Where were we? Where are we now? The Distributional Imbalance of Health Human Resources: Improvements in Turkey in a decade

Background: Turkey, which suffers from both undersupply of physicians and nurses-midwives and imbalanced distribution of health care personnel, has been developing and implementing various policies in order to solve this problem. This study aims to take a closer glance at the impact of policies implemented for the reducing of imbalance of the distribution of health human resources last ten years in Turkey.  

Methods: Turkish Ministry of Health registries were used to reach the provincial distribution of active health personnel. Distributional imbalance was analyzed by using Lorenz curves and Gini coefficients for the years 2002, 2005, 2008 and 2012.  Eighty-one provinces consisted of the analysis units and number of health personnel and population of each province has taken into account for the selected years.  

Results: The distribution imbalances for all health care professions have shown a noticeable decrease along the last ten years period. Gini coefficient was 0.24 for specialists’ distribution in 2002, but it fell down gradually to 0.22 in 2005, 0.18 in 2008 and finally 0.12 in 2012. Similarly these coefficients were 0.21, 0.23 and 0.23 for general practitioners, nurses and nurse plus midwives respectively in 2002 in Turkey. In 2012 the coefficients for the same professionals were calculated as 0.10, 0.15 and 0.17 respectively.

Conclusion: The findings indicate that the policies, which have been implemented for the distribution of the health care personnel in Turkey, have yielded positive results. Yet, it is obvious that these positive results are not due to a single action merely. In this context, it is essential to further improve the existing implementations, search for the instruments and factors that will further satisfy and motivate health care personnel, and to continue developing and implementing comprehensive policies aiming proper solutions.