Health in Tunisia
Measles, tetanus, and polio have been largely eliminated by a major immunization program. Schistosomiasis and malaria are rare, though rabies, stings, and leishmaniasis are still an issue. Non-communicable diseases associated with an unhealthy lifestyle are now the leading causes of death.
Tunisia has a public health system funded from taxation run by the Caisse Nationale d'Assurance Maladie that provides care for the majority of the population. It includes health centres providing primary care, district and regional hospitals, and university hospitals. Contributions were set in 2010 at 6.75%: 2.75% paid by the employee from salary and 4% by the employer. Some treatment in the private sector is covered by the scheme.
Co-payments were introduced in 1994 at 10% and increased to 20% in 1998. Out-of-pocket payments are now more than half of the total health care expenditure.
There is a private health care sector, concentrated in the cities, with both for-profit and non-profit organizations running hospitals and facilities. This has 12% of the total bed capacity and 70% of the top range medical equipment. More than half the doctors, 73% of the dentists, and 80% of the pharmacists work in the private sector. The medical tourism industry is the second largest employer and second highest foreign currency earner.