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Key findings
  • Almost all Tunisians (96%) live in zones served by a piped water system, but only a slim majority (55%) live within easy walking distance of a health facility.
  • About four in 10 Tunisians say they went without medical care (43%) or clean water (40%) at least once during the previous year, including about three in 10 (33% and 29%, respectively) who did so “several times,” “many times,” or “always.”
  • More than half (53%) of Tunisians who had contact with public health facilities during the previous year say they found it “difficult” or “very difficult” to obtain needed health care.
  • A majority (58%) of Tunisians say the government treats them unfairly based on their economic status, including four in 10 (39%) who say this happens “often” or “always.”
  • Only one-third (35%) of Tunisians say government is doing “fairly well” or “very well” in providing water and sanitation services. Fewer than three in 10 (27%) rate the government positively for its performance in improving basic health services.

Despite gains in building its democracy, Tunisia still struggles with poor economic conditions and high rates of unemployment and inequality (Diwan, 2019). The country, especially in the interior region, is also plagued by unreliable public services such as medical care and water supply – particular problems during the COVID-19 pandemic.

Tunisia’s public health facilities face severe challenges, including substantial debt, too few beds to meet demand, inadequate equipment, and a shortfall of 14,000 qualified medical staff (News24, 2017).

In addition, water shortages have sparked warnings of a “thirst uprising” as residents in the interior suffer long water-supply cuts, reservoirs run dry, and farmers experience drastic losses (National, 2016). These challenges add to social tensions in a country still struggling with instability since its 2011 revolution.

Findings from the most recent Afrobarometer survey show that inadequate access to health care and water is an issue for many Tunisians, and the government is rated poorly for its performance in providing these two essential services. The survey also shows significant rural-urban gaps in access to water and medical care.

Arabic version

French version

Aida Elbeji

Aida Béji is a data analyst for One to One for Research and Polling in Tunisia

Imen Mezlini

Imen Mezlini is the national investigator for Tunisia.