Strategy formulation for enhancing the effectiveness of health services after a devastating earthquake in Turkey: An integrated approach of in-depth interview and AHP

This study aims to identify and prioritize problems experienced during the acute post-earthquake period in secondary healthcare facilities using AHP and Fuzzy AHP methods. Qualitative interviews were conducted with managers actively involved in healthcare facility management during this period. The research was carried out in three secondary healthcare institutions located in provinces affected by the February 6, 2023 earthquakes: Elbistan State Hospital (Kahramanmaraş/9th region), Dörtyol State Hospital (Hatay/13th region), and Malatya Battalgazi State Hospital (Malatya/4th region). A two-stage research design was employed: qualitative methods were used in the first phase and quantitative methods in the second. The population consisted of all secondary-level healthcare institutions in the earthquake zone, and purposive sampling was used to select the sample. In the qualitative phase, individual interviews were conducted with 17 managers. As a result, 9 main criteria were identified. In the quantitative phase, these criteria were prioritized using AHP and Fuzzy AHP methods with input from 5 additional managers who played active roles in post-earthquake management. The most critical criteria and their importance weights are as follows: hospital operations and management after an earthquake (AHP: 0.227, FAHP: 0.231), infrastructure and technical conditions (AHP: 0.208, FAHP: 0.209), hospital disaster and emergency planning (AHP:0.178, FAHP:0.182), logistics and material management (AHP:0.123, FAHP:0.119), personnel management process (AHP:0.092, FAHP:0.089), communication and collaboration process (AHP:0.084, FAHP:0.085), funeral identification and security process (AHP:0.042, FAHP:0.043), patient and patient relative relations (AHP:0.030, FAHP:0.028), and social media impact (AHP:0.016, FAHP:0.015). If decision-makers allocate existing resources to the first three criteria, they will have resolved more than 60 % of the identified problems.