Savaş ve Göç Girdabında Derinleşen Sağlıkta Sosyal Eşitsizlikler: Çok Kriterli Bir Yaklaşım

Year 2025, Issue: Special Issue: Crisis Entangled – Reimagining the Social in Turbulent Times, 176 - 187, 30.10.2025

Emre Yılmaz

Abstract

Bu çalışmada, savaş ve zorunlu göç süreçlerinde sağlık hizmetlerine erişimde ortaya çıkan sosyal eşitsizliklerin çok kriterli karar verme (ÇKKV) yöntemiyle analiz edilmesi amaçlanmıştır. Çalışma, kriz durumlarında derinleşen sağlık eşitsizliklerini sistematik biçimde ağırlıklandırmayı ve bu eşitsizlikleri azaltmaya yönelik politika önerileri geliştirmeyi hedeflemektedir. Sağlıkta sosyal eşitsizlikler literatür taraması neticesinde 10 ana başlıkta belirlenmiştir. Eşitsizliklerin göreceli ağırlık skorlarının belirlenmesi için sağlık yönetimi, psikoloji, sosyoloji, davranış bilimleri ve sağlık ekonomisi alanlarından 6 uzmanın görüşleri F-AHP soru formu aracılığıyla toplanmıştır. Yöntemin ilgili hesaplamaları yapılarak sağlıkta sosyal eşitsizliklerin önem dereceleri belirlenmiştir. Analiz sonuçlarına göre, savaş ve zorunlu göç sürecinde sağlık hizmetlerine erişimde ortaya çıkan en önemli sosyal eşitsizlikler sırasıyla; sosyoekonomik durum, kültürel ve etnik farklılıklar ve yasal durum olarak tespit edilmiştir. Sağlık hizmetlerine erişimin artırılması için kaynak tahsisi öncelikli olarak bu eşitsizliklere yönlendirilmelidir. Düşük gelirli, yoksulluk sınırının altında yaşayan göçmenler için hibeler yoluyla finansal destek ve sosyal yardım mekanizmalarının güçlendirilmesi, sağlık kurumlarında kültürel arabuluculuk hizmetlerinin genişletilmesi, diller ve kültürler arasında iletişim kanallarının oluşturulması önemlidir. Ayrıca göçmenler için hukuki statüye bakılmaksızın asgari düzeyde sağlık hizmeti garantisi sağlanmalı, adalet temelli bir yaklaşım benimsenmelidir.

Keywords

sağlık , savaş , göç , eşitsizlik , çok kriterli karar verme

Deepening Social Inequalities in Health in the Maelstrom of War and Migration: A Multi-Criteria Approach

Abstract

This study analyzes social inequalities in access to healthcare that emerge during periods of war and forced migration using a multi-criteria decision-making (MCDM) approach. The aim is to systematically assess the severity of inequalities that intensify during crises and to propose policy recommendations to reduce them. Based on a literature review, ten main categories of social inequalities in health were identified. To determine their relative weights, expert opinions were collected through an F-AHP questionnaire from six specialists in health management, psychology, sociology, behavioral sciences, and health economics. The analysis revealed that the most important inequalities in accessing healthcare services during war and forced migration are socioeconomic status, cultural and ethnic differences, and legal status. These findings highlight that disadvantaged socioeconomic groups, cultural and linguistic barriers, and uncertainties in legal identity significantly hinder access to essential health services. To mitigate these challenges, resource allocation in crisis settings should primarily focus on reducing such inequalities. Recommended strategies include providing financial support and social assistance to low-income immigrants, expanding cultural mediation services in healthcare institutions, and ensuring multilingual communication. Additionally, adopting a justice-based approach by guaranteeing a minimum level of healthcare for all immigrants, regardless of their legal status, is crucial for promoting equity in health access.

Keywords

health , war , migration , inequality , multi-criteria decision making

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