Assessment of the Turkish health care system reforms: A stakeholder analysis

Background: The Turkish health care system has been undergoing a significant transformation with the Health Transformation Program (HTP) since 2003. The HTP's overall objective is to improve governance, efficiency, user and provider satisfaction, and long-term fiscal sustainability of the health care system in Turkey. Objectives: To systematically evaluate the effects of the HTP Phase I reforms on various stakeholders, and to outline strategic options for the implementation of the second phase of health transformation in Turkey. Methods: A total of 47 formal structured stakeholder interviews, representing 29 different institutions, are conducted between December 2008 and January 2009. Five main components of the HTP were examined: strengthening of the Ministry of Health (MoH) capacity for stewardship, universal health insurance, reorganizing health service delivery, human resources development, and national health information system. Results and conclusions: There is a general agreement among stakeholders that the progress made thus far is the greatest in the national health information system and the slowest in strengthening the MoH capacity for stewardship. It appears that the HTP has the capacity to deliver cost-effective health care services and the implementation progress, so far, is in congruence with the overall economic development and growth in Turkey. (C) 2012 Elsevier Ireland Ltd. All rights reserved.