Municipal home health and care services: Current situation analysis and model suggestion for Türkiye

The aim of this study is to provide information about the provision and content of home healthcare and caregiving services implemented both in Turkey and globally; to analyze the strengths and weaknesses, as well as the opportunities and threats faced by municipalities—which are the most essential components of local administrations in Turkey—in delivering these services; and to offer recommendations based on a comparative examination of international practices. Home healthcare and caregiving services provided by municipalities are critically important for groups that face difficulties in accessing healthcare services, such as individuals aged 65 and above, those with chronic illnesses, persons with disabilities, and bedridden patients. The population of the study consists of 15 metropolitan municipalities selected from among the 30 metropolitan municipalities in Turkey that offer home healthcare and caregiving services. Among these, 11 metropolitan municipalities agreed to participate in the study. For data collection, interviews—one of the qualitative research methods—were employed. A semi-structured interview form was developed to identify descriptive characteristics, assess the current state of home healthcare and caregiving services, determine the strengths and weaknesses of the process, and identify opportunities and threats. The collected data were subjected to content analysis. The data were thematically categorized and coded using the NVIVO software. According to the analysis results, the most prominent weaknesses in the process are regulatory limitations and insufficient financial support. On the other hand, the strongest aspects are the municipalities' ability to establish direct contact with citizens and the fast accessibility of services by individuals. One of the main challenges faced by municipalities is the high demand for services coupled with the shortage of adequately trained personnel. Based on the data obtained from participants, best practice examples, literature review, and international applications, the study proposes a model for effective and sustainable home healthcare and caregiving services provided by municipalities. In conclusion, municipalities must be supported, monitored, and empowered by the central government in delivering these services. Equipping municipalities with the necessary capabilities and ensuring the sustainability of these services is of vital importance for the future of Turkey's healthcare system.