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Mother Health in Turkey |
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| Authors: Tamer Edirne, MD; Fusun Ersoy, MD; Hakan Yaman, MD; Mother and Child Health - Family Planning Center Family Physician , Kirikkale Turkey Dept of Family Practice, Kirikkale University Medical School, Kirikkale, Turkey Dept. Of Family Medicine, Akdeniz University Medical School , Antalya, Turkey Summary The health status of mothers in Turkey is below the desired level, although data show some improvement in the last years. This paper aims to review current data about mother health and studies designed to improve mother health in Turkey. Background According to the census 2000 there are 16.3 million married women belonging to the reproductive period of 15-49 years in Turkey and this makes about 25% of the population . In 1990, 14.1 million women in this group were recorded. It is shown that only 1% of women aged 45-49 have never married in Turkey. Age of first marriage is increasing in Turkey with the mean age of 18.3 years in the 45-49 year-old group which rises to 20 years in the 25-29 year-old group . Marriages at young ages are responsible for complications related to pregnancy, birth and pospartum period that are seen in young women. The failure to obtain periodical care in the reproductive period restricts the success of the preventive measures against frequently seen diseases in women. In 1993, the percentage of pregnant women obtaining antenatal care showed an increase with 63%. In addition, the mean time of first antenatal care has decreased from 7 months to 3 months . However, 68% of future pregnancies are related at least with one risk . Nutrition is insufficient and unbalanced and anemia is not rare. Although the number of induced abortions is decreasing it is shown in 1993 that while 70% of families do not desire another child, the rate of families using family planning is only 62.6% and only 34.5% use a modern method . Fifty percent of maternal deaths occur at birth and the rate of births at home without attendance is as high as 24%, similar to the results of 1988-93 surveys . |
Maternal deaths Deaths occuring after the beginning of pregnancy until day 42 after birth are accepted as maternal death by WHO. There are confusing data about maternal death rates and reasons in Turkey. In 1974, maternal death rate was reported to be 208 per 100 000 live births. In a study from the provinces Kahramanmaras and Adiyaman, maternal death rates were reported to be 284 and 94 per 100 000 live births, respectively . According to a study conducted by the National Statistics Institute in 1989, maternal death rate was reported to be 132/100 000 .It is estimated that the maternal death rate is about 100/100 000 at present. There were 671 cases of maternal deaths among patients advised to the hospital for pregnancy and birth, according to the Hospital Yearbook publicated in 1993 by the Ministry of Health . Causes for maternal deaths The majority of maternal deaths occur at birth in Turkey. A study conducted by the National Statistics Institute confirmed this finding and reported that approximately half of the maternal deaths occur at birth, a quarter in pregnancy and a quarter in the postpartum period. The major medical causes for maternal deaths are haemorrhage, infections and toxemia. The main factors that contribute to maternal death are multiparity, insufficent prenatal care and nutrition, insufficient benefit from health care services and low status of women. 1- High birth rate: In Turkey, the crude birth rate is about 23/1000 and approximately 1.4 million births occur in a year. Crude birth rate is higher (24/1000) in rural regions compared to urban areas (21.7/1000). At the end of their reproductivity (ages 40-49) women in Turkey show a ratio of 4.6 births. This ratio is 5.6 in rural areas, 4.0 in urban areas, 3.5 in the western and 7.3 in the eastern regions. |
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