Health system challenges of NCDs in Tunisia

被引:19
作者
Ahmad, Balsam [1 ]
Fouad, Fouad M. [2 ,3 ]
Elias, Madonna [3 ]
Zaman, Shahaduz [1 ]
Phillimore, Peter [1 ]
Maziak, Wasim [3 ,4 ]
机构
[1] Newcastle Univ, Inst Hlth & Soc, Newcastle Upon Tyne NE2 4AX, Tyne & Wear, England
[2] Amer Univ Beirut, Fac Hlth Sci, Dept Epidemiol & Populat Hlth, Beirut, Lebanon
[3] Syrian Ctr Tobacco Studies, Aleppo, Syria
[4] Florida Int Univ, Robert Stempel Coll Publ Hlth & Social Work, Miami, FL 33199 USA
关键词
Health system; Syria; Aleppo; Cardiovascular disease; Diabetes; Qualitative study; NONCOMMUNICABLE DISEASES; CARDIOVASCULAR-DISEASE; SYRIA; COUNTRIES; PRIORITY; POLICY; WORLD;
D O I
10.1007/s00038-014-0616-0
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The objective of this study was to present a qualitative 'situation analysis' of the healthcare system in Tunisia, as it applies to management of cardiovascular disease (CVD) and diabetes. A primary concern was the institutional capacity to manage non-communicable diseases (NCDs). Research took place during 2010 (analysis of official documents, semi-structured interviews with key informants, and case studies in four clinics). Walt and Gilson's framework (1994) for policy analysis was used: content, actors, context, and process. Problems of integration and coordination have compounded funding pressures. Despite its importance in Tunisian healthcare, primary health is ill-equipped to manage NCDs. With limited funds, and no referral or health information system, staff morale in the public sector was low. Private healthcare has been the main development filling the void. This study highlights major gaps in the implementation of a comprehensive approach to NCDs, which is an urgent task across the region. In strategic planning, research on the health system is vital; but the capacity within Ministries of Health to use research has first to be built, with a commitment to grounding policy change in evidence.
引用
收藏
页码:S55 / S62
页数:8
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