emergencies in Tunisia

If you have a general emergency in Tunisia, you can call 197, which is the number for the National Guard. However, there is little chance that the emergency responder will speak English. In this case, it's best to have someone by your side who can speak Arabic or French. When on the call with an emergency responder, you will need to present the following information:

• the nature of the emergency
• the state of the person in danger
• the location of the emergency

If you need to call an ambulance in Tunisia, you should dial 190. Note, however, that ambulance services in the country are limited to big cities. In some cases, it may be a better option to call a taxi to get to the nearest hospital.

Pregnancy in Tunisia

If you plan to have a baby in Tunisia, it is recommended to arrange your delivery in a private hospital. While public hospitals provide a full range of prenatal and postnatal services, the conditions of your stay and wait times may be quite stressful.

This is why most expats opt for private hospitals when it comes to hospital stays. In most cases, if you give birth in a private hospital, you will be offered a “pregnancy package”. This will include

essential delivery and post-delivery services. However, even if you purchase a pregnancy package, the final price of your hospital stay will be determined when you check out, depending on any additional services you've received.

Note that if you have a complicated pregnancy, you will most likely be referred to a public hospital as they are more equipped to deal with pregnancy complications.

Useful links:

Mutuelle de la santé

Hannibal International Clinic, Tunis

Centre Hospitalier International Carthagène, Tunis

Carthage International Medical Centre, Monastir