7.6 Mechanisms of early detection and signposting of young people facing health risks
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According to the Statutory Decree on the Organization and Duties of the Ministry of Health and Affiliated Institutions (Sağlık Bakanlığı ve Bağlı Kuruluşlarının Teşkilat ve Görevleri Hakkında Kanun Hükmünde Kararname); concerning the early detection of health risks, predicting their status, and intervening when necessary:
The General Directorate of Health Services is responsible for planning all kinds of protective, diagnostic, curative and rehabilitative health services, carrying out technical arrangements, setting standards, classifying these services and service providers, and having the related works and procedures carried out.
The General Directorate of Health Development is responsible for the protection and improvement of public health, reducing the disease risks, preventing the diseases, and developing warning, informative and educational programs for more efficient use of diagnostic, curative and rehabilitative health services or having them developed.
The Strategic Plan of the Ministry of Health (Sağlık Bakanlığı Stratejik Planı) accepts preventive health services as a basic component of the plan, and sees the mitigation of risks and prevention of diseases as the basis of service provision. With a view to ensuring early diagnosis of diseases and detecting the risk factors in order to improve health services for young people and all other citizens, the Strategic Plan of the Ministry of Health (Sağlık Bakanlığı Stratejik Planı) has adopted the following policy measures and objectives:
- To combat and monitor communicable diseases and risk factors
- To reduce and monitor the incidence of non-communicable diseases and risk factors
- To strengthen the surveillance system for early diagnosis and management of communicable diseases
- To improve and expand the scope of cancer screening programs
In the framework of the Family Training Program (FTP) (Aile Eğitim Programı (AEP)) conducted by the General Directorate of Family and Community Services under the Ministry of Family and Social Policies, a book titled “Risk of Drug Usage and Protection from Drug Addiction” for parents was printed and delivered to the governorates in 81 provinces. A training for trainers was held on November 17, 2014 in order to give priority to the module titled “Risk of Drug Usage and Protection from Drug Addiction”. In the context of FTPs, “Risk of Drug Usage and Protection from Drug Addiction” training was provided to 19,873 people in 2015.
Anka Child Support Program: The Psychosocial Support and Action Program (Psikososyal Destek ve Müdahale Programı) implemented at Child Support Centers was launched in December 2014 by providing applied training to the professionals in charge of implementing the program; and informative training as well as “training of trainers” to the managers of these centers. In 2015, Practitioner Training as well as Trainings on Personal Interviewing Techniques and Working with Families were provided to the counselors who started working at Child Support Centers without receiving any training. And accordingly, the training activities covered under the project were completed. Anka Child Support Program is aimed at minimizing the impacts of trauma suffered by children who have been driven into crime, victimized, or exposed to social dangers on the streets; and help them become individuals who think, improve, believe in themselves and success, improve their life skills, intellectual capacity and quality of life and live in peace and harmony. The Anka Child Support Program, which aims an all-purpose approach and action, consists of the following components: Individual Needs and Risk Assessment Form, Supportive Environment Components, Group Works, Individual Counseling, Family Works, Principles of Approach for Supportive Staff, and Institutional Approach to Crisis Management. Each child accepted by the center is asked by the counselor, who is assigned for the respective child, to fill in the individual needs and risk assessment form in the first 10 days. This form is used for defining the content of the psychosocial support program to be applied to the child. Information collected through the form includes how and why the child has come to the center, the child’s educational background, economic status of the family, the place where he lives, friend relationships, physical status, psychological status, drug usage status, abuse status and status about being driven to crime, personal characteristics, behavioral problems, and family characteristics. According to the needs and risks identified by evaluating the form, group works and individual counseling services are provided to the child and his family.
In addition, the Guide on the Diagnosis and Treatment of Drug Addiction issued by the General Directorate of Health Services under the Ministry of Health covers a lot of mechanisms and methods about early detection methods.
With a focus on improving and protecting the health of the society living in their respective neighborhood, community health centers are health centers that define the health-related risks and problems; make plans to overcome these problems; implement these plans and have them implemented; organize primary preventive, curative and rehabilitative health services under the management of the directorate; monitor, evaluate and support the effective provision of these services; and ensure coordination between the health institutions and other institutions and organizations in their area of responsibility.
Community health centers have been established in all districts (at least one in each district) including the central districts, under the supervision of the respective health administration in the district. These centers carry out the relevant examinations and tests in the context of family physicians implementation. In addition, they also provide other primary healthcare services that are beyond the duties of family physicians. Thus, primary healthcare services other than the protective health services, diagnosis, treatment and rehabilitation services addressing the individuals have been compiled under a single umbrella and this allows the provision of more effective and efficient services.
Community health centers provide coordination both among family physicians and with other institutions for the works, which have an individual and social aspect, conducted at family health centers (infant and pediatric health, obstetrics and follow-up of mothers after birth, vaccination, family planning, etc.). They detect the potential disruptions that may occur with regard to following up of patients directed by family health centers to secondary level health institutions; receiving feedback from secondary health institutions; and evaluating these feedback. Then they eliminate such disruptions if there are any. They cooperate with the relevant public and private institutions as well as civil society organizations in all levels of service.
Community health centers collect on a regular basis the printed or electronic data used by family physicians as official records or documents, and communicate them to the directorate in a timely manner. They monitor and evaluate the works conducted by the family health centers in their respective area of responsibility. In this context, they monitor and evaluate the works conducted by family physicians serving in these centers, through site visits and the records kept by the physicians. With this aim, they visit family health centers, access all records, and every six months, they communicate the results of their evaluations to the directorate in writing, and to the family health center staff preferably in writing or verbally. When carrying out this duty, they act in compliance with the principles about patient rights and the protection of personal privacy.
In line with the programs conducted by the Ministry of Health, they collect the data about communicable diseases in their respective areas of responsibility, keep their records, evaluate them, carry out surveillance or have it carried out, and cooperate with relevant institutions for the taking of all related measures. They carry out filiation and duly notify the family physicians about the communicable diseases in their respective areas of responsibility, and evaluate the situation together with the family physicians. If the family physician is registered under a different community health center area, then the result of the filiation carried out is communicated to that community health center.
As in all other sectors, stakeholder analysis has become a significant component of strategic management activities also in the health sector. In the Strategic Plan of the Ministry of Health 2013-2017 (2013-2017 Sağlık Bakanlığı Stratejik Planı), which is the basic policy document in the field of health, has defined the respective stakeholders and responsibilities for each of the policy measures and objectives set forth in the document. This plan serves as a guide for all related stakeholders.
The National Youth and Sports Policy Document (Ulusal Gençlik ve Spor Politikası Belgesi) has set forth the policy measure of “Extending the measures for the protection of young people from harmful habits such as smoking, drug addiction, alcohol etc.” and the targets defined under this policy measure cover all young people who are at risk of drug addiction and who have a tendency to become smokers or alcohol addicts.
In the context of the Youth Projects Support Program of the Ministry of Youth and Sports, civil society organizations, which are operating in the field of fight against addiction and addressing the young people at risk, are supported and these grant supports are funded by the general budget. Youth centers and youth camps under the Ministry of Youth and Sports have been continuously organizing Seminars on the fight against addiction, and these events are also funded by the general budget.