Tunis Med. 2021 Jan;99(1):59-79.
The Basic Health Care Policy (BHC), the Maghrebian version of WHO's Primary Health Care, is celebrating forty years in Tunisia. The aim of this paper was to contribute to the evaluation of BHCs in Tunisia, by listening to the testimonies of experts / leaders who have led their journey during these four decades.
The experts / leaders included in this testimony were invited via email and throu gh the use of the Delphi technique to report the acquired lessons and the errors. The collected qualitative data was analyzed through a process of categorization which classified them into: assets (strengths and opportunities) and handicaps (weaknesses and threats).
Four experts / leaders took part in this call for testimonies, including two consultants to international organizations, a trade union doctor and a professor of Preventive Medicine. The main assets of the BHC in Tunisia, according to the participants, were: 1. The medical leadership initiated from the student phase; 2. The political commitment of public authorities ; 3. The academic support from the medical faculties and their Preventive Medicine departments ; 4. The institutionalization of the organizational framework of the Health Unit ; 5. The Academic training of professionals in integrated medicine. As for the handicaps of BHC in Tunisia, the experts / leaders particularly mentioned: 1. The weakness of community participation ; 2. The international attractiveness of accompanying national doctors; 3. The pressures of academic career imperatives ; 4. The lack of a National School of Public Health; 5. The context of privatization and hospital-centrism.
This feedback from the experts / leaders concerning BHC policies in Tunisia highlighted the perception of its performance "in tune" with WHO and "three years before Alma Ata". The new generation of BHC leaders have an obligation to safeguard their principles and adapt their practices to population expectations and new managerial approaches.
基本医疗保健政策（BHC）是世界卫生组织初级卫生保健的马格里布版本，在突尼斯已经实施了四十年。本文旨在通过倾听在这四十年中领导 BHC 的专家/领导人的见证，为突尼斯的 BHC 评估做出贡献。
通过电子邮件邀请这些专家/领导人参加这项见证，并通过使用德尔菲技术报告所获得的经验教训和错误。收集的定性数据通过分类过程进行分析，将其分为资产（优势和机会）和障碍（劣势和威胁）。
共有四位专家/领导人参与了这次呼吁，包括两位国际组织顾问、一位工会医生和一位预防医学教授。根据参与者的说法，BHC 在突尼斯的主要资产包括：1. 从学生阶段开始的医学领导；2. 公共当局的政治承诺；3. 来自医学院及其预防医学系的学术支持；4. 卫生单位组织框架的制度化；5. 综合医学专业人员的学术培训。至于 BHC 在突尼斯的障碍，专家/领导人特别提到：1. 社区参与的薄弱；2. 国家医生的国际吸引力；3. 学术职业压力的必要性；4. 缺乏国立公共卫生学校；5. 私有化和医院中心主义的背景。
这些来自突尼斯 BHC 政策专家/领导人的反馈突出了人们对其与世界卫生组织保持一致的表现的看法，以及“比阿尔及尔会议提前三年”。新一代 BHC 领导人有责任维护其原则，并使其做法适应人口的期望和新的管理方法。
