A person-list-based family medicine model was introduced in Turkey during health care reforms. This study aimed to explore from primary care workers’ perspectives whether this model could achieve the cardinal functions of primary care and have an integrative position in the health care system.

The Turkish government has implemented several reforms to improve the Turkish Statistical Institute Death Reporting System (TURKSTAT-DRS) since 2009. However, there has been no assessment to evaluate the impact of these reforms on causes of death statistics. This study attempted to analyse the impact of these reforms on the TURKSTAT-DRS for Turkey, and in the case of Izmir, one of the most developed provinces in Turkey. The evaluation framework comprised three main components each with specific criteria. Firstly, data from TURKSTAT for Turkey and Izmir for the periods 2001–2008 and 2009–2013 were assessed in terms of the following dimensions that represent quality of mortality statistics (a. completeness of death registration, b. trends in proportions of deaths with ill-defined causes). Secondly, the quality of information recorded on individual death certificates from Izmir in 2010 was analysed for a. missing information, b. timeliness of death notifications and c. characteristics of deaths with ill-defined causes. Finally, TURKSTAT data were analysed to estimate life tables and summary mortality indicators for Turkey and Izmir, as well as the leading causes-of-death in Turkey in 2013. Registration of adult deaths in Izmir as well as at the national level for Turkey has considerably improved since the introduction of reforms in 2009, along with marked decline in the proportions of deaths assigned ill-defined causes. Death certificates from Izmir indicated significant gaps in recorded information for demographic as well as epidemiological variables, particularly for infant deaths, and in the detailed recording of causes of death. Life expectancy at birth estimated from local data is 3–4 years higher than similar estimates for Turkey from international studies, and this requires further investigation and confirmation. The TURKSTAT-DRS is now an improved source of mortality and cause of death statistics for Turkey. The reliability and validity of TURKSTAT data needs to be established through a detailed research program to evaluate completeness of death registration and validity of registered causes of death. Similar evaluation and data analysis of mortality indicators is required at regular intervals at national and sub-national level, to increase confidence in their utility as primary data for epidemiology and health policy.

Background: Occupational pesticide poisoning is an important public health concern worldwide, especially in developing countries. Objectives: This study was aimed at determining the prevalence and risk factors of acute pesticide poisoning (APP) among the vegetable and fruit farmers in Karacabey District in northwest Turkey. Methods: The study group consisted of 565 farmers. The dependent variable of the study is APP defined according to the World Health Organization’s APP case definition matrix. The study’s independent variables are the farmers’ sociodemographic characteristics and the preventive measures they use when they are applying pesticides. The chi-square and logistic regression analysis analyzed the relationship between the dependent and independent variables. Results: A total of 64 (11.3%) farmers reported APP and 75% of them presented to a health institution due to symptoms. The factors associated with increased risk of APP were: illiteracy (odds ratio (OR)=2.5), 14 years and less farming experience (OR=3.3), not reading the pesticide labels (OR=6.4), and contact with liquid pesticides (OR=2.3). ­Conclusions: The study shows that approximately one out of ten farmers experience APP. Training programs should be planned and monitored to improve farmers’ awareness of the dangers of pesticides, and they should be encouraged to adopt and implement protective measures.

Background: Cervix, breast and colorectal cancers are included in the national population-based screening (PBS) program in Turkey. This study aimed to assess participation in PBSs for these cancers and to identify factors associated with participation in screenings in Safranbolu district of Karabuk, Turkey in 2016-2017. Methods: In this cross-sectional study, separate studying groups for cervix, breast and colorectal cancers were identified, taking into account the target age range specified in the national screening standards. The sample size was determined to be 374 for cervical cancer, 371 for breast cancer and 373 for colorectal cancer in the Epi-Info StatCalc program with a prevalence of 50%, a 95% Confidence Interval (CI) and a 5% error margin. The results of the data collected through face-to-face interview using questionnaires were evaluated with Chisquare tests (P<0.05) and included in the binary logistic regression model. Results: Participation in PBS at least once between 2011 and 2016 years was 26.2% for cervical cancer, 27.6% for breast cancer and 31.6% for colorectal cancer, whereas the level of PBS or opportunistic screening at least once was 51.1%, 42.7% and 32.2%, respectively. A 2.9-fold increase in participation for the cervical cancer screening was associated with informing women about cervical cancer by the family physicians. Being married and living in the district center showed associations with a higher rate of participation for colorectal cancer screening. Conclusion: Participation in PBS was low for the 5.5-year period. More effort is needed to increase the effectiveness of the program.

Objective: To evaluate the access of married women of reproductive age to family planning (FP) services and associated factors in Karabuk. Method: This cross-sectional study was conducted in Karabuk in 2015-2016. The population of the study was married women living in Karabuk. The sample size was calculated by the Epi-Info-7 StatCalc software as 284, within a universe of 34,207 married women of 15-49 age group, with a confidence interval of 95%, a margin of error of 5% and a prevalence of 75.2% (prevalence of women in the Western Black Sea Region of Turkey using any contraceptive method - 2013 Demographic and Health Survey of Turkey), and it was planned to reach 300 women. The sample was distributed proportionally by the populations of residential areas. Data was collected through face-to-face interviews. In the analysis of data, Chi-Square Test and binary logistic regression were applied. Results: Of all the women, 80.3% were found to use some form of FP method. More specifically, 48.6% were found to use modern methods, while 31.7% were found to use traditional methods. The three most common methods were coitus-interruptus (31.0%), condoms (18.3%) and tubal-ligation (16.0%). The unmet need for FP was found to be at 9.7%. Conclusions: This study shows that traditional FP methods are widely used to prevent pregnancy and that the FP needs are not met for one in every ten women in Karabuk. To remove the barriers in accessing FP services, comprehensive primary care which focuses on the needs of the community is needed.