{"id":13877,"date":"2015-09-14T07:34:05","date_gmt":"2015-09-14T06:34:05","guid":{"rendered":"http:\/\/kapitalis.com\/tunisie\/?p=13877"},"modified":"2015-09-14T08:20:38","modified_gmt":"2015-09-14T07:20:38","slug":"la-reforme-de-la-sante-publique-en-question","status":"publish","type":"post","link":"https:\/\/kapitalis.com\/tunisie\/2015\/09\/14\/la-reforme-de-la-sante-publique-en-question\/","title":{"rendered":"La r\u00e9forme de la sant\u00e9 publique en question"},"content":{"rendered":"

\"Hopitaux-systeme-de-sante\u0301\"<\/p>\n

Un programme de r\u00e9forme du syst\u00e8me de sant\u00e9 tunisien doit \u00eatre \u00e9labor\u00e9, mis en route d\u2019urgence et \u00e9tal\u00e9 sur 10 ou 15 ans.<\/strong><\/em><\/p>\n

Par Amor Abbassi<\/strong>*<\/p>\n

<\/p>\n

Le syst\u00e8me de sant\u00e9 publique en Tunisie pr\u00e9sente de graves carences et dysfonctionnements structurels, car les probl\u00e8mes constat\u00e9s au fil des ans n\u2019ont pas \u00e9t\u00e9 r\u00e9gl\u00e9s \u00e0 temps, mais ils se sont accumul\u00e9s, rendant la t\u00e2che aussi complexe, sur le plan de la d\u00e9marche \u00e0 suivre et des priorit\u00e9s \u00e0 \u00e9tablir, que couteuse en terme de financement, qui plus est dans un contexte \u00e9conomique difficile marqu\u00e9 par de graves d\u00e9ficits publics.<\/p>\n

Inventaire des besoins et d\u00e9finition des priorit\u00e9s<\/strong><\/p>\n

Il n\u2019est pas difficile d\u2019\u00e9tablir les grandes lignes de cette r\u00e9forme. Une commission minist\u00e9rielle pluridisciplinaire, o\u00f9 si\u00e8geraient aussi quelques experts nationaux et internationaux et certains acteurs de la soci\u00e9t\u00e9 civile (repr\u00e9sentants des m\u00e9decins, pharmaciens, assureurs, etc.) pourrait, en effet:<\/p>\n

– dresser un inventaire complet des \u00e9tablissements hospitaliers existants sur tout le territoire avec leurs \u00e9quipements, effectifs, capacit\u00e9s et r\u00e9partitions par r\u00e9gion;<\/p>\n

– \u00e9tudier, cas par cas, la situation de ces \u00e9tablissements, pour en d\u00e9gager les points forts (assez rares) et les points faibles (plut\u00f4t nombreux) sur tous les plans;<\/p>\n

– \u00e9tablir un programme global et une \u00e9valuation des actions avec un ordre des priorit\u00e9s, visant \u00e0 rem\u00e9dier aux carences d\u00e9gag\u00e9es par les \u00e9tudes sp\u00e9cifiques de chaque \u00e9tablissement;<\/p>\n

– d\u00e9finir les besoins mat\u00e9riels et humains, tant quantitatifs que qualitatifs, de chaque r\u00e9gion en mati\u00e8re de soins de sant\u00e9 (construction, am\u00e9nagement, \u00e9quipement, effectif manquant, etc.);<\/p>\n

Il est \u00e9vident, vu la situation actuelle de nos \u00e9tablissements hospitaliers, que leur mise \u00e0 niveau, conform\u00e9ment aux exigences r\u00e9v\u00e9l\u00e9es par les \u00e9tudes, n\u00e9cessitera de grands investissements, humains et mat\u00e9riels. Auxquels s\u2019ajoutent les investissements n\u00e9cessaires pour construire de nouveaux \u00e9tablissements dans certaines r\u00e9gions, les am\u00e9nager et les \u00e9quiper de moyens humains et mat\u00e9riels.<\/p>\n

Augmenter le budget de la sant\u00e9<\/strong><\/p>\n

En prenant l’exemple de la France, \u00e0 titre indicatif, nous devrions avoir:<\/p>\n

–\u00a0 un centre hospitalier pour 90.000 habitants, soit au total 122 centres hospitaliers (CH), contre 56 actuellement, r\u00e9partis entre 33 h\u00f4pitaux r\u00e9gionaux et 23 h\u00f4pitaux, centres et \u00e9tablissements universitaires;<\/p>\n

–\u00a0 un centre hospitalier universitaire pour 365.000 habitants, soit au total 30 centres hospitaliers universitaires (CHU), contre seulement 23 actuellement.<\/p>\n

Le financement de ce programme, qui s\u2019\u00e9talera sur 10 ou 15 ans, on puisera, bien s\u00fbr, dans le budget de l\u2019Etat, sachant que la part du budget du minist\u00e8re de la Sant\u00e9 dans celui de l\u2019Etat est de 7-8%, soit environ 153 dinars par t\u00eate d\u2019habitant.<\/p>\n

D\u2019o\u00f9 la n\u00e9cessit\u00e9 d\u2019accroitre les recettes publiques, et notamment fiscales, de mani\u00e8re \u00e0 pouvoir augmenter le budget du minist\u00e8re de la Sant\u00e9.<\/p>\n

On recourra aussi au financement ext\u00e9rieur \u00e0 travers des cr\u00e9dits contract\u00e9s aupr\u00e8s de certains organismes et institutions financiers \u00e9trangers. Ce financement sera d\u2019autant plus facile \u00e0 obtenir que les axes de la r\u00e9forme et les modalit\u00e9s de leur mise en route sont clairement d\u00e9finis, avec des \u00e9ch\u00e9anciers raisonnables.<\/p>\n

* Ing\u00e9nieur g\u00e9n\u00e9ral du g\u00e9nie maritime.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Un programme de r\u00e9forme du syst\u00e8me de sant\u00e9 tunisien doit \u00eatre \u00e9labor\u00e9, mis en route d\u2019urgence et \u00e9tal\u00e9 sur 10 ou 15 ans. Par Amor Abbassi*<\/p>\n","protected":false},"author":8,"featured_media":13878,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[992,1000,2433],"tags":[173,2603,774,1881],"class_list":["post-13877","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-a-la-une","category-tribune","category-tunisie","tag-budget","tag-equipements","tag-reforme","tag-sante-publique"],"yoast_head":"\nLa r\u00e9forme de la sant\u00e9 publique en question - Kapitalis<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/kapitalis.com\/tunisie\/2015\/09\/14\/la-reforme-de-la-sante-publique-en-question\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"La r\u00e9forme de la sant\u00e9 publique en question - Kapitalis\" \/>\n<meta property=\"og:description\" content=\"Un programme de r\u00e9forme du syst\u00e8me de sant\u00e9 tunisien doit \u00eatre \u00e9labor\u00e9, mis en route d\u2019urgence et \u00e9tal\u00e9 sur 10 ou 15 ans. 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