Tunisia - Department of Epidemiology, University Hospital Farhat Hached

Map of Tunisia with  marked.

Center of Excellence

Department of Epidemiology, University Hospital Farhat Hached
Sousse, Tunisia
Principal Investigator: Hassen Ghannem, M.D., M.Sc.

Center of Excellence Activity Sites

  • Tunisia
  • Other countries in the North Africa and Eastern Mediterranean Region

Developed Country Partner

Department of Chronic Disease Prevention and Health Promotion, National Public Health Institute of Helsinki, KTL, Finland
Principal Investigator: Tiina Laatikainen, M.D., Ph.D.

Background

Aerial view of Sousse

Tunisia is now facing an epidemiological transition. This change is reflected by a decrease in total mortality, increase in life expectancy, and adoption of lifestyles associated with chronic noncommunicable diseases, including diabetes and cardiovascular diseases (CVD). CVD are the leading cause of death in Tunisia and chronic disease risk factors are rapidly increasing with a high prevalence of hypertension and diabetes among the adult population, affecting 29 percent and 10 percent, respectively. With this epidemiological transition, Tunisia’s health care system is currently under pressure due to the growing burden of chronic diseases. Environmental and behavioral changes, such as the adoption of new dietary habits, the lack of physical activity, and the stress of urbanization and work conditions, have contributed to the rise of the chronic disease burden, which the health care system is not prepared to face.

Three common and preventable risk factors — tobacco use, unhealthy diet, and physical inactivity — play a dominant role in the development of major chronic diseases. An urgent need exists for feasible and cost-effective intervention programs directed toward reducing these behavioral risk factors at the community level.

Objectives

  • Determine the effectiveness, feasibility, and necessary cultural adaptations of evidence-based interventions directed at tobacco use, unhealthy diet, and physical inactivity in adults and children.
  • Develop a model for implementing, monitoring, and assessing sustainable comprehensive community interventions in Tunisia and across North Africa and the Middle East in countries with similar socioeconomic and cultural situations.
  • Train health officials from Tunisia and other countries in the North Africa and Eastern Mediterranean region who are interested in planning, implementing, or evaluating programs for chronic disease prevention and control.

Research Activities

Determine the effectiveness and feasibility of evidenced-based interventions directed at tobacco use, unhealthy diet, and physical inactivity, targeting adults and children. The intervention program will be based on three main components:

  • Community coalition-building: key stakeholders will work together to encourage healthy lifestyle changes throughout the community.
  • Health education: disseminate health messages, using mass media, social marketing, or peer educators.
  • Structural change: advocate and implement policy, environmental, and economic changes.

The effectiveness of the interventions will be evaluated by making comparisons with a control community. This community intervention for health is similar to programs currently being implemented in China, India, Mexico, and the United Kingdom (www.oxha.org/initiatives/cih).

Training

The program in Tunisia will provide training in the development of national chronic disease prevention strategies, community-based prevention programs, intervention methods, and health monitoring, with a focus on capacity building at the regional and national levels. North African neighboring countries will benefit from this training opportunity. The capacity building will be done in the fields of planning, implementing, and evaluating community-based interventional activities for chronic diseases prevention and control, risk factor prevention, and healthy lifestyle promotion. The main components of this training program will be:

  • Organize national and international short-term training courses and workshops on community-based programs for chronic disease prevention and control.
  • Organize national and international short-term training courses and workshops on the role of tobacco control in chronic disease prevention.
  • Organize general training workshops and modules in research methodology skills, grant writing principles, statistical analysis, scientific communication, and burden of disease estimates for chronic diseases.

Other Partner Organizations

Duluth Medical Research Institute, University of Minnesota Medical School
Minneapolis, Minnesota, USA
Principal Investigator: Mustafa al’Absi, Ph.D.

Additional Partners in Sousse, Tunisia

Department of Biochemistry, Faculty of Medicine
Regional Direction of Health of Sousse, Primary Health Care, School Medicine Unit
Regional Direction of Education of Sousse
Regional Direction of Youth, Sport and Physical Education of Sousse
Group of Occupational Health of Sousse
Tunisian Heart Foundation
Tunisian Association of Life and Earth Sciences Teachers

Additional International Collaborators

Oxford Health Alliance
MATRIX Public Health Solutions, Inc.
World Health Organization (WHO) Office in Tunisia

Funding

The Center of Excellence in Tunisia receives funding from UnitedHealth Group.

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Last Updated: December 2013

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