Sağlık hizmetlerinde toplum katılımı ve Türkiye deneyimi

One of the most important components of health promotion is community participation. The importance of community participation in health care was raised by the Alma-Ata Declaration in 1978. According to the Alma-Ata Declaration community participation should be ensured by planning, organization, implementation and supervision of health services at the highest levels. Nowadays, community participation is distanced from the definition in the Alma-Ata Declaration. Citizens cannot take part in the decision making process and community financing has been mentioned as a part of the community participation in health services. Community participation in the health sector in Turkey was initially regulated by the Law on the Socialization of Health Services (No. 224) published in 1961. Unfortunately, this regulation has not been put widely into practice. Community participation is regulated as a contribution to the financing of health services (prescription fee, surcharge, inpatient bed fee, etc.) by the Health Transformation Program (HTP). With HTP, the user fee for health services applies only for medical examinations provided by the Social Security Institution has increased to 2.132 billion TL in 2012 from 466 million TL in 2009. User fees in the health services only for medical examinations increased over the years and in the ratio of household health expenditures exceeded 18% for 2012. The Health Transformation Program should be discussed because of a structure that does not allow for community participation. Keywords: Community participation, health services, community financing, Turkey