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To investigate the changes in the provision of preventive health services in
terms of woman and child health after reorganization of the primary health
care services.
Background
The primary care system in Turkey has undergone fundamental changes as a part
of Health Transformation Program during last decade. But there was no
community-based study to evaluate these changes.
Method
This community-based and cross-sectional study was conducted in 2010, just
before the reorganization of primary care services and in 2015, five year
after the reforms. The 30×7 cluster sampling method was used in
Zümrütevler quarter of Maltepe District. The socio-demographic
characteristics of the participants, the presence of the physician who can
be consulted for any health problem, the presence of smokers at home were
questioned. The women aged 18 years or older and gave consent provided
information about history of pregnancy and birth, the number of follow-ups
during pregnancy, family planning method usage, cervical and breast cancer
screening, breastfeeding duration, vaccinations, and prophylactic iron and
vitamin D supplementation for their children.
Findings
After the reorganization of primary care, more people stated that they had
physicians to whom they could consult for all kinds of health problems (27.8
versus 44.7%; P<0.001) and that physician was
the primary care physician (30.2 versus 64.7%;
P<0.001). The reported frequency of at least one
smoker at home was decreased after reorganization of primary care (63.6
versus 53.1%; P=0.034). There were no
significant differences in terms unplanned pregnancy, the use of family
planning method, the number of pregnancy follow-ups and the frequency of Pap
smears and mammography. There are no significant differences in terms of
healthy children follow-ups, vaccination, vitamin D and iron supplementation
(P>0.05). It was found that the duration of
total breastfeeding increased after reorganization of primary care
(P<0.001).
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