Health for all by the year 2000 and primary health care : the Turkish case
This study aims at analyzing Turkish health policy from a Primary Health Care perspective as pronounced in Alma-Ata, 1978. The Alma-Ata Declaration has long been regarded as a watershed in the health field and 134 countries, including Turkey, have endorsed the Declaration showing their support for the views expressed in the Document. However, although the international community gave its full support, in practice, different interpretations and implementation of the principles have emerged. Turkey, one of the countries where health has rarely occupied the agenda, has been undergoing radical reforms since the mid 1980s with the ultimate aim of achieving Health for all by the Year 2000 through Primary Health Care. There is full commitment at the national policy-making level to endorse policies coherent with the principles of Alma-Ata. However, not all policies adopted seem to be consonant with what was declared in Alma-Ata requiring a detailed analysis of the policies suggested and implemented. In the light of this, the aims of the study are: (1) to analyze Turkish health policy since the 1960s from a Primary Health Care perspective with the aim of exploring the Turkish response to Alma-Ata; (2) to explore the perceptions of Turkish health policy-makers about Primary Health Care and related issues; (3) to discuss the prospects for Primary Health Care in Turkey. Basic principles of the Primary Health Care approach as declared in Alma-Ata have been taken as a guideline in analyzing Turkish health policy and the perceptions of the Turkish health policy-makers. These principles and their implementation, or the way they are perceived, have guided the research in answering the question ''what are the prospects for Primary Health Care in Turkey?" The nature of the research, based on document analysis and semi-structured interviews, has necessitated a qualitative stance. It was concluded that the Turkish version of Primary Health Care differs from the Declaration in a number of ways. A number of possible reasons for this have been offered. The perceptions of the policy-makers on certain issues that are closely related with the Approach, inter alia, has been found as one of the most possible explanations behind the current situation and a need to alter the ascendant approach towards health issues in general has been emphasized.