A Study on the Functions of Urban Health Centers under the Local Autonomy system

지방자치제에서의 도시보건소 기능강화 방안에 관한 연구

Recently, two main changes were observed in relation to activities of District Health Centers. One is the rapid increase in the quantity and variety of people's demands for health services due to improvement of income level and the other is an introduction of autonomy in local administration. Unitl recently, the District Health Services were mostly depended on the instructions and orders given by Central Governments, and it would be necessary to prepare for the future implementation of autonomous local administration. Especially, the urban health centers may need more attention than those in rural areas because of their complexity and it would be more difficult in choosing and implementing a most suitable health programs for urban communities. This study was made to find out a feasibl developmental model which could be applicable for the urban bealth centers in Kyeongnam- do area. The most studies relating to health centers activities in the past were made by saking questions to current health center workers, but this study has made an effort to find out the opinions of those who are representing the people in the community. For this study, therefore, the Members of Gity Parliament and Village Headmen from 10 cities is Kyeongnam- do were interviewed for the study and the results obtained were compared to those of health officers. It was found that both Parliament Members and Village Headmen were well aware of the need of health centers, however, they tend to put lower priority for health services in compare with other community activities, and pointed out poor quality of services and lack of public understanding as the problems to be overcome. As to the desirable body for policy decision and implementation of health programs, the Members of Local Parliament think the Local Parliament as ideal, where as Village Headmen prefer health experts, and health officenr prefer District Health Center respectively. The most urgent problems of the District health Centers are mentioned as lack of health manpower. As the results of his study, the followings are suggested for improvement of District Health Services; First : reinforcement of professional health workers, Second : establishment of Community Health Council, Third : strengthening of public health education and support, Fourth : flexibility in Local Autonomy and target system relating to health activities.