Uluslararası Sağlık Tüzüğü Temel Kapasitesi ile Bulaşıcı Hastalıklara Bağlı Ölüm Oranları Arasında Evrensel Sağlık Kapsamının Aracılık Rolü

Yıl 2025, Cilt: 35 Sayı: 3, 544 - 553, 30.06.2025

Deniz Tugay Arslan

https://doi.org/10.54005/geneltip.1623431

Öz

Amaç: Bulaşıcı hastalıklar toplum sağlığı ve sürdürülebilir kalkınma çabaları üzerinde önemli bir tehdit olmaya devam etmektedir. Bulaşıcı hastalıklarla mücadele amacıyla sürdürülebilir kalkınma hedefleri kapsamında sağlık hizmeti kapasitesinin oluşturulması ve evrensel sağlık kapsamının sağlanması için hedefler belirlenmiştir. Sağlık hizmetinin fiziki ve teknik kapasitesinin iyileşmesi ve hizmete erişimin sağlanmasıyla bulaşıcı hastalıklarla mücadele edilmesi amaçlanmaktadır. Çalışmanın temel amacı International Health Regulations (IHR) hizmet kapsamının bulaşıcı hastalıklar bağlı ölüm oranları üzerindeki etkisinde Universal Health Coverage (UHC) hizmet kapsamının aracılık rolünün belirlenmesidir.
Gereç ve Yöntem: Çalışma kapsamında örneklem seçimi yapılmayıp IHR’ye taraf olan Dünya Sağlık Örgütüne üye 183 ülkenin 2021 yılına ait verileri kullanılmıştır. Çalışmanın amacı doğrultusunda basit aracılık modeli oluşturulmuştur. Değişkenler arasındaki ilişkiyi test eden aracılık etkisi analizi varsayımları regresyon analizleriyle test edilmiştir.
Bulgular: IHR temel kapasitesi ile bulaşıcı hastalıklara bağlı ölüm oranı arasında anlamlı negatif etki tespit edilmiştir. IHR temel kapasitesi ile UHC hizmet kapsamı arasında ise anlamlı pozitif etki olduğu belirlenmiştir. IHR ve UHC’nin birlikte dahil edildiği modelde UHC hizmet kapsamı ile bulaşıcı hastalıklara bağlı ölüm oranı arasında anlamlı negatif etki tespit edilmiştir. Aracılık etkisi analizi sonucunda ise IHR hizmet kapsamının bulaşıcı hastalıklara bağlı ölüm oranı üzerindeki etkisinde UHC hizmet kapsamının tam aracı rolü oynadığı belirlenmiştir.
Sonuç: Belirlenen bulgulara göre IHR temel kapasitesinin sağlık hizmetlerine erişim olmadan bulaşıcı hastalıklara bağlı ölüm oranı üzerinde sınırlı etkisinin olduğu söylenebilir. IHR temel kapasitelerinin toplumun sağlık hizmetine erişimiyle desteklenmesi gerekmektedir. Ülkelerin bulaşıcı hastalıklarla mücadelede IHR temel kapasitelerini arttırmaya yönelik çabalara devam etmesi ve bu çabaların UHC politikalarıyla entegre edilmesi önerilmektedir.

Anahtar Kelimeler

Bulaşıcı hastalık , Evrensel Sağlık Kapsamı , halk sağlığı , sürdürülebilir kalkınma , Uluslararası Sağlık Tüzüğü

The Mediating Role of Universal Health Coverage Between International Health Regulations Core Capacities and Mortality from Communicable Diseases

Öz

Aim: Communicable diseases continue to pose a significant threat to public health and sustainable development efforts. To address this challenge, targets under the Sustainable Development Goals focus on enhancing healthcare capacity and achieving Universal Health Coverage (UHC). Improving the physical and technical capacity of healthcare services and ensuring access aim to support the fight against communicable diseases. This study aims to determine the mediating role of Universal Health Coverage (UHC) service coverage in the relationship between International Health Regulations (IHR) core capacities and mortality rates due to communicable diseases.
Materials and Methods: The study utilized 2021 data from 183 World Health Organization member states that are party to the IHR, without sample selection. A simple mediation model was developed, and assumptions of mediation effect analysis were tested through regression analyses to evaluate relationships between variables.
Results: A significant negative effect was observed between IHR core capacities and mortality rates due to communicable diseases. Additionally, a significant positive effect was identified between IHR core capacities and UHC service coverage. In the model incorporating both IHR and UHC, a significant negative effect was observed between UHC service coverage and mortality rates due to communicable diseases. Mediation analysis revealed that UHC service coverage fully mediates the effect of IHR core capacities on mortality rates due to communicable diseases.
Conclusion: The findings suggest that IHR core capacities alone have a limited effect on reducing mortality rates without adequate healthcare access. Supporting IHR core capacities with improved access to healthcare is essential. Countries should continue efforts to enhance IHR core capacities and integrate these efforts with UHC policies to effectively combat communicable diseases.

Anahtar Kelimeler

Communicable disease , International Health Regulations , public health , sustainable development , Universal Health Coverage

Etik Beyan

Ethical approval was not required as the data included in the study and analyzed were obtained from open data sources.

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