THE ROLE OF TRADITIONAL, COMPLEMENTARY AND INTEGRATIVE MEDICINE PRACTICES IN GLOBAL HEALTH SYSTEMS: AN ECOLOGICAL ANALYSIS

Öz

This study aims to examine the structural characteristics of Traditional, Complementary and Integrative Medicine (TCIM) systems within global health systems and their association with socioeconomic indicators. Designed as an ecological study, the research evaluates TCIM indicators from 103 countries based on data obtained from the WHO TCIM Dashboard. Key variables include the presence of national legislation on TCIM, responsible national bodies, university-level education, national research institutes, and payment systems. Their associations with health expenditure per capita and the Human Development Index (HDI) were analysed. Data were analysed using SPSS v25.0; Mann-Whitney U and Kruskal-Wallis tests were used for group comparisons, while the chi-square test was applied to categorical variables. The findings revealed significant structural differences in TCIM systems across countries. Countries with national TCIM legislation had significantly higher HDI scores (p=0.027), and HDI was also higher in countries with national research institutes (p=0.008). Significant regional differences were observed in the distribution of TCIM structural indicators across WHO regions. In conclusion, the level of institutionalization of TCIM systems appears to be associated with countries’ development indicators, and integration into health systems is not equally distributed globally.

Anahtar Kelimeler

• Health Policies
• Human Development Index
• Regional Analysis
• TCIM

Öz

Bu çalışmanın amacı, küresel sağlık sistemleri içindeki Geleneksel, Tamamlayıcı ve Bütünleyici Tıp (TCIM) sistemlerinin yapısal özelliklerini ve sosyoekonomik göstergelerle ilişkilerini incelemektir. Ekolojik bir çalışma olarak tasarlanan araştırma, DSÖ TCIM Gösterge Tablosundan elde edilen verilere dayanarak 103 ülkeden TCIM göstergelerini değerlendirmektedir. Temel değişkenler arasında TCIM ile ilgili ulusal mevzuatın varlığı, sorumlu ulusal kurumlar, üniversite düzeyinde eğitim, ulusal araştırma enstitüleri ve ödeme sistemleri yer almaktadır. Kişi başına sağlık harcaması ve İnsani Gelişme Endeksi (HDI) ile ilişkileri analiz edilmiştir. Veriler SPSS v25.0 kullanılarak analiz edilmiştir; grup karşılaştırmaları için Mann-Whitney U ve Kruskal-Wallis testleri kullanılırken, kategorik değişkenlere ki-kare testi uygulanmıştır. Bulgular, ülkeler arasında TCIM sistemlerinde önemli yapısal farklılıklar olduğunu ortaya koymuştur. Ulusal TCIM mevzuatına sahip ülkelerin önemli ölçüde daha yüksek HDI puanları vardı (p=0,027) ve ulusal araştırma enstitülerine sahip ülkelerde de HDI daha yüksekti (p=0,008). TCIM yapısal göstergelerinin DSÖ bölgeleri genelindeki dağılımında önemli bölgesel farklılıklar gözlemlenmiştir. Sonuç olarak, TCIM sistemlerinin kurumsallaşma düzeyi, ülkelerin kalkınma göstergeleriyle ilişkili görünmektedir ve sağlık sistemlerine entegrasyon küresel olarak eşit bir şekilde dağılmamıştır.

Anahtar Kelimeler

• Sağlık Politikaları
• İnsani Gelişme Endeksi
• Bölgesel Analiz
• TCIM

Kaynakça

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