Impact of Covid 19 on Primary healthcare in Tunisia.

Introduction: Public primary healthcare facilities, the cornerstone of the Tunisian health system, were impacted by the Covid 19 crisis as all health systems in the world.

Aim: This study aims to assess this impact of the pandemic.

Methods: We analyzed the budgetary evolution of the basic healthcare group (BHG) of Medenine and Djerba between 2019 and 2020. Similarly, we examined the evolution of all the activities of BHG of Medenine. This analysis was also completed by a semi-structured questioning with a regional expert.

Results: Our results showed an increase in expenditure, a decrease in revenue (12.4% for GSB of Medenine and 10.8% for BHG of Djerba), and an accumulation of outstanding payment. BHG's activities have been affected by the pandemic. We showed that stomatology and vaccine activities were well maintained during the pandemic. However, we noted a regression in the number of patients and some illnesses. Activity related to child health and health education has significantly decreased. This impact has had and will have repercussions on the epidemiological state of the population. Despite the intervention of the regional management in terms of organization, training and strengthening of equipment and human resources, the pandemic has generally impacted the operation process of these establishments, which are already facing several challenges.

Conclusion: We recommend above all to activate the already existing opportunities to replenish the financial resources of primary healthcare facilities, to improve work environment and continuous professional development and to computerize the data and its analysis according to a scientific approach.