Nesrin Çilingiroğlu

Catastrophic health expenditure and impoverishment in Turkey

OBJECTIVES This study aims to identify the level of catastrophic health expenditure (CHE) in Turkey and, to reveal household factors predicting this outcome. METHODS CHE is calculated from a national representative data derived from TurkStat, Household Budget Survey, Consumption Expenditures, 2006. The methods introduced by Ke Xu and colleagues are employed for calculations. RESULTS The proportion of households with CHE is 0.6%. Impoverished households consist 0.4% of total. Average out-of-pocket health payment is 7.36 USD (PPP

Financial protection in health in Turkey: the effects of the Health Transformation Programme

-2006) in lowest fifth that is approximately one tenth of the highest fifth (70.18 PPP USD-2006). In the logistic model, probability of facing CHE increases by each unit rise of per capita expenditure. Household heads health insurance is closely related with catastrophe. Rural households face 2.5 times more catastrophe than the urban area residents. Having preschool child in the household is seen as a protective factor for catastrophic expenditure. On the other hand, elderly or disabled person increases risk of catastrophe. CONCLUSIONS Results indicate that more people in Turkey benefited from risk pooling/health insurance by 2006 and were, therefore, on average, better protected from catastrophic medical expenses, than in many other countries with comparable income levels at that time.

390 Intimate partner violence: Turkey’s femicide problem

Financial protection should be the principal objective of any health system. Commonly used indicators for financial protection are out-of-pocket (OOP) payments as a share of total health expenditure and the amount of households driven into poverty by catastrophic health expenditures (CHEs). In the last decade, OOP health payments consisted of approximately one-fifth of the health finance resources in Turkey. Until the year 2008, Turkish health system covered different public and private financing programmes as well as different types of service provision. After 2008, universal financial coverage became a part of the Health Transformation Programme (HTP). This study aimed to evaluate the financial protection in health in the era of health reforms in Turkey between 2003 and 2009. Household expenditures were derived from nationally representative Turkish Household Budget Surveys (HBSs), 2003, 2006 and 2009. Proportion of households facing CHE and impoverishment are calculated by using the methodology proposed by Ke Xu. Probability of incurring and volume of OOP spending were assessed across the health insurance groups by two-part model approach using logistic and OLS regression methods. Our findings showed that the probability of incurring and volume of OOP spending increased gradually in publicly insured households between 2003 and 2009. However, there was a diminishing trend in CHE in Turkey during the period under consideration. The official data showing an ∼3-fold increase in per capita health care use since 2003 and our study findings on decreasing CHE in this period can be interpreted as positive impact of HTP. On the other hand, increased household consumption as a share of OOP health payment and the deterioration in the progressivity of OOP spending in this period should be monitored closely.

How do municipality employees in Ankara approach persons with disabilities

Background Throughout Turkey, violence that women have been subjected to is still widespread. Murder of women or femicide involve intentional-murder-of-women because they are women and increasing worldwide as it is in Turkey. In spite of juristic-regulations and precautions made to prevent violence against women, femicide in Turkey has not stopped-proof that the problem is structural in-nature. Collecting correct-data on femicide is challenging, largely because police and medical-data-collection-systems on homicide often do not have satisfactory-information or do not report the victim–perpetrator relationship or the motives, let alone gender-related motivations for murder. The study objective is to collect data on number and some characteristics of femicide in 2012 in the newspapers and compare the numbers them with other available data. Methods 2012 issues of four top-newspapers from different media-agencies are reviewed. For every femicide a file-created, and collected-data from four-newspapers merged according to the 37 items of data-collection-sheet. Results 202 femicide cases were found. Of the victims 31.7% were aged 25–34, 43.1% were married, 59.4% had children, 4% were pregnant. Of the perpetrators, 26.7% were aged 25–34, 56.9% were married, 48.5% had children, 41.1% were the victim’s-husband, 7.4% were the victim’s-separated-spouse, 5.9% were the victim’s-ex-husband, 19.3% were victim’s-boyfriend and 4.5% were victim’s-ex-boyfriend. Of the femicides, 33% had discord, 18.4% had violence, 9.4% had intimidation-history. 8.9% of women demanded police-protection. Firearm use was 44.2%, and 54.5% cases’ place of death was home. Conclusions A huge gap between existing laws and what is happening in reality and femicide which is a common criminal problem in Turkey. But data is not consistent. In 2012, according to newspapers 202, Ministry of Family and Social Policies 145, woman organisations 210 femicide were detected mainly due to the definition-differences. In spite of the limitations, newspapers are the only accessible-source at the national-level. The penalties of the Law (Protection-of-the-Family-and-the-Prevention-of-Violence-against-Women) are not a deterrent force and in spite of juristic regulations and precautions made to prevent violence against women, femicide in Turkey has not stopped-proof that the problem is structural in nature. Thus, ending this problem requires additional reforms and the establishment of new sustainable policies with the ultimate aim of reconstructing society.