The Contribution of the Social and Solidarity Economy to Social Inclusion: The Role of Social Coverage in Tunisia

Abstract

Abstract

Purpose: This article examines the contribution of the Social and Solidarity Economy (SSE) to social inclusion in Tunisia, with particular attention to access to CNAM health coverage. Methodology and sample: The empirical analysis uses a balanced panel covering the 24 Tunisian governorates over 2015–2025, corresponding to 264 governorate-year observations. A fixed-effects econometric model is estimated, and the Hausman test is used to choose between fixed and random effects. The explanatory variables include SSE employment, informal employment, unemployment, inflation, population, the number of cooperatives, and the poverty rate. Findings: SSE employment is positively and significantly associated with CNAM coverage, whereas informal employment is negatively and significantly associated with it. Inflation and the poverty rate are positively associated with coverage, while population size is negatively associated with coverage. The unemployment rate and the number of cooperatives are not statistically significant. Implications: The findings support policies that strengthen formal employment within the SSE, facilitate collective affiliation to CNAM, formalize informal activities, and improve coordination among institutions responsible for social protection.

Keywords: Social and Solidarity Economy; CNAM coverage; health insurance; informal employment; social protection; panel data; fixed effects; health inclusion.