Nearly eight out of ten Tunisians (81.0%) have some form of health coverage, whether contributory or assistance-based, while around 2.2 million people, representing 19% of the population, remain completely uninsured. This marks a slight increase of 0.5 percentage points compared to the rate recorded in 2014 (80.5%).
According to the Social Protection Flash Report for September 2025, published by the National Institute of Statistics (INS), results from the 2024 General Population and Housing Census (RGPH) show that the number of employed persons effectively covered by a contributory social security scheme amounts to 2.40 million, or 65.6% of all employed people aged 18 and above. This represents a one-point increase compared to 2014 (64.6%).
A notable gender gap appears: among men, 1.56 million employed individuals are covered, corresponding to a coverage rate of 63.5%, while among women, 834,000 are covered, representing a rate of 69.8%.
Women Better Protected
The National Health Insurance Fund (CNAM) is the main driver of health coverage in Tunisia, providing coverage for more than 7.2 million people, about 60.6% of the population.
The Amen Social program accounts for 18% of total coverage, including 6.9% through free care cards (AMGI) and 11.1% through reduced-rate care cards (AMGII). Mutual health funds and other schemes cover only 2.4%.
Gender analysis shows that women are generally better protected, with a coverage rate of 85.3% compared to 76.5% for men. Men are proportionally more likely to remain outside any coverage system (23.5% versus 14.7% for women).
Greater Tunis Leads the Way
An age-based analysis reveals an inverted U-shaped pattern in effective social coverage rates. Young people aged 18 to 29 have the lowest levels of social coverage (45.4%), particularly men (37.3%), reflecting their greater exposure to precarious and informal employment.
According to the INS, this situation stems from the fact that early in their careers, young people tend to accept initial jobs that are often low-quality and lack social protection, prioritizing experience and future opportunities over immediate job stability.
A territorial analysis of social coverage rates highlights sharp contrasts between governorates. The highest rates are found in Greater Tunis, Ben Arous (77%), Tunis (73.8%), and Ariana (72.3%), while several inland governorates show significantly lower rates, such as Kairouan (48.4%) and Sidi Bouzid (46.6%).
When analyzed by district, Tunisia’s map of effective social coverage remains uneven. District 2 records the highest national coverage rate (72%), supported by strong industrial and service sectors, while District 5 posts the lowest rate (56%), reflecting the dominance of agricultural and informal employment.
