Abstract
Motivation
Turkey has been acknowledged as a “successful” example of Universal Health Coverage (UHC) reforms and has recently gained donor “darling status.” While the literature on UHC and health reforms in various countries has increased significantly in recent years, there is still little research on the political dynamics of the rise of UHC in national and global development agendas.
Purpose
This study examines the politics of UHC in Turkey’s Health Transformation Program (HTP). It investigates how various policy actors, such as international organizations, policy experts and national political leaders, use UHC framing for different purposes.
Approach & Methods
The article develops an interdisciplinary conceptual framework that combines elements of ideational scholarship and critical policy analysis. The analysis is based on a review of the secondary literature and primary sources. Qualitative content analysis is used to identify major themes and analyse patterns of interactions across the various policy levels.
Findings
The article’s main findings demonstrate the ways in which international actors and national policy‐makers engage in policy work and use their relationships, global policy ideas and experiences to build legitimacy and support for their respective agendas. Reforms in Turkey were proposed and implemented before the rise of UHC in the global agenda, suggesting an ex post facto rebranding of its reforms as UHC. For Turkey’s policy‐makers, rebranding worked to tie their policy solutions, summarized in the HTP, to UHC as a widely accepted cultural symbol. The Ministry of Health’s deliberate strategy to encourage data collection and monitoring was also a key part of its efforts to construct a success narrative in collaboration with global policy actors. For the global‐level advocates of UHC, Turkey provided evidence that UHC works. Before it became a target under the health‐related Social Development Goals (SDGs), advocates needed to demonstrate that they had the right framing and metrics for a UHC agenda. After 2015, successful examples have served as strategic tools for building support and political momentum as the agenda was diffused, and as these diverse agendas and interests overlapped.
Policy Implications
This article contributes to the current debates on policy diffusion, translation and implementation of the UHC agenda. It unpacks the use of success stories to navigate the political dynamics among national governments and global policy communities. Success stories, alongside an emphasis on country ownership, may serve to encourage the co‐production of policy across local, national and global levels.