The basic human right to access basic health care for hundreds of millions of fragile people provides motivation for social and health actors to design, implement and support innovative social health care solutions.

For significant change to occur, the TEC-MED project based on the most promising social care models in Europe and in the Mediterranean area is being developed to ensure the inclusion and integration of dependent elderly people with lack of family support and/or at risk of social exclusion, boost competency training, develop leadership diversity, and strengthen community partnerships. This will encourage decision-makers to provide support for this model.

On July 16th, 2021, TEC-MED project partners teams held the second international workshop 'Advances and Capitalization plan'.  The main objective of this online meeting was to exchange on the state of implementation of the TEC-MED project with the key stakeholders and to share with them the capitalization plan in order to collect their input and their opinion.

The TEC-MED capitalization plan has been designed considering the need for greater implementation in the long term of the project results in both the TEC-MED model itself and the tools associated with it, in the Mediterranean basin.

Parallel sessions were dedicated to contextualizing specifically for each country, the SWOT analysis in the TEC-MED project’s Capitalization Plan. The analysis will be used to adjust the implementation activities from the development phase to the end of the project, to adapt the model to the needs of the final users, and integrate collaboration between projects that address the same thematic objective and also the interest groups in Spain, Lebanon, Greece, Egypt, and Tunisia where the workshop was celebrated.

1. Priority actions selected in Tunisian country group 

More than 20 participants, including partners and relevant experts with different profiles in macro- or meso-management, due to the influence of these areas on health and social policies were engaged in the Tunisian TEC-MED capitalization process through SWOT Analysis.

A full understanding of the advantages they track, the actions they can take in support of the TEC- MED project objectives, and the reactive approach of the risk assessment, was especially useful. 

Understandings concerning the Strengths, Weaknesses, Opportunities, and Threats of the capitalization plan have been collected. they are detailed below:

- Strengths

• The TEC-MED model would improve access for people who are dependent and/or at risk of exclusion, in all settings where they live.
• The intervention is directed towards the person, rather than the person seeking the intervention
• The TEC-MED project will allow the targeted elderly to benefit from free social and health services.
• A standardized model, applied in the same way within the same country and among the different countries.
• A digital platform that allows key actors to communicate with each other and exchange information and training.

- Weaknesses

• The pilot study only covers the Greater Tunis area; generalization could be difficult, especially in rural areas.
• Family caregivers are not always permanent or have the same profile. Thus, it would be necessary to train 4 to 5 people per family.
• The selection of retirement homes is not random. It is based on the criterion of voluntary participation. Thus, the sample of retirement homes is not representative of the care structures. 
• Accessibility to the platform can be a problem for isolated and illiterate elderly people or those with a low level of education and digital literacy.

-Opportunities
 

• The national context is favorable to the promotion of the health of the elderly with the development of the national multisectoral strategy for the care of the elderly, coordinated by the Ministry of Women, Family and the Elderly (MFFPA). Possible synergy between this strategy and the TEC-MED project is an opportunity to be seized.
• The project of the "national magazine for the elderly", published by the MFFPA to defend the rights of the elderly and facilitate their social and cultural reintegration, and to fight against all forms of stigmatization. This magazine provides an opportunity to make the elderly population aware of the TEC-MED project. 
• At the regional level, particularly in the Arab region, the Pan Arab strategy to promote the social and health conditions of the elderly offers an opportunity for synergy and collaboration to the TEC-MED project.
• The elderly is among those most at risk of severe forms of Covid-19. The pandemic has resulted in a lack of access to care and medication. The project provides integrated patient-centered care, enhanced by the use of technology to better communicate with the target population. The care of this at-risk group is an opportunity to showcase the model and demonstrate its effectiveness.

-Threats
 

• Political instability in the country can stall the implementation of the project and the model.
• The feasibility of the TEC-MED project’s planned tasks is ensured through the involvement and commitment of all partners and stakeholders. 
• The needs of dependent and/or at-risk seniors are substantial and the project's care model may not meet the expectations of this vulnerable population.

The technological tools and particularly the project's platform may be inaccessible to a wide range of end-users.

2. Main actions described to be included in the Capitalization Plan

• First action

The national context is favorable to the promotion of the health of the elderly with the development of the national multisectoral strategy for the care of the elderly, coordinated by the Ministry of Women, Family and the Elderly (MFFPA). Possible synergy between this strategy and the TEC-MED project is an opportunity to be seized.

• Second action

Accessibility to the platform can be a problem for isolated and illiterate elderly people or those with a low level of education and digital literacy.

• Third action

The intervention is directed towards the person, rather than the person seeking the intervention

• Fourth action

The elderly are among those most at risk of severe forms of Covid-19. The pandemic has resulted in a lack of access to care and medication. The project provides integrated patient-centered care, enhanced by the use of technology to better communicate with the target population. The care of this at-risk group is an opportunity to showcase the model and demonstrate its effectiveness.

3. Conclusion 

At the end, actions described as strategies to insert in the Capitalization Plan were endorsed by the Tunisian team with the support of Tunisian stakeholders, based on the outcomes of the SWOT analysis. In this way, the Tunisian TEC-MED research team had obtained 4 strategies that will be used as material for writing the Capitalization Plan.