Amaç: Salgın hastalık dönemlerinde, ülkelerin en çok zorlandıkları durumlardan biri de aşı karşıtı politikalardır. Aşı uygulamalarının hukuki boyutlarından dolayı bireyler aşı olmaya zorlanamamakta, sadece teşvik edilebilmektedir. Bireylerin aşı olmalarını etkileyen birçok faktör olmasına karşın ülkelerin her birine zaman ve kaynak ayrılabilmesi çok mümkün değildir. Bu nedenle çalışmamızın amacı, vatandaşların aşılanmaya teşvik edilebilmesi için gerekli olan en uygun stratejinin belirlenmesidir. Gereç ve Yöntemler: Dünya Sağlık Örgütünün belirlemiş olduğu bireyleri aşıya teşvik edici kriterler küresel bulanık [spherical fuzzy (SF)] DEMATEL yöntemi ile analiz edilmiştir. SF-DEMATEL, kriterler arasında önem ağırlığı belirlemede kullanılan bir yöntemdir. Bu sayede aşılanmayı artıracak kriterler arasında en önemli olanları belirlenerek uygun stratejiler geliştirilebilecektir. Bulgular: Aşı karşıtı politikalarda en fazla teşvik eden ana kriterin bağlamsal etkiler olduğu sonucuna varılmıştır. Ağırlıklandırma katsayılarına bakıldığında, bağlamsal etkiler 0,37, aşı ve aşılanmaya ait etkileri 0,36 ve birey ve grup etkileri 0,26 hesaplanmıştır. Alt kriterler bazında da yasalar/politikalar aşı teşvikinde oldukça etkilidir. Yasalar/politikalar kriterinin ağırlığı 0,164, iletişim ve medya araçları kriterinin ağırlığı 0,160 ve ilaç endüstrisi kriterinin ağırlığı 0,159 olarak hesaplanmıştır. Sonuç: Bağlamsal etkiler, ana kriterinin alt kriteri olan politikalar/yasalar aşı teşvikinde en önemli argüman olarak karşımıza çıkmıştır. Ülkeler aşı teşvikini yaygınlaştırmak için belirlenen tüm kriterlere emek, zaman ve bütçe ayıramayacağı için analiz sonucunda en önemli etken olarak bulunan yasalara/politikalara ağırlık vermesi büyük oranda çözüm olacaktır. Bireyleri aşı olmaya teşvik etmek için devletin yetkili makamlarının yürüttüğü politikaların, aşılanmanın gerekli ve zararsız olduğu yönünde olmalıdır. Ayrıca yürütülen politikaların, halkı bilgilendirmeye yönelik gerçekleştirilmesi, aşı hakkında halka doğru bilgilerin iletilmesi yönünde olması hâlinde aşı karşıtlığı azalacaktır.
Anahtar Kelimeler: Aşı; SF-DEMATEL; halk sağlığı; aşı karşıtlığı
Objective: One of the most difficult situations for countries during pandemics is anti-vaccine policies. Due to the legal aspects of vaccination practices, individuals cannot be forced to be vaccinated, they can only be encouraged. Because these incentives are often inadequate or made incorrectly, vaccination of citizens cannot be achieved at the desired level. Although there are many factors that affect individuals to be vaccinated, it is not possible for countries to allocate time and resources to each. Therefore, the aim of our study is to find the most significant criteria for countries with scarce resources to encourage their citizens to get vaccinated and to develop a strategy accordingly. Material and Methods: The criteria for encouraging individuals to vaccinate, determined by the World Health Organization, were analyzed with the spherical fuzzy (SF) DEMATEL method. SF-DEMATEL is a method used to determine the weight of importance among the criteria. In this way, the most important ones among the criteria that will increase vaccination will be determined and appropriate strategies will be developed. Results: It was concluded that the main criterion most encouraging in anti-vaccine policies is contextual effects. Considering the weighting coefficients, contextual effects were calculated as 0.37, vaccine and vaccination effects of 0.36, and individual and group effects of 0.26. Laws/policies on the basis of sub-criteria are also very effective in promoting vaccination. The weight of the law/policies criterion is calculated as 0.164, the weight of the communication and media tools criterion as 0.160 and the weight of the pharmaceutical industry criterion as 0.159. Conclusion: Policies/laws, which are the sub-criteria of the contextual effects main criterion, have emerged as the most important argument in vaccine promotion. Since countries cannot allocate effort, time and budget to all criteria determined to promote vaccine promotion, it will be a solution to a great extent that they focus on laws/policies, which are the most important factors as a result of the analysis. To encourage individuals to be vaccinated; the policies of the competent authorities of the state should be that vaccination is necessary and harmless. In addition, if the policies carried out are aimed at informing the public and conveying accurate information about the vaccine to the public, anti-vaccination will decrease.
Keywords: Vaccine; SF-DEMATEL; public health; anti-vaccine
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