Employment of Syrian health workers

The project in brief

Implemented by

Turkish Ministry of Health (General Directorate of Public Health)

Country

Turkey

Duration

Almost 3 years

Description

Syrians registered in Turkey and provided with a temporary identity number may benefit, like Turkish citizens, from emergency medical, preventative and primary health care services free of charge. They also benefit from all curative health services in the provinces where they reside within the scope of the Healthcare Implementation Communique. It sets forth the principles and procedures regarding general health insurance beneficiaries' and their dependents' access to healthcare services funded by Social Insurance Institution, as well as the prices and fees determined by Healthcare Services Pricing Commission for healthcare services, medication and medical devices.

Those who have not received a temporary identity number are provided with limited services such as treatment against infectious diseases, immunization and emergency health services in accordance with the Temporary Protection Regulation.

This ensures that Syrians in Turkey can access services of all health facilities affiliated with the Ministry of Health.

However, the fact that the number of Syrians in Turkey exceeded three million and that they were scattered across the country caused a capacity problem. This was a challenge particularly in provinces already densely populated. Language and culture barriers also posed challenges.

As a result, in 2016 the Ministry of Health decided to employ, at its migrant health centres, doctors and nurses from the Syrians under temporary protection community.

This was in an effort to also increase access to health services and reduce the capacity gap.

As of 30 June 2019, 127 specialist physicians, 533 general practitioners and 901 midwives and nurses were employed.

Main activities of the Good Practice

Activity 1: Primary health care services

Primary diagnosis and treatment
Immunization
Pregnancy and Puerperant Monitoring
Baby and Child Monitoring
Micronutrient support (Iron and Vitamin D)
Cancer screening (Cervical Cancer, Colon Cancer and Breast Cancer screenings are carried out for the target groups and supported by mobile service)
Reproductive health
Psycho-social support
Health education

Activity 2: Employment of Syrian health personnel

Developing legislation
Receiving applications
Collecting and confirming authenticity of the documents
Undergoing interviews under the guidance of the related academics
Providing a five day theoretical training and six week practical adaptation training for those who are successful
Announcing the vacancies and recruiting the applicants while taking into consideration their preferences
Obtaining work permits
Starting the delivery of health services

Challenges and how they were overcome

Challenge 1: There were difficulties in collecting and standardizing the documents required for the inauguration of the health workers.

Solution: These difficulties were solved by ensuring effective coordination with the relevant general directorates and universities.

Challenge 2: Planning and conducting training for the healthcare workers

Solutions:

Technical and financial support was provided in cooperation with the World Health Organization (WHO).
Training materials have been developed through workshops attended by all relevant parties (the relevant technical departments of the Ministry, Turkish health workers providing services to the Syrians, international organizations, Syrian health workers, Universities).
Migrant Health Training Centres (MHTC) were established in seven provinces with the financial support of WHO for the implementation of practical training. The MHTC was developed to enable Syrian health workers to adapt to the Turkish Health System by providing practical training for them under the guidance of Turkish Health professionals. This was done after they successfully completed the interviews and theoretical trainings conducted by the Ministry of Health.
The theoretical trainings were provided by academics and adaptation training were conducted under the guidance of Turkish health professionals.
Financial support was provided for the health professionals during the six-week adaptation training.

Challenge 3: Challenges in obtaining work permits for Syrians to be employed.

Solutions:

The Directorate General for Migration Management (DGMM) enabled the change of province of residence.
Directorate General of International Labour Force of the Ministry of Family, Labour and Social Services facilitated the process of granting work permits for these particular cases.

Challenge 4: Salaries of the Syrian health professionals

Solution: Funding was provided by the EU.

Results of the Good Practice

Increased access to health services for Syrians under temporary protection.
Demand for primary healthcare services has increased.
The burden on hospitals has decreased.
It ensured that Syrian health professionals were able to continue practice their profession in Turkey and live in better conditions.