A Political Economy Analysis of Turkey's Health Transformation Program

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dc.creatorBump, Jesse B.
dc.creatorPowers Sparkes, Susan
dc.date2015-04-08T22:14:14Z
dc.date2015-04-08T22:14:14Z
dc.date2014-07
dc.date.accessioned2026-07-01T00:55:29Z
dc.descriptionBeginning in 2003, Turkey initiated a series of reforms under the Health Transformation Program (HTP) that over the past decade have reshaped the health system. Understanding the political economy of this process is important for the future of Universal Health Coverage (UHC) in Turkey, and also for many other countries and the development agencies that assist them. This report analyzes the historical context and complex political economy challenges of the reform. Our findings are based on stakeholder interviews and a review of literature. First, we identified five contextual factors that were important in bringing health reform to the policy agenda in Turkey, and were helpful in sustaining the reform during adoption and implementation: (1) a long history of reform plans and attempts; (2) fiscal pressure to reform the social sectors; (3) public support for health reform; (4) strong economic growth; and (5) favorable demographic conditions. Second, we assessed four political economy challenges central to the reform and the strategies used by the Ministry of Health (MoH) to overcome them. First, the MoH built public support for reform among the broad base of beneficiaries by focusing on highly visible and fast changes. Second, the MoH overcame well-organized interest group opposition to the reforms by splintering their support or delegitimizing their views. Third, Turkey asserted its own domestic priorities over those of the IMF and World Bank in cases of direct conflict. Fourth, the MoH circumvented potential political and institutional opposition to the large expansion of benefits and coverage through a carefully sequenced adoption and implementation plan that could be executed mostly without requiring the support of other ministries. This analysis also highlights important trade-offs made by the MoH with respect to the redistribution of resources, quality of care, financial sustainability, and physician satisfaction, which will all have to be considered as Turkey enters its next phase of health system development.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2014/07/24146871/political-economy-analysis-turkey s-health-transformation-program
dc.identifierhttps://hdl.handle.net/10986/21716
dc.identifierhttps://doi.org/10.1596/21716
dc.identifier.urihttp://hdl.handle.net/123456789/413016
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.rightsWorld Bank
dc.subjectABUSE
dc.subjectACADEMIC MEDICAL CENTERS
dc.subjectACCESS TO HEALTH SERVICES
dc.subjectAGGRESSIVE
dc.subjectAMBULANCE
dc.subjectANTENATAL CARE
dc.subjectBUDGETARY CONTROL
dc.subjectBULLETIN
dc.subjectCAPACITY BUILDING
dc.subjectCAPITATION
dc.subjectCAPITATION SYSTEM
dc.subjectCHILD HEALTH
dc.subjectCHRONIC DISEASES
dc.subjectCITIES
dc.subjectCITIZEN
dc.subjectCITIZENS
dc.subjectCLINICIAN
dc.subjectCLINICIANS
dc.subjectCOST CONTROL
dc.subjectDEBT
dc.subjectDELIVERY SYSTEM
dc.subjectDEMAND FOR HEALTH
dc.subjectDEMAND FOR HEALTH SERVICES
dc.subjectDEVELOPMENT PLANNING
dc.subjectDILUTION OF RESOURCES
dc.subjectDISEASES
dc.subjectDOMESTIC POLITICS
dc.subjectECONOMIC GROWTH
dc.subjectECONOMIC RESOURCES
dc.subjectELIGIBILITY DETERMINATIONS
dc.subjectENROLLEES
dc.subjectENTITLEMENT
dc.subjectENTITLEMENT PROGRAM
dc.subjectEXISTING RESOURCES
dc.subjectEXPENDITURES
dc.subjectFAMILIES
dc.subjectFAMILY PHYSICIAN
dc.subjectFINANCIAL INCENTIVES
dc.subjectFINANCIAL MARKETS
dc.subjectFINANCIAL PRESSURE
dc.subjectFINANCIAL PROTECTION
dc.subjectFINANCIAL RISKS
dc.subjectFORECASTS
dc.subjectGLOBAL HEALTH
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE DELIVERY
dc.subjectHEALTH CARE SYSTEM
dc.subjectHEALTH COVERAGE
dc.subjectHEALTH DELIVERY
dc.subjectHEALTH DELIVERY SYSTEM
dc.subjectHEALTH FINANCING
dc.subjectHEALTH FINANCING SYSTEM
dc.subjectHEALTH INDICATORS
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH INSURANCE SCHEME
dc.subjectHEALTH INSURANCE SCHEMES
dc.subjectHEALTH INSURANCE SYSTEM
dc.subjectHEALTH ORGANIZATION
dc.subjectHEALTH POLICY
dc.subjectHEALTH PROFESSIONALS
dc.subjectHEALTH PROJECTS
dc.subjectHEALTH REFORM
dc.subjectHEALTH REFORMS
dc.subjectHEALTH RESEARCH
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICE
dc.subjectHEALTH SERVICE DELIVERY
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SPENDING
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEMS
dc.subjectHEALTH WORKERS
dc.subjectHEALTH-CARE
dc.subjectHEALTH-CARE SYSTEM
dc.subjectHEALTHCARE
dc.subjectHEALTHCARE PROVIDERS
dc.subjectHEALTHCARE SYSTEM
dc.subjectHOSPITAL
dc.subjectHOSPITAL ADMINISTRATORS
dc.subjectHOSPITALS
dc.subjectHUMAN RESOURCES
dc.subjectILL-HEALTH
dc.subjectIMMUNIZATION
dc.subjectINCOME
dc.subjectINCOME COUNTRIES
dc.subjectINCOME GROUPS
dc.subjectINCOME HOUSEHOLDS
dc.subjectINDUCED DEMAND
dc.subjectINEQUITIES
dc.subjectINSURANCE COVERAGE
dc.subjectINSURANCE PREMIUM
dc.subjectINSURANCE SCHEMES
dc.subjectINTEGRATION
dc.subjectLACK OF CAPACITY
dc.subjectLAWS
dc.subjectLOCAL AUTHORITIES
dc.subjectMARGINAL COST
dc.subjectMATERNAL HEALTH
dc.subjectMATERNAL HEALTH SERVICES
dc.subjectMEDICAL ASSOCIATION
dc.subjectMEDICAL CENTERS
dc.subjectMEDICAL DOCTORS
dc.subjectMEDICAL EDUCATION
dc.subjectMEDICAL SCHOOL
dc.subjectMEDICAL SERVICES
dc.subjectMEDICAL SPECIALISTS
dc.subjectMEDICINES
dc.subjectMIDWIFERY
dc.subjectMIDWIVES
dc.subjectMINISTRY OF HEALTH
dc.subjectMINISTRY OF LABOUR
dc.subjectNATIONAL HEALTH
dc.subjectNATIONAL HEALTH INSURANCE
dc.subjectNATIONAL SOVEREIGNTY
dc.subjectNUMBER OF PEOPLE
dc.subjectNURSES
dc.subjectNUTRITION
dc.subjectOUTPATIENT SERVICES
dc.subjectOUTREACH ACTIVITIES
dc.subjectPARTY PLATFORM
dc.subjectPATIENT
dc.subjectPATIENT SATISFACTION
dc.subjectPATIENTS
dc.subjectPHARMACISTS
dc.subjectPHYSICIAN
dc.subjectPHYSICIANS
dc.subjectPOLICY CHANGE
dc.subjectPOLICY DECISIONS
dc.subjectPOLICY DEVELOPMENT
dc.subjectPOLICY DISCUSSIONS
dc.subjectPOLICY GOALS
dc.subjectPOLICY RESEARCH
dc.subjectPOLICY RESEARCH WORKING PAPER
dc.subjectPOLITICAL OPPOSITION
dc.subjectPOLITICAL PARTIES
dc.subjectPOLITICAL POWER
dc.subjectPOLITICAL PROCESS
dc.subjectPOLITICAL SUPPORT
dc.subjectPOPULAR SUPPORT
dc.subjectPREGNANT WOMEN
dc.subjectPRIMARY CARE
dc.subjectPRIVATE SECTOR
dc.subjectPROFESSIONAL ASSOCIATIONS
dc.subjectPROGRESS
dc.subjectPROVIDER PAYMENT
dc.subjectPROVISION OF HEALTH SERVICES
dc.subjectPROVISION OF SERVICES
dc.subjectPUBLIC DISCOURSE
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH CARE
dc.subjectPUBLIC HEALTH EXPENDITURES
dc.subjectPUBLIC HEALTH SYSTEM
dc.subjectPUBLIC HOSPITALS
dc.subjectPUBLIC PROVIDERS
dc.subjectPUBLIC SECTOR
dc.subjectPUBLIC SERVICE
dc.subjectPUBLIC SUPPORT
dc.subjectPURCHASER-PROVIDER SPLIT
dc.subjectQUALITATIVE INFORMATION
dc.subjectQUALITY ASSURANCE
dc.subjectQUALITY CARE
dc.subjectQUALITY OF CARE
dc.subjectQUALITY OF SERVICES
dc.subjectRESPECT
dc.subjectRURAL AREAS
dc.subjectSERIES OF MEETINGS
dc.subjectSERVICE PROVISION
dc.subjectSERVICE QUALITY
dc.subjectSMALL WORLD
dc.subjectSOCIAL INSURANCE
dc.subjectSOCIAL POLICIES
dc.subjectSOCIAL POLICY
dc.subjectSOCIAL SECTOR
dc.subjectSOCIAL SECTORS
dc.subjectSOCIAL SECURITY
dc.subjectSOCIAL SECURITY SYSTEMS
dc.subjectSTATE PLANNING
dc.subjectTECHNICAL RESOURCES
dc.subjectTRADE UNIONS
dc.subjectTRAUMA
dc.subjectTREATMENTS
dc.subjectVISITS
dc.subjectWORKERS
dc.subjectWORKFORCE
dc.subjectWORLD HEALTH ORGANIZATION
dc.titleA Political Economy Analysis of Turkey's Health Transformation Program
dc.typeWorking Paper
dc.typeDocument de travail
dc.typeDocumento de trabajo

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