Assessing Barriers to Hospital Resilience in War and Conflict Settings: A Fuzzy AHP Approach

Year 2025, Volume: 22 Issue: 6, 1238 - 1253, 17.12.2025

Ersin Kocaman

https://doi.org/10.26466/opusjsr.1816575

Abstract

This study aimed to identify the primary barriers that undermine the resilience of hospitals operating in war and conflict environments and to prioritize these barriers according to their importance. Hospital resilience has become an important research area in recent years due to the increasing attacks and system vulnerabilities in terms of ensuring the continuity of healthcare services under crisis conditions. In the study, the Fuzzy Analytical Hierarchy Process (AHP) method, which is a multi-criteria decision-making method that can provide reliable prioritization under uncertainty conditions, was used to address the limited number of research gaps in the literature on the subject. The data obtained from eight experts selected through purposive sampling method were analyzed by following the Fuzzy AHP steps. The findings reveal nine key barriers. The highest priority barrier was identified as “Interruptions in the supply of medicines, medical supplies and oxygen” (0.2300), followed by “Healthcare worker loss and retention” (0.1348) and “Weak governance/coordination and financing fragility” (0.1287). The conclusions show that for the sustainability of health services in war and conflict environments, the supply chain must be secured, health workers must be protected and retained, and governance and financial sustainability must be strengthened. The study contributes to the literature by providing an evidence-based prioritization framework for policy makers and managers to increase hospital resilience under crisis conditions.

Keywords

Hospital resilience , War and conflict environments , Supply chain disruption , Healthcare workers , Fuzzy AHP

Savaş ve Çatışma Ortamlarında Hastane Dayanıklılığına Yönelik Engellerin Önceliklendirilmesi: Bulanık AHP Yaklaşımı

Abstract

Bu çalışma savaş ve çatışma ortamlarında faaliyet gösteren hastanelerin dayanıklılığını zayıflatan temel engelleri belirlemek ve bu engelleri önem derecelerine göre önceliklendirmek amacıyla gerçekleştirilmiştir. Hastane dayanıklılığı, kriz koşullarında sağlık hizmetlerinin sürekliliğini sağlaması bakımından son yıllarda artan saldırılar ve sistem kırılganlıkları nedeniyle önemli bir araştırma alanı haline gelmiştir. Çalışmada, konuya ilişkin literatürde bulunan sınırlı sayıdaki çalışma boşluğunu gidermek üzere, belirsizlik koşullarında güvenilir önceliklendirme yapabilen çok kriterli karar verme yöntemlerinden Bulanık Analitik Hiyerarşi Prosesi (AHP) yöntemi kullanılmıştır. Amaçlı örnekleme yöntemiyle seçilen sekiz uzmandan elde edilen veriler Bulanık AHP adımları izlenerek analiz edilmiştir. Bulgular dokuz temel engeli ortaya koymaktadır. En yüksek önceliğe sahip engel “İlaç, tıbbi sarf ve oksijen tedarikinde kesintiler” (0,2300) olarak belirlenmiş, bunu “Sağlık çalışanı kaybı ve elde tutamama” (0,1348) ve “Yönetişim/koordinasyon zayıflığı ve finansman kırılganlığı” (0,1287) izlemiştir. Sonuçlar, savaş ve çatışma ortamlarında sağlık hizmetlerinin sürdürülebilirliği için öncelikle tedarik zincirinin güvence altına alınması, sağlık çalışanlarının korunması ve elde tutulması ile yönetişim ve finansal sürdürülebilirliğin güçlendirilmesi gerektiğini göstermektedir. Çalışma, kriz koşullarında hastane dayanıklılığını artırmaya yönelik politika yapıcılar ve yöneticiler için kanıta dayalı bir önceliklendirme çerçevesi sunarak literatüre katkı sağlamaktadır.

Keywords

Hastane dayanıklılığı , Savaş ve çatışma ortamları , Tedarik zinciri kesintisi , Sağlık çalışanları , Bulanık AHP

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