Supply Chain Vulnerability in Health Systems: Management of Medical Supplies Import Dependency in Türkiye

This study examines the evolution of Türkiye's dependence on imported medical products and its association with health supply vulnerability from 2002 to 2024. Guided by Resource Dependence Theory, a Health Supply Vulnerability Index (HSVI) was constructed from three dimensions: import dependency, exchange rate sensitivity, and financial pressure. Medical imports were converted from U.S. dollars to Turkish lira before the import-dependency ratio was calculated; public health expenditure and gross domestic product were expressed in compatible units; and all three indicators were transformed to a common 0-1 scale using Min-Max normalization. The normalized indicators were aggregated with equal weights, and robustness was examined using three alternative weighting schemes together with Pearson, Spearman, Kendall, absolute-deviation, and rank-stability measures. The HSVI reached its highest value in 2022 (0.640), followed by 2021 (0.612) and 2020 (0.551). These results identify periods of comparatively greater exposure to import dependence, exchange-rate movements, and fiscal pressure; they do not establish causal effects or directly measure product shortages. The findings also have policy implications, highlighting the need to strengthen domestic production capacity, establish strategic stock mechanisms for critical medical products, diversify suppliers, and develop adaptive supply management strategies to enhance the resilience and sustainability of Türkiye's health system during economic and global supply chain crises.