The Turkish health system in transition: family planning in the case of Istanbul

Abstract

This thesis focuses on the institutional history of family planning in Turkey and the ways in which it was shaped as part of larger official, international and academic discourses. The thesis provides a historical background on the period starting with the end of the 1960s and coming up to 2012, but it specifically focuses on the changes that took place after the transition in the health system in 2003 until March 2012. Family planning has been used for different purposes under changing socio-economic circumstances from the establishment of the Turkish Republic until the present day. The state policy has utilized family planning for promoting reproduction, thus maintaining a certain population growth in the early decades of the Republic, while the emphasis has changed over time from a pronatalist policy to anti-natalist policy making, especially after the 1960s. In the 1960s mainly the developmentalist perspective and Neo-Malthusian approach were dominant in policy-making. To the developmentalist approach, demographic concerns such as uncontrolled population growth, urbanization, and immigration were added during the 1970s. When the 1980s arrived, the concern with health moved to the center in the family planning. In the 1990s, the rise of human rights discourse on the global scale caused reproductive health to gain further importance. Family planning began to be conceived as a part of reproductive health. In neither of these periods were feminist sensitivities and gender specific considerations not granted their due importance. During the first decade of the 2000s, the emphasis on family planning declined in the state discourse. This was a result of the transformation in the health system initiated by the AKP regime, characterized by a neoliberal attitude to health services, in accordance with the world-wide trends.