politics : culture : economics

A snapshot of Turkey’s health system

In Society on July 10, 2010 at 12:01 am

The OECD published its annual Health Data report at the end of June, providing a broad survey of conditions in the health systems of the organisation’s 31 member countries. Turkey continues to have the lowest level of per capita health spending among these countries, at US$767 in 2008. This is well below the OECD average of US$3,060, but hardly surprising given that Turkey also has the lowest GDP per capita in the OECD. However, Turkey also underperforms in relative terms, spending just 6.0 per cent of its GDP on health each year. This compares to an OECD average of 9.0 per cent—only Mexico devotes less of its economic resources to health, with a figure of 5.9 per cent.

The lower-than-average level of health spending in Turkey feeds through, as one would expect, to lower-than-average resourcing in its health system. In 2008, Turkey had 1.5 doctors per 1,000 of population, less than half the OECD average of 3.2. This discrepancy is dwarfed by its nursing counterpart—Turkey’s 1.3 nurses per 1,000 of population compare with an average figure of 9.0 across the OECD. In addition, the number of hospital beds in Turkey is less than half the average OECD figure (2.3 per 1,000 of population, as against 5.4), as is the number of CT scanners (10.2 per million of population compared to an average of 22.5)

In terms of Turkey’s health outcomes, the most striking figure is a long-term one. While life expectancy has increased significantly in most OECD countries over the past 50 years, it has surged particularly strongly in Turkey. In 1960, Turkish life expectancy was 20 years lower than the OECD average. By 2008, that gap had narrowed to six years (73.6 years in Turkey, 79.4 on average across the OECD). This reflects a remarkable increase of 25 years in Turkish life expectancy over the last five decades, which in turn reflects rising living standards, greater public health provision and improvements in medical care.

There has been an even more dramatic improvement in Turkey’s performance on infant mortality rates (defined as the number of deaths of babies below the age of one, per 1,000 live births). In 1960 this stood at an eye-watering 190. By 2003 it had fallen by 83 per cent to 33, and by 2008 it had halved again to reach 17. Among the factors that have contributed to this fall have been improvements in prenatal care and efforts to improve educational opportunities for girls and to promote breastfeeding. (Figures from UNICEF suggest that the proportion of babies being exclusively breastfed in Turkey increased by a factor of four between the 1990s and the first decade of the 2000s.) Despite its rapid decline, however, infant mortality remains much higher in Turkey than in the rest of the OECD, where the average rate is 4.7.

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