Fundamental and systemic changes wouldhave to be brought about in the ways that health care isfinanced, delivered, organized, and managed in Turkey inorder to meet the ultimate objective of improving the healthstatus of people, and not only meet but surpass thehealth-related Millennium Development Goals. This wouldrequire significant improvements in resource mobilization,allocation and utilization, enhanced efficiency inproduction and delivery of health services, includingprimary and hospital care, and greater emphasis on clinicalquality and patient access to health services. Against thisbackdrop, the World Bank and the Government of Turkey agreedto undertake an intensive review of all aspects of thehealth sector, and the present report is produced from thiseffort. One objective of an evaluation at this juncture isto lay the foundation for developing a medium-term healthsector strategy and a prioritized action plan aimed atimproving access to health services, enhancing equity inutilization, increasing cost-effectiveness, enhancingquality of care and improving health outcomes overall. Inparticular, the emphasis of this study is to develop viablemedium-term options for enhancing the health servicescoverage of poor and vulnerable groups and examine whichpriorities and approaches are likely to be most pro-poor.The study also examines the appropriate role of thegovernment in providing health services, and theinstitutional, managerial, and administrative requirementsfor developing an efficient, sustainable, andpatient-responsive health system. In doing so, the studyexamines ways in which public spending can be oriented so asto maximize its effects on access, equity, and efficiency inthe health sector. An added objective of this study is toengage policy makers and major stakeholders in discussionsand debates on health reforms and bring about a consensusamong them not only on broad principles but also in terms ofintegrated and coordinated approach to implementing reformmeasures. This report is organized in two volumes. Volume 1contains a discussion of health sector priorities and keyrecommendations for developing a medium-term reform strategyfor Turkey's health sector. Volume 1 concludes with animplementation plan for the short and medium terms. Volume 2contains the full background reports and data annexes thatform the basis of the suggested health system reform.
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