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publication December 12, 2019

Building an Improved Primary Health Care System in Turkey through Care Integration

Non-communicable diseases remain one of the key health challenges in Turkey, currently the major cause of premature death among the lower-income population. Promoting healthy living and addressing major risk factors such as smoking, obesity, physical inactivity, and alcohol use have become critical.

World Bank Group


An estimated 41 million of the 57 million deaths globally (71%) were due to non-communicable diseases (NCDs) in 2016. Just four NCDs were responsible: cardiovascular disease, cancer, chronic respiratory disease, and diabetes.

A new report, entitled Building an Improved Primary Health Care System in Turkey through Care Integration provides a systematic analysis of care integration through its basic elements, how these elements prominently appear in different country contexts, and what Turkey should do to establish an effective integration in provision of health care services. 

Changing population demographics (aging populations), shifting lifestyles, environmental factors, and the increasing burden of non-communicable diseases are exerting significant pressure on health systems around the world - both in terms of costs and service delivery. These multiple and complex problems are prompting heath-system policy makers to find more effective and efficient means of providing and sustaining health care - a basic human right.

Integrated care stands out as an emerging concept to address these pressing health system issues. Integrated care involves effective coordination, collaboration, and communication among multiple care providers - with a patient-centered focus on providing continuous care to all who need it.

It also necessitates the formation of multidisciplinary health care teams, as well as a cultural and operational shift in health care service delivery. Integrated care systems can succeed and be sustained when they evolve and adapt to better address the changing care needs of a population. Therefore, care integration requires strong monitoring and evaluation systems that are in-line with well-functioning health information systems.

Despite very successful health reforms that occured in Turkey between 2003 and 2013 - which aimed to improve access, efficiency, and quality in health care, as well as establish universal health coverage - an explicit ‘integrated care’ model has never been discussed in Turkey.