Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Gebeliği Önleyici Modern Yöntem Kullanımının İç Göç, Sosyodemografik ve Sosyoekonomik Faktörler ile İlişkisi
The Relationship Between the Use of Modern Contraceptive Methods and Internal Migration, Socio- Demographic and Socio-Economic Factors
Gülcan ŞANTAŞa, Mehmet Ali ERYURTb
aYozgat Bozok Üniversitesi İktisadi ve İdari Bilimler Fakültesi, Sağlık Yönetimi Bölümü, Yozgat, TÜRKİYE
bHacettepe Üniversitesi, Nüfus Etütleri Enstitüsü, Ankara, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2020;5(1):46-55
doi: 10.5336/healthsci.2019-70395
Article Language: TR
ÖZET
 Amaç: Bu çalışmanın amacı, Türkiye'de iç göçün, çeşitli sosyodemografik ve sosyoekonomik faktörlerin gebeliği önleyici modern yöntem kullanımı ile ilişkisini incelemektir. Gereç ve Yöntemler: Bu çalışmada, Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü tarafından yürütülen Türkiye Nüfus ve Sağlık Araştırması (TNSA) verileri kullanılmıştır. Çalışma verileri, 1993-1998-2003-2008-2013 dönemlerinde toplanan TNSA verilerinden oluşmaktadır. TNSA'larda 'hanehalkı soru kâğıdı' ve 15-49 yaş aralığındaki kadınlar için 'kadın soru kâğıdı' kullanılmaktadır. TNSA'larda araştırmanın evreni doğurgan yaşlardaki kadınlardan oluşmaktadır. Araştırmalarda örneklem seçiminde ağırlıklı örnekleme yöntemi, çok aşamalı örnekleme yöntemi ve tabakalı küme örneklemesi yöntemlerinden yararlanılmaktadır. Bu araştırmanın bağımlı değişkeni kadınların araştırma esnasında gebeliği önleyici modern yöntem kullanımlarıdır. Araştırmanın bağımsız değişkenleri ise göç durumu değişkeni, dönem değişkeni, sosyodemografik ve sosyoekonomik faktörlerdir. Çalışmada, göç durumunun, sosyodemografik ve sosyoekonomik faktörlerin gebeliği önleyici modern yöntem kullanımı üzerindeki etkisinin belirlenmesi için lojistik regresyon analizinden faydalanılmıştır. Bulgular: Çalışmada gebeliği önleyici yöntem kullanımının iç göçten etkilendiği bulgusu elde edilmiştir. Kırda yaşayan kadınlara göre kentte yaşayanlarda, kırdan kente göç etmişlerde ve kentten kıra göç etmişlerde gebeliği önleyici modern yöntem kullanımı istatistiksel olarak anlamlı şekilde daha yüksek bulunmuştur. Ayrıca, gebeliği önleyici yöntem kullanımının çeşitli sosyo-demografik ve sosyo-ekonomik faktörlerden etkilendiği belirlenmiştir. Analizler sonucunda, gebeliği önleyici modern yöntem kullanımı, 15-19 yaş grubuna göre 20-29 ve 30-39 yaş grubunda; eğitimi olmayan/ilkokulu bitirmemiş kadınlara göre ilkokul mezunu kadınlarda ve ortaokul ve üzeri eğitim düzeyindeki kadınlarda daha yüksek bulunmuştur. Kadınların eşlerinin eğitim düzeyi arttıkça yöntem kullanımının arttığı saptanmıştır. Çocuğu olmayan kadınlara göre modern yöntem kullanımı dört ve üzeri çocuğu olan kadınlarda; çalışmayan kadınlara göre çalışan kadınlarda; Doğu bölgesine göre diğer dört bölgede; sağlık sigortası kapsamında olmayan kadınlara göre sağlık sigortası kapsamında olan kadınlarda daha yüksek bulunmuştur. Sonuç: Araştırma sonucunda, gebeliği önleyici modern yöntem kullanımının 1993 dönemine göre 2013 döneminde 1,453 kat arttığı belirlenmiştir. Ancak çalışmada, gebeliği önleyici modern yöntem kullanımına ilişkin yerleşim yeri ve bölgeler arasında farklılıklar olduğu sonucuna ulaşılmıştır. Eğitimler, eğitici materyaller ve medya aracılığıyla gebeliği önleyici yöntem kullanımı konusunda farkındalığı artırmanın, kadınlar açısından bölgeler arasındaki farklılıkları azaltmada faydalı olabileceği düşünülmektedir.

Anahtar Kelimeler: Gebeliği önleyici modern yöntem kullanımı; iç göç
ABSTRACT
 Objective: The purpose of this study is to examine the relationship between internal migration, various socio-demographic and socio-economic factors and the use of modern contraceptive method in Turkey. Material and Methods: In this study, 'Turkey Demographic and Health Survey (TDHS)' data were used, which was conducted by Hacettepe University Institute of Population Studies. The data of the study consisted of the TDHS data collected between 1993-1998-2003-2008-2013. The 'Household Questionnaire' and 'Women Questionnaire' were used for women of reproductive age (15-49 years) in the TDHS. The population of the study consisted of women in reproductive age in the TDHS. Weighted sampling method, multi-stage sampling method and stratified cluster sampling methods were used in the sample selection. The dependent variable of this study was the use of modern contraceptive method by women during the study. The independent variables of the study were migration status variable, period variable, socio-demographic and socio-economic factors. In this study, logistic regression analysis was used to determine the effect of migration status, socio-demographic and socio-economic factors on the use of modern contraceptive methods. Results: It was found that the use of modern contraceptive methods was affected by internal migration in this study. The use of modern contraceptive methods was found to be significantly higher in urban women, rural-tourban women and urban-to-rural women compared to rural women. In addition, it was determined that the use of modern contraceptive methods was affected by various socio-demographic and socio-economic factors. As a result of the analysis, the use of modern contraceptive methods was found to be higher in women with 20-29 and 30-39 age compared to 15-19 age group; women with primary school education and women with secondary school education and higher education compared to women without education/who have not completed primary school. As the education level of the spouses of women increased, the use of methods increased. The use of modern methods was found to be higher in women with four or more children compared to women without children; working women compared to non-working women; four other regions compared to East Region; women covered by health insurance compared to women not covered by health insurance. Conclusion: As a result of the study, it was determined that the use of modern contraceptive methods increased 1.453 times in 2013 period compared to 1993 period. However, it was concluded that there were some differences between the residential areas and regions regarding the use of modern contraceptive methods in the study. Raising awareness about the use of modern contraceptive methods may be useful in reducing the differences between regions for women through trainings, educational materials and media.

Keywords: Contraceptive usage; internal migration
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