title: Living with diabetes and hypertension in Tunisia: popular perspectives on biomedical treatment.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Based on qualitative methods and semi-structured interviews with 24 patients attending two clinics, one urban and one rural.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: CVD Epidemiology and Prevention Research Laboratory (CAVEPLA), Faculté de Médecine de Tunis, Tunis, Tunisia, faten.tlili@ymail.com.
authors.forename: Faten
authors.initials: F
authors.lastname: Tlili
authors.forename: Francine
authors.initials: F
authors.lastname: Tinsa
authors.forename: Afef
authors.initials: A
authors.lastname: Skhiri
authors.forename: Shahaduz
authors.initials: S
authors.lastname: Zaman
authors.forename: Peter
authors.initials: P
authors.lastname: Phillimore
authors.forename: Habiba
authors.initials: H
authors.lastname: Ben Romdhane
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D003920:Diabetes Mellitus / Q000523:psychology*; D004032:Diet; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010465:Perception; D012111:Residence Characteristics / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000453:epidemiology; D014416:Tunisia