Data Envelopment Analysis on the Fulfillment of Right to Health for Syrian Refugees in Turkey

To withstand the increasing demand for health care services, the inflow of refugees from Syria into Turkey and other receiving states requires a robust efficient health care system tailored to refugees in Turkey. The guaranteeing of essential health care services, namely, the fulfillment of the right to health, is governed by a principle of international human rights law: progressive realization of the right, to the maximum of its available resources. Thus, the study evaluated the efficiency of the Syrian refugee health care system in Turkey, Lebanon, Jordan, Iraq, and Egypt from 2015 to 2018 by applying the data envelopment analysis (DEA) model. Two input variables: the number of trained health personnel and total health expenditure, and one output variable, the number of primary health consultations, were used. A qualitative analysis of the health care system structure of Turkey’s refugee health care was conducted to highlight its legislative and operational features. The findings identified that the realization of primary health care access for Syrians in Turkey was second most efficient among the major receiving states and exhibited a high, consistent level of efficiency in resource utilization, despite overwhelming demands due to the health of Syrian patients. Such performance can be attributed to the strengthening of the institutional and operational capacity building of health care facilities and personnel. DEA also suggested that certain countries such as Lebanon and Iraq are potential reference points to further evaluate health care system performance and its implication on future improvements. The study finally infers that the health care system in Turkey can fulfill the Syrians’ right to health by focusing its resources on enhancing the technical and operative aspects of the health care system on the basis of the observed augmentation in Turkey’s ability to fully use a greater scale of health expenditure and development of health workforce.