Inequalities in Reproductive, Maternal, Newborn, and Child Health in Turkey: An Analysis of the Demographic and Health Survey Series

Objective: This study aimed to examine trends in health inequalities by place of residence and household welfare using data from the Turkey Demographic and Health Survey. Methods: Absolute and relative inequalities were calculated using the methods recommended in the WHO Health Inequality Monitoring Handbook, which focuses on low- and middle-income countries. Absolute inequality is the difference between the two subgroups and relative inequality is the ratio between the two subgroups. Inequalities in the field of child, reproductive, and women's health were measured using simple measurement methods recommended in the WHO Health Inequality Monitoring Handbook. To examine changes in health inequalities across household welfare levels and rural-urban residence, we used data from the 2008, 2013, and 2018 Turkey Demographic and Health Surveys. Results: Living in rural and low-income areas has been found to be predominantly disadvantaged. Increased inequality in child vaccination and the use of modern contraceptive methods has been seen by wealth level. Increases in inequality were found in indicators such as adolescent pregnancy, violence against women, years of education for women, and low birth weight, both by wealth level and by residence. However, inequalities in prenatal and postnatal care and the percentage of children receiving all basic vaccinations by residence have decreased, and rural areas have even become more advantaged. Conclusion: Policies targeting rural areas and low levels of welfare are needed to reduce health inequalities. While addressing disadvantaged groups to reduce inequalities is necessary, urban areas are at higher risk for childhood obesity and exclusive breastfeeding. Interestingly, these groups have higher wealth levels and should be selected as the target group for intervention. The findings suggest that the programs implemented in our country are effective in reducing inequalities in some indicators.