Health policy analysis in Turkey: cardiovascular diseases and diabetes mellitus

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Last month, thousands of people walked in Istanbul, showing their support to the obesity prevention program. Obesity is a major health concern in Turkey, leading- amongst others- to cardiovascular diseases (CVD) and diabetes mellitus (DM). Those two diseases are quite prevelant in Turkey: Ischemic hear disease is the number one cause of death there (causing 22% deaths), while the prevalence of diabetes mellitus is 16.5% and has increased about 90% between 1998-2010.

In a paper we recently published, the authors aimed to evaluate current policies for managing the burden of CVD and DM and related risk factors in the Turkish health system. This study is part of a bigger project called MedCHAMPS , that was conducted across 4 countries. The study evaluates existing policies in different ways:

– By qualitatively evaluating documents describing existing policies

– By conducting interviews with key informants

– By observation and rapid appraisal fieldwork in clinical settings

 

The authors summarize their main results as follows:

– The policy documents examined strongly addressed prevention and control; however, there was no mention for country-wide early detection and screening programs.

– Key informants indicated over-fragmented management of CVD–DM by the Ministry of Health  and poor coordination and lack of trust between the Ministry of Health, organizational structure at provincial level and civil society organizations

– The appraisal of clinical settings showed lack of a referral structure and a lack of follow-up, and general absence of functioning health information systems for patient records.

The authors conclude that there needs to be better training of staff in public facilities and that patients data. Moreover, patient data,  referrals and follow-up across all levels of the health system need to be integrated.

How are health policies regarding cardiovascular diseases and diabetes mellitus in your country? What can be improved?

 

*picture credit

** This study was written by Bulent Kilic, Sibel Kalaca, Belgin Unal, Peter Phillimore and Shahaduz Zaman

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