$QDGROX+HPúLUHOLNYH6D÷OÕN%LOLPOHUL'HUJLVL 204 $5$ù7,50$ .,56$/%g/*('(<$ù$<$1.$',1/$5,19$-ø1$/$.,17,'858081'$ 6$ö/,.$5$0$'$95$1,ù/$5, )LOL]2.808ù 1XUGDQ'(0ø5&ø $OÕQÕú7DULKL .DEXO7DULKL ÖZET
Amaç:Bu araştırma, kırsal bölgelerde yaşayan kadınların vajinal akıntı durumunda sağlık arama
davranışlarını ve sağlık arama davranışlarını engelleyen nedenleri belirlemek amacıyla yapılmıştır.
Yöntem: Araştırma, kırsal bir bölgede bulunan bir sağlık ocağı bölgesinde yapılmıştır. Basit rastgele
örnekleme yöntemine göre seçilen 438 kadın araştırmaya katılmıştır. Veriler, araştırmacılar tarafından literatür taranarak hazırlanan veri toplama formu ile toplanmıştır. Değerlendirmede yüzdelik, ortalama ve ki-kare testleri kullanılmıştır.
Bulgular: Araştırmaya katılan kadınların yaş ortalaması 32.1±8.2 olup çoğunluğu 25-29 yaş
grubundadır. Sağlık kuruluşuna başvurma oranı oldukça yüksek olup başvuran kadınların bir kısmı hekimin verdiği tedaviyi ya hiç kullanmamış ya da yarıda bırakmıştır. Kadınların vajinal akıntı durumunda sağlık kuruluşuna başvurmama nedenleri akıntının kendiliğinden iyileşeceğini düşünmeleri, ekonomik nedenler, zamansızlık, ulaşım zorlukları, utanma, evdeki sorumluluklar, bilgisizlik ve sağlık çalışanlarının ilgisizliğidir.
Sonuçlar: Yaş, eğitim ve çalışma durumu, gelir seviyesi, sağlık sigortası aile tipi, evlenme yaşı, ilk
gebelik ve doğum yaşı, gebelik sayısı ile sağlık hizmeti arama davranışı arasında istatistiksel olarak anlamlı bir fark bulunmamıştır.Düşük/küretaj öyküsü açısından gruplar arasında istatistiksel olarak anlamlı farklılık saptanmıştır.
Anahtar kelimeler: Sağlık arama davranışı; vajinal akıntı; kırsal nüfus. ABSTRACT
Health-Seeking Behavior in The Case of Vaginal Discharge in Women Living in Rural Areas Objective: This research was conducted to determine the behavior of women living in rural areas in
terms of seeking healthcare in the event of vaginal discharge and the reasons that hindered their seeking healthcare.
Methods: The study was carried out in a rural area overseen by a community health center. Using the
method of random sampling, 438 women participated in the study. Data were collected by the researchers using a data collection form inspired by a scan of the literature. Percentages, means and chi-square tests were used in the evaluation.
Results: The mean age of the women recruited into the study was 32.1±8.2 and the majority was in the
25-29 age group. The percentage of women presenting at the health center was noticeably high but a portion of these women either never made use of or never completed the treatment recommended by the physician. The reasons the women did not apply to the health center in the event of vaginal discharge were their thinking that the discharge would disappear by itself, economic rationales, lack of time, transportation difficulties, feeling embarrassed, household responsibilities, ignorance and the indifference of health professionals.
Conclusions: No significant relationship was found between the women's seeking health care and their
ages, educational levels, working status, income levels, health insurance status, family type, age of marriage, age of first pregnancy and first delivery, or the number of pregnancies. There was a significant statistical difference observed between the groups in terms of their histories of miscarriage/abortion.
Keywords:Health care seeking behaviour; vaginal discharge; rural population.
*ø5øù
'R÷XPNDQDOÕQÕQDOWE|OPRODQYDMLQD PHQVWUXDO NDQÕQ ERúDOGÕ÷Õ YH NRLWXVXQ JHUoHNOHúWL÷L ELU E|OJHGLU9DMLQD NDGÕQLQWHUQDO YH HNVWHUQDO JHQLWDO RUJDQODUÕ DUDVÕQGD ELU SDVDM |]HOOL÷L WDúÕGÕ÷ÕQGDQ GROD\Õ FLQVHO VD÷OÕN YH
UHPHVD÷OÕ÷ÕQÕQEHOLUOH\LFLVLROPDVÕEDNÕPÕQGDQ NDGÕQ VD÷OÕ÷Õ DoÕVÕQGDQ |]HO ELU |QHPH VDKLSWLU 1RUPDOGH|VWURMHQG]H\L\HWHUOLRODQNDGÕQODUGD YDMLQDODNÕQWÕODUWPUHPHoD÷ÕER\XQFDoHúLWOL úHNLOOHUGH PHYFXWWXU $QFDN ]DUDUOÕ ELU HWNHQLQ YDMLQDO GRNXGD X\DUGÕ÷Õ UHDNVL\RQ VRQXFX øVWDQEXO0HGLSROhQLYHUVLWHVL6D÷OÕN%LOLPOHUL<NVHNRNXOX(EHOLN%|OP<UG'Ro'U
HSRVWD IRNXPXV#PHGLSROHGXWU
0DUPDUDhQLYHUVLWHVL6D÷OÕN%LOLPOHUL)DNOWHVL+HPúLUHOLN%|OP'Ro'U
$QDGROX+HPúLUHOLNYH6D÷OÕN%LOLPOHUL'HUJLVL
205 DNÕQWÕQÕQ |]HOOL÷L GH÷LúLU YH DQRUPDO YDMLQDO DNÕQWÕODUPH\GDQDJHOLU9DMLQDODNÕQWÕODUDHQoRN QHGHQ RODQ HQIHNVL\RQ DMDQODUÕQ WULFKRPRQDV YDJLQDOLV FDQGLGD DOELFDQV YH EDNWHUL\DO YDJLQR]LV ROGX÷X ELOGLULOPLúWLU 0RRUH DQG 'DOOH\ $SDQ
'Q\DGD KHU \ÕO RUWD\D oÕNDQ JHQLWDO RUJDQ HQIHNVL\RQODUÕQÕQ \DNODúÕN \DUÕVÕ $V\D NÕWDVÕQGD EXOXQDQ ONHOHUGH PH\GDQD JHOPHNWHGLU /L +DQ /HH /HH DQG /HH 7UNL\H NDGÕQODU DUDVÕQGD YDMLQDO HQIHNVL\RQODUÕQ \D\JÕQ RODUDN \DúDQGÕ÷Õ ELU ONHOHUGHQ ELULGLU <DSÕODQ ELU oDOÕúPDGD 7UN NDGÕQODUÕDUDVÕQGDYDMLQDOHQIHNVL\RQVÕNOÕ÷Õ RODUDN EXOXQPXúWXU +DFÕDOLR÷OX øQDQGÕ YH 3DVLQOLR÷OX %DúND ELU oDOÕúPDGD 7UN NDGÕQODUÕQGD WULFKRPRQDV YDJLQDOLV SUHYDODQVÕQÕ RODUDNEXOXQPXúYHEXQXQGL÷HUONHOHUH J|UH \NVHN ROGX÷XQX ELOGLULOPLúWLU <D]DU 'D÷FÕ $NVR\ hVWQ $NÕV $N YH 'DOGDO *HQLWDO KLM\HQ YDMLQDO HQIHNVL\RQODUGDQ NRUXQPDQÕQ HQ EDVLW YH |QHPOL ELU \ROX JLEL J|UQVH GH NÕUVDO E|OJHOHUGH \DúD\DQ NDGÕQODU JHQLWDO KLM\HQH \HWHULQFH |QHP YHUHPHPHNWHGLU .DUDWD\ YH g]YDUÕú 7UNL\H¶GH JHFHNRQGX E|OJHOHULQGH \DúD\DQ NDGÕQODUÕQ JHQLWDO KLM\HQH \HWHULQFH |QHP YHUPHGL÷LQH GLNNDW oHNPLúWLU %H\GD÷ LVH H÷LWLP YH oDOÕúPD GXUXPX LOH NDGÕQODUÕQ JHQLWDO KLM\HQ GDYUDQÕúODUÕ DUDVÕQGD LVWDWLVWLNVHO RODUDN DQODPOÕ ELULOLúNLROGX÷XQXELOGLUPLúWLU
6D÷OÕN DUDPD GDYUDQÕúÕ ³VD÷OÕN SUREOHPL RODQ NLúLOHULQ X\JXQ WHGDYL EXOPDN DPDFÕ\OD NHQGL ELUH\VHO VRUXPOXOXNODUÕQÕ DODUDN \DSWÕNODUÕ KHUKDQJL ELU DNWLYLWH´ RODUDN WDQÕPODQÕU :DUG 0HUWHQV DQG 7KRPDV $QRUPDO YDMLQDO DNÕQWÕODU YDMLQDO HQIHNVL\RQODUÕQ HQ \D\JÕQ EHOLUWLVL ROPDVÕQD UD÷PHQ oR÷X ]DPDQ NDGÕQODU WDUDIÕQGDQ LKPDO HGLOHELOPHNWHGLU .DGÕQODUÕQ DQRUPDO DNÕQWÕ GXUXPXQGD VD÷OÕN NXUXOXúXQD EDúYXUDUDN HUNHQ WDQÕ YH WHGDYL RODQDNODUÕQGDQ ID\GDODQPDVÕ úSKHVL] NDGÕQ VD÷OÕ÷ÕQÕ NRUX\XFX IDDOL\HWOHUGHQ ELULGLU (EHOHU YH NDGÕQ VD÷OÕ÷Õ DODQÕQGD oDOÕúDQ KHPúLUHOHU VD÷ODP YH KDVWD ELUH\HXODúPDDoÕVÕQGDQHWNLQNRQXPGDEXOXQDQ VD÷OÕN oDOÕúDQODUÕGÕU g]HOOLNOH YDMLQDO VHPSWRPODUÕQ GDKD \D\JÕQ J|UOG÷ NÕUVDO NHVLPOHUGH YH VRV\RHNRQRPLN G]H\L GúN NDGÕQODUÕQ DQRUPDO YDMLQDO DNÕQWÕ GXUXPODUÕQÕQ EHOLUOHQPHVL VD÷OÕN DUDPD GDYUDQÕúODUÕ YH DUDPDPD QHGHQOHULQLQ DUDúWÕUÕOPDVÕ ELULQFL EDVDPDN VD÷OÕN KL]PHW IDDOL\HWOHULQL EHOLUOHPHN DoÕVÕQGDQ |QHPOLGLU %X oDOÕúPD NÕUVDO ELU E|OJHGH \DúD\DQ NDGÕQODUÕQ DQRUPDO YDMLQDO DNÕQWÕ GXUXPXQGD VD÷OÕN KL]PHWL DUDPD
GDYUDQÕúODUÕQÕ EHOLUOHPHN YH VD÷OÕN KL]PHWL DUDPDGDNL HQJHOOHUL RUWD\D oÕNDUPDN DPDFÕ\OD \DSÕOPÕúWÕU
*(5(d9(<g17(0
$UDúWÕUPDQÕQ ùHNOL $UDúWÕUPD NHVLWVHO WDQÕPOD\ÕFÕDUDúWÕUPDWLSLQGHGLU
$UDúWÕUPDQÕQ <DSÕOGÕ÷Õ <HU YH =DPDQ $UDúWÕUPD $UDOÕN 2FDN WDULKOHUL DUDVÕQGD 'R÷X $NGHQL] %|OJHVL VÕQÕUODUÕ LoHULVLQGH \HU DODQ .DKUDPDQPDUDú LOLQGH JHUoHNOHúWLULOPLúWLU
$UDúWÕUPDQÕQ (YUHQ YH gUQHNOHPL $UDúWÕUPDQÕQ HYUHQLQL .DKUDPDQPDUDú LOLQGH EXOXQDQ ELU VD÷OÕN RFD÷Õ E|OJHVLQGH \DúD\DQ NDGÕQODU ROXúWXUPDNWDGÕU $UDúWÕUPDQÕQ \DSÕOGÕ÷Õ VD÷OÕN RFD÷Õ E|OJHVLQGH NDGÕQ QIXVX ¶GLU $UDúWÕUPD\D NDWÕOPD NULWHUOHUL HYOL ROPDN JHEH YH ORKXVD ROPDPDN FHUUDKL \D GD GR÷DO RODUDN PHQDSR]D JLUPHPLú ROPDN KRUPRQDO \D GD DQWLEL\RWLNVWHURLGWHGDYLVLDOPÕ\RUROPDNWÕU
gUQHNOHP KHVDSODQPDVÕQGD HYUHQGHNL ELUH\VD\ÕVÕELOLQHQIRUPOQGHQ\DUDUODQÕOPÕúWÕU gUQHNOHP E\NO÷ KHVDSODQÕUNHQ +DFÕDOLR÷OX øQDQGÕ YH 3DVLQOLR÷OX ¶QXQ oDOÕúPDVÕQD J|UH ¶OLN HQIHNVL\RQ KÕ]Õ IDUNÕ GLNNDWH DOÕQPÕúWÕU %XQD J|UH |UQHNOHP E\NO÷ |QHPOLOLN G]H\LQGH HQ D] RODFDN úHNLOGH KHVDSODQPÕúWÕU.D\ÕSODU RODELOHFH÷L J|] |QQGH EXOXQXODUDN UDVWJHOH VD\ÕODU WDEORVXQD J|UH VHoLOHQ HYOHUGH NDGÕQOD J|UúOPúWU $UDúWÕUPD NULWHUOHULQH X\JXQ EXOXQDQ NDGÕQGDQ¶LQLQDQRUPDOYDMLQDODNÕQWÕúLND\HWL ROGX÷X LoLQ DUDúWÕUPD NDSVDPÕQD DOÕQPÕúWÕU 6PEOR÷OXYH6PEOR÷OX
9HULOHULQ 7RSODQPDVÕ 9HULOHU DUDúWÕUPDFÕODU WDUDIÕQGDQOLWHUDWUWDUDQDUDNKD]ÕUODQDQ IRUPLOH WRSODQPÕúWÕU)RUP NDGÕQODUÕQVRV\RGHPRJUDILN |]HOOLNOHULVD÷OÕNGXUXPX|]HOOLNOHULGR÷XUJDQOÕN |]HOOLNOHULYHVD÷OÕNKL]PHWLDUDPDGDYUDQÕúODUÕQD \|QHOLN VRUXODUÕQ \HU DOGÕ÷Õ G|UW E|OPGHQ ROXúPDNWDGÕU 6D÷OÕN NXUXOXúXQD EDúYXUPDPD QHGHQOHUL DoÕN XoOX RODUDN VRUXOPXúWXU 8\JXODPDGDQ |QFH 6D÷OÕN <NVHNRNXOX (EHOLN %|OP VRQ VÕQÕI |÷UHQFLOHULQGHQ ROXúDQ DQNHW|UHDUDúWÕUPDQÕQDPDFÕDoÕNODQPÕúYHDQNHW IRUPXQGD \HU DODQ VRUXODU WHN WHN WDUWÕúÕOPÕúWÕU $QNHW|UOHU ELOJLOHQGLULOGLNWHQ VRQUD NDGÕQODUOD HYOHULQGHJ|UúOPúWU.DWÕOÕPFÕODUDQRUPDOYH DQRUPDO DNÕQWÕ KDNNÕQGD DoÕNODPD \DSÕOGÕNWDQ VRQUD YDMLQDO DNÕQWÕ úLND\HWL RODQ NDGÕQODUD DUDúWÕUPDIRUPODUÕ\]\]HJ|UúPH\|QWHPL\OH X\JXODQPÕúWÕU +HU J|UúPH RUWDODPD GN VUPúWU $QNHW VRQUDVÕQGD PXD\HQH YH WHGDYL LoLQ VD÷OÕN RFD÷ÕQD GDYHW HGLOPLúWLU .DGÕQODUÕQ WDPDPÕQDJHQLWDOKLM\HQH÷LWLPL\DSÕOPÕúWÕU
$QDGROX+HPúLUHOLNYH6D÷OÕN%LOLPOHUL'HUJLVL
206 ø]LQOHULQ $OÕQPDVÕ $UDúWÕUPDQÕQ \DSÕODELOPHVL LoLQ .DKUDPDQPDUDú 6Wo øPDP hQLYHUVLWHVL 7ÕS )DNOWHVL $NDGHPLN $UDúWÕUPD 'H÷HUOHQGLUPH .RPLV\RQX¶QGDQ HWLN RQD\ DOÕQPÕúWÕU $UDúWÕUPDQÕQ \DSÕOGÕ÷Õ VD÷OÕN RFD÷Õ EDúKHNLPOL÷LQGHQJHUHNOLL]LQOHUDOÕQGÕNWDQVRQUD YHUL WRSODQPD\D EDúODQPÕúWÕU .DWÕOÕPFÕODUD DUDúWÕUPDQÕQ DPDFÕ KDNNÕQGD ELOJL YHULOHUHN \D]ÕOÕ YH V|]O L]LQOHUL DOÕQDUDN YHULOHU HOGH HGLOPLúWLU
9HULOHULQ 'H÷HUOHQGLULOPHVL 9HULOHULQ LVWDWLVWLNVHO DQDOL]OHUL 6366 LVWDWLVWLN SDNHW SURJUDPÕ NXOODQÕODUDN \DSÕOPÕúWÕU 9HULOHULQ GH÷HUOHQGLULOPHVLQGH \]GHOLN RUWDODPD NLNDUH WHVWL NXOODQÕOPÕú S LVWDWLVWLNVHO RODUDN DQODPOÕNDEXOHGLOPLúWLU
%8/*8/$59(7$57,ù0$ 7RSODP NDGÕQ HYLQGH ]L\DUHW HGLOPLúWLU %X NDGÕQODUÕQ ¶VL DUDúWÕUPD NULWHUOHULQH X\JXQ EXOXQPXú YH RQODUÕQ ¶L DQRUPDO YDMLQDO DNÕQWÕ úLND\HWL ROGX÷X LoLQ DUDúWÕUPD NDSVDPÕQD DOÕQPÕúWÕU $UDúWÕUPD \DSWÕ÷ÕPÕ] E|OJHGH NDGÕQODU DUDVÕQGD DQRUPDO YDMLQDO DNÕQWÕ úLND\HWL J|UOPH RUDQÕ ¶WLU 9DMLQDO DNÕQWÕ NDGÕQ KD\DWÕQÕQ KHU G|QHPLQGH NDUúÕODúWÕ÷Õ ELU GXUXPGXU dLQ¶LQ NÕUVDO ELU E|OJHVLQGH \DSÕODQ ELU DUDúWÕUPDGD NDGÕQODUÕQ ¶ KD\DWÕ ER\XQGD HQ D] ELU NH] UHPH \ROODUÕQÕ LOJLOHQGLUHQ ELU HQIHNVL\RQOD NDUúÕODúWÕNODUÕQÕ LIDGH HWPLúOHUGLU /L +DQ /HH /HHDQG/HH
9DMLQDO DNÕQWÕODU IL]\RORMLN RODELOGL÷L JLELSDWRORMLNELUGXUXPXQJ|VWHUJHVLGHRODELOLU %X\]GHQDQRUPDODNÕQWÕGXUXPXQGDNDGÕQODUÕQ VD÷OÕN DUDPD GDYUDQÕúODUÕQD VDKLS ROPDVÕ KDVWDOÕNODUÕQ HUNHQ WDQÕ YH WHGDYLVL DoÕVÕQGDQ |QHPOLGLU %X oDOÕúPDGD NDGÕQODUÕQ ¶VL YDMLQDO DNÕQWÕ LoLQ VD÷OÕN NXUXOXúXQD EDúYXUGX÷XQXLIDGHHWPLúWLU 7DEOR .DUDWD\ YH g]YDUÕú 7UNL\H¶GH ELU JHFHNRQGX E|OJHVLQGH \DSWÕ÷Õ DUDúWÕUPDGD JHoPLúWH YDMLQDO DNÕQWÕ \DúD\DQ NDGÕQODUÕQ VDGHFH ¶XQXQ KHNLPH EDúYXUGX÷XQX ELOGLUPLúWLU dLQ¶GH \DSÕODQELUDUDúWÕUPDGDLVHVRQD\LoLQGHDNÕQWÕ SUREOHPL RODQ NDGÕQODUÕQ ¶X VD÷OÕN NXUXOXúXQD EDúYXUXUNHQ ¶VLQLQ HF]DQH\H EDúYXUGX÷X EHOLUOHQPLúWLU *XDQ :X /L /LQ 5RWKHUDP%RUXV 'HWHOV DQG +VLHK +LQGLVWDQ¶ÕQ %DWÕ %HQJDO E|OJHVLQGH NÕUVDO ELU DODQGD \DSÕODQ ELU oDOÕúPDGD NDGÕQODUÕQ ¶L N|WNRNXOXDNÕQWÕGDQúLND\HWHWWL÷LKDOGHVDGHFH
¶VLWÕEELWHGDYLLoLQEDúYXUPXúWXU 6DPDQWD *KRVK DQG 0XNKHUMHH %LU WRSOXPGD VD÷OÕN DUDPD GDYUDQÕúÕQÕQ \NVHN ROPDVÕ WRSOXPXQRKDVWDOÕNKDNNÕQGDIDUNÕQGDOÕ÷ÕQÕYHR E|OJHGH VD÷OÕN KL]PHWOHULQLQ PHYFXGL\HWLQL J|VWHULU $UDúWÕUPD \DSWÕ÷ÕPÕ] E|OJH úHKLU PHUNH]LQH \DNÕQGÕU YH E|OJHGH NROD\OÕNOD XODúÕODELOHQ ELU VD÷OÕN RFD÷Õ EXOXQPDNWDGÕU 1LWHNLP YDMLQDO DNÕQWÕ LoLQ VD÷OÕN NXUXOXúXQD EDúYXUDQ NDGÕQODUÕQ oR÷X VD÷OÕN RFD÷ÕQD EDúYXUPXúWXU 7DEOR $\UÕFD DUDúWÕUPDQÕQ \DSÕOGÕ÷Õ WDULKWH VD÷OÕN RFD÷ÕQD ED÷OÕ RODUDN oDOÕúDQ HEHOHU \ÕOGD LNL NH] GR÷XUJDQ \DúWDNL NDGÕQODUDHY]L\DUHWLQGHEXOXQPDNWDGÕU
.DGÕQODUÕQ YDMLQDO DNÕQWÕ LoLQ VD÷OÕN NXUXOXúXQD EDúYXUPDVÕQÕQ \DQÕQGD UHoHWH HGLOHQ LODoODUÕQ X\JXQ úHNLOGH NXOODQPDVÕ YH LODo ELWWLNWHQ VRQUD NRQWUROH JLWPHVL GH |QHPOLGLU $UDúWÕUPDPÕ]GDDQRUPDODNÕQWÕúLND\HWLLOHVD÷OÕN NXUXOXúXQD EDúYXUDQ NDGÕQODUÕQ WDPDPÕ KHNLP WDUDIÕQGDQ PXD\HQH HGLOHUHN UHoHWH \D]ÕOPÕúWÕU )DNDWNDGÕQODUÕQ¶VLKHNLPLQYHUGL÷LWHGDYL\L X\JXODPDGÕ÷Õ \D GD \DUÕGD EÕUDNWÕ÷ÕQÕ LIDGH HWPLúWLU 7DEOR +HUKDQJL ELU UDKDWVÕ]OÕN GXUXPXQGD KHNLPH EDúYXUDQ KDVWDODUÕQ ELU E|OPYHULOHQLODoODUÕ\DKLoNXOODQPDPDNWD\D GDEHOLUWLOHUND\EROXQFD\DNDGDUNXOODQPDNWDYH WHGDYL\L\DUÕGDEÕUDNPDNWDGÕU%KDWWL DQG)LNUHH WDUDIÕQGDQ3DNLVWDQ¶ÕQ.DUDFKLE|OJHVLQGH \DSÕODQ ELU DUDúWÕUPDGD LVH NDGÕQODU YDMLQDO SUREOHPOHU LoLQ GRNWRUXQXQ YHUGL÷L WDEOHWOHUL YH NUHPOHUL NXOODQGÕ÷Õ KDOGH ELU VUH VRQUD SUREOHPLQ WHNUDU JHUL G|QG÷Q LIDGH HWPLúOHUGLU 9DMLQDO HQIHNVL\RQODUD QHGHQ RODQ N|W KLM\HQ DOÕúNDQOÕNODUÕ GHYDP HWWL÷L VUHFH DQRUPDO DNÕQWÕODUÕQ WHNUDU HWPHVLQLQ PPNQ ROGX÷X GúQOPHNWHGLU %X GXUXP NDGÕQODUÕQ WÕEEL WHGDYL\H RODQ LQDQoODUÕQÕ VDUVDUDN LODoODUÕ \DUÕGDEÕUDNPDVÕQDQHGHQRODELOLU
dDOÕúPDPÕ]GDNDGÕQODUÕQ¶LYDMLQDO DNÕQWÕODUÕ ROGX÷X KDOGH VD÷OÕN NXUXOXúXQD EDúYXUPDGÕNODUÕQÕ LIDGH HWPLúOHUGLU dLQ¶GH \DSÕODQ ELU DUDúWÕUPDGD LVH NDGÕQODUÕQ QHUHGH\VH \DUÕVÕ UHPH \ROODUÕQÕ LOJLOHQGLUHQ HQIHNVL\RQODUGD GRNWRUD EDúYXUPDPÕúODUGÕU /L +DQ /HH /HH DQG /HH $UDúWÕUPDPÕ]GD VD÷OÕN NXUXOXúXQD EDúYXUPD\DQ NDGÕQ RUDQÕQÕQ GL÷HUDUDúWÕUPDODUDJ|UHGúNROPDVÕQÕQQHGHQL DUDúWÕUPDQÕQ \DSÕOGÕ÷Õ E|OJHQLQ VD÷OÕN NXUXOXúODUÕQD \DNÕQ ROPDVÕ YH PDKDOOHGH ELU VD÷OÕN RFD÷ÕQÕQ EXOXQPDVÕQGDQ ND\QDNODQGÕ÷Õ GúQOPHNWHGLU
$QDGROX+HPúLUHOLNYH6D÷OÕN%LOLPOHUL'HUJLVL 207 7DEOR9DMLQDO$NÕQWÕVÕ2ODQ.DGÕQODUÕQ6D÷OÕN+L]PHWL$UDPD'DYUDQÕúODUÕQÕQ'D÷ÕOÕPÕ 6D÷OÕN+L]PHWL$UDPD'DYUDQÕúÕ Q 6D÷OÕNNXUXOXúXQDEDúYXUPDGXUXPX %DúYXUDQ %DúYXUPD\DQ 6D÷OÕNKL]PHWLDOGÕ÷ÕVD÷OÕNNXUXOXúX Q 6D÷OÕNRFD÷Õ 'HYOHWKDVWDQHVL g]HOKDVWDQH 5HoHWHHGLOHQWHGDYL\LNXOODQPDGXUXPX Q .XOODQDQ .XOODQPD\DQ 6D÷OÕNKL]PHWLDUDPDPDQHGHQOHUL Q .HQGLOL÷LQGHQJHoHFH÷LQLGúQPH (NRQRPLNQHGHQOHU =DPDQVÕ]OÕN 8ODúÕP]RUOXNODUÕ 8WDQPD (YGHNLVRUXPOXOXNODU %LOJLVL]OLN 6D÷OÕNoDOÕúDQODUÕQÕQLOJLVL]OL÷L
*Sağlık hizmeti aramayan kadınlar dahil edilmedi, **Sağlık hizmeti arayan kadınlar dahil edilmedi
$UDúWÕUPD\D NDWÕODQ NDGÕQODUÕQ VD÷OÕN NXUXOXúXQD EDúYXUPDPDODUÕQÕQ HQ E\N VHEHEL YDMLQDODNÕQWÕQÕQNHQGLOL÷LQGHQJHoHFH÷LQL GúQPHOHULGLU 7DEOR .DUDWD\ YH g]YDUÕú WDUDIÕQGDQ \DSÕODQ oDOÕúPDGD DQRUPDO DNÕQWÕúLND\HWL\DúD\DQNDGÕQODUÕQ¶VÕKLoELU úH\\DSPDGÕ÷ÕQÕYHNHQGLOL÷LQGHQJHoWL÷LQLLIDGH HWPLúWLU 1LMHU\DOÕ NDGÕQODUGD \DSÕODQ ELU oDOÕúPD\D J|UH LVH NDGÕQODUÕQ ¶L VHPSWRPODUÕQ NHQGLOL÷LQGHQ JHoPHVL YH NÕVD VUPHVLQGHQ GROD\Õ WHGDYL DUDPD\D JHUHNVLQLP GX\PDPDNWDGÕU 5DELX$GHZXQPL$NLQOXVLDQG $NLQROD .DGÕQODU UHPH RUJDQODUÕQÕ LOJLOHQGLUHQ VRUXQODUGD \D WHGDYL DUDPD\Õ UHGGHWPHNWH \D GD HUWHOHPHNWHGLU 2]DQ YH g]HUNDQ \DSWÕNODUÕ oDOÕúPDGD -LQHNRORML 3ROLNOLQL÷L¶QH EDúYXUDQ NDGÕQODUÕQ ¶LQLQ ELU \ÕOÕDúNÕQVUHGLUDQRUPDODNÕQWÕODUÕROGX÷XKDOGH WÕEEL\DUGÕPLoLQEDúYXUXGDEXOXQPDGÕ÷ÕQÕWHVSLW HWPLúOHUGLU%DúNDELUDUDúWÕUPDGD&<%(¶XRODQ NDGÕQODUÕQ¶VLQLQWÕEEL\DUGÕPDUDPD\ÕHQD] ELU D\ HUWHOH\HELOPHNWHGLU 7KX 'R =LHUFK DQG +DUW 9DMLQDO DNÕQWÕODU PHQVWUXHO VLNOXVXQ ID]ODUÕQD ED÷OÕ RODUDN NHQGLOL÷LQGHQ JHoPLú JLEL J|UQVH GH GDKD VRQUD WHNUDU HGHELOPHNWHGLU %XQD ED÷OÕ RODUDN NDGÕQODUÕQ VD÷OÕN DUDPD ]DPDQÕQÕ GL÷HU D\ODUD HUWHOHGLNOHUL \D GD KLo VD÷OÕN DUDPD GDYUDQÕúÕ J|VWHUPHGLNOHUL GúQOPHNWHGLU
.DGÕQODUÕQ YDMLQDO DNÕQWÕGD WHGDYL DUDPDPDODUÕQÕQ GL÷HU VHEHSOHUL HNRQRPLN
QHGHQOHU ]DPDQVÕ]OÕN XODúÕP ]RUOXNODUÕ XWDQPD HYGHNL VRUXPOXOXNODU ELOJLVL]OLN YH VD÷OÕN oDOÕúDQODUÕQÕQ LOJLVL]OL÷LGLU 7DEOR <DSÕODQ DUDúWÕUPDODUGD GD NDGÕQODUÕQ EHQ]HU QHGHQOHUGHQ GROD\Õ VD÷OÕN NXUXOXúXQD EDúYXUPDGÕ÷Õ EHOLUOHQPLúWLU 5L]YL DQG /XE\ (O.DN .KDZDMD 6DOHP DQG =XUD\N
$UDúWÕUPD VRQXoODUÕQD J|UH NDGÕQODU HYGHNL VRUXPOXOXNODUÕ YH ]DPDQVÕ]OÕNWDQ GROD\Õ YDMLQDO DNÕQWÕ GXUXPXQGD VD÷OÕN DUDPD\Õ LKPDO HGHELOPHNWHGLU %HQ]HU úHNLOGH 5L]YL DQG /XE\ NDGÕQODUÕQ JQON LúOHULQL DNVDWPDGÕ÷Õ PGGHWoH VD÷OÕN KL]PHWL DUDPDGÕ÷ÕQÕ |QFH NHQGLOHUL WHGDYL HWWL÷LQL YH EDúDUÕOÕ RODPD]ODUVD VD÷OÕN NXUXOXúXQD EDúYXUGXNODUÕQÕ ELOGLUPLúWLU .ÕUVDO 0XPEDL E|OJHVLQGH \DSÕODQ NDOLWDWLI ELU DUDúWÕUPDGDNDGÕQODUÕQHYLoLVRUXPOXOXNODUÕQGDQ GROD\Õ YDMLQDO DNÕQWÕ GXUXPXQGD WHGDYL DUDPD\Õ LKPDO HWWLNOHUL EHOLUOHQPLúWLU .RVWLFN 6FKHQVXO -DGKDY6LQJK%DYDGHNDUDQG6DJJXUWL
$UDúWÕUPDQÕQ \DSÕOGÕ÷Õ E|OJH úHKLU PHUNH]LQH \DNÕQ YH PDKDOOHGH ELU VD÷OÕN RFD÷Õ EXOXQPDVÕQD UD÷PHQ DUDúWÕUPD\D NDWÕODQ NDGÕQODUGDQ XODúÕP ]RUOX÷XQGDQ GROD\Õ VD÷OÕN DUDPD\ÕLKPDOHWWLNOHULQLLIDGHHGHQOHUROPXúWXU %HQ]HU úHNLOGH %KDWWL DQG )LNUHH WDUDIÕQGDQ 3DNLVWDQ¶ÕQ .DUDFKL E|OJHVLQGH \DSÕODQ ELU DUDúWÕUPDGD |]HOOLNOH LOHUL \DúWDNL
$QDGROX+HPúLUHOLNYH6D÷OÕN%LOLPOHUL'HUJLVL
208 NDGÕQODUVD÷OÕNNXUXOXúXQDJLWPHNLoLQXODúÕPÕQ E\N]RUOXNODU\DUDWWÕ÷ÕQÕLIDGHHWPLúOHUGLU
$UDúWÕUPDGD NDGÕQODU DQRUPDO YDMLQDO DNÕQWÕGDQ PX]GDULS ROVDODU GDKL XWDQPD GX\JXVXQGDQ GROD\Õ VD÷OÕN NXUXOXúXQD EDúYXUPDGÕ÷ÕQÕ LIDGHHWPLúWLU .ÕUVDO NHVLPOHUGH \DúD\DQNDGÕQODUVDKLSROGXNODUÕNOWUQYHELU WDNÕP JHOHQHNVHO WXWXPODUÕQ HWNLVL\OH WHGDYL DUDPDPDNWDGÕU %XQGDQ GROD\Õ VD÷OÕN DUDPD GDYUDQÕúÕVD÷OÕNYHFLQVL\HWOHLOLúNLOLIDNW|UOHUGHQ D\UÕ GúQOHPH] :DUG 0HUWHQV DQG 7KRPDV %KDWWL DQG )LNUHH 7LDQ /L =KDQJ DQG *XHVW %RXUQH .ÕUVDO E|OJHOHUGH \DúD\DQ NDGÕQODU ]HULQGH \DSÕODQ oDOÕúPDODUGD NDGÕQODUÕQ URJHQLWDO VLVWHPL LOJLOHQGLUHQ VRUXQODUGD GDPJDODQPD NRUNXVX XWDQPD YH PDKFXEL\HW GX\JXODUÕQGDQ GROD\Õ WHGDYL DUDPDGÕNODUÕ ELOGLULOPLúWLU 3UDVDG $EUDKDQ .XU] *HRUJH /DOLWKD -RKQ -D\DSDXO HWDO /LHEHU/L:X5RWKHUDP%RUXVDQG *XDQ 3HUHUD .LUWKLQDQGD :LMHUDWQH DQG :LFNUDPDUDFKFKL %HQ]HU úHNLOGH 1HSDO .DWPDQGX¶GD \DSÕODQ ELU oDOÕúPDGD NDGÕQODUÕQ YDMLQDO DNÕQWÕ SUREOHPLQL NLPVH LOH SD\ODúPDPDVÕQÕQ QHGHQL XWDQPDGÕU 5L]YL DQG /XE\ +LQGLVWDQ¶GD\DSÕODQDUDúWÕUPDODUGD NDGÕQODUÕQ PDKFXEL\HW YH XWDQJDoOÕN QHGHQL\OH JHQLWDO RUJDQODUÕQÕ LOJLOHQGLUHQ NRQXODUGD VD÷OÕN NXUXOXúXQDEDúYXUPDGÕNODUÕJ|VWHULOPLúWLU %DUXD DQG .XU] .XPDUÕ 6LQJK DQG -DLQ dLQ¶GH \DSÕODQ ELU DUDúWÕUPD\D J|UH NDGÕQODU MLQHNRORMLN SUREOHPOHULQL HUNHN GRNWRUODUD DQODWPDNWDQ XWDQGÕNODUÕQ LoLQ GRNWRUD JLWPHPHNWHGLU /L +DQ /HH /HH DQG /HH 8WDQPD YH PDKFXEL\HW7UNL\H¶GHNÕUVDO E|OJHOHUGH \DúD\DQ NDGÕQODUÕQ VDKLS ROGX÷X NOWUHO ELU GX\JXGXU %X NDGÕQODU VD÷OÕNODUÕQÕ LOJLOHQGLUHQ NRQXODUGD EXQX EDúNDODUÕ LOH SD\ODúPDNWD oHNLQJHQOLN \DúD\DELOPHNWH YH EXQGDQ GROD\Õ VD÷OÕN DUDPD GDYUDQÕúÕ J|VWHUPHPHNWHGLU
$UDúWÕUPDGD VD÷OÕN oDOÕúDQODUÕQÕQ LOJLVL]OL÷L NDGÕQODUÕQ YDMLQDO DNÕQWÕ GXUXPXQGD VD÷OÕN NXUXOXúXQD EDúYXUPDPD QHGHQOHUL DUDVÕQGD \HU DOPDNWDGÕU 1HSDO .DWPDQGX¶GD \DSÕODQ oDOÕúPD\D J|UH NDGÕQODU VD÷OÕN SURIHV\RQHOOHULQLQ QD]LN ROPDGÕNODUÕQÕ YH JL]OLOL÷H |QHP YHUPHGLNOHULQGHQ GROD\Õ YDMLQDO DNÕQWÕ LoLQ VD÷OÕN NXUXOXúXQD EDúYXUPDPDNWDGÕU 5L]YLDQG/XE\ +LQGLVWDQ¶GD\DSÕODQELU DUDúWÕUPDGD NDGÕQODUÕQ UHPH RUJDQODUÕQÕ LOJLOHQGLUHQ VRUXQODUGD JL]OLOL÷LQ \HWHUOL ROPDGÕ÷ÕQÕ GúQGNOHULQGHQ VD÷OÕN NXUXOXúXQD EDúYXUPDGÕNODUÕ LIDGH HGLOPLúWLU 3UDVDG $EUDKDQ .XU] *HRUJH /DOLWKD -RKQ -D\DSDXO
HW DO %DúND ELU oDOÕúPD LVH 9LHWQDP¶GD \DSÕOPÕúWÕU %X oDOÕúPDGD NDWÕOÕPFÕODU VD÷OÕN oDOÕúDQODUÕQÕQ QHJDWLI WXWXPODUÕQGDQ GROD\Õ &<%( YH *<( GXUXPXQGD VD÷OÕN NXUXOXúXQD EDúYXUPDPDNWDGÕU /DQ )D[HOLG &KXF 0RJUHQ DQG/XQGERUJ *HQLWDORUJDQODUDDLWVD÷OÕN SUREOHPOHULPDKUHPL\HWOHLOJLOLGLU%XWUVD÷OÕN SUREOHPOHULQL NDGÕQODU VD÷OÕN oDOÕúDQODUÕQD UDKDWOÕNOD DoÕNOD\DPDPDODUÕQÕQ \DQÕQGD VD÷OÕN oDOÕúDQODUÕQGDQ J|UGNOHUL WDYÕU YH GDYUDQÕúODU RQODUÕQ VD÷OÕN NXUXOXúXQD EDúYXUPD LVWH÷LQL NÕUDELOPHNWHGLU
$UDúWÕUPD\D NDWÕODQ NDGÕQODUÕQ \Dú RUWDODPDVÕROXSoR÷XQOX÷X \DúJUXEXQGDGÕU$\UÕFDNDGÕQODUÕQoR÷XQOX÷X LONRNXO PH]XQX ROGX÷XQX EHOLUWPLúWLU 7UNL\H 1IXV YH 6D÷OÕN $UDúWÕUPDVÕ 716$ YHULOHULQH J|UH ONHPL]GH GR÷XUJDQ \DúWDNLNDGÕQODUÕQoR÷XQOX÷X \DúJUXEXQGD YH NDGÕQODU DUDVÕQGDLONRNXO PH]XQX ROPD RUDQÕ \NVHNWLU $UDúWÕUPD VRQXoODUÕPÕ] 7UNL\H YHULOHUL LOH EHQ]HU VRQXoODU LoHUPHNWHGLU hONHPL]GH NDGÕQODU DUDVÕQGD LVWLKGDP RUDQÕ ¶GLU 716$ $UDúWÕUPD JUXEXPX]GDNL NDGÕQODUGD EX RUDQ ROXS NDGÕQODUÕQ oR÷XQOX÷X DLOH JHOLULQLQ DVJDUL FUHWLQ DOWÕQGD ROGX÷XQX LIDGH HWPLúWLU dDOÕúDQ NDGÕQ RUDQÕQÕQ 7UNL\H RUDQODUÕQD J|UH GúN ROPDVÕQÕQ VHEHEL DUDúWÕUPD JUXEXPX]XQ NÕUVDO E|OJHGH \DúD\DQ YH D] JHOLUOL DLOHOHUGH
\DúD\DQ NDGÕQODUGDQ ROXúPDVÕQGDQ
ND\QDNODQGÕ÷Õ GúQOPHNWHGLU .DGÕQODUÕQ VRV\RGHPRJUDILN |]HOOLNOHUL LOH YDMLQDO DNÕQWÕ GXUXPXQGD VD÷OÕN KL]PHWL DUDPD GDYUDQÕúÕ DUDVÕQGD LVWDWLVWLNVHO RODUDN DQODPOÕ ELU LOLúNL EXOXQPDPÕúWÕU S! 7DEOR
.DWÕOÕPFÕODUÕQ JHQHO VD÷OÕN GXUXPX |]HOOLNOHUL LQFHOHQGL÷LQGH WP NDGÕQODUÕQ EHGHQ NLWOH LQGHNVL RUWDODPDVÕ ROXS oR÷XQOX÷X KDILI úLúPDQ JUXEXQGDGÕU .DGÕQODUÕQ ¶VÕQÕQ NURQLN ELU KDVWDOÕ÷Õ YDUGÕUYHEXQODUÕQ¶NURQLNKLSHUWDQVL\RQ ¶L GL\DEHW ¶VL JXDWU KDVWDVÕ ROGX÷XQX ELOGLUPLúWLU 7P NDGÕQODUÕQ ¶ VUHNOL ELU LODo NXOODQGÕ÷ÕQÕ LIDGH HWPLúWLU $UDúWÕUPD\D NDWÕODQ NDGÕQODUÕQ ¶VL VÕN VÕN LGUDU \ROX HQIHNVL\RQX JHoLUGL÷LQL ¶VÕ VÕN VÕN DQRUPDO DNÕQWÕ úLND\HWL \DúDGÕ÷ÕQÕ EHOLUWPLúWLU 7DEOR /LWHUDWUGH NDGÕQODUÕQ ¶LQLQ \DúDPÕQÕQ EHOOL ELU G|QHPLQGH LGUDU \ROX HQIHNVL\RQX JHoLUGL÷L ELOGLULOPLúWLU *|QHQ $NoDP YH <D\OÕ hURMLQHNRORML 3ROLNOLQL÷L¶QH EDúYXUDQ NDGÕQODUÕQ ¶QH LGUDU \ROX HQIHNVL\RQX WDQÕVÕ NRQXOPXúWXU g]GHPLU dHOHEL 1XUXOODKR÷OX YH $N
$QDGROX+HPúLUHOLNYH6D÷OÕN%LOLPOHUL'HUJLVL
209 0DODW\D¶GD\DSÕODQELUDUDúWÕUPDGDLVHNDGÕQODUÕQ ¶VLQLQ KD\DWÕ ER\XQFD HQ D] ELU NH] JHQLWDO HQIHNVL\RQ \DúDGÕ÷Õ RUWD\D oÕNPÕúWÕU <D÷PXU %L]LP DUDúWÕUPDPÕ]GD LGUDU \ROX HQIHNVL\RQX JHoLUPH YH VÕN VÕN DQRUPDO YDMLQDO DNÕQWÕ\DúDPDRUDQÕQÕQ\NVHNROPDVÕDUDúWÕUPD JUXEXPX]XQ|]HOOLNOHEXWUVD÷OÕNSUREOHPLRODQ NDGÕQODUGDQ VHoLOPHVLQGHQ ND\QDNODQGÕ÷Õ GúQOPHNWHGLU
$UDúWÕUPD\D NDWÕODQ NDGÕQODUÕQ ¶L ULQHULQNRQWLQDQVúLND\HWLROGX÷XQXEHOLUWPLúWLU <DSÕODQ ELU DUDúWÕUPDGD NDGÕQODUÕQ ¶LQLQ ULQHU LQNRQWLQDQV EXOJXODUÕ ROGX÷X WHVSLW
HGLOPLúWLU .|N ùHQHO YH $N\] %DúND ELU DUDúWÕUPDGD 7UN NDGÕQODUÕ DUDVÕQGD ULQHU LQNRQWLWDQVSUHYDODQVÕ RODUDNEXOXQPXúWXU .RFD|] 7DODV YH $WDEHNR÷OX $UDúWÕUPD JUXEXPX]GDNL NDGÕQODUGD ULQHU LQNRQWLQDQV \DúDPD GXUXPX OLWHUDWU LOH X\XPOX EXOXQPXúWXU .DGÕQODUÕQ VD÷OÕN GXUXPX |]HOOLNOHUL LOH YDMLQDO DNÕQWÕ GXUXPXQGD VD÷OÕN KL]PHWL DUDPD GDYUDQÕúÕ DUDVÕQGD LVWDWLVWLNVHO RODUDNDQODPOÕELULOLúNLVDSWDQPDPÕúWÕU S! 7DEOR
7DEOR 9DMLQDO $NÕQWÕVÕ 2ODQ .DGÕQODUÕQ 7DQÕWÕFÕ g]HOOLNOHULQH *|UH 6D÷OÕN .XUXOXúXQD %DúYXUXS %DúYXUPDPD'XUXPODUÕQÕQ.DUúÕODúWÕUÕOPDVÕ g]HOOLNOHU 6D÷OÕN.XUXOXúXQD %DúYXUDQ Q 6D÷OÕN.XUXOXúXQD %DúYXUPD\DQ Q 7RSODP 7HVWYH SGH÷HUL <Dú Q Q Q Ȥ S YH]HUL (÷LWLPGXUXPX 2NXODJLWPH\HQ øONRNXO Ȥ 2UWDRNXOYH]HUL S dDOÕúPDGXUXPX (YHW Ȥ +D\ÕU S $\OÕNJHOLUGXUXPX ']HQVL]JHOLU $VJDULFUHWĻ Ȥ $VJDULFUHW S $VJDULFUHWĹ 6D÷OÕNVLJRUWDVÕ 9DU Ȥ <RN S $LOHWLSL dHNLUGHNDLOH Ȥ *HQLúDLOH S
$QDGROX+HPúLUHOLNYH6D÷OÕN%LOLPOHUL'HUJLVL
210
7DEOR 9DMLQDO $NÕQWÕVÕ 2ODQ .DGÕQODUÕQ 6D÷OÕN 'XUXPX g]HOOLNOHULQH *|UH 6D÷OÕN .XUXOXúXQD %DúYXUXS%DúYXUPDPD'XUXPODUÕQÕQ.DUúÕODúWÕUÕOPDVÕ g]HOOLNOHU 6D÷OÕN.XUXOXúXQD %DúYXUDQ Q 6D÷OÕN.XUXOXúXQD %DúYXUPD\DQ Q 7RSODP 7HVWYHS GH÷HUL %.ø Q Q Q =D\ÕI 1RUPDO Ȥ +DILIúLúPDQ S 2EH] .URQLNKDVWDOÕN 9DU Ȥ <RN S hULQHULQNRQWLQDQV 9DU Ȥ <RN S 6ÕNVÕNLGUDU\ROXHQIHNVL\RQX 9DU Ȥ <RN S 6ÕNVÕNDQRUPDODNÕQWÕ 9DU Ȥ <RN S
$UDúWÕUPDPÕ]D NDWÕODQ NDGÕQODUÕQ oR÷XQOX÷X \Dú DUDOÕ÷ÕQGD LON JHEHOLN GHQH\LPLQL \DúDPÕú EHúWH ELUL LVH DG|OHVDQ \DúODUGD JHEH NDOPÕúWÕU $UDúWÕUPD JUXEXPX]GD RUWDQFD LON JHEHOLN \DúÕ ¶GXU 7DEOR 716$YHULOHULQHJ|UHNDGÕQODUÕQ oR÷XQOX÷XQXQ LON GR÷XPX \Dú DUDOÕ÷ÕQGD ROXS RUWDQFD LON JHEHOLN \DúÕ ¶GXU hONHPL]GH NDGÕQODU \DúÕQD JHOGL÷LQGH oRFXN GR÷XUPDRUDQÕNHVNLQELUúHNLOGHDUWPDNWDYH GDKD HUNHQ \DúODUGD oRFXN GR÷XUPD QDGLUGLU $QFDN NÕUVDO DODQODUGD \DúD\DQ NDGÕQODUGD DG|OHVDQ \DúWD oRFXN VDKLEL ROPD RUDQÕ NHQWVHO DODQODUGD \DúD\DQODUD J|UH GDKD ID]ODGÕU .ÕUVDO DODQODUGD \Dú JUXEXQGD GR÷XUJDQOÕN KÕ]Õ KÕ]OÕ ELU úHNLOGH DUWPDNWD \Dú DUDVÕQGD HQ VW VHYL\H\H XODúPDNWDGÕU 716$ $UDúWÕUPD JUXEXPX]XQ NÕUVDO E|OJHGH \DúD\DQ NDGÕQODUGDQROXúPDVÕQGDQGROD\ÕLONGR÷XPODUÕQÕ HUNHQ \DúODUGD \DSPD\D H÷LOLPOL ROGXNODUÕ GúQOPHNWHGLU%HQ]HUúHNLOGH%DUXDDQG.XU] ELOGLUGL÷LQH J|UH +LQGLVWDQ¶GD GD NDGÕQODUÕQ oR÷X \DúÕQGD HYOHQ GLULOPHNWHGLU %X NDGÕQODUÕQ VD÷OÕN KL]PHWL DOÕS DOPD\DFD÷ÕQD JHQHOOLNOH HúOHUL ED]HQ GH ND\ÕQYDOLGHOHUL NDUDU YHUPHNWHGLU .DGÕQODUÕQ HúOHUL MLQHNRORMLN SUREOHPOHUGHQ GROD\Õ WÕEEL KL]PHWH LKWL\DFÕ ROGX÷X NRQXVXQGD LNQD HGLOHPHPHNWH YH EX UDKDWVÕ]OÕNODUÕQ |QHPLQL DOJÕOD\DPDPDNWDGÕU %DUXDDQG.XU]
$UDúWÕUPD JUXEXPX]GD JHEHOLN VD\ÕVÕ RUWDODPDVÕ YH GR÷XP VD\ÕVÕ RUWDODPDVÕ ¶GLU 0HG\DQ JHEHOLN YH GR÷XP VD\ÕVÕ RODUDN KHVDSODQPÕúWÕU 716$ ¶H J|UH ONHPL]GH GR÷XUJDQ \DúWDNL NDGÕQ EDúÕQDoRFXNGúPHNWHGLU.ÕUVDODODQGDLVH EX RUDQ NHQWVHO DODQGDQ \]GH GDKD \NVHNWLU $UDúWÕUPD JUXEXPX] JHEHOLN YH GR÷XP VD\ÕVÕ DoÕVÕQGDQ 716$ YHULOHUL LOH EHQ]HUOLN J|VWHUPHNWHGLU .DGÕQODUÕQ LON JHEHOLN \DúÕGR÷XPYHJHEHOLNVD\ÕODUÕLOHYDMLQDODNÕQWÕ GXUXPXQGD VD÷OÕN KL]PHWL DUDPD GDYUDQÕúÕ DUDVÕQGD LVWDWLVWLNVHO RODUDN DQODPOÕ ELU LOLúNL EXOXQPDPDNWDGÕU S! 7DEOR
$UDúWÕUPD VRQXFXQGD NDGÕQODUÕQ ¶LQGH GúNNUHWDM |\NV EXOXQGX÷X EHOLUOHQPLúWLU 'úNNUHWDM |\NV LOH YDMLQDO DNÕQWÕ GXUXPXQGD VD÷OÕN KL]PHWL DUDPD DUDVÕQGD LVWDWLVWLNVHO RODUDN DQODPOÕ LOLúNL ROGX÷X YH EX LOLúLNLQLQ GúNNUHWDM |\NV RODQ NDGÕQODUGD YDMLQDO DNÕQWÕ GXUXPXQGD VD÷OÕN NXUXOXúXQD EDúYXUPD RUDQÕQÕQ \NVHN ROPDVÕQGDQ ND\QDNODQGÕ÷ÕVDSWDQPÕúWÕU S 7DEOR %X JUXSWD VD÷OÕN DUDPD GDYUDQÕúÕQÕQ \NVHN ROPDVÕQÕQVHEHELRODUDN GúN\DGDNUHWDMLoLQ VD÷OÕN NXUXOXúXQD EDúYXUPDN JHUHNWL÷L LoLQ VD÷OÕNDUDPDGHQH\LPLRODQNDGÕQODUÕQEDúNDELU VD÷OÕN VRUXQXQGD VD÷OÕN DUDPD GDYUDQÕúÕ
J|VWHUPH RODVÕOÕ÷ÕQÕQ \NVHOGL÷L
$QDGROX+HPúLUHOLNYH6D÷OÕN%LOLPOHUL'HUJLVL
211
7DEOR 9DMLQDO $NÕQWÕVÕ 2ODQ .DGÕQODUÕQ 'R÷XUJDQOÕN g]HOOLNOHULQH *|UH 6D÷OÕN .XUXOXúXQD %DúYXUXS%DúYXUPDPD'XUXPODUÕQÕQ.DUúÕODúWÕUÕOPDVÕ g]HOOLNOHU 6D÷OÕN.XUXOXúXQD %DúYXUDQ Q 6D÷OÕN.XUXOXúXQD %DúYXUPD\DQ Q 7RSODP 7HVWYHS GH÷HUL
2UW66 2UW66 2UW66
øONJHEHOLN\DúÕ ) S *HEHOLNVD\ÕVÕ ) S 'R÷XPVD\ÕVÕ ) S øONJHEHOLN\DúÕ *HEHOLN\RN \DúYHDOWÕ \Dú \DúYH]HUL Q Q Q Ȥ S *HEHOLNVD\ÕVÕ YH]HUL Ȥ S 'R÷XPVD\ÕVÕ YH]HUL Ȥ S 'úNNUHWDM |\NV 9DU <RN Ȥ S 6218d9(g1(5ø/(5
%X oDOÕúPDQÕQ VRQXoODUÕQD J|UH NÕUVDO E|OJHGH \DúD\DQ GR÷XUJDQ \DúWDNL NDGÕQODUÕQ ¶L DQRUPDO YDMLQDO DNÕQWÕGDQ PX]GDULSWLU 'úN NUHWDM |\NV LOH YDMLQDO DNÕQWÕ GXUXPXQGD VD÷OÕN KL]PHWL DUDPD GDYUDQÕúÕ DUDVÕQGD LVWDWLVWLNVHO RODUDN DQODPOÕ ELU LOLúNL ROGX÷X VDSWDQPÕúWÕU 'DKD |QFHGHQ EDúND ELU VHEHSWHQ GROD\Õ VD÷OÕN NXUXOXúXQD EDúYXUDQ NDGÕQODU YDMLQDO DNÕQWÕ GXUXPXQGD GD VD÷OÕN KL]PHWL DUDPD\Õ LKPDO HWPHPHNWHGLU gUQHNOHP JUXEXPX]GD VD÷OÕN NXUXOXúXQD EDúYXUPD RUDQÕ ROGXNoD \NVHN ROPDVÕQD UD÷PHQ NDGÕQODUÕQ ELU NÕVPÕ KHNLPLQ UHoHWH HWWL÷L WHGDYL\L \D KLo NXOODQPDPÕú\DGD\DUÕGDEÕUDNPÕúWÕU.DGÕQODUÕQ YDMLQDO DNÕQWÕ GXUXPXQGD VD÷OÕN NXUXOXúXQD EDúYXUPDPD QHGHQOHUL oR÷XQOXNOD DNÕQWÕQÕQ NHQGLOL÷LQGHQ L\LOHúHFH÷LQL GúQFHVLGLU %XQXQ \DQÕQGD NDGÕQODU HNRQRPLN QHGHQOHU ]DPDQVÕ]OÕN XODúÕP ]RUOXNODUÕ XWDQPD HYGHNL VRUXPOXOXNODUELOJLVL]OLNYHVD÷OÕNoDOÕúDQODUÕQÕQ LOJLVL]OL÷LQHGHQOHULLOHGHVD÷OÕNDUDPDGDYUDQÕúÕ J|VWHUPHPHNWHGLU %XVRQXoODUGR÷UXOWXVXQGD|QHULOHULPL] x 'DKD |QFH VD÷OÕN NXUXOXúXQD
EDúYXUPDPÕú NDGÕQODU HUNHQ WHúKLV YH WHGDYL RODQDNODUÕ NRQXVXQGD ELOJLOHQGLULOPHOLGLU
x $QRUPDO YDMLQDO DNÕQWÕ úLND\HWL EXOXQDQ NDGÕQODUUHoHWHHGLOHQLODoODUÕQNXOODQÕPÕ NRQXVXQGDELOLQoOHQGLULOPHOLGLU
x 0HQVWUXHO VLNOXV YH YDMLQDO DNÕQWÕODU NRQXVX RUWDRNXO YH OLVH RNXO GHUV PIUHGDWODUÕQDHNOHQPHOLGLU
x (YLoLVRUXPOXOXNODUÕID]ODRODQNDGÕQODU ULVNOLJUXSRODUDNWHVSLWHGLOPHOLYHL]OHP VD\ÕODUÕDUWWÕUÕOPDOÕGÕU
x 7UNL\H¶GH NDGÕQODUÕQ VD÷OÕN DUDPD GDYUDQÕúODUÕQD \|QHOLN QLWHOLNVHO DUDúWÕUPDODUSODQODQPDOÕGÕU
$QDGROX+HPúLUHOLNYH6D÷OÕN%LOLPOHUL'HUJLVL
212 7HúHNNU
9HUL WRSODPD DúDPDVÕQGD DQNHWOHUL X\JXOD\DUDN NDWNÕGDEXOXQDQ6WoøPDPhQLYHUVLWHVL6D÷OÕN <NVHNRNXOX (EHOLN %|OP PH]XQODUÕQD
YH GHVWHNOHULQL HVLUJHPH\HQ .DKUDPDQPDUDú 0HUNH] $VODQEH\ 6D÷OÕN 2FD÷Õ oDOÕúDQODUÕQD WHúHNNUHGHUL]
.$<1$./$5
$SDQ7 dHYUH0LNUREL\RORMLVL1RUPDO)ORUD YH gUQHN $OPD 7HNQLNOHUL øoLQGH +HPúLUHOHU LoLQ 0LNUREL\RORML(G $OWÕQGLú01REHO7ÕS.LWDEHYOHUL øVWDQEXOS
%DUXD $ .XU] . 5HSURGXFWLYH +HDOWK6HHNLQJ E\ 0DUULHG $GROHVFHQW *LUOV LQ 0DKDUDVKWUD ,QGLD 5HSURG+HDOWK0DWWHUV
%H\GD÷ . ' -LQHNRORML 3ROLNOLQL÷LQH %DúYXUDQ .DGÕQODUÕQ *HQLWDO +LM\HQ 'DYUDQÕúODUÕ $WDWUN hQLYHUVLWHVL +HPúLUHOLN <NVHNRNXOX 'HUJLVL
%KDWWL/,)LNUHH )) +HDOWK6HHNLQJ %HKDYLRU RI .DUDFKL:RPHQ:LWK 5HSURGXFWLYH7UDFW,QIHFWLRQV 6RFLDO6FLHQFH 0HGLFLQH %RXUQH 3$6RFLRGHPRJUDSKLF 'HWHUPLQDQWV RI +HDOWK &DUH6HHNLQJ %HKDYLRXU 6HOI5HSRUWHG ,OOQHV DQG 6HOI(YDOXDWHG +HDOWK 6WDWXV LQ -DPDLFD ,QWHUQDWLRQDO -RXUQDO RI &ROODERUDWLYH 5HVHDUFK RQ ,QWHUQDO0HGLFLQH 3XEOLF+HDOWK (O.DN).KDZDMD06DOHP0=XUD\N+&DUH 6HHNLQJ %HKDYLRU RI :RPHQ :LWK 5HSURGXFWLYH +HDOWK 3UREOHPV )URP /RZøQFRPH $UHDV RI%HLUXW ,QWHUQDWLRQDO -RXUQDO *\QHFRORJ\ DQG 2EVWHWULFV
*|UHQ ø $NoDP )= <D\OÕ * .DGÕQODUGD 6ÕN *|UOHQ hULQHU (QIHNVL\RQODUD <DNODúÕP 67('
*XDQ-:X=/L//LQ&5RWKHUDP%RUXV0- 'HWHOV 5 +VLHK - HW DO 6HOI5HSRUWHG 6H[XDOO\ 7UDQVPLWWHG 'LVHDVH 6\PSWRPV DQG 7UHDWPHQW 6HHNLQJ %HKDYLRUV LQ &KLQD $,'6 3DWLHQW &DUH DQG 67'V0DU\$QQ/LHEHUW,QF +DFÕDOLR÷OX 1 øQDQGÕ 7 3DVLQOLR÷OX 7 (U]XUXP $QDdRFXN 6D÷OÕ÷Õ YH $LOH 3ODQODPDVÕ 0HUNH]LQH %DúYXUDQ .DGÕQODUGD *HQLWDO <RO (QIHNVL\RQODUÕQÕQ 6ÕNOÕ÷Õ YH 5LVN )DNW|UOHUL $WDWUN hQLYHUVLWHVL +HPúLUHOLN<NVHNRNXOX'HUJLVL .DUDWD\ * g]YDUÕú ù % %LU 6D÷OÕN 0HUNH]L %|OJHVLQGHNL *HFHNRQGXODUGD <DúD\DQ .DGÕQODUÕQ *HQLWDO +LM\HQH øOLúNLQ 8\JXODPDODUÕQÕQ 'H÷HUOHQGLULOPHVL &h +HPúLUHOLN <NVHNRNXOX 'HUJLVL
.RFD|] 6 7DODV 06 $WDEHNR÷OX &6 8ULQDU\ ,QFRQWLQHQFH$PRQJ7XUNLVK:RPHQ $Q2XWSDWLHQW 6WXG\RI3UHYDOHQFH5LVN)DFWRUVDQG4XDOLW\RI/LIH -RXUQDO RI :RXQG 2VWRP\ DQG &RQWLQHQFH 1XUVLQJ
.RVWLFN .0 6FKHQVXO 6/-DGKDY . 6LQJK 5 %DYDGHNDU $ 6DJJXUWL 1 7UHDWPHQW 6HHNLQJ 9DJLQDO'LVFKDUJHDQG3V\FKRVRFLDO'LVWUHVV $PRQJ :RPHQ LQ 8UEDQ 0XPEDL &XOW 0HG 3V\FKLDWU\ .|N * ùHQHO 1 $N\] $ *$7$ -LQHNRORML 3ROLNOLQL÷L¶QH %DúYXUDQ <Dú hVW .DGÕQODUÕQ hULQHU øQNRQWLQDQV $oÕVÕQGDQ )DUNÕQGDOÕN 'XUXPODUÕQÕQ'H÷HUOHQGLULOPHVL*OKDQH7ÕS'HUJLVL
.XPDUL 6 6LQJK $- -DLQ 9 7UHDWPHQW 6HHNLQJ %HKDYLRU IRU 8ULQDU\ ,QFRQWLQHQFH $PRQJ 1RUWK ,QGLDQ ZRPHQ,QGLDQ -RXUQDO 0HG 6FL
/DQ37)D[HOLG(&KXF170RJUHQ,/XQGERUJ &6 3HUFHSWLRQV DQG $WWLWXGHV LQ 5HODWLRQ WR 5HSURGXFWLYH 7UDFW ,QIHFWLRQV ,QFOXGLQJ 6H[XDOO\ 7UDQVPLWWHG ,QIHFWLRQV LQ 5XUDO 9LHWQDP $ 4XDOLWDWLYH 6WXG\ +HDOWKSROLF\
/LHEHU(/L/:X=5RWKHUDP%RUXV0-*XDQ - +,967' 6WLJPDWL]DWLRQ )HDUV DV +HDOWK6HHNLQJ %DUULHUV LQ &KLQD $,'6 DQG %HKDYLRU
/L & +DQ + /HH - /HH 0 /HH < .QRZOHGJH %HKDYLRUV DQG 3UHYDOHQFH RI 5HSURGXFWLYH 7UDFW ,QIHFWLRQV $ 'HVFULSWLYH 6WXG\ RQ 5XUDO :RPHQ LQ +XQFKXQ&KLQD$VLDQ1XUVLQJ5HVHDUFK
0RRUH ./ 'DOOH\ $) &OLQLFDOO\ 2ULHQWHG $QDWRP\ .OLQL÷H <|QHOLN $QDWRPL dHYLUL HG ùDKLQR÷OX . EV 1REHO 7ÕS .LWDEHYOHUL øVWDQEXO S
2]DQ + g]HUNDQ .9DMLQDO $NÕQWÕ\D +DVWDODUÕQ <DNODúÕPÕ8OXGD÷hQLYHUVLWHVL7ÕS)DNOWHVL'HUJLVL
g]GHPLU 6 dHOHEL ø 1XUXOODKR÷OX 1 $N +& hURMLQHNRORML .OLQL÷LPL]H %DúYXUDQ hULQHU øQNRQWLQDQV 2OJXODUÕQÕQ 'D÷ÕOÕPÕ *HQHO 7ÕS 'HUJLVL
3HUHUD - .LUWKLQDQGD '6 :LMHUDWQH 6 :LFNUDPDUDFKFKL 7. 'HVFULSWLYH &URVV 6HFWLRQDO 6WXG\ RQ 3UHYDOHQFH 3HUFHSWLRQV 3UHGLVSRVLQJ )DFWRUV DQG+HDOWK6HHNLQJ%HKDYLRXU RI :RPHQ :LWK 6WUHVV 8ULQDU\ ,QFRQWLQHQFH %0& :RPHQV +HDOWK '2, 5DELX.$$GHZXQPL$$$NLQOXVL)0$NLQROD 2 )HPDOH 5HSURGXFWLYH 7UDFW ,QIHFWLRQV 8QGHUVWDQGLQJ DQG &DUH 6HHNLQJ %HKDYLRXU $PRQJ :RPHQRI5HSURGXFWLYH$JHLQ/DJRV1LJHULD%0& :RPHQ¶V+HDOWK
3UDVDG -+ $EUDKDQ 6 .XU] .0 *HRUJH 9 /DOLWKD 0. -RKQ 5 -D\DSDXO 01 HW DO 5HSURGXFWLYH7UDFW,QIHFWLRQV$PRQJ<RXQJ0DUULHG :RPHQ LQ 7DPLO 1DGX ,QGLD ,QWHUQDWLRQDO )DPLO\ 3ODQQLQJ3HUVSHFWLYHV
$QDGROX+HPúLUHOLNYH6D÷OÕN%LOLPOHUL'HUJLVL
213 5L]YL1/XE\69DJLQDO'LVFKDUJH 3HUFHSWLRQVDQG +HDOWK 6HHNLQJ %HKDYLRU $PRQJ 1HSDOHVH :RPHQ -RXUQDO3DN0HG$VVRF
6DPDQWD$*KRVK60XNKHUMHH63UHYDOHQFHDQG +HDOWK 6HHNLQJ %HKDYLRU RI 5HSURGXFWLYH 7UDFW ,QIHFWLRQ6H[XDOO\ 7UDQVPLWWHG ,QIHFWLRQV 6\PSWRPDWLFV $ &URVV6HFWLRQDO 6WXG\ RI D 5XUDO &RPPXQLW\LQ7KH+RRJKO\'LFWULFWRI:HVW%HQJDO ,QGLDQ-RXUQDORI3XEOLF+HDOWK 6PEOR÷OX . 6PEOR÷OX 9 %L\RLVWDWLVWLN %DVNÕ$QNDUD +DWLSR÷OX<D\ÕQHYL S 7KX'R+7=LHUFK$+DUW*+HDOWK&DUH6HHNLQJ %HKDYLRXUV IRU 6H[XDOO\ 7UDQVPLWWHG ,QIHFWLRQV $PRQJ :RPHQ $WWHQGLQJ 7KH 1DWLRQDO ,QVWLWXWH RI 'HUPDWRORJ\ DQG 9HQHUHRORJ\ LQ 9LHWQDP 6H[ 7UDQVP,QIHFW 7LDQ / /L - =KDQJ . *XHVW 3:RPHQ¶V 6WDWXV ,QVWLWXWLRQDO %DUULHUV DQG 5HSURGXFWLYH +HDOWK &DUH $&DVH6WXG\LQ<XQQDQ&KLQD+HDOWK3ROLF\ ±
:DUG+0HUWHQV7(7KRPDV& +HDOWK 6HHNLQJ %HKDYLRXU DQG 7KH &RQWURO RI 6H[XDOO\ 7UDQVPLWWHG 'LVHDVH+HDOWK3ROLF\DQG3ODQQLQJ
<D÷PXU < 0DODW\D LOL )ÕUDW 6D÷OÕN 2FD÷Õ %|OJHVL¶QGH <DúD\DQ <Dú .DGÕQODUÕQ *HQLWDO +LM\HQ'DYUDQÕúODUÕ76..RUX\XFX+HNLPOLN%OWHQL
<D]DU6'D÷FÕ+$NVR\hhVWQù$NÕVd$N 0 'DOGDO 1 )UHTXHQF\ RI 7ULFKRPRQDV 9DJLQDOLV $PRQJ :RPHQ +DYLQJ 9DJLQDO 'LVFKDUJH LQ ,]PLU øQ|QhQLYHUVLWHVL7ÕS)DNOWHVL'HUJLVL
