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Aim: To investigate the changes in the provision of preventive health services in terms of woman and child health after reorganization of the primary health care services., Background: The primary care system in Turkey has undergone fundamental changes as a part of Health Transformation Program during last decade. But there was no community-based study to evaluate these changes., Method: This community-based and cross-sectional study was conducted in 2010, just before the reorganization of primary care services and in 2015, five year after the reforms. The 30×7 cluster sampling method was used in Zümrütevler quarter of Maltepe District. The socio-demographic characteristics of the participants, the presence of the physician who can be consulted for any health problem, the presence of smokers at home were questioned. The women aged 18 years or older and gave consent provided information about history of pregnancy and birth, the number of follow-ups during pregnancy, family planning method usage, cervical and breast cancer screening, breastfeeding duration, vaccinations, and prophylactic iron and vitamin D supplementation for their children., Findings: After the reorganization of primary care, more people stated that they had physicians to whom they could consult for all kinds of health problems (27.8 versus 44.7%; P<0.001) and that physician was the primary care physician (30.2 versus 64.7%; P<0.001). The reported frequency of at least one smoker at home was decreased after reorganization of primary care (63.6 versus 53.1%; P=0.034). There were no significant differences in terms unplanned pregnancy, the use of family planning method, the number of pregnancy follow-ups and the frequency of Pap smears and mammography. There are no significant differences in terms of healthy children follow-ups, vaccination, vitamin D and iron supplementation (P>0.05). It was found that the duration of total breastfeeding increased after reorganization of primary care (P<0.001).

Aim: Family health centers (FHCs) are reimbursed for their current expenditures based on a classification of four clusters in Turkey. This study compared the coordination, comprehensiveness, continuity, accessibility, and the first contact of care among different reimbursement FHC groups. Methods: The data were obtained from the Turkish data of the Quality and Costs of Primary Care in Europe study. Data was collected in provinces from six geographical regions. Physicians and patients from Classes A and B FHCs were called the first group, and others were called the second group. Results: A total of 296 physicians and 2623 patients were enrolled. According to the reimbursement groups, 593 (22.6%) patients received services from the first group and 2012 (77.4%) patients from the second group. The first contact with care and the admission frequency of 3 or more in the last six months were higher in the first group (respectively, 99.2% vs. 97.7%, p=0.027; 55.4% vs. 49.6%, p=0.015). Conclusion: The reimbursement classification did not make a difference in coordination, comprehensive care, continuity, accessibility, and being the first contact of care. Therefore, the current classification does not contribute to improving the quality of primary care in terms of service provision. [ABSTRACT FROM AUTHOR]

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Aim: To investigate the effect of the BATHE therapeutic interview technique on the empowerment of diabetes mellitus patients in primary care.Method: A cluster randomised controlled study using the BATHE interview technique was conducted on diabetes mellitus patients in primary care. Physicians in the intervention group were trained in the BATHE interview technique and used it with their diabetic patients in addition to the usual care. In the control group physicians delivered only the usual care. A total of 112 diabetes mellitus patients who met the study criteria (57 intervention, 55 control) were included. Three interviews were conducted with the patients in both groups at the beginning, the 3rd and 6th months. The Diabetes Empowerment Scale (DES) was filled up at baseline and in the 6th month.Results: Due to some drop outs, the study finished with 44 patients in the control and 49 in the intervention group. According to an 'Intention to treat analysis' increase in the DES total score for the intervention group was higher than for the control group (Δ=10.56±8.97; Δ=5.64±7.36; p<0.001). Using multiple regression analysis, the BATHE intervention showed a significant predictor of the DES difference (B: 8.861; CI: 6.092-11.629; p<0.001).Conclusion: The use of the BATHE technique in primary care has a positive effect on the empowerment of diabetes mellitus patients. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore the breast-feeding profiles and the factors that affect breast-feeding and weaning attitudes among mothers of 0-12 month old babies in a baby-friendly primary care unit. Material and Method: The study was conducted in a Mother and Child Health Centre in ıstanbul in May-October 2006. All 364 mothers who were registered in the health centre were enrolled. A total of 358 mothers were included in the study. Results: The frequencies of breastfeeding initiation and of breastfeeding within the first hour were 98.9 %and 62.3 %respectively. Among the babies older than 6 months (n=200), 52.5 %were weaned before 6 months. Pacifier use (OR 3.01, 95 %CI: 1.35-6.69), being preterm (OR: 3.36, 95 %CI: 1.04-10.79), having a job (OR: 2.83, 95%CI:1.14-7.04) or smoking (OR: 2.27, 95 %CI: 1.01-5.14) werefound to be risk factors for early weaning. Conclusion: Although the frequency of initiating breastfeeding is very high, the continuation duration is below the World Health Organization (WHO)'s recommendations. Physicians and other health workers should strongly recommend against smoking during, prenatal and postnatal visits. Physicians should not support pacifiers, until we have sufficient data to support its benefits. In order to increase the duration of breast feeding, health professionals should focus on preterm babies, smoking or working mothers. [ABSTRACT FROM AUTHOR]