Uluslararası Öğrencilerin Sağlık Hizmetlerine Erişimi: Kurumsal Engeller ve Yapısal Çözüm İhtiyacı
Year 2025,
Volume: 14 Issue: Eğitim Bilimleri Ek Sayısı, 218 - 234, 23.10.2025
Madina Konakbayeva
,
Serra Sevde Hatipoğlu
Abstract
Yükseköğretimin küreselleşmesiyle birlikte uluslararası öğrenci hareketliliği artmış, bu da öğrencilerin sağlık hizmetlerine erişim sorunlarını daha görünür kılmıştır. Bu çalışma, sağlığın sosyal belirleyicileri (SDOH) çerçevesinde, sağlık sistemleri ve uluslararasılaşma politikaları farklı olan Türkiye ve Kazakistan’daki uluslararası öğrencilerin deneyimlerini karşılaştırmaktadır. Çeşitli disiplinlerden gelen 20 öğrenciyle (her ülkeden 10) yapılan yarı yapılandırılmış görüşmeler nitel karşılaştırmalı bir analizle değerlendirilmiştir. Bulgular, sağlık hizmetlerine erişimde beş temel engeli ortaya koymaktadır: ekonomik zorluklar, dil engeli, idari yetersizlikler, kültürel farklılıklar ve sağlık hizmetleri hakkında bilgi eksikliğidir. Türkiye’de devlet bursu alan öğrenciler kapsamlı sağlık sigortasına sahip olurken, kendi imkanlarıyla okuyan öğrenciler yüksek maliyetli özel sağlık sigortaları ve bürokratik engellerle karşılaşmakta ve kimi zaman tedavi için ülkelerine dönmektedir. Kazakistan’da düşük maliyetli özel sağlık sigortası yaygın olsa da öğrenciler dil engeli ve çeviri desteği eksikliği nedeniyle sağlık hizmetlerine erişimde güçlük yaşamaktadır. Her iki ülkede de sağlık hizmetlerine erişim konusunda yeterli oryantasyonun olmaması ve belirsiz prosedürler, öğrencilerin sağlık hizmetine ulaşımlarının geciktirmesine veya sağlık hizmetlerine erişmekten kaçınmasına yol açmaktadır. Bu araştırmanın sonuçlarıyla, sağlık hizmetlerine erişimde bireysel uyum süreçlerine kıyasla yapısal koşulların belirleyici etkisinin altı çizilmiştir. Eşitsizliklerin azaltılması için çok dilli bilgilendirme, kapsayıcı sağlık sigortası programları ve sağlık okuryazarlığını güçlendiren uygulamalar önerilmektedir.
Ethical Statement
“Uluslararası Öğrencilerin Sağlık Hizmetlerine Erişimi: Kurumsal Engeller ve Yapısal Çözüm İhtiyacı” başlıklı çalışmanın yazım sürecinde bilimsel kurallara, etik ve alıntı kurallarına uyulmuş; toplanan veriler üzerinde herhangi bir tahrifat yapılmamış ve bu çalışma herhangi başka bir akademik yayın ortamına değerlendirme için gönderilmemiştir. Gerekli olan etik kurul izinleri Ankara Hacı Bayram Veli Üniversitesi Etik Kurulu’nun 23.10.2024 tarih ve 11 sayılı toplantısında alınmıştır (Araştırma kodu: 2024/399).
References
-
Atun, R. Aydın, S. Aran, M. Gürol, I. Chakraborty, S. Akdağ, R. (2014). Health-care reform in Türkiye: far
from perfect. Lancet.
-
Balbus, J., Crimmins, A., Gamble, J. L., Easterling, D. R., Kunkel, K. E., Saha, S., & Sarofim, M. C. (2016). Ch. 1: Introduction: Climate Change and Human Health. The Impacts of Climate Change on Human Health in
the United States: A Scientific Assessment. The Impacts of Climate Change on Human Health in The United
States. https://doi.org/10.7930/j0vx0dfw
-
Beckfield, J. Olafsdottir, S. Sosnaud, B. (2013). Healthcare Systems in Comparative Perspective:
Classification, Convergence, Institutions, Inequalities, and Five Missed Turns. Annual Review of
Sociology 39, 1: 127-146.
-
Blouin, C. Chopra, M. van der Hoeven R. (2009). Trade and social determinants of health. Lancet 373:
5027.
-
Council of Higher Education. (2025). Internationalization strategy document in higher education
2024-2028. YÖK.
-
European Commission. (2013). Health inequalities in the EU Final report of a consortium. Consortium
lead: Sir Michael Marmot, Health and Consumers. Health Inequalities in the EU. https://doi.org/10.2772/34426
-
Hossin, M. Z. (2020). International Migration and health: It Is Time to Go beyond Conventional
Theoretical Frameworks. BMJ Global Health, 5(2). https://doi.org/10.1136/bmjgh-2019-001938
-
Lee, E. S. (1966). A Theory of Migration. Demography, 3(1), 47–57.
https://emigratecaportuguesa.wordpress.com/wp-content/uploads/2015/04/1966-a-theory-of-migration.pdf
-
Link, B.G. Phelan, J.C. (1996). Editorial: understanding sociodemographic differences in health-the role
of fundamental social causes. Am J Public Health. 1996;86:471-473.
-
Mackert, M. Koh, H.E. Mabry-Flynn, A. Champlin, S. Bea, A. (2017). Domestic and
International College Students: Health Insurance Information Seeking and Use. ISSN: 2162-3104 Print/ ISSN: 2166-3750 Online Volume 7, Issue 3 (2017), pp. 542-561 © Journal of International Students.
-
Masai, A. N., Güçiz-Doğan, B., Ouma, P. N., Nyadera, I. N., & Ruto, V. K. (2021). Healthcare services
utilization among international students in Ankara, Türkiye: a cross-sectional study. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06301-x
-
Ministry of Science and Higher Education of the Republic of Kazakhstan. (2025). Kazakhstan expands
support measures for education and youth employment [Review of Kazakhstan expands support measures for education and youth employment]. Kazakhstan expands support measures for education and youth employment - Official Information Source of the Prime minister of the Republic of Kazakhstan
-
Ministry of Health of Republic of Türkiye. (2008). Türkiye Sağlıkta Dönüşüm Programı İlerleme Raporu
[Progress Report on the Health Transformation Program in Türkiye]. Ministry of Health Publication No: 749.
-
National Center for Health Statistics. (2020). Healthy People 2030. WHO.
www.cdc.gov/nchs/healthy_people/hp2030/hp2030.htm.
-
Official Information Source of the Prime minister of Republic of Kazakhstan. (2024). Half-Year Results:
Development of Science and Higher Education, Research, and International Cooperation. https://primeminister.kz/ru/news/reviews/itogi-polugodiya-razvitie-nauki-i-vysshego-obrazovaniya-issledovaniya-i-mezhdunarodnoe-sotrudnichestvo-28837
-
Parliament of the Republic of Kazakhstan. (2025) Law of the Republic of Kazakhstan No. 405-V “On
Mandatory Social Health Insurance” (as of October 16, 1995). PARAGRAPH Information System. https://online.zakon.kz/Document/?doc_id=32908862
-
Phillips, S.P. (205 C.E.). “Defining and Measuring Gender: A Social Determinant of Health Whose Time
Has Come.” Int J Equity Health, 4, 1–4. www.cdc.gov/nchs/healthy_people/hp2030/hp2030.htm
-
Tang, C. Gui, X. Chen, Y. Magueramane, M. (2018). New to a Country: Barriers for
International Students to Access Health Services and Opportunities for Design. Pervasive Health 18, NY, USA Association for Computing Machinery.
-
Titrek, O. Hashimi, S.H. Ali, A.S. Nguluma, H.F. (2016). “Challenges Faced by International Students in Türkiye”, Anthropologist, 24(1): 148-156.
-
World Health Organization. (2008). Closing the Gap in a Generation: Health Equity through Action on
the Social Determinants of Health. WHO.
-
World Health Organization. (2017). World Health Statistics 2017: Monitoring Health for the SDGs,
Sustainable Development Goals. WHO.
Structural Challenges to Healthcare Access: A Comparative Analysis of International Students in Türkiye and Kazakhstan
Year 2025,
Volume: 14 Issue: Eğitim Bilimleri Ek Sayısı, 218 - 234, 23.10.2025
Madina Konakbayeva
,
Serra Sevde Hatipoğlu
Abstract
The globalization of higher education has increased awareness of healthcare access issues by expanding international student mobility. This study examines the experiences of international students in Kazakhstan and Türkiye, guided by the Social Determinants of Health (SDOH) framework as a guide. Twenty students from various disciplines participated in semi-structured interviews (10 in each country), and the results were analyzed using a qualitative comparative method. The study identifies five main obstacles to healthcare access: insufficient knowledge about medical services, administrative shortcomings, cultural differences, financial hardship, and language barriers. While self-funded students must endure expensive private insurance and administrative obstacles and occasionally travel back to their home countries for treatment, state-funded scholarship recipients in Türkiye benefit from comprehensive health insurance. In Kazakhstan, low-cost private health insurance is more common, but students frequently struggle with language barriers and the lack of translation support. In both countries, insufficient orientation and unclear procedures delay access to healthcare or discourage students from seeking it. These findings emphasize that structural conditions play a more decisive role in healthcare access than individual adjustment processes. The study suggests initiatives to improve international students' health literacy, inclusive insurance plans, and multilingual information provision as ways to reduce disparities.
Ethical Statement
During the writing process of the study titled “Structural Challenges to Healthcare Access: A Comparative Analysis of International Students in Türkiye and Kazakhstan” scientific, ethical, and citation principles were followed. No falsification was made to the collected data, and this study has not been submitted to any other academic publication medium for evaluation. In addition, permission was obtained from the Ankara Hacı Bayram Veli University of Ethics Committee (Date: 23/10/2024 and Meeting no: 11 and Research code 2024/399) to conduct the research.
References
-
Atun, R. Aydın, S. Aran, M. Gürol, I. Chakraborty, S. Akdağ, R. (2014). Health-care reform in Türkiye: far
from perfect. Lancet.
-
Balbus, J., Crimmins, A., Gamble, J. L., Easterling, D. R., Kunkel, K. E., Saha, S., & Sarofim, M. C. (2016). Ch. 1: Introduction: Climate Change and Human Health. The Impacts of Climate Change on Human Health in
the United States: A Scientific Assessment. The Impacts of Climate Change on Human Health in The United
States. https://doi.org/10.7930/j0vx0dfw
-
Beckfield, J. Olafsdottir, S. Sosnaud, B. (2013). Healthcare Systems in Comparative Perspective:
Classification, Convergence, Institutions, Inequalities, and Five Missed Turns. Annual Review of
Sociology 39, 1: 127-146.
-
Blouin, C. Chopra, M. van der Hoeven R. (2009). Trade and social determinants of health. Lancet 373:
5027.
-
Council of Higher Education. (2025). Internationalization strategy document in higher education
2024-2028. YÖK.
-
European Commission. (2013). Health inequalities in the EU Final report of a consortium. Consortium
lead: Sir Michael Marmot, Health and Consumers. Health Inequalities in the EU. https://doi.org/10.2772/34426
-
Hossin, M. Z. (2020). International Migration and health: It Is Time to Go beyond Conventional
Theoretical Frameworks. BMJ Global Health, 5(2). https://doi.org/10.1136/bmjgh-2019-001938
-
Lee, E. S. (1966). A Theory of Migration. Demography, 3(1), 47–57.
https://emigratecaportuguesa.wordpress.com/wp-content/uploads/2015/04/1966-a-theory-of-migration.pdf
-
Link, B.G. Phelan, J.C. (1996). Editorial: understanding sociodemographic differences in health-the role
of fundamental social causes. Am J Public Health. 1996;86:471-473.
-
Mackert, M. Koh, H.E. Mabry-Flynn, A. Champlin, S. Bea, A. (2017). Domestic and
International College Students: Health Insurance Information Seeking and Use. ISSN: 2162-3104 Print/ ISSN: 2166-3750 Online Volume 7, Issue 3 (2017), pp. 542-561 © Journal of International Students.
-
Masai, A. N., Güçiz-Doğan, B., Ouma, P. N., Nyadera, I. N., & Ruto, V. K. (2021). Healthcare services
utilization among international students in Ankara, Türkiye: a cross-sectional study. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06301-x
-
Ministry of Science and Higher Education of the Republic of Kazakhstan. (2025). Kazakhstan expands
support measures for education and youth employment [Review of Kazakhstan expands support measures for education and youth employment]. Kazakhstan expands support measures for education and youth employment - Official Information Source of the Prime minister of the Republic of Kazakhstan
-
Ministry of Health of Republic of Türkiye. (2008). Türkiye Sağlıkta Dönüşüm Programı İlerleme Raporu
[Progress Report on the Health Transformation Program in Türkiye]. Ministry of Health Publication No: 749.
-
National Center for Health Statistics. (2020). Healthy People 2030. WHO.
www.cdc.gov/nchs/healthy_people/hp2030/hp2030.htm.
-
Official Information Source of the Prime minister of Republic of Kazakhstan. (2024). Half-Year Results:
Development of Science and Higher Education, Research, and International Cooperation. https://primeminister.kz/ru/news/reviews/itogi-polugodiya-razvitie-nauki-i-vysshego-obrazovaniya-issledovaniya-i-mezhdunarodnoe-sotrudnichestvo-28837
-
Parliament of the Republic of Kazakhstan. (2025) Law of the Republic of Kazakhstan No. 405-V “On
Mandatory Social Health Insurance” (as of October 16, 1995). PARAGRAPH Information System. https://online.zakon.kz/Document/?doc_id=32908862
-
Phillips, S.P. (205 C.E.). “Defining and Measuring Gender: A Social Determinant of Health Whose Time
Has Come.” Int J Equity Health, 4, 1–4. www.cdc.gov/nchs/healthy_people/hp2030/hp2030.htm
-
Tang, C. Gui, X. Chen, Y. Magueramane, M. (2018). New to a Country: Barriers for
International Students to Access Health Services and Opportunities for Design. Pervasive Health 18, NY, USA Association for Computing Machinery.
-
Titrek, O. Hashimi, S.H. Ali, A.S. Nguluma, H.F. (2016). “Challenges Faced by International Students in Türkiye”, Anthropologist, 24(1): 148-156.
-
World Health Organization. (2008). Closing the Gap in a Generation: Health Equity through Action on
the Social Determinants of Health. WHO.
-
World Health Organization. (2017). World Health Statistics 2017: Monitoring Health for the SDGs,
Sustainable Development Goals. WHO.
Year 2025,
Volume: 14 Issue: Eğitim Bilimleri Ek Sayısı, 218 - 234, 23.10.2025
Madina Konakbayeva
,
Serra Sevde Hatipoğlu
References
-
Atun, R. Aydın, S. Aran, M. Gürol, I. Chakraborty, S. Akdağ, R. (2014). Health-care reform in Türkiye: far
from perfect. Lancet.
-
Balbus, J., Crimmins, A., Gamble, J. L., Easterling, D. R., Kunkel, K. E., Saha, S., & Sarofim, M. C. (2016). Ch. 1: Introduction: Climate Change and Human Health. The Impacts of Climate Change on Human Health in
the United States: A Scientific Assessment. The Impacts of Climate Change on Human Health in The United
States. https://doi.org/10.7930/j0vx0dfw
-
Beckfield, J. Olafsdottir, S. Sosnaud, B. (2013). Healthcare Systems in Comparative Perspective:
Classification, Convergence, Institutions, Inequalities, and Five Missed Turns. Annual Review of
Sociology 39, 1: 127-146.
-
Blouin, C. Chopra, M. van der Hoeven R. (2009). Trade and social determinants of health. Lancet 373:
5027.
-
Council of Higher Education. (2025). Internationalization strategy document in higher education
2024-2028. YÖK.
-
European Commission. (2013). Health inequalities in the EU Final report of a consortium. Consortium
lead: Sir Michael Marmot, Health and Consumers. Health Inequalities in the EU. https://doi.org/10.2772/34426
-
Hossin, M. Z. (2020). International Migration and health: It Is Time to Go beyond Conventional
Theoretical Frameworks. BMJ Global Health, 5(2). https://doi.org/10.1136/bmjgh-2019-001938
-
Lee, E. S. (1966). A Theory of Migration. Demography, 3(1), 47–57.
https://emigratecaportuguesa.wordpress.com/wp-content/uploads/2015/04/1966-a-theory-of-migration.pdf
-
Link, B.G. Phelan, J.C. (1996). Editorial: understanding sociodemographic differences in health-the role
of fundamental social causes. Am J Public Health. 1996;86:471-473.
-
Mackert, M. Koh, H.E. Mabry-Flynn, A. Champlin, S. Bea, A. (2017). Domestic and
International College Students: Health Insurance Information Seeking and Use. ISSN: 2162-3104 Print/ ISSN: 2166-3750 Online Volume 7, Issue 3 (2017), pp. 542-561 © Journal of International Students.
-
Masai, A. N., Güçiz-Doğan, B., Ouma, P. N., Nyadera, I. N., & Ruto, V. K. (2021). Healthcare services
utilization among international students in Ankara, Türkiye: a cross-sectional study. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06301-x
-
Ministry of Science and Higher Education of the Republic of Kazakhstan. (2025). Kazakhstan expands
support measures for education and youth employment [Review of Kazakhstan expands support measures for education and youth employment]. Kazakhstan expands support measures for education and youth employment - Official Information Source of the Prime minister of the Republic of Kazakhstan
-
Ministry of Health of Republic of Türkiye. (2008). Türkiye Sağlıkta Dönüşüm Programı İlerleme Raporu
[Progress Report on the Health Transformation Program in Türkiye]. Ministry of Health Publication No: 749.
-
National Center for Health Statistics. (2020). Healthy People 2030. WHO.
www.cdc.gov/nchs/healthy_people/hp2030/hp2030.htm.
-
Official Information Source of the Prime minister of Republic of Kazakhstan. (2024). Half-Year Results:
Development of Science and Higher Education, Research, and International Cooperation. https://primeminister.kz/ru/news/reviews/itogi-polugodiya-razvitie-nauki-i-vysshego-obrazovaniya-issledovaniya-i-mezhdunarodnoe-sotrudnichestvo-28837
-
Parliament of the Republic of Kazakhstan. (2025) Law of the Republic of Kazakhstan No. 405-V “On
Mandatory Social Health Insurance” (as of October 16, 1995). PARAGRAPH Information System. https://online.zakon.kz/Document/?doc_id=32908862
-
Phillips, S.P. (205 C.E.). “Defining and Measuring Gender: A Social Determinant of Health Whose Time
Has Come.” Int J Equity Health, 4, 1–4. www.cdc.gov/nchs/healthy_people/hp2030/hp2030.htm
-
Tang, C. Gui, X. Chen, Y. Magueramane, M. (2018). New to a Country: Barriers for
International Students to Access Health Services and Opportunities for Design. Pervasive Health 18, NY, USA Association for Computing Machinery.
-
Titrek, O. Hashimi, S.H. Ali, A.S. Nguluma, H.F. (2016). “Challenges Faced by International Students in Türkiye”, Anthropologist, 24(1): 148-156.
-
World Health Organization. (2008). Closing the Gap in a Generation: Health Equity through Action on
the Social Determinants of Health. WHO.
-
World Health Organization. (2017). World Health Statistics 2017: Monitoring Health for the SDGs,
Sustainable Development Goals. WHO.
Year 2025,
Volume: 14 Issue: Eğitim Bilimleri Ek Sayısı, 218 - 234, 23.10.2025
Madina Konakbayeva
,
Serra Sevde Hatipoğlu
References
-
Atun, R. Aydın, S. Aran, M. Gürol, I. Chakraborty, S. Akdağ, R. (2014). Health-care reform in Türkiye: far
from perfect. Lancet.
-
Balbus, J., Crimmins, A., Gamble, J. L., Easterling, D. R., Kunkel, K. E., Saha, S., & Sarofim, M. C. (2016). Ch. 1: Introduction: Climate Change and Human Health. The Impacts of Climate Change on Human Health in
the United States: A Scientific Assessment. The Impacts of Climate Change on Human Health in The United
States. https://doi.org/10.7930/j0vx0dfw
-
Beckfield, J. Olafsdottir, S. Sosnaud, B. (2013). Healthcare Systems in Comparative Perspective:
Classification, Convergence, Institutions, Inequalities, and Five Missed Turns. Annual Review of
Sociology 39, 1: 127-146.
-
Blouin, C. Chopra, M. van der Hoeven R. (2009). Trade and social determinants of health. Lancet 373:
5027.
-
Council of Higher Education. (2025). Internationalization strategy document in higher education
2024-2028. YÖK.
-
European Commission. (2013). Health inequalities in the EU Final report of a consortium. Consortium
lead: Sir Michael Marmot, Health and Consumers. Health Inequalities in the EU. https://doi.org/10.2772/34426
-
Hossin, M. Z. (2020). International Migration and health: It Is Time to Go beyond Conventional
Theoretical Frameworks. BMJ Global Health, 5(2). https://doi.org/10.1136/bmjgh-2019-001938
-
Lee, E. S. (1966). A Theory of Migration. Demography, 3(1), 47–57.
https://emigratecaportuguesa.wordpress.com/wp-content/uploads/2015/04/1966-a-theory-of-migration.pdf
-
Link, B.G. Phelan, J.C. (1996). Editorial: understanding sociodemographic differences in health-the role
of fundamental social causes. Am J Public Health. 1996;86:471-473.
-
Mackert, M. Koh, H.E. Mabry-Flynn, A. Champlin, S. Bea, A. (2017). Domestic and
International College Students: Health Insurance Information Seeking and Use. ISSN: 2162-3104 Print/ ISSN: 2166-3750 Online Volume 7, Issue 3 (2017), pp. 542-561 © Journal of International Students.
-
Masai, A. N., Güçiz-Doğan, B., Ouma, P. N., Nyadera, I. N., & Ruto, V. K. (2021). Healthcare services
utilization among international students in Ankara, Türkiye: a cross-sectional study. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06301-x
-
Ministry of Science and Higher Education of the Republic of Kazakhstan. (2025). Kazakhstan expands
support measures for education and youth employment [Review of Kazakhstan expands support measures for education and youth employment]. Kazakhstan expands support measures for education and youth employment - Official Information Source of the Prime minister of the Republic of Kazakhstan
-
Ministry of Health of Republic of Türkiye. (2008). Türkiye Sağlıkta Dönüşüm Programı İlerleme Raporu
[Progress Report on the Health Transformation Program in Türkiye]. Ministry of Health Publication No: 749.
-
National Center for Health Statistics. (2020). Healthy People 2030. WHO.
www.cdc.gov/nchs/healthy_people/hp2030/hp2030.htm.
-
Official Information Source of the Prime minister of Republic of Kazakhstan. (2024). Half-Year Results:
Development of Science and Higher Education, Research, and International Cooperation. https://primeminister.kz/ru/news/reviews/itogi-polugodiya-razvitie-nauki-i-vysshego-obrazovaniya-issledovaniya-i-mezhdunarodnoe-sotrudnichestvo-28837
-
Parliament of the Republic of Kazakhstan. (2025) Law of the Republic of Kazakhstan No. 405-V “On
Mandatory Social Health Insurance” (as of October 16, 1995). PARAGRAPH Information System. https://online.zakon.kz/Document/?doc_id=32908862
-
Phillips, S.P. (205 C.E.). “Defining and Measuring Gender: A Social Determinant of Health Whose Time
Has Come.” Int J Equity Health, 4, 1–4. www.cdc.gov/nchs/healthy_people/hp2030/hp2030.htm
-
Tang, C. Gui, X. Chen, Y. Magueramane, M. (2018). New to a Country: Barriers for
International Students to Access Health Services and Opportunities for Design. Pervasive Health 18, NY, USA Association for Computing Machinery.
-
Titrek, O. Hashimi, S.H. Ali, A.S. Nguluma, H.F. (2016). “Challenges Faced by International Students in Türkiye”, Anthropologist, 24(1): 148-156.
-
World Health Organization. (2008). Closing the Gap in a Generation: Health Equity through Action on
the Social Determinants of Health. WHO.
-
World Health Organization. (2017). World Health Statistics 2017: Monitoring Health for the SDGs,
Sustainable Development Goals. WHO.