Tunisia Health System Strengthening Project

active

The components are financed with US$108 million of IBRD financing and US$17.16 million RETF grant from the Pandemic Fund. This covers part of the investments needed to finance the ambition and scope of health reforms envisioned by the government. Component 1: Strengthening Health System Resilience (US$24.9M, including US$17.2M RETF from the Pandemic Fund)Component 1 focuses on strengthening surveillance systems, climate change adaptation, and laboratory capacity for pandemic preparedness. It aims to enhance Tunisia's ability to effectively detect, assess, and respond to public health threats before, during, and after health events, with coordination across sectors, including human, animal, and environmental health. Key activities under this component include: 1) strengthening and integrating data for surveillance, coordination of the preparation, response, and recovery for public health emergencies; 2) enhancing laboratory capacity and quality management for effective diagnostic networks and improved biosafety standards; 3) supporting energy efficiency systems and climate change adaptation and mitigation; and 4) improving waste management systems. Activities related to early warning systems and laboratory capacity are funded by the Pandemic Fund. Component 2: Supporting reorganization of preventive and primary health services (US$50 M)Component 2 seeks to transform primary health care services to improve the efficiency, distribution and quality of services. It will do so through three subcomponents: i) strengthening the organizational structure and governance of PHCs by developing and operationalizing a PHC service reorganization plan, developing a new governance framework, and strengthening human resources for health at the PHC level; ii) upgrading the capacity of CSBs based on the PHC service reorganization plan; and iii) supporting the deployment of a comprehensive PHC information system. Component 3: Strengthening emergency medical services ($48M)Component 3 aims to strengthen Tunisia’s emergency medical services. It will enhance all phases of emergency care including pre-hospitalization, hospitalization and discharge. This will improve the pre-hospitalization phase by improving emergency call management and ambulance dispatch systems. It will also focus on the hospitalization phase by enhancing triage systems and ensuring efficient patient transfers and address the post-hospitalization phase by establishing a referral network to connect discharged patients with primary care and intensive care services. This component will also promote environmental sustainability in emergency services by adopting green technologies and reducing energy consumption in emergency management systems.Component 4: Implementation Support, Training and Project Management (US$2M) This component will provide technical assistance and capacity-building support to the Ministry of Health, strengthening project management functions. It will finance technical assistance for fiduciary tasks, including audits of project financial statements, procurement management, and support the implementation of environmental and social (E&S) measures to ensure alignment with the Environmental and Social Framework (ESF). MOH has designated E&S focal points from different directorates and the ES consultant would support with the coordination and reporting across the different units. Regular monitoring and reporting on project implementation will also be supported by the component. Training under this component will focus on enhancing fiduciary aspects, monitoring and evaluation, while also integrating E&S risk management into the Project implementation. This will build capacity within the MOH to identify, mitigate, and monitor environmental and social impacts throughout the project lifecycle. The component will particularly address key environmental issues such as healthcare waste management, climate resilience, and improving energy efficiency in healthcare facilities as well as social risks, including SEA/SH, exclusion risks, exposure to biohazards, and grievance management. Eligible expenditures under this component will include goods, services, ICT equipment and software, consultancies, and non-salary operating costs.