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Living with diabetes and hypertension in Tunisia: popular perspectives on biomedical treatment



The growing prevalence of non-communicable diseases across the Middle East and North Africa poses major challenges for underfunded health services. This article presents data on the perspectives of ordinary Tunisians who are coping with two of these diseases—diabetes and hypertension—and who are obtaining treatment through Tunisian public health clinics. Little has been written to date on patient experiences of biomedical treatment in Maghreb countries.


Based on qualitative methods and semi-structured interviews with 24 patients attending two clinics, one urban and one rural.


We examine popular aetiological beliefs, ideas about biomedical treatment and its implications, and comparative views on the benefits and drawbacks of treatment in both public and private clinics.


We highlight two main themes. One was nostalgia for a recent past when ‘pure’ and ‘natural’ food, ‘proper’ meals and less stressful lives meant less chronic illness, with demanding and costly treatment. The other concerned communication in the clinic, and the recurrent dismay patients felt at what they saw as the cursory attention and guidance they received from clinic staff in public facilities.

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The research on which this article is based was conducted as part of MedCHAMPS, a project funded by the European Commission under the Framework 7 Programme (Grant No. 223075). We would like to acknowledge the contribution of Professor Julia Critchley, the Scientific Coordinator of MedCHAMPS.

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Correspondence to Peter Phillimore.

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This article is part of the supplement "The rising burden of noncommunicable diseases in four Mediterranean countries and potential solutions".

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Tlili, F., Tinsa, F., Skhiri, A. et al. Living with diabetes and hypertension in Tunisia: popular perspectives on biomedical treatment. Int J Public Health 60 (Suppl 1), 31–37 (2015).

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