Publication: Turkey : Reforming the Health Sector for Improved Access and Efficiency, Volume 1. Main Report
Loading...
Published
2003-03
ISSN
Date
2013-08-06
Author(s)
Editor(s)
Abstract
Fundamental and systemic changes would have to be brought about in the ways that health care is financed, delivered, organized, and managed in Turkey in order to meet the ultimate objective of improving the health status of people, and not only meet but surpass the health-related Millennium Development Goals. This would require significant improvements in resource mobilization, allocation and utilization, enhanced efficiency in production and delivery of health services, including primary and hospital care, and greater emphasis on clinical quality and patient access to health services. Against this backdrop, the World Bank and the Government of Turkey agreed to undertake an intensive review of all aspects of the health sector, and the present report is produced from this effort. One objective of an evaluation at this juncture is to lay the foundation for developing a medium-term health sector strategy and a prioritized action plan aimed at improving access to health services, enhancing equity in utilization, increasing cost-effectiveness, enhancing quality of care and improving health outcomes overall. In particular, the emphasis of this study is to develop viable medium-term options for enhancing the health services coverage of poor and vulnerable groups and examine which priorities and approaches are likely to be most pro-poor. The study also examines the appropriate role of the government in providing health services, and the institutional, managerial, and administrative requirements for developing an efficient, sustainable, and patient-responsive health system. In doing so, the study examines ways in which public spending can be oriented so as to maximize its effects on access, equity, and efficiency in the health sector. An added objective of this study is to engage policy makers and major stakeholders in discussions and debates on health reforms and bring about a consensus among them not only on broad principles but also in terms of integrated and coordinated approach to implementing reform measures. This report is organized in two volumes. Volume 1 contains a discussion of health sector priorities and key recommendations for developing a medium-term reform strategy for Turkey's health sector. Volume 1 concludes with an implementation plan for the short and medium terms. Volume 2 contains the full background reports and data annexes that form the basis of the suggested health system reform.
Link to Data Set
Citation
“World Bank. 2003. Turkey : Reforming the Health Sector for Improved Access and Efficiency, Volume 1. Main Report. © World Bank. http://hdl.handle.net/10986/14824 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Turkey : Reforming the Health Sector for Improved Access and Efficiency, Volume 2. Background Papers(Washington, DC, 2003-03)Fundamental and systemic changes would have to be brought about in the ways that health care is financed, delivered, organized, and managed in Turkey in order to meet the ultimate objective of improving the health status of people, and not only meet but surpass the health-related Millennium Development Goals. This would require significant improvements in resource mobilization, allocation and utilization, enhanced efficiency in production and delivery of health services, including primary and hospital care, and greater emphasis on clinical quality and patient access to health services. Against this backdrop, the World Bank and the Government of Turkey agreed to undertake an intensive review of all aspects of the health sector, and the present report is produced from this effort. One objective of an evaluation at this juncture is to lay the foundation for developing a medium-term health sector strategy and a prioritized action plan aimed at improving access to health services, enhancing equity in utilization, increasing cost-effectiveness, enhancing quality of care and improving health outcomes overall. In particular, the emphasis of this study is to develop viable medium-term options for enhancing the health services coverage of poor and vulnerable groups and examine which priorities and approaches are likely to be most pro-poor. The study also examines the appropriate role of the government in providing health services, and the institutional, managerial, and administrative requirements for developing an efficient, sustainable, and patient-responsive health system. In doing so, the study examines ways in which public spending can be oriented so as to maximize its effects on access, equity, and efficiency in the health sector. An added objective of this study is to engage policy makers and major stakeholders in discussions and debates on health reforms and bring about a consensus among them not only on broad principles but also in terms of integrated and coordinated approach to implementing reform measures. This report is organized in two volumes. Volume 1 contains a discussion of health sector priorities and key recommendations for developing a medium-term reform strategy for Turkey's health sector. Volume 1 concludes with an implementation plan for the short and medium terms. Volume 2 contains the full background reports and data annexes that form the basis of the suggested health system reform.Publication Better Outcomes through Health Reforms in the Russian Federation : The Challenge in 2008 and Beyond(World Bank, Washington, DC, 2008-02)The purpose of this discussion paper is to discuss selected health challenges in the Russian Federation, focusing on outcomes, expenditures and options for policy and institutional reforms in the health care system. The areas covered in the paper draw on recent studies and reports, and take into account lessons derived from the implementation of the World Bank-funded Health Reform Implementation Project (HRIP) at the federal level and in the Chuvash Republic and the Voronezh Oblast-the pilot regions of the project, over the 2005-2007 period.Publication Croatia Program-for-Results : Improving Quality and Efficiency of Health Services(Washington, DC, 2014-01-04)This technical assessment has been carried out as part of the preparation of the Health Program-for-Results (PforR) operation in Croatia. The primary focus of the assessment is on the Government's Program, and the National Health Care Strategy 2012-2020, and serves as the policy framework for this operation. The needs that Croatia's health system must address have changed as a consequence of the demographic and epidemiological transition in the country. The disease burden in Croatia has shifted from being dominated by maternal and child health and communicable diseases to being dominated by chronic and non-communicable conditions. The Government of Croatia's National Health Care Strategy sets out development directions for the health sector and is the framework for making policy and operational decisions, including the distribution of budgetary resources. The development of emergency medical services and investment planning project supported technical assistance to develop a hospital rationalization master plan, and this will enable the Ministry of Health to develop specific proposals for funding that can be submitted to European Union (EU) structural funds. The hospital rationalization plan will be completed only in December 2013. In the interim, however, the Ministry of Finance has expressed its commitment to support the Ministry of Health to meet interim funding needs.Publication Integrating the Poor into Universal Health Coverage in Vietnam(World Bank, Washington DC, 2013-01)This case study is aimed at providing a descriptive assessment of the key features of Vietnam's Social Health Insurance (SHI), focusing on the impediments to integrating the poor into universal coverage. The trajectory of SHI in Vietnam is similar to that of many other countries in the East Asia and Pacific region. The poor were covered under a separate Health Care Fund for the Poor to begin with. The 2009 Law on Health Insurance merged all of the different programs into one. Health insurance premiums for the poor were fully subsidized by the government and enrolment became mandatory, resulting in almost complete enrollment of the poor by 2011. Vietnam has combined elements of contributory social health insurance with substantial levels of tax financing to provide coverage for the poor and informal sector. The case study is structured as follows. Section 2 describes the institutional structure and system characteristics of Vietnam's SHI. Section 3 addresses the main topic of the case study - the impediments to integrating the poor. Section 4 concludes by addressing the pending agenda.Publication Romania - Functional Review : Health Sector(Washington, DC, 2011-05-11)This Functional Review was carried by a Bank team upon request by the Government of Romania. As a starting point, it shows that: (i) health outcomes in Romania lag behind those of the EU; (ii) users are not satisfied with its lack of responsiveness - long lines, informal payments, discourteous handling of patients, poor cleanliness, lack of maintenance, and breach of safety measures; (iii) the poor and other vulnerable groups (for example Roma communities) suffer from a significant lack of access to services; and (iv) the fiscal contraction of 2008-2010 exposed the weakness of financial controls in the health sector. The Review examines four health functions in depth: service delivery, financing, stewardship and resources (including pharmaceuticals). Based on our findings, we present recommendations categorized by the three set of challenges that the sector is facing: (i) improving governance and management; (ii) streamlining the health service network and re-launching quality control systems; and (iii) increasing preventive services and equity. For any expansion of the sector to be sustainable, a number of pre-requisites will need to be in place, including a private sector development strategy, stronger fiscal controls, a system of health technology assessment, and stronger management in key agencies.
Users also downloaded
Showing related downloaded files
Publication Business Ready 2024(Washington, DC: World Bank, 2024-10-03)Business Ready (B-READY) is a new World Bank Group corporate flagship report that evaluates the business and investment climate worldwide. It replaces and improves upon the Doing Business project. B-READY provides a comprehensive data set and description of the factors that strengthen the private sector, not only by advancing the interests of individual firms but also by elevating the interests of workers, consumers, potential new enterprises, and the natural environment. This 2024 report introduces a new analytical framework that benchmarks economies based on three pillars: Regulatory Framework, Public Services, and Operational Efficiency. The analysis centers on 10 topics essential for private sector development that correspond to various stages of the life cycle of a firm. The report also offers insights into three cross-cutting themes that are relevant for modern economies: digital adoption, environmental sustainability, and gender. B-READY draws on a robust data collection process that includes specially tailored expert questionnaires and firm-level surveys. The 2024 report, which covers 50 economies, serves as the first in a series that will expand in geographical coverage and refine its methodology over time, supporting reform advocacy, policy guidance, and further analysis and research.Publication Services Unbound(Washington, DC: World Bank, 2024-12-09)Services are a new force for innovation, trade, and growth in East Asia and Pacific. The dramatic diffusion of digital technologies and partial policy reforms in services--from finance, communication, and transport to retail, health, and education--is transforming these economies. The result is higher productivity and changing jobs in the services sector, as well as in the manufacturing sectors that use these services. A region that has thrived through openness to trade and investment in manufacturing still maintains innovation-inhibiting barriers to entry and competition in key services sectors. 'Services Unbound: Digital Technologies and Policy Reform in East Asia and Pacific' makes the case for deeper domestic reforms and greater international cooperation to unleash a virtuous cycle of increased economic opportunity and enhanced human capacity that would power development in the region.Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication Poverty, Prosperity, and Planet Report 2024(Washington, DC: World Bank, 2024-10-15)The Poverty, Prosperity, and Planet Report 2024 is the latest edition of the series formerly known as Poverty and Shared Prosperity. The report emphasizes that reducing poverty and increasing shared prosperity must be achieved in ways that do not come at unacceptably high costs to the environment. The current “polycrisis”—where the multiple crises of slow economic growth, increased fragility, climate risks, and heightened uncertainty have come together at the same time—makes national development strategies and international cooperation difficult. Offering the first post-Coronavirus (COVID)-19 pandemic assessment of global progress on this interlinked agenda, the report finds that global poverty reduction has resumed but at a pace slower than before the COVID-19 crisis. Nearly 700 million people worldwide live in extreme poverty with less than US$2.15 per person per day. Progress has essentially plateaued amid lower economic growth and the impacts of COVID-19 and other crises. Today, extreme poverty is concentrated mostly in Sub-Saharan Africa and fragile settings. At a higher standard more typical of upper-middle-income countries—US$6.85 per person per day—almost one-half of the world is living in poverty. The report also provides evidence that the number of countries that have high levels of income inequality has declined considerably during the past two decades, but the pace of improvements in shared prosperity has slowed, and that inequality remains high in Latin America and the Caribbean and Sub-Saharan Africa. Worldwide, people’s incomes today would need to increase fivefold on average to reach a minimum prosperity threshold of US$25 per person per day. Where there has been progress in poverty reduction and shared prosperity, there is evidence of an increasing ability of countries to manage natural hazards, but climate risks are significantly higher in the poorest settings. Nearly one in five people globally is at risk of experiencing welfare losses due to an extreme weather event from which they will struggle to recover. The interconnected issues of climate change and poverty call for a united and inclusive effort from the global community. Development cooperation stakeholders—from governments, nongovernmental organizations, and the private sector to communities and citizens acting locally in every corner of the globe—hold pivotal roles in promoting fair and sustainable transitions. By emphasizing strategies that yield multiple benefits and diligently monitoring and addressing trade-offs, we can strive toward a future that is prosperous, equitable, and resilient.