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Turkey Healt Transformation

Turkey Healt Transformation

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Published by Ahmet Muhtar Kansu

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Published by: Ahmet Muhtar Kansu on Jan 06, 2013
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The World Bank
Page 1 of 6
   P  u   b   l   i  c   D   i  s  c   l  o  s  u  r  e   C  o  p  y   P  u   b   l   i  c   D   i  s  c   l  o  s  u  r  e   C  o  p  y
Report No:
ISR5686
Implementation Status & Results
TurkeyHealth Transformation and Social Security Reform Project (P102172)
Operation Name:
Health Transformation and Social Security Reform Project(P102172)
Project Stage:ImplementationSeq.No:5Status:ARCHIVEDArchive Date:05-Jul-2011 Country:TurkeyApproval FY:2009 Product Line:IBRD/IDARegion:EUROPE AND CENTRAL ASIALending Instrument:Adaptable Program Loan Implementing Agency(ies):Ministry of Health, Social Security Institution
Key Dates
Board Approval Date
11-Jun-2009
Original Closing Date
31-Jul-2013
Planned Mid Term Review DateLast Archived ISR Date
05-Jul-2011
Effectiveness Date
29-Sep-2009
Revised Closing Date
31-Jul-2013
Actual Mid Term Review Date
24-Oct-2011
Project Development Objectives
Project Development Objective (from Project Appraisal Document)
The specific objectives of the HTSSRP are: (i) increasing the effectiveness of the Social Security Institute (SSI) and the Ministry of Health (MOH) in formulatingand implementing reforms in provider payments and health systems performance; and (ii) piloting output-based financing for non-communicable diseases(NCD) prevention and control.
Has the Project Development Objective been changed since Board Approval of the Project?
YesNo
Component(s)
Component NameComponent Cost
Support for MOH's Strategic Plan46.17Output Based Financing for Preventive Health Services6.84Capacity Building for Social Security Institution3.09
Overall Ratings
Previous RatingCurrent RatingProgress towards achievement of PDO
SatisfactorySatisfactory
Overall Implementation Progress (IP)
SatisfactorySatisfactory
Overall Risk Rating
LowLow
Implementation Status Overview
The World Bank has been supporting the Government's Health Transformation program through a two-phased approach. The first phase supported the introduction of the familymedicine model, and helped build capacity of the Ministry of Health and the Social Security Institute to expand health insurance coverage and improve family medicine servicedelivery. The second phase, through the ongoing Health Transformation and Social Security Reform Project supports reforms aimed at increasing hospital autonomy, expanding
 
The World Bank
Page 2 of 6
   P  u   b   l   i  c   D   i  s  c   l  o  s  u  r  e   C  o  p  y   P  u   b   l   i  c   D   i  s  c   l  o  s  u  r  e   C  o  p  y
Report No:
ISR5686family medicine services, and further strengthening performance management and pay-for-performance initiatives. The second phase became effective on September 29, 2009. TheProject has already disbursed US$24.43 million as of December 2011 (33% of loan proceeds) and is making satisfactory progress towards achieving its objectives. Significantprogress is noted with key legislations (MOH Restructuring Law and Hospital Union Law) having been passed as a decree law this November. The MOH Restructuring Law redefinesthe role of the MOH away from that of a provider to that of a steward for the sector focusing on policy formulation, regulation and monitoring and evaluation. The family medicineprogram has achieved nationwide coverage as of December 2010. Utilization of primary care services has increased and is 3.6 outpatient visits per capita in 2011 compared with 2 in2008. Patient satisfaction with health services has increased from 38% in 2003 to 73% in 2010.
Locations
No Location data has been entered
Results
Project Development Objective Indicators
Indicator NameCoreUnit of MeasureBaselineCurrentEnd Target
1. Increase in the utilization of primary healthcare.Number
Value
2.003.604.00
Date
30-Jul-200920-Dec-201130-Jul-2013
Comments
Target on track. 3.6 Visits percapita in 20114 visits per capita2. Increase in the percentage of first-time visitsto specialists that are referrals by familymedicine practicesNumber
Value
1.201.501.50
Date
30-Jun-200920-Dec-201131-Jul-2013
Comments
Target met. 2010 data3. Increased client satisfaction with healthservices as compared with baseline.Text
Value
63.473.070
Date
14-Jul-200820-Dec-201130-Jul-2013
Comments
percentTarget met. 73% in 2010.percent4. Smoking prevalence among 18-29 agegroup in pilot provinces relative to non-pilotprovinces.Percentage
ValueDate
08-Jul-200920-Dec-201131-Jul-2013
Comments
NCD survey to beimplemented in 2011.The OBF component is yet tobe implemented as secondarylegislation is being drafted toallow for this. NCD surveybeing analyzed.
 
The World Bank
Page 3 of 6
   P  u   b   l   i  c   D   i  s  c   l  o  s  u  r  e   C  o  p  y   P  u   b   l   i  c   D   i  s  c   l  o  s  u  r  e   C  o  p  y
Report No:
ISR5686
Indicator NameCoreUnit of MeasureBaselineCurrentEnd Target
5. High blood pressure in population in pilotprovinces decreases more as compared tonon-pilot provincesPercentage
ValueDate
08-Jul-200920-Dec-201131-Jul-2013
Comments
Baseline NCD assessment tobe carried out in 2011The OBF component is yet tobe implemented as secondarylegislation is being drafted toallow for this. NCD surveybeing analyzed.6. Decrease in SSI expenditures onpharmaceuticals and outpatient health carePercentage
Value
40.0041.8033.00
Date
08-Jul-200910-Jun-201131-Jul-2012
Comments
40% of expenditures onpharmaceuticals 50% oftreatment costs on inpatient41.8% in 2010 - SSIexpenditures onpharmaceuticals as a % ofSSI spending33% ,42%
Intermediate Results Indicators
Indicator NameCoreUnit of MeasureBaselineCurrentEnd Target
Component A: 1. Percentage of familymedicine practices that have completedsecond level training as compared withbaselinePercentage
Value
0.0021.0080.00
Date
08-Jul-200920-Dec-201131-Jul-2013
Comments
021% in 201180%2. Annual performance reports onimplementation of MOH Strategic Plan usinginformation from MOH Monitoring andEvaluation system disseminated by MOH toParliament and published on MOH websiteText
Value
2011 Performance programsubmitted to NationalAssemblyThird Report published
Date
08-Jul-200920-Dec-201130-Jul-2013
Comments
Done.3. Percentage of acute care publichospitals using revised clinical guidelines forsecondary care as requirement of performancepayment systemText
Value
0
Date
31-Jul-200920-Dec-201131-Jul-2013
Comments
Indicator to be revised a partof level 1 restructuring.4. Dissemination of bi-annual HTPTracking reports by M&E Directorate of MOHText
Value
Not availableHSPA report tracks HTPperformance and is currentlybeing published.1 bi-annual report
Date
08-Jul-200920-Dec-201131-Jul-2013
Comments

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