improvement of the vaccination cover, of the quality of care given to deaths, of
the socio-economic development and the improvement of hygiene and nutrition.
343. Within the framework of the national action programme drawn up in 1992,
Tunisia had attained most of the objectives (from the World Summit for the year
2000) of « Health for All ». Thus:
• Infant mortality and that of children aged less than five years had been
reduced by 40% and 33% respectively during the last decade;
• The total vaccination cover given to children aged less than a year
exceeded 90%;
• Poliomyelitis, neo-natal tetanus and measles are virtually eradicated;
• The prevalence of malnutrition had been reduced by more than half;
• Mortality due to diarrhoeal diseases no longer constitutes a public health
problem;
• The incidence of low weight at birth is 9%;
• All Tunisian households eat iodized salt.
B) Life expectancy at birth
344. Life expectancy at birth was estimated in 2004 at 73.4 years (75.3 for the
women and 71.4 for the men). In 1966, this indicator had been globally evaluated
at 54 years. This increase in life expectancy, combined with the decline in infant
mortality and birth rate results in the progressive increase of the aged population
and thereby an increase in the demand for care relating specifically to the elderly.
C) The National Vaccination Programme
345. From 1979, a national vaccination programme had replaced the vaccination
campaigns which had been carried out for three months per year against
tuberculosis and poliomyelitis essentially and where needed, against diphtheria
and whooping cough. This programme benefitted from the highly dense network
of grassroots health centres distributed throughout the country. This allowed the
attainment, from the early 1990s, of the rates of vaccination cover higher than
90% with a vaccination calendar targetting in the beginning the six most deadly
illnesses for the child (Tuberculosis, Poliomyelitis, Diphtheria, Tetanus, Whooping
Cough and Measles).
346. This national vaccination programme had been reinforced, first by an
acceleration strategy consisting of the organization of National Days, then
Maghrebi Days of Vaccination, through the conduct of strategies of eradication or
of the elimination of certain targeted illnesses and through the introduction of new
vaccines in the vaccination calendar provided free for all the children in the entire
country.
347. The MICS II inquiry carried out in 2000 showed that at the age of 2 years,
the vaccination cover by DTCP3 and BCG was higher than 95% at the national
level and higher than 90% for all the governorates of the country without
exception.
348. The national vaccination programme supported by a monitoring system
which conforms to WHO standards, achieved the eradication of poliomyelitis.
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