Changes in life expectancy Years Men Women Altogether 1970 52.6 52.8 52.6 1980 55.9 58.8 57.4 1985 62.7 64.2 63.6 1996 66.8 68.4 67.7 2000 71.5 73.4 72.5 2006 74.7 76.8 75.7 2008 74.8 76.4 75.6 2009 74.7 76.3 75.5 2010 75.6 77.0 76.3 2011 76.0 77.3 76.7 281. Health Programmes: The hierarchical organization of the national health system around the health sector as the basic public service entity was confirmed by the launch of national health programmes in the 1970s, including those related to combating endemic and epidemic diseases and the promotion of maternal and child health. It should be pointed out that a national programme was launched in 1974 for maternal and child protection and the National Programme for Combating Infant Mortality (1985) consisting of eight sub-programmes, which include inter alia, “child spacing” and the expanded programme on immunization. 282. The resultant effect was a significant improvement in access to health by the population in the rural areas as reflected in the national indicators where very significant achievements have been recorded in the last two decades. 283. The adoption of the national programme for the control of population growth (1983) and the emergence of the government’s population policy from the beginning of the 1990s also resulted in accelerated population transition (in the middle of the 1990s) driven by concurrent factors related to economic and social development of the country and the drastic decline in the fertility of women as a result of the dissemination of modern contraceptives among couples and the increase in the marriage age. The midwife is competent to deal with all acts and products relating to maternal and child health including contraceptive s. All these cases and contraceptives are provided free of charge in the public sector and reimbursed fully (100%) when such services are delivered by the private sector . Child Health: Trends in Child Mortality Rates (CMR): (P. 1 000) 1990 57.8 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 36.9 37.5 34.7 32.5 30.4 30.4 26.9 26.2 25.5 24.8 23.7 23.1 284. Nine national programmes specifically target early childhood. Expanded Programme on Immunization (EPI), acute respiratory infections (ARI), diarrheal diseases, acute rheumatic fever (ARF), nutrition, domestic accidents, trachoma and cerebrospinal meningitis. 285. The overall objectives are to reduce serious forms of diseases, their complications and more especially mortality associated with these diseases. With regard to Expanded Programme on Immunization (EPI), the main objectives are: the eradication of poliomyelitis and measles, diphtheria and neonatal tetanus. The rate of immunization coverage and all types of vaccines has reached 88 %. It attained 98% for BCG and 96% for DTCP, then 92 % for anti-measles and 82 % for vaccination against Hepatitis B (introduced in 2003). 47

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