Compared to other countries in the Arab region, Tunisia’s social protection system is well-designed. It features contributory schemes for a large proportion of the working population and their dependents, and non-contributory schemes in the form of universal subsidies, targeted cash transfers and social health insurance for poor and vulnerable populations.1
Following the 2011 revolution in Tunisia, the right to social protection was reinforced under the principles of social justice. The right to social coverage has been enshrined in the Constitution since 2014.2
In 2019, the Ministry of Social Affairs integrated all social protection programs under one umbrella program, Amen Social. The program incorporates pre-existing programs, such as the National Program of Assistance to Needy Families (PNAFN), the Free Medical Assistance (AMGI), and the Program of Access to Reduced-Fee Health Care (AMGII), and expands them to include a wider swathe of the population. Amen Social is an expansion of the social protection concept and includes measures beyond income, such as health, education, access to public services, and living conditions.3 Amen Social has two pillars: social assistance and social insurance.
- Social assistance is provided by the state to targeted groups (people living on low income, people living with a disability, and people within the state care system). It includes the PNAFN, which provides cash transfers to low-income and vulnerable groups, and the AMGI and AMGII, which provide either subsidized or free access to health care for those who are not covered by health insurance, with the goal of reaching universal health coverage.4
- Social insurance is provided via the State through citizen contributions in the form of tax. It comprises three schemes: (1) the National Pension and Social Insurance Fund (CNRPS), (2) the National Social Security Fund (CNSS), and (3) the National Health Insurance Fund (CNAM). CNRPS and CNSS provide pension, invalidity, accidents at work, death, maternity and paternity coverage for public and private sector workers, respectively (although different benefits exist for different categories of workers). CNAM provides health coverage, in particular for sickness, accidents, and occupational diseases for all formally employed workers (estimated at 56 percent of the private sector in 2019).5,6 Universal subsidies exist for essential commodities (typically food, transport, and fuel).
Tunisia’s social protection system first emerged in the 1960s and has been gradually strengthened over time to become more comprehensive and adapt to new working and social conditions. During the revolution in 2011, there was a renewed recognition that social assistance still excluded some of the most vulnerable Tunisian households, such as informal workers, rural populations, unemployed young persons, persons with disabilities, and migrant workers.
The Ministry of Social Affairs oversees all the social protection programs noted in the previous section (both the social assistance and social insurance), although each program is managed through a separate program fund.
Indirect (and universal) assistance (in the form of subsidies) is transferred through the General Compensation Fund (CGC), established in May 1970 to control the prices of certain food staples.7 Since 2013, social workers of the Ministry of Social Affairs have been mapping social assistance beneficiaries with the goal of creating an exhaustive database, now supported by the social identifier number (SIN) initiative. Beneficiary eligibility is confirmed through a proxy means test, which is designed to reduce inclusion (including non-targeted beneficiaries) and exclusion (excluding targeted beneficiaries) errors.8
The Tunisian Ministry of Finance allocated one billion Tunisian dinar (TND) (USD 2.8 billion), or approximately 5 percent of the 2022 budget to social security.9
In 2021, the total cost of the Amen program reached USD 259 million, of which USD 229 million were cash transfers.10 At the same time, TND 3,100 million (approximately USD 1.1 billion at the 2021 exchange rate) was allocated towards subsidies: TND 2,200 million [approximately USD 800 million) towards commodities (e.g., food)], TND 500 million (USD 180 million) towards transport and TND 400 million (approximately USD 150 million) towards fuel.11
Contributions under the CNRPS (for public workers) amount to 23.7 percent of employee wages per month, of which 14.5 percent is paid by the employer and 9.2 percent by the employee. Contributions under the CNSS (private sector workers) vary by the category of worker. For non-agricultural workers, contributions amount to 27.75 percent of employee wages, of which 16.57 percent is paid by the employer and 9.18 percent by the employee.12 For agricultural workers, the contributions are lower.
Under Amen Social, PNAFN has consistently grown in the size of assistance offered and the coverage since its inception. Since 1987, it has grown faster than the minimum wage (although it remains below it). By 2021, 266,000 households, or eight percent of the population, benefited from cash transfers and free health care. Beneficiaries of cash transfers receive TND 180 (USD 64) per month, which is 45 percent of the minimum wage, plus TND 30 per quarter for every child of school age, as an incentive to keep children in school.13 At the same time, 620,000 households benefited from subsidized health care, bringing the total number of health-care beneficiaries to over a quarter of the population.14
75 percent of the population contribute towards a pension scheme,15 whilst CNAM (health insurance for formal workers) covered 8,064,733 individuals, (approximately 70 percent of the population) in 2018.16
However, private sector workers (79 percent of the employed population, of which 56 percent are formally employed and 44 percent informally employed)17 and public sector workers (21 percent of the employed population) do not receive equal benefits. Private sector workers receive less favorable pension coverage, and shorter and lesser-paid maternity leave. Gender pay gaps and low female labor force participation risk reducing women’s social insurance contributions, and thus their final pensions and benefits, and many pension payouts remain below the minimum wage. Unemployment insurance only covers dismissal for technological or economic reasons.18
Poorer regions are less well-equipped medically, and thus, there is a disparity in the health-care services provided by the different types of health insurance and between poorer and wealthier regions.19