Improvements achieved particularly in the health sector since the proclamation of the Republic have reached substantial proportions. Struggle against contagious diseases during the planned development period in the 1960s, an endeavor initiated for the more efficient use of resources, was a remarkable success story. Meanwhile, substantial ground has been covered in increasing the number of health institutions and meeting the demand for health personnel.
The average life expectancy in 2007 was 74.2 years for women and 69.3 years for men. The average life expectancy for both sexes is projected to rise to 73.2 years by 2015-2020 and to 76.4 years by 2035-2040. The birth rate was 18,4‰ and the estimated death rate 6.3‰ in 2007.
The birth rate is expected to drop to 16‰ by 2015-2020 and to 12.6‰ by 2035-2040. The fertility rate dropped to 2.17% and the infant mortality rate to 21.7‰ in 2007.
Although interregional differences still remain in infant and under 5-year-old mortality rates, serious improvements have been seen in the recent years.
Within the framework of strengthening the preventive and protective health services and as part of the special importance attached to the health of mothers and their children, Turkey is carrying out Sexual Health/Fertility prog-rams such as immunization, control of diseases with diarrhea, acute respiratory infections, encouraging mother’s milk, neonatal scanning and provision of iron. Since the boosting of efforts to encourage the vaccination of children, the proportion of vaccinated children throughout the country has risen to 90 percent on average. Vaccination for rubella, mumps and meningitis are all covered under free vaccination programs.
The public sector continues to provide the majority of health services. Approximately 92% of the beds available for patients belong to the public sector which is responsible for almost all of the protective health services as well. On the other hand, incentives for private sector investments are still available. Because of the green card implementation, which has launded in 1992, 9 million 122 thousand people have had opportunity to be treated per of charge. The Ministry of Health covers all the out-patient treatment and medicine costs of green card holders. From 2010, the green card hold will be integrated into the General Health Insurance Scheme.
Moreover, a decree allowing the medical treatment of civil servants and the family members they are responsible for, in private health facilities and private polyclinics, apart from public institutions, was published in the Official Gazette No. 25123 on May 30th, 2003 and is currently in effect.
The ongoing Program on Transformations in Health envi-sages a Ministry of Health dealing with only supervisory and planning aspects; a general health insurance system covering all citizens; an easily accessible system of impro-ved health services and further spreading the practice of family doctors; a sound dispatching system; administrative and financial autonomy for health institutions; a motivated and specialized health workforce employing up-to-date technology; educational and scientific councils supporting this new system; quality control, accreditation and rational use of medicals and equipment for efficient health services; the establishment of a national pharmaceutical and medical equipment institutions; and an on-line health information network to access critical information during the decision making process. To improve the quality of services and enrich first step health services under the Transportation at Health Services Program, a pilot study in 10 provinces is continuing to shift to the system of Family Care.
In addition to all of these, in every state hospital patients’ rights units have been established. The right to choose a doctor was initiated in 2004 in 11 hospitals and this number was increased to 400 in the first half of 2007. Within the framework of separating the funding and provision of health services, the Ministry of Health took over all public health facilities on January 19th, 2005, unifying all public hospitals under a single umbrella.
The new 5510 Social Securities and General Health Insurance Law, enacted to cover everyone by the General Health Insurance, has facilitated the insurance premiums of the people in need to be covered by the public sector and everyone in the country have been brought into the General Health Insurance Scheme.
In the meantime, a project has been started to establish a joint data base for common use with the social security institutions within the scope of the e-Turkey Project, envi-saging the adoption of an automated health information system called e-health. As a result of efforts to determinethe exact number of people covered by the Retirement Fund, SSK, BAĞ-KUR and Green Card holders in order to eliminate redundancy, substantial ground has been covered to implement a system of individual identification for each patient and the electronic processing of personal health information.
Furthermore, efforts are under way to improve health information, to determine the factors affecting health and to take swift measures against detrimental factors in accordance with the Public Health Action Program, for which a memorandum of understanding has been signed with the EU.
In 2007, the number of hospitals reached 1,205 and bed capacity reached 201,600, nationwide. The recent addition of a new article to the Basic Law on Health Services (Law No. 3359) has given the Ministry of Health the opportunity to cooperate with the private sector on a build-and-rent model to overcome a number of problems in health care services coming from a lack of funds.
In addition, the data collected as a result of the “Turkish Health Inventory” studies, launched and completed by the Research, Planning and Coordination Council of the Ministry of Health, are integrating with the “Geographic Information System”. This study aims to increase the rationality of planning vis-à-vis investments and services in the health sector. It covers all public institutions, organizations, hospitals and outpatient clinics, and all health facilities belonging to universities, foundations, associations and the private sector.
Meanwhile, a Continuous Training Program for Oral and Dental Health is being prepared to solve the existing dental problems in the country. This program envisages the supply of detailed information to parents and particularly to mothers regarding oral and dental hygiene beginning from pregnancy as well as oral and dental health for all primary school students in the 6-12 years age group throughout the country so that 90 to 100% of them would adopt the habit of regularly brushing their teeth.
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