During the 1990s and early 2000s, Turkey had a terrible healthcare system in almost every aspect, according to healthcare assessment indicators. To change this, the country started the acclaimed Healthcare Transformation Program (HTP) in 2003. The program aimed to reorganize healthcare administration, provide sufficient financing for healthcare services and deliver the best services to every citizen universally. As one of the pioneering policies of the Justice and Development Party (AK Party), which came into power in 2002, the program set performance targets for creating efficiency and productivity alongside planning massive infrastructure investments across the country.
The main principles of the HTP, as originally set by the Health Ministry in 2003, was human centrism, sustainability, continuous improvement in quality, consistency, volunteerism, the separation of service provision from financing, decentralization, competition and stakeholders' participation in every stage of healthcare services. Because these principles are self-explanatory, similar to the many policy reforms of the time across Europe, the program was an amalgam of neoliberal marketing, new public management (NPM) and modernization approaches with an ambitious investment target for healthcare infrastructure.
What has been achieved?
This year, the ambitious HTP finished its 15th year in action. Despite some small bumps, it can be said that the program propelled Turkey's healthcare system into the 21st century. Over the past 15 years, Turkey has shown impressive improvements in almost every healthcare sector. Through the program, Turkey has managed to transform its healthcare system extensively. Both the depth and width of healthcare services expanded during this period, and as a result, the quality of life of an average citizen has steadily improved for a consecutive 15 years. Thanks to the HTP, Turkey, once a laggard in healthcare, is now level with the other healthcare leaders in Europe.
Here are some impressive indicators demonstrating this. Turkey's total public healthcare spending increased to TL 111 billion ($28.22 billion) in 2016, from TL 13.5 billion in 2002. An average citizen visited a physician 8.4 times annually in 2016, compared to 3.2 visits in 2002. According to the World Bank, healthcare expenditures per capita have increased from $189 in 2002, to $567 in 2014 with current prices. As a result of the increase in accessibility to qualified healthcare and the decrease in mortality rates, Turkey's average life expectancy rose to 79.5 years for women and 75 years for men in 2016, a significant rise when compared to the 74.7 for women and 70.5 for men in 2002. Additionally, Health Ministry surveys show that user satisfaction with healthcare services was 72.3 percent in 2016, compared to 39.5 percent in 2002.
Infant mortality key indicator
Are these statistics merely fabricated by the government to create the illusion of success in healthcare? To answer this we need to compare international statistics regarding Turkey's healthcare system against national ones, or those originating from national databases.
Let us look the symbolic healthcare indicator of infant mortality in relation to Turkey. The infant mortality rate of a country is regarded as a key indicator of healthcare development because it allows for comparison through both national and international statistics.
Infant mortality rates are reduced through factors such as developments in healthcare, creation and accessibility to new treatment methods and medicines and organized healthcare services for pregnant women. For these reasons, there is a strong relationship between the increase in the level of development of a country and the decline of its infant mortality rate.
ACCORDING TO STATISTICS
When we look at national data on the subject, an impressive improvement is evident. According to Health Ministry statistics, the infant mortality was 31.5 in 2002, and it fell to 7.8 by 2014. Regarding the Turkish Statistical Institute (TurkStat) figures on the subject, it is possible to reach data reported after 2009. According to this, the rate of infant mortality in Turkey was 10.8 in 2013, compared to 13.9 in 2009. Overall, national data shows that the infant mortality rate has declined over the past 15 years in Turkey.
When data from international resources regarding infant mortality rates are examined, it is clear that these sources show a trend of steady improvement in Turkey. According to Eurostat, the EU's statistical office, the rate of infant mortality in Turkey showed a steady decline between 2002 and 2013. Eurostat concluded that the infant mortality rate of the country, which was 29.6 in 2002, declined to 10.8 in 2015, an impressive, threefold improvement.
The Organization for Economic Cooperation and Development (OECD) has released comparative statistics on the infant mortality rates since 2006. When the OECD's analysis regarding Turkey is examined, it is noteworthy that it also confirms the immense improvement. According to the OECD, the infant mortality rate of the country, which was 16.5 in 2006, dropped to 7.4 in 2012.
In conclusion, when the key factor of infant mortality rates is considered, it turns out that the steady improvement in Turkey's healthcare services over the past 15 years has been confirmed by both national and international data. Despite the fact that the ratios in Turkey's national statistics are different from international data, it is obvious that over a decade-and-a-half, Turkey has rapidly closed the gap between itself and developed countries in terms of healthcare.
