Identifying and Prioritizing Causes of Informal Payments for Healthcare in Türkiye

Objective Understanding the determinants of informal payments can help policymakers identify appropriate policies and increase the effectiveness of health systems. However, very few studies address this topic in Türkiye. This paper aims to identify and prioritize the causes of informal payments for healthcare to provide accurate information for policymaking and resource allocations. Methods 21 sub-factors were determined and divided into four main factors. Analytical Hierarchy Process was used to determine the relative importance of the factors and sub-factors. Pair-wise comparisons were carried out by eight participants, which consisted of scholars, medical doctors, and health managers. Results The most important cause of informal payments was found to be “healthcare provision-related factors”. The overall weights of other sub-factors provide evidence that the monopoly power of some doctors, insufficient payment to providers, search for more quality healthcare by patients, and public belief that informal payment is inevitable are prominent determinants of the burden of informal payments. Seeking quality of healthcare and a common belief that informal payment is required to receive desired services are important causes of informal payments. Conclusion Policymakers and managers must reconsider the quality and effectiveness of healthcare provision and improve the payments to health staff. Public awareness should be increased to make individuals adopt their health-related rights.