Maternal and Infant Mortality Health Crisis in Turkey

Introduction: Scope of the Health Threat

One of the most substantial health threats in Turkey is infant and maternal mortality. Unlike many diseases, this problem is universal — it can potentially affect any family, not just those in a certain area or with specific health risk factors. Turkey has an infant mortality rate of 42 per 1,000 live births, ranking it among the 30 worst in the world (Kaul and Tomaselli-Moschovitis 42). Additionally, 180 per 100,000 women in Turkey die during pregnancy, childbirth, or directly following delivery (Kaul and Tomaselli-Moschovitis 292).

The Ministry of Health and other expert organizations make clear that the concerns associated with infant and maternal mortality are universal. Women across many socioeconomic and regional groups are fundamentally unaware of the necessity for prenatal care, trained delivery assistance, and postnatal follow-up. Many areas of Turkey are also recognized as having limited access to basic health care ("Let My Baby Live" n.p.).

A national media campaign was launched in 2006 entitled "Let My Baby Live." It is described as "a joint project by the Ministry of Health and the European Union." The goal of the campaign was to utilize well-known and popular public figures to reach the public with information about the need to provide basic health care for women, ensuring that potential concerns could be detected and resolved before they resulted in the death of an infant or mother. In November 2007, the program held a press conference to announce the successful achievement of its primary goal: reaching 66% of the population in the targeted regions of Turkey with its message.

The 'Let My Baby Live' Media Campaign

The campaign was carried out in 16 provinces that have limited access to health care services and face regional disparities in health service delivery. Interviews and meetings were held with households, and mothers, adolescent girls, and young mothers in the 15–49 age group — as well as their relatives and husbands — were informed about the importance of medical check-ups before, during, and after pregnancy. Media institutions also broadcast informative advertisements and programs during popular women-oriented television productions ("Let My Baby Live" n.p.).

According to the experts behind the campaign, maternal and infant mortality are two of the largest social problems in the nation, compounded by the fact that many people are simply unaware of the need for pregnancy-related care. The value of informing women and their partners of this need is indispensable, particularly in regions that are already challenged for medical resources.

"Approximately 387 maternal deaths occur every year in Turkey and 62% of them are preventable, according to the data provided by the Health Ministry" ("Let My Baby Live" n.p.). Additional messages of the campaign stressed the need to avoid high-risk pregnancies — those occurring before age 18 or after age 35 — and to space pregnancies at least two years apart, allowing the maternal body to recover and be strong enough to sustain the developing infant and endure labor successfully. The campaign reports that it has been successful in reaching its stated goals, having reached 66% of the population in the provinces where it was launched. There is no mention of whether the campaign will conclude or be expanded to a broader national audience ("Let My Baby Live" n.p.).

This media campaign coincides with a broader movement in Turkey to develop an e-health system that will enable communications between doctors at different locations and provide patients with secure access to their own health information. This project has been sponsored by the Turkish Ministry of Health to develop a system that allows coordination between medical care providers in different agencies and hospitals, and to help empower patients by offering them greater access to health-related information ("E-Health Project in Turkey" n.p.).

This program could also play a vital role in improving infant and maternal mortality outcomes, as it offers an additional avenue for information sharing — particularly between hospitals, laboratories, and primary care physicians who may be in varying geographic locations relative to one another and to the patient ("E-Health Project in Turkey" n.p.). This trend toward modernization in the health care arena is relatively new in Turkey; previously, the country had been reluctant to alter traditional medical care practices and expand access to modern care (Brennan 210).

Traditional pregnancy care has historically been provided to women at a local level by trained or lay midwives — there is currently a significant shortage of trained, licensed midwives in Turkey (Weiker 259) — as well as through limited clinic care and hospitals where available. The prevailing standard practice has been to seek care only when the patient is aware of a problem, and usually only during labor. This approach can often leave women and children at risk, as intervention may come too late to resolve complications effectively.

E-Health Modernization and Traditional Care Practices

Turkey's example program could serve as a template for addressing other health issues that require public communication in Turkey and in other nations with challenged health care delivery infrastructures and limited public knowledge of needed care — both in pregnancy and in disease-related conditions. The need to redistribute medical care across geographical regions can be met to some degree through education, as has been seen in the e-medicine movement. Yet Turkey still faces many obstacles to effectively distributing basic and advanced medical care across the nation.

Additionally, women occupy a particularly challenged position when it comes to health care and other social issues. The traditional social order frequently places them in a role of subservience, and they are expected to fulfill traditional roles without question. Though this is slowly changing — and women have gained a somewhat stronger voice in education and government — traditional roles remain deeply intrinsic to the nation and its culture (Weiker 57).

If decisions were to be made about health care and the ongoing crisis of maternal and infant mortality in Turkey, the most effective step would be to expand the media campaign — through the existing cultural infrastructure — to include not only recognized underserved populations but the entire national population. Regardless of how widespread the belief may be that medical care is unnecessary during what seems like a natural human condition, modern medicine must continue to communicate that care can prevent or entirely avoid many tragic outcomes through simple, cost-effective means.

There are many cultural issues that affect women more than men but in turn affect the entire fabric of society, given that women constitute more than fifty percent of the population, live longer than men on average, and bear a significant share of the social burden in any nation. Broadening social awareness among both men and women about these issues — and about the need to change practices that are genuinely harmful, while carefully avoiding challenges to deeply held cultural or religious values — is both necessary and wise.