Health policy analysis for prevention and control of cardiovascular diseases and diabetes mellitus in Turkey

Int J Public Health. 2015 Jan:60 Suppl 1:S47-53. doi: 10.1007/s00038-014-0557-7. Epub 2014 May 11.

Abstract

Objectives: Current capacity of the Turkish health system is reviewed to evaluate and develop appropriate policies for cardiovascular diseases (CVD), diabetes mellitus (DM) and related risk factors.

Methods: This paper qualitatively evaluates existing policies; interviews with key informants (KIs); and rapid appraisal fieldwork in clinical settings about CVD-DM through the framework of Walt and Gilson (Health Policy Plan 9:353-370, 1994).

Results: Document review shows that prevention and control of CVD-DM were strongly addressed in Turkey, yet no document mentioned country-wide early detection or screening programs. KIs indicated over-fragmented management of CVD-DM by the Ministry of Health (MoH). Coordination among the MoH, organizational structure at provincial level and civil society organizations are poor where mutual trust is a significant problem according to KIs. Clinical setting findings point to a complete lack of a referral structure and a lack of follow-up, compounding the absence of functioning health information systems for patient records.

Conclusions: Primary care services for CVD-DM require urgent attention, focusing particularly on the training of staff in public facilities, the integration of patient data, referrals and follow-up across all levels of the health system.

MeSH terms

  • Cardiovascular Diseases / prevention & control*
  • Cardiovascular Diseases / therapy
  • Continuity of Patient Care / organization & administration
  • Diabetes Mellitus / prevention & control*
  • Diabetes Mellitus / therapy
  • Health Policy*
  • Humans
  • Policy Making*
  • Primary Health Care / organization & administration*
  • Qualitative Research
  • Quality of Health Care / organization & administration
  • Risk Factors
  • Socioeconomic Factors
  • Turkey