Protection of
Health
Table 5.1. Vaccination Rate by Years, (%)
2002 2015 2016 2017 2018 2019
DaPT 3 78 97 98 96 98 99
BCG 77 96 96 93 96 96
HBV 3 72 97 98 96 98 99
MMR 82 97 98 96 96 97
Source: General Directorate of Public Health
Figure 5.1. Third Dose Vaccination Rate of 5-Component Combined Vaccine (DaPT+IPV+Hib) by NUTS-1, (%), 2002, 2019
Source: General Directorate of Public Health
91 93
96 97 97 98
99 99 99 100
100 100 100
65 74
80 81
82 75
78 89 85 65
81 85 80
0 20 40 60 80 100
Mideastern Anatolia Northeastern Anatolia Central Anatolia Western Blacksea Eastern Blacksea Istanbul Turkey Eastern Marmara Western Anatolia Southeastern Anatolia Western Marmara Mediterranean Aegean
% NUTS-1
2002 2019
Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency
Figure 5.2. International Comparison of DaPT+IPV+Hib Vaccination Rate, (%), 2019
Source: General Directorate of Public Health, WHO Global Health Observatory Database
Figure 5.3. HBV 3 Vaccination Rate by NUTS-1, (%), 2002, 2019
Source: General Directorate of Public Health
99 95 95 92
85
0 30 60 90
Turkey High Income Group
Countries WHO European
Region Upper Middle Income Group Countries
Global
%
91 93
96 97 97 98
99 99 99 99 100 100 100
52 61
82 77 76 65
72
88 85 50
82 83 82
0 20 40 60 80 100
Mideastern Anatolia Northeastern Anatolia Central Anatolia Western Blacksea Eastern Blacksea Istanbul Turkey Eastern Marmara Western Anatolia Southeastern Anatolia Aegean Mediterranean Western Marmara
% NUTS-1
2002 2019
Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency
Figure 5.4. MMR Vaccination Rate by NUTS-1, (%), 2002, 2019
Source: General Directorate of Public Health
Figure 5.5. International Comparison of MMR Vaccination Rate, (%), 2019
Source: General Directorate of Public Health, WHO Global Health Observatory Database
89 89
95 96 96
97 97 97 97 99 99
100 100
66
78 83
87 90 83
92 82
84 68
85 89 84
0 20 40 60 80 100
Mideastern Anatolia Northeastern Anatolia Western Blacksea Eastern Blacksea Western Anatolia Istanbul Eastern Marmara Turkey Central Anatolia Southeastern Anatolia Aegean Mediterranean Western Marmara
% NUTS-1
2002 2019
97 96 93 93
85
0 30 60 90
Turkey WHO European
Region Upper Middle Income Group
Countries
High Income
Group Countries Global
%
Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency
Figure 5.6. Number of Vaccine Antigen by Years and Vaccine Schedule, Ministry of Health
Source: General Directorate of Public Health
Table 5.2. Indicators of Birth by NUTS-1, (%), 2019
NUTS-1 Births at Hospital, (%) Cesarean Sections Among Live Births, (%)
Primary Cesarean Sections Among Live
Births, (%)
Istanbul 98 58,9 30,8
Western Marmara 95 59,2 31,8
Aegean 98 62,2 32,4
Eastern Marmara 97 58,0 29,6
Western Anatolia 99 53,2 27,3
Mediterranean 99 64,0 29,1
Central Anatolia 96 51,0 23,8
Western Blacksea 97 61,1 30,3
Eastern Blacksea 95 60,4 29,6
Northeastern Anatolia 92 37,5 17,4
Mideastern Anatolia 95 40,2 18,7
Southeastern Anatolia 96 43,5 18,0
Turkey 97 54,4 26,5
Source: General Directorate of Public Health
Note: Birth data for 2019 was obtained from the e-rapor database.
5 6
7
6
7
10 11
13 13
0 3 6 9 12 15
1960 1963 1970 1981 1998 2002 2006 2008 2012 2019
Year
Number of Antigen Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency
Figure 5.7. International Comparison of Proportion of Births Attended by Skilled Health Personnel, (%), 2018
Source: TDHS 2018, UNICEF/WHO Joint Database
Note: Turkey’s data belongs to TDHS 2018.Countries’ data belong to the year of 2018 or nearest.
Figure 5.8. International Comparison of Cesarean Sections Among Live Births, (%), 2018
Source: General Directorate of Public Health, OECD Health Data 2020
Note: Turkey’s data belongs to the year 2019. Countries’ data belong to the year of 2018 or nearest.
99,2 99,1 99,1 99,0 98,8 96,5
81,3
0 30 60 90
Turkey WHO
European Region42
EU22 High Income Group Countries
OECD29 Upper Middle Income Group Countries
Global
%
54,4 45,2 38,9 38,0 33,2 33,1 31,6 30,0 29,6 29,3 29,0 28,6 27,7 27,4 26,3 25,3 24,5 24,1 23,1 22,2 21,1 19,5 19,2 19,1 18,7 17,1 16,4 16,1 15,8 15,7 14,9
0 10 20 30 40 50 60
Turkey South Korea Poland Hungary Italy Ireland Switzerland Luxembourg Germany Slovakia Austria United Kingdom Canada New Zealand OECD29 EU21 Spain Latvia Czech Republic Slovenia Belgium France Denmark Lithuania Estonia Sweden Finland Iceland Norway Netherlands Israel
%
Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency
Table 5.3. Proportions of Cesarean and Primary Cesarean Section Among All Births Given at Hospital by Sectors, (%), 2019
Cesarean Sections Primary Cesarean Sections
Ministry of Health 41,8 15,9
University 70,4 35,3
Private 71,8 39,8
Total 57,0 27,8
Source: General Directorate of Public Health
Note: Birth data for 2019 was obtained from the e-rapor database.
Table 5.4. Antenatal Care Coverage (Minimum 1 Visit) by Years and NUTS-1, (%)
NUTS-1 2017 2018 2019
Istanbul 99,8 99,4 98,7
Western Marmara 99,8 99,7 99,9
Aegean 99,7 99,7 99,8
Eastern Marmara 99,8 99,6 99,8
Western Anatolia 99,6 99,0 99,4
Mediterranean 99,7 99,5 99,2
Central Anatolia 99,7 99,6 99,7
Western Blacksea 99,6 99,7 99,7
Eastern Blacksea 99,6 99,8 99,9
Northeastern Anatolia 99,6 99,7 99,8
Mideastern Anatolia 99,8 99,8 99,8
Southeastern Anatolia 99,7 99,3 99,2
Turkey 99,7 99,5 99,4
Source: General Directorate of Public Health
Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency
Figure 5.9. International Comparison of Antenatal Care Coverage (Minimum 1 Visit), (%), 2018
Source: General Directorate of Public Health, UNICEF - Maternal and Newborn Health Coverage Database
Note: Turkey’s data belongs to the year 2019. Countries’ data belong to the year of 2018 or nearest.
Figure 5.10. Proportion of Induced Abortion by Years, (in 100 Gestation)
Source: TDHS, 1993, 1998, 2003, 2008, 2013, 2018
99,4 98,3 97,6 97,5 97,1 95,9
86,9
0 30 60 90
Turkey OECD20 EU16 High Income
Group Countries
EuropeanWHO Region33
Upper Middle Income Group Countries
Global
%
18,0
14,5
11,3
10,0
4,7 5,9
0 5 10 15 20
TDHS 1993 TDHS 1998 TDHS 2003 TDHS 2008 TDHS 2013 TDHS 2018 in 100 Gestation
Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency
Figure 5.11. Proportion of Births by Age Group of Mother Among All Births, (%), 2019
Source: TURKSTAT, Birth Statistics 2019
Figure 5.12. Age-Specific Fertility Rate, (‰), 2019
Source: TURKSTAT, Birth Statistics 2019
0,01 0,83 3,71
22,40
32,11
24,84
13,03
2,81
0,23 0,02 0
5 10 15 20 25 30 35
<15 15-17 18-19 20-24 25-29 30-34 35-39 40-44 45-49 50+
Age Group
%
16,7
82,7
122,4
93,8
47,7
11,0 0,9
0 20 40 60 80 100 120 140
15-19 20-24 25-29 30-34 35-39 40-44 45-49
Age Group
‰
Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency
Figure 5.13. Adolescent Fertility Rate by Years, (‰)
Source: TURKSTAT, Birth Statistics 2019
Figure 5.14. International Comparison of Adolescent Fertility Rate, (‰), 2018
Source: TURKSTAT Birth Statistics 2019, UNPD Note: Turkey’s data belongs to the year 2019.
28,9 27,9
25,8 24,0
21,8
18,8
16,7
0 10 20 30
2013 2014 2015 2016 2017 2018 2019
‰
Year
42
33
22
17 17
12
9
0 20 40
Global Upper Middle Income Group
Countries
OECD WHO
European Region
Turkey High Income Group Countries
EU
‰
Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency
Figure 5.15. Proportion of Adolescent Mothers Among All Mothers by Years, (%)
Source: TDHS, 1993, 1998, 2003, 2008, 2013, 2018
Table 5.5. Full Follow-Up Ratio of Pregnant, Infant and Child by NUTS-1, (%), 2019
NUTS-1 Pregnancy Infant Child
Istanbul 98,1 90,2 93,6
Western Marmara 99,2 97,0 97,4
Aegean 99,4 95,0 96,5
Eastern Marmara 98,7 94,4 95,8
Western Anatolia 97,8 95,0 96,5
Mediterranean 97,8 93,5 93,5
Central Anatolia 98,8 95,4 95,2
Western Blacksea 98,9 96,4 97,2
Eastern Blacksea 99,7 96,4 97,0
Northeastern Anatolia 98,8 92,0 93,4
Mideastern Anatolia 98,3 88,9 92,1
Southeastern Anatolia 97,3 84,5 87,2
Turkey 98,3 91,7 93,6
Source: General Directorate of Public Health 10,2
9,3
7,5
5,9
4,6
3,5
0 3 6 9 12
TDHS 1993 TDHS 1998 TDHS 2003 TDHS 2008 TDHS 2013 TDHS 2018
% Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency
Explanations for Chapter 5
MMR vaccine was administered as measles vaccine alone before the year 2006.
The DaPT vaccine which had been administered until 2008 was introduced in the form of DaPT + IPV + Hib (5 in one vaccine).
The population that was used to calculate the vaccination rate is the target population that was calculated by the Ministry of Health.
Values in the tables and figures in the Chapter may not give the sum due to rounding.
Data on birth indicators before 2015 were obtained from the provinces by official letter, and between 2015 and 2018, using the “Hospital Birth Information System”, and as of 2019, the data collection method was changed and the “e-rapor” database has been used.
Births at Hospitals, (%): It is the ratio of number of births in hospital to the number of live births in the given year.
Proportions of Cesarean Sections Among Live Births, (%): It is the ratio of number of Cesarean Sections to the number of live births in the given year.
Proportions of Primary Cesarean Sections Among Live Births, (%): It is the ratio of number of Primary Cesarean Sections to the number of live births in the given year.
Proportions of Cesarean Sections Among Births in Hospitals, (%): It is the ratio of number of Cesarean Sections to the number of all births procedure in hospital in the given year.
Proportions of Primary Cesarean Sections Among Births in Hospitals, (%): It is the ratio of number of Primary Cesarean Sections to the number of all births procedure in hospital in the given year.
Fertility Rate, (‰): It represents the average number of live births that would be born to a woman during her reproductive life (from 15 to 49).
Adolescent Fertility Rate, (‰): It represents the average number of live births per thousand women in 15-19 age group.
Full Follow-Up of Pregnant: A pregnant woman should be followed 4 times during her pregnancy. The pregnant woman who has been followed at least 4 times in the determined period and time intervals is considered to be fully followed.
Pregnancy follow-up periods and intervals;
1. Follow-up: Within the first 14 weeks of pregnancy 2. Follow-up: Between 18-24 weeks of pregnancy 3. Follow-up: Between 28-32 weeks of pregnancy 4. Follow-up: Between 36-38 weeks of pregnancy
Full Follow-Up of Infant: A baby should be followed 9 times during the first year of life. The baby who has been followed first in the hospital immediately after birth and in addition at least 8 times (ie, 9 times in total) in the determined period and time intervals is considered to be fully followed.
Infant follow-up periods and intervals;
1.Follow-up: At birth (in hospital)
2. Follow-up: Follow-up of the newborn in the first week after birth (1st to 10th day) 3. Follow-up: Day 15 (Between 11th-29th days)
4. Follow-up: Day 41 (Between 30th-59th days) 5. Follow-up: 2 months (Between 60th-89th days) 6. Follow-up: 3 months (Between 90th-115th days) 7. Follow-up: 4 months (Between 120th-150th day) 8. Follow-up: 6 months (Between 180th-210th days)
Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency
9. Follow-up: 9 months (Between 250th-290th days)
Full Follow-Up of Child: A child should be followed 7 times until the age of 6 years. The child who has been followed At least 7 times in the determined period and time intervals is considered to be fully followed.
Child follow-up period and time intervals;
1. Follow-up: 12 months follow-up (Between 365th-394th days) 2. Follow-up: 18-month follow-up (Between 481th-570th days) 3. Follow-up: 24-month follow-up (Between 661th-760th days) 4. Follow-up: 30-month follow-up (Between 841th-930th days) 5. Follow-up: 36 months follow-up (Between 1.021th-1.110th days) 6. Follow-up: 48 months follow-up (Between 1.321th-1.530th days) 7. Follow-up: 60-month follow-up (Between 1.681th-1.890th days)
Mortality
Morbidity
FactorsRisk
Prevention of Diseases and Protection of
Health Global Burden of
Diseases 2019 Turkey
Results
Health Care Facilities and Infrastructures
Utilization of Health Care
Services
Pharmaceutical Statistics
Human Resources for
Health
Health Economics and Financing
Emergency