Do health care reforms in Turkey have a significant effect in equal access to maternal and child health services in Turkey: An evidence from 20 years

Int J Health Plann Manage. 2018 Jan;33(1):e344-e356. doi: 10.1002/hpm.2482. Epub 2017 Dec 26.


This study aimed to investigate whether there was an improvement in the equitable access to maternal and child health care services by examining the effects of socioeconomic and individual factors in Turkey from 1993 to 2013 and determine the effectiveness of health care reforms implemented mainly under the Health Transformation Program since 2003 on equitable access t;o maternal and child health care services in terms of years. The study used nationally representative 5 Turkey Demographic and Health Surveys (1993, 1998, 2003, 2008, and 2013). Prenatal care utilization rate increased from 67.0% in 1993 to 96.2% in 2013 while the rate of women giving birth at health care facilities increased from 63.8% to 98.1% in 2013. Prenatal care utilization and giving birth at health care facilities were higher among women who were under health insurance coverage, first time mothers, those staying in the western region and urban areas, and those with the highest level of wealth. The findings suggest that the issue of equity in the utilization of maternal and child health care services exists in Turkey, and the latest health care reforms under HTP are not effective in diminishing the effect of wealth.

Keywords: Turkey; demographic and health survey; equal access; giving birth at health care facilities; prenatal care utilization.

MeSH terms

  • Child
  • Female
  • Health Care Reform* / organization & administration
  • Health Care Surveys
  • Health Services Accessibility / organization & administration*
  • Healthcare Disparities / organization & administration*
  • Humans
  • Insurance, Health / statistics & numerical data
  • Maternal-Child Health Services / organization & administration*
  • Maternal-Child Health Services / statistics & numerical data
  • Medically Uninsured / statistics & numerical data
  • Pregnancy
  • Socioeconomic Factors
  • Turkey