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.
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.
Authors: Sarah Bowman; Nigel Unwin; Julia Critchley; Simon Capewell; Abdullatif Husseini; Wasim Maziak; Shahaduz Zaman; Habiba Ben Romdhane; Fouad Fouad; Peter Phillimore; Belgin Unal; Rana Khatib; Azza Shoaibi; Balsam Ahmad Journal: Bull World Health Organ Date: 2012-09-14 Impact factor: 9.408
Authors: Brian Serumaga; Dennis Ross-Degnan; Anthony J Avery; Rachel A Elliott; Sumit R Majumdar; Fang Zhang; Stephen B Soumerai Journal: BMJ Date: 2011-01-25
Authors: Gill Walt; Jeremy Shiffman; Helen Schneider; Susan F Murray; Ruairi Brugha; Lucy Gilson Journal: Health Policy Plan Date: 2008-09 Impact factor: 3.344
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