Country Report of Turkey

COUNTRY REPORT OF TURKEY

FOR

THE FIFTH ASIAN AND PACIFIC POPULATION CONFERENCE

Introduction

Turkey, as a European, Balkan, Black Sea, Mediterranean and Middle East country and as a country occupying a unique position in its region, has been taking the necessary steps to adapt herself to the new world order by achieving radical improvements with regard to her economic and social structure and by taking part in internationally agreed documents.

Population growth rate of Turkey, which was above 2 percent until the year 1990, displays a decreasing trend in recent years. According to the 2000 Population Census, the population of Turkey is estimated to be 70.3 million at the end of the year 2002 with an annual growth rate of 1.48 percent. Birth rate and infant mortality rates are decreasing at a considerable level. Interprovincial migration appears to be the most outstanding population problem of Turkey.

The interrelation between “population” and “development” has gained a new dimension reflecting the effects of globalisation, democratisation, participation and higher emphasis on the quality of life, human rights and poverty. These two basic concepts have been taken as main pillars of the development strategy in planning process in Turkey.

In fact, Bali Declaration on Population and Sustainable Development, the ICPD Programme of Action and Key Future Actions adopted by High-level Meeting (ICPD + 5) have similarities with the Five-Year Development Plans, which Turkey has been implementing since 1960s. The population policies are taken both implicitly and explicitly as an integral part of sectorial plans within the context of Turkish development planning. These sectorial plans specify the objectives, strategies and programmes designed to influence the key elements of population change in the country. Therefore, population concerns are integrated in all policies and programmes relating to sustainable development.

The basic purpose of development is enhancing the level of individual well being. In order to assist in the realisation of this aim, measures and programmes directly or indirectly affecting population variables, such as the size of population, growth rate, distribution and quality become integral parts of the population policy. Therefore, a population policy has the feature of being integrated with social development policies.

Population policies, while respecting fundamental human rights and the responsibilities of individuals and families, gained a perspective encompassing our responsibilities for future generations. Adoption of an approach, that emphasises the interaction between population, resources, environment and development, has become the cornerstone of sustainable development.

In the Eighth Five-Year Development Plan that encompasses 2001-2005 period, basic population policy is to improve quality of life with respect to health, education and human resources, and alleviate regional disparities to reach a balanced and sustainable development.

1. Overview of the population and development situation and prospects, with special attention to poverty

Turkey is currently the most populous country of the Middle East and is among the most populous 20 countries of the world. In 1990, the Population Census had established a population of 56.5 millions. The latest population census in 2000 puts Turkey's population at 67.8 millions, indicating an annual growth rate of around 18 per thousand for the 1990-2000 period. These figures imply that the country's population has increased more than five times since the establishment of the Republic in 1923.

Subsequent to discussions in the 1960s on problems regarding the environment, population, economic development and future safety, and the declerations about the need for international policies in these areas, the concept of sustainable development emerged as a new objective to solve these problems at the local, national, regional and global levels. Relative to this development the international community has also started a new process of debating the relationship between poverty, population and sustainability.

Turkey does not face a problem of absolute poverty by the standards of a developing country. However, indicators of living standards and economic opportunity describe a country which despite substantial progress, still faces a steep challenge in bringing the great majority of its poor and economically vulnerable population into the economic mainstream. Progress in reducing poverty, while significant, has been uneven. The data also reveal disparities within the country, between urban and rural areas, between prospering regions and impoverished ones. Poverty in Turkey affects mostly specific groups of the population whose ability to participate in economic progress is handicapped. Education, employment and earnings opportunities are key determinants of poverty risks.

Poverty alleviation and effective social protection of vulnerable persons and groups are important policy issues stressed both in the five year development plans and in the government programmes. There are earnest efforts for creating both legal and institutional structures for poverty related issues in Turkey. Many organisations have been created, in particular the Social Solidarity Fund and The General Directorate of Social Services and Child Protection, which form the institutional structure of efforts to combat poverty. Regional development programmes the Southeastern Anotolian Project, The General Directorate of Women Status and Problems, which aim to contribute to solution of gender discrimination problems and The Administration for Persons with Disabilities, which gives support to persons with disabilities to enable their participation in the society as active and productive individuals, can also be added to this institutional structure.

However, in practice, combatting poverty generally takes the form of expost interventions and little is done to address the causes of poverty and unequal distribution of income. Almost all efforts are geared towards alleviating effects of these disparities and poverty. Although succesfull projects have been developed in this regard, the fact that the causes of these problems can not be eliminated without making structural changes, is not given full recognition.

While the number of persons that can be classified under “absolute poverty” line is low in Turkey, income ditribution is extremely skewed, and thus, “relative poverty” exists as a significant problem. According to the research study on income distribution conducted in 1994 and the analysis made in the following years:

(a) About 2.5 percent of the population has a daily income less than US$ 1.

(b) While the share of income of the poorest 10 percent of the population is 2.3 percent, the share of the richest 10 percent is 32.3 percent. The GINI coefficient of Turkey is about 45 percent, which indicates an income distribution far from being equal.

(c) If access to minimum nutritution per capita is taken the variable to indicate poverty, there are disparities both between rural and urban areas and among regions.

As there has not been any study on income distribution after 1994, there is no reliable information on where Turkey today stands in terms of income distribution and poverty.

In connection with the relationship with the nutrition and health, sinificant nutritional problems are observed which are thought to be largely related to poverty. The fact that a portion of the population can hardly afford the foodstuffs that are the basic sources of nutrition and important for a balanced diet unavoidably lead to health problems that burden the society with new cost.

The situation of education and health services also provides additional information on poverty in Turkey. Although importants progress has been made since 1992, Turkey lags behind countries at a similar level of economic development in terms of the indicators listed below. The gaps between these and the European average are even larger.

· Life expectancy at birth is 69 years.

· Infant mortality rate is 38 per 1000 live births.

· The ratio of underweight children under age six is about 10 percent.

· The ratio of births not attanded by health staff is about 20 percent.

· The estimated number of persons with disabilities varies between 3 to 7 million persons. Some of these disabilities are the type of disabilities that could have been prevented with timely and correct interventions.

· The share of total health expenditure in GDP is 3.5 percent.

· The share of total expenditure on education is 2.5 percent

· The ratio of adult illiteracy is 13 percent, the ratio being 20 percent for women.

Turkey is ranked 85th among 174 countries according to the Human Development Index of the year 2000, based on 1997 data. The Human Development Report also indicates there are serious regional differences.

When we look at the functional income distribution on the other hand, despite the fact that the productivity of labour (total value added/average number of workers) has been steadily increasing since 1980, the real wages of workers did not increase parellel to the increase in productivity and remained mostly stable.

The unemployment rate has grown considerably, particularly during the last economic crisis. The current official unemployment rate of 10 percent is expected to result in social problems and increased poverty both in the short and long terms. In addition to this, a large section of the labour force is either employed as family workers or in the informal sector, and thus, does not have social security.

The informal sector is believed to have a considerable weight in Turkey. Studies on the informal sector have shown that the children working in this sector do not receive the education they need. The uneducated child labourers, mostly working under sub-standards working conditions, are also important with respect to poverty. According to 1999 data, although the number of working children aged 6-17 was lower than previous years, it still stood around 1.6 millions.

Poverty is the most significant factor reinforcing child labour. On the other hand, child labor may cause poverty to become permanent. Children who are affected by the unhealthy conditions of their working environments, are debilitated at an early age and can not work productively in their adult years. Since they miss schooling for professional training, they have to continue working as unskilled labourers in their adult lives.

It can be argued that, all these problems are largely related to high fertility rates of the recent decades. While the population growth rate of Turkey are declining, history of high fertility rate puts extra pressure on society.

The Eighth Five-Year Plan addresses following issues as the main objectives for eradication of poverty;

· The main principle will be to implement economic and social policies in harmony which aim at increasing economic growth, eliminating absolute poverty, alleviating realtive poverty and approximating the income of the poor segment to an average welfare level.

· The transfer system will be restructured with a view to ensuring a more effective redistribution of income to the poor or those who are at the poverty line.

· In order to alleviate disparities among regions, along with economic investments, investments on education, health and social services shall be increased.

· Social services and social assistance systems shall be made more accessible to the poor population. Local administrations, private sector and NGOs shall be encouraged to be more efficient in programmes combatting with poverty in collaboration with public institution.

2. Fertility levels and trends, and their implications for reproductive health, including family planning programmes

The latest estimate of the total fertility rate (TFR) comes from the 1998 Turkish Demographic and Health Survey (TDHS), referring to 1996-1998 period, at 2,6 live births per woman. The long-term trend of declining fertility, which began in the 1950s, and accelerated after 1970s, when the TFR was about 5 children per woman and continued until the early 1990s, declining to 2,6 births, is estimated to reach replacement level by 2015.

Current fertility is characterised by significant regional and urban-rural differences. While TFR is at replacement level in the Western region, it is still as high as 4,2 in the East, according to the 1998 TDHS. There is also considerable difference in the fertility of women in urban and rural areas (2,4 versus 3,1). From the standpoint of the national trend, the weight of the high fertility areas is declining due to out-migration and the weight of low fertility areas is rising due to in-migration. Thus, the national decline of fertility is reinforced by a process of selective internal migration and population redistribution.

While marriage remains as a universal social institution and celibacy is very rare, Turkish women marry at moderately late ages. Age at first marriage was around 23 for females and 26 for males in 2000. Latest estimates show that women aged 25-29 married at a median age of 20.4, and had their first births at the median age of 22.2, indicating some control of fertility even at early stages of marriages.

Turkish Governments diverted from traditional pro-natalist population policy due to medical problems and high maternal mortality caused by illegal abortions in 1965 with a legislative reform. During the1980s, the government considered revising the existing population planning law in order to meet the needs of the families on a more comprehensive scale. A new population law was accepted in 1983. The new legislation authorised non-physicians to insert intra-uterine devices (IUD), legalised surgical contraception and abortion and permitted general practitioners to terminate pregnancies. According to the new law, intersectoral collaboration was also emphasised for successful family planning services. Since then, Turkey has had one of the most comprehensive and liberal population planning legislation, which means that there is no legal barrier in the country to practice family planning.

Fifty five percent of the female population consists of women in reproductive age whereas children under 15 years of age constitute 35 percent of the total population. Overall contraceptive prevalence is 63 percent for families in reproductive age. User prevalence of modern methods is 35 percent. Overall, the recent change seems to have been characterised by an increase in the overall contraceptive use in rural areas and decline in the use of traditional methods, especially in the urban areas. Male involvement in family planning, together with reproductive health care activities for adolescents need to be improved and expanded.

Induced abortion ratio is 17,9 in 100 pregnancies. Unmet need in family planning, which is the proportion of women who do not want any more children but at the same time who are not using any method is 12 percent. The infant mortality rate has been declining steadily over the years, but it is still high with a number of 43 per thousand in 1998.

There are 1.5 million births per year, 63 percent of pregnant women receive antenatal care, and 76 percent of deliveries is assisted by health personnel while 24 percent are helped by traditional birth assistants. Proportion of families who do not want further children is 70 percent. Twenty-seven percent of deliveries during the last five years were the results of unwanted pregnancies. Sixty-eight percent of women in reproductive age carry at least one of the following features which are risk factors for pregnancy: age under 20 or above 35; having 5 or more pregnancies; having 2 years or less pregnancy interval.