Türkiye'de Mülteci Kadınların Anne Bakım Hizmetlerine Erişimini Anlamada Ekolojik Sağlık Modeli

Öz

Bu makale, Türkiye'de mülteci kadınların anne bakım hizmetlerine erişim deneyimlerini analiz etmektedir. İnsan hakları çerçevesini kullanarak, makale ekolojik sağlık modelini benimsemekte ve mülteci kadınların güvencesiz yasal statüleri, sosyal konumları, cinsiyetleri ve sağlık durumları nedeniyle savunmasızlıklarını vurgulamaktadır. Ev sahibi ülkedeki savunmasızlıklarının çok yönlü karakteri, araştırmanın mülteci kadınların anne bakımına ilişkin temel haklarını incelemedeki çoklu karmaşıklıkları kapsayan kesişimsel bir analiz yapmasını gerektirmektedir. Ekolojik model (Thurston ve Vissadjee, 2005), anne bakımı, belirleyicileri ve sonuçları arasındaki etkileşimlerin karmaşıklıklarına ilişkin normatif ve pratik bir örnek sunmaktadır. Ağların etkileşimlerini üç aşamada analiz etmemizi sağlar: (1) mikro düzey (mültecilerin etkileşimleri) (2) Mezo düzey (sağlık klinikleri/merkezleri, sağlıkla ilgili toplum düzeyindeki sorunlar vb.) ve (3) makro düzey (devlet politikaları ve uluslararası kuruluşların düzenlemeleri). UNHCR'ye göre, kısıtlı imkânlara sahip mülteciler menşe ülkelerine geri dönemezler, bu nedenle hükümetler insanca bir yaşam sağlamak için yollar yaratmak amacıyla politikalarını (yeniden) tasarlamalıdır. 'Sağlık hakkı', tanımlanmış bölgelerdeki yasal statülerinden bağımsız olarak, her bireyin ortak insanlığın bir üyesi olarak sahip olduğu temel insan haklarından biridir. Devletler ve devlet dışı aktörler, mülteci kadınlar da dahil olmak üzere tüm kadınlara anne sağlığı hizmeti sağlama ve kolaylaştırma sorumluluğuna sahiptir. Makale, literatür taramasından elde edilen araştırma bulgularını ve Türk sağlık hizmetlerindeki katılımcı gözlemlerden elde edilen saha çalışması verilerini sunarak mülteci kadınların Türkiye'deki anne bakımı hizmetleri deneyimlerini göstermektedir.

Anahtar Kelimeler

• mülteci kadınlar
• sağlık hakkı
• anne bakımı
• kesişimsellik
• ekolojik model.

Ecological Model of Health in Understanding Refugee Women’s Access to Maternal Care Services in Türkiye

Öz

This paper analyses refugee women’s experiences of accessing maternal care services in Türkiye. By using the human rights framework, the paper adopts the ecological model of health and emphasises the vulnerability of refugee women due to their precarious legal status, social position, gender and health status. The multi-faceted character of their vulnerability in the host country necessitates the research to take an intersectional analysis encompassing the multiple complexities in studying refugee women’s fundamental right to maternal care. The ecological model (Thurston and Vissadjee, 2005) offers a normative and practical illustration of the complexities of interactions between maternal care and its determinants and outcomes. It allows us to analyse the interactions of networks through three stages: (1) micro-level (refugees’ interactions), (2) Meso-level (healthcare clinics/centres, community-level issues on health, etc.) and (3) macro-level (state policies and international agencies’ regulations). According to the UNHCR, refugees with little means cannot return to their origin countries, thus, the governments ought to (re)design their policies to create pathways for providing decent life. ‘Right to health’ is one of the fundamental human rights that every individual possesses as a member of common humanity regardless of their legal status in defined territories. States and non-state actors have a responsibility to provide and facilitate maternal healthcare to all women, including refugee women. The paper illustrates refugee women’s experiences of maternal care services in Türkiye by presenting research findings from the literature review and fieldwork data from participant observations in Turkish health services.

Anahtar Kelimeler

• refugee women
• right to health
• maternal care
• intersectionality
• ecological model.

Destekleyen Kurum

The research is funded by the British Academy

Etik Beyan

Ethical approval is obtained by the University of Lincoln Ethics Committee (UoL2023_16174). The researcher obtained official permission from each health institution.

Teşekkür

I would like to thank the British Academy for funding my research and my Institution, the University of Lincoln, for all their support. I also would like to thank AID (Alliance of International Doctors) for supporting me in the fieldwork.

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