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The effect of adult learners' motivation to participate in hair education and program satisfaction on lifelong learning happiness index (성인학습자의 헤어교육 참여동기와 프로그램 만족도가평생학습 행복지수에 미치는 영향)

  • Lim Soon Ja
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.5
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    • pp.367-372
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    • 2024
  • It was intended to explore the relationship between motivation for participation in hair education, program satisfaction, and lifelong learning happiness index for adult learners at the Lifelong Education Center, and to provide basic data for revitalizing lifelong education programs. Today, universities have conditions as a comprehensive educational institution with practicality that can meet various and high-quality lifelong educational needs. The university-affiliated Lifelong Education Center plays a role in ensuring the right to learn for all citizens as well as fulfilling the social service function and greatly expanding educational opportunities, which is one of the essential functions of universities, by making good use of the excellent transfer material resources of universities. Adults should now seek professional self-identity through retraining, and respond flexibly to various social situations such as increasing roles, expanding responsibility, and uncertainty in the job and employment structure toward professional socialization in the professional world The subject of the study was to collect data by distributing 90 questionnaires to adult learner hair education subjects in G area, and 85 copies were finally used for SPSS 26.0 for Windows analysis, excluding questionnaires with insufficient responses. The survey period was from November 1 to December 27, 2023. First, it was found that adult learners' motivation to participate in hair education has an effect on the lifelong learning happiness index. Second, it was found that adult learners' satisfaction with the program of hair care workers has an effect on the lifelong learning happiness index. Through this study, it is judged that it is necessary to understand what can maximize the high lifelong learning happiness index, and to meet the learning needs of modern people living in the age of 100, increase their potential, help them design a second life, contribute to self-realization and society, and help them have steady, self-directed lifelong learning opportunities.

A Study on the Present Situation, Management Analysis, and Future Prospect of the Ornamental Tree Cultivation with respect to Environmental Improvement (환경개선(環境改善)을 위한 녹화수목재배(綠化樹木裁培)의 현황(現況) 및 경영분석(經營分析)과 전망(展望))

  • Park, Tai Sik;Kim, Tae Wook
    • Journal of Korean Society of Forest Science
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    • v.34 no.1
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    • pp.31-46
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    • 1977
  • The study was made to give some helpful information for policy-making on ornamental tree cultivation by doing a survey on general situations, management analysis, and future prospects of the ornamental tree growing. The study was carried out through literature studies related to the subject, questionaire surveys, and on-the-spot investigation. The questionaire surveys could be divided into two parts: pre-questionaire survey and main-questionaire survey. In the pre-questionaire survey, the researchers intended to identify the total number of ornamental tree growers, cultivation areas in size and their locations. The questionaires were sent to each town and county administration authorities, forest cooperatives, and related organizations through-out the nation. The main-questionaires were prepared for detailed study and the questionaires were sent to 200 tree growers selected by option by taking considerations of the number of tree growers and the size of cultivating areas in regions. The main findings and some information obtained in the survey were as follows: 1. The total land for ornamental tree growing was amounted to 1,873.02 hectares and the number of cultivators was totaled to 2,717. 2. The main occupations of the ornamental tree growers were found in horticulture (41.9%), agronomy (25.9%), officialdom (11.3%), animal husbandry (6.5%), business circle(4.8%), and forestry (3.2%) in sequence. 3. The ornamental trees were cultivated mostly upperland (54.8), forest land (19.4%), rice paddy (11.3%) and others. 4. The educational training of the tree growers seemed quite high. The results of the survey indicated that a large number of tree growers was occupied by college graduates (38.7%), and then high school graduates (34.7%), middle school graduates (12.9%) in order. 5. The tree farming was undertaken as a side-job (41.9%) rather than main-job (23.4%), but a few of respondents rated as subsidiary-job (18.6%). 6. The management status classified by the rate of hired labors used was likely to belong to three categories: independant enterprise management (41.9%); half independant management (31.5%); and self-management (32.4%). 7. The majority of the tree growers sold their products to the consumers through middle-man channel (48.4%), or directly to the house-holder and detailers (13.7%), but a few of the respondents answered that they disposed of their products by bidding (11.2%) or by direct selling to the contractors (4.8%). 8. The channel cf marketing seemed somewhat complicated. The results of the survey were as: (1) producers ${\rightarrow}$consumers (22.6%) (2) producers ${\rightarrow}$field middle-men${\rightarrow}$consumers (33.1%) (3) producers ${\rightarrow}$field middle-men${\rightarrow}$first stage brokers${\rightarrow}$consumers (15.3%) (4) producers ${\rightarrow}$field middle-men${\rightarrow}$second stage middle-men${\rightarrow}$brokers${\rightarrow}$consumers (5.7%) (5) producers${\rightarrow}$field middle-men${\rightarrow}$third stage middle-men${\rightarrow}$second stage middlemen${\rightarrow}$brokers${\rightarrow}$consumers (4.8%) 9. It was responded that the margin for each stage of middle-men or brokers was assumed to be 30-50%(33.1%), 20-30%(32.3%), 50-100%(9.7%), and 100-200%(2.4%) in sequence. 10. The difference between the delivery price of consumers and field selling price of the producers seemed quite large. Majority of producers responded that they received half a price compared to the consumer's prices. 11. About two thirds of the respondents opposed to the measure of "Law on Preservation and Utilization of Agricultural Land" in which says that all the ornamental trees grown on flat agricultural lands less than 8 degrees in slope must be transplanted within three years to other places more than 8 degrees in slope. 12. The tree growers said that they have paid rather high land taxes than they ought to pay (38.7%), but come responded that land tax seemed to be appropriate (15.3%), and half of the respondents answered "not known". 13. The measures for the standardization of ornamental trees by size were backed up by a large number of respondents (57.3%), but one third of the respondents showed negative answer (29.8%). 14. About half of the respondents favored the systematic marketing through organization such as forest cooperatives (54%), but quite a few respondents opposed to organizing the systematic marketing channel (36.3%). 15. The necessary measures for permission in ornamental tree cultivation was rejected by a large number of respondents (49.2%) than those of favored (43.6%).

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Considerable Aspects for Technical and Vocational Training in Forestry (임업기술(林業技術) 및 직업훈련(職業訓練)에 고려(考慮)되어야 할 사항(事項))

  • Ma, Sang Kyu
    • Journal of Korean Society of Forest Science
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    • v.51 no.1
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    • pp.56-65
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    • 1981
  • The training of forest ranger level and forest worker level to push the sound forest management and to increase the employment effects in forestry will be done without delay as soon as possible. So several opinions to be considered are here discussed. 1. The ranger level will be at first completely trained with the technics developed and modernized, to process really the sound forest management based on the concept of ecological and economical technic. 2. The organization of vocational training and it's systematical training method will be newly adopted to increase the labour efficiency in forestry. The case of fulltime worker level should be more intensively trained and part-time worker or forest famer level should be trained by the forest ranger and skilled worker with visiting circularly their working place. And the daily employed workers and village people for working should be done by the skilled workers. 3. The training subjects for them at the beginning step will be exploited by the instructors and concerned experts with studying their current conditions. Their practical training is more reasonable to do in the practically managing forest and to carry out under the responsible of leader of this forest. 4. The instructors included rangers of training forest will get specially certain intensive training through the aids of outside experts or through the group instruction with them. 5. The training fields and their reasons to be learned by them are discussed in this paper from the basic knowledge to the skill technics. 6. In oder to systematize and mordernize more rapidly our forest technics that need for training them and also applying directly in the forest management, a total effort of certain type by scientists and technicians scattered individually all over the country is now earnestly demanded to synthesize their knowledge, technic and experience. So to do like this, the establishment of certain organization through which can do their total efforts together will be considered and assisted by the concerned authority. 7. For better lieving of full-time workers, the whole-round year working amount have to be supplied though the work technic-and working plan development. And under the conditions that the timber harvesting work is still not so enough and it has a bad climatic season, the in-side working system and side - job aids will be developed for their sound lieving. 8. The organization of labour management will be soon introduced in the concerning administrativ authority to solve the forest labour problems and to increase the employing effects in forestry in future. 9. The supply programm of improved and trained tools and maschines for forest work is also considered to use by the trained persons. If not to do so, the training results will return to the original condition and will get nothing any more.

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An Analysis of the Differences in Management Performance by Business Categories from the Perspective of Small Business Systematization (영세 소상공인 조직화에 대한 직능업종별 차이분석과 경영성과)

  • Suh, Geun-Ha;Seo, Mi-Ok;Yoon, Sung-Wook
    • Journal of Distribution Science
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    • v.9 no.2
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    • pp.111-122
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    • 2011
  • The purpose of this study is to survey the successful cases of small and medium Business Systematization Cognition by examining their entrepreneurial characteristics and analysing the factors affecting their success. To that end, previous studies on the association types of small businesses were studied. A research model was developed, and research hypotheses for an empirical analysis were established upon it. Suh et al. (2010) insist on the importance of Small Business Systematization in Korea but also show that small business performance is suffering: they are too small to stand alone. That is why association is so crucial for them: they must stand together. Unfortunately, association is difficult, as they have few specific links and little motivation. Even in franchising networks, association tends to be initiated by big franchisers, not small ones. In that sense, association among small businesses is crucial for their long-term survival. With this in mind, this study examines how they think and feel about the issue of 'Industrial Classification', how important Industrial Classification is to their business success, and what kinds of problems it raises in the markets. This study seeks the different cognitions among the association types of small businesses from the perspectives of participation motivation, systematization expectation, policy demand level, and management performance. We assume that different industrial classification types of small businesses will have different cognitions concerning these factors. There are four basic industrial classification types of small businesses: retail sales, restaurant, service, and manufacturing. To date, most of the studies in this area have focused on collecting data on the external environments of small businesses or performing statistical analyses on their status. In this study, we surveyed 4 market areas in Busan, Masan, and Changwon in Korea, where business associations consist of merchants, shop owners, and traders. We surveyed 330 shops and merchants by sending a questionnaire or visiting. Finally, 268 questionnaires were collected and used for the analysis. An ANOVA, T-test, and regression analyses were conducted to test the research hypotheses. The results demonstrate that there are differences in cognition depending upon the industrial classification type. Restaurants generally have a higher cognition concerning job offer problems and a lower cognition concerning their competitiveness. Restaurants also depend more on systematization expectation than do the other industrial classification types. On the policy demand level, restaurants have a higher cognition. This study identifies several factors that are contributing to management performance through differences in cognition that depend upon association type: systematization expectation and policy demand level have positive effects on management performance; participation motivation has a negative effect on management performance. We confirm also that the image factors of different cognitions are linked to an awareness of the value of systematization and that these factors show sequential and continual patterns in the course of generating performances. In conclusion, this study carries significant implications in its classifying of small businesses into the four different associational types (retail sales, restaurant, services, and manufacturing). We believe our study to be the first one to conduct an empirical survey in this subject area. More studies in this area will likely use our research frameworks. The data show that regionally based industrial classification associations such as those in rural cities or less developed areas tend to suffer more problems than those in urban areas. Moreover, restaurants suffer more problems than the norm. Most of the problems raised in this study concern the act of 'associating itself'. Most associations have serious difficulties in associating. On the other hand, the area where they have the least policy demand is that of service types. This study contributes to the argument that associating, rather than financial assistance or management consulting, promotes the start-up and managerial performance of small businesses. This study also has some limitations. The main limitation is the number of questionnaires. We could not survey all the industrial classification types across the country because of budget and time limitations. If we had, we could have produced many more useful results and enhanced the precision of our analysis. The history of systemization is very short and the number of industrial classification associations is relatively low in Korea. We should keep in mind, though, that this is very crucial to systemization entrepreneurs starting their businesses, as it can heavily affect their chances of success. Being strongly associated with each other might be critical to the business success of industrial classification members. Thus, the government needs to put more effort and resources into supporting the drive of industrial classification members to become more strongly associated.

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Referral Patterns and Needs for Specialist Care among Patient Referred from Health Center (보건소의 진료의뢰 양상과 의뢰환자들의 전문과목 요구도)

  • Hwang, Tae-Yoon;Kim, Chang-Yoon;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.1 s.52
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    • pp.133-143
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    • 1996
  • This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongju-City Health Center, Seongju-Gun Health Center and Koryong-Gun Health Center in Kyongsangbuk-Do, from June 10 to October 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6%), easy to get referral permission in health centers(27.1%), and very difficult to get referral permission in local clinics(16.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% of patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested specialty is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.

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A Methodology to Develop a Curriculum based on National Competency Standards - Focused on Methodology for Gap Analysis - (국가직무능력표준(NCS)에 근거한 조경분야 교육과정 개발 방법론 - 갭분석을 중심으로 -)

  • Byeon, Jae-Sang;Ahn, Seong-Ro;Shin, Sang-Hyun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.1
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    • pp.40-53
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    • 2015
  • To train the manpower to meet the requirements of the industrial field, the introduction of the National Qualification Frameworks(hereinafter referred to as NQF) was determined in 2001 by National Competency Standards(hereinafter referred to as NCS) centrally of the Office for Government Policy Coordination. Also, for landscape architecture in the construction field, the "NCS -Landscape Architecture" pilot was developed in 2008 to be test operated for 3 years starting in 2009. Especially, as the 'realization of a competence-based society, not by educational background' was adopted as one of the major government projects in the Park Geun-Hye government(inaugurated in 2013) the NCS system was constructed on a nationwide scale as a detailed method for practicing this. However, in the case of the NCS developed by the nation, the ideal job performing abilities are specified, therefore there are weaknesses of not being able to reflect the actual operational problem differences in the student level between universities, problems of securing equipment and professors, and problems in the number of current curricula. For soft landing to practical curriculum, the process of clearly analyzing the gap between the current curriculum and the NCS must be preceded. Gap analysis is the initial stage methodology to reorganize the existing curriculum into NCS based curriculum, and based on the ability unit elements and performance standards for each NCS ability unit, the discrepancy between the existing curriculum within the department or the level of coincidence used a Likert scale of 1 to 5 to fill in and analyze. Thus, the universities wishing to operate NCS in the future measuring the level of coincidence and the gap between the current university curriculum and NCS can secure the basic tool to verify the applicability of NCS and the effectiveness of further development and operation. The advantages of reorganizing the curriculum through gap analysis are, first, that the government financial support project can be connected to provide quantitative index of the NCS adoption rate for each qualitative department, and, second, an objective standard is provided on the insufficiency or sufficiency when reorganizing to NCS based curriculum. In other words, when introducing in the subdivisions of the relevant NCS, the insufficient ability units and the ability unit elements can be extracted, and the supplementary matters for each ability unit element per existing subject can be extracted at the same time. There is an advantage providing directions for detailed class program and basic subject opening. The Ministry of Education and the Ministry of Employment and Labor must gather people from the industry to actively develop and supply the NCS standard a practical level to systematically reflect the requirements of the industrial field the educational training and qualification, and the universities wishing to apply NCS must reorganize the curriculum connecting work and qualification based on NCS. To enable this, the universities must consider the relevant industrial prospect and the relation between the faculty resources within the university and the local industry to clearly select the NCS subdivision to be applied. Afterwards, gap analysis must be used for the NCS based curriculum reorganization to establish the direction of the reorganization more objectively and rationally in order to participate in the process evaluation type qualification system efficiently.

Trends of Study and Classification of Reference on Occupational Health Management in Korea after Liberation (해방 이후 우리나라 산업보건관리에 관한 문헌분류 및 연구동향)

  • Ha, Eun-Hee;Park, Hye-Sook;Kim, Young-Bok;Song, Hyun-Jong
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.809-844
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    • 1995
  • The purposes of this study are to define the scope of occupational health management and to classify occupational management by review of related journals from 1945 to 1994 in Korea. The steps of this study were as follows: (1) Search of secondary reference; (2) Collection and review of primary reference; (3) Survey; and (4) Analysis and discussion. The results were as follows ; 1. Most of the respondents majored in occupational health(71.6%), and were working in university (68.3%), males and over the age 40. Seventy percent of the respondents agreed with the idea that classification of occupational health management is necessary, and 10% disagreed. 2. After integration of the idea of respondents, we reclassified the scope of occupational health management. It was defined 3 parts, that is , occupational health system, occupational health service and others (such as assessment, epidemiology, cost-effectiveness analysis and so on). 3. The number of journals on occupational health management was 510. It was sightly increased from 1986 and abruptly increased after 1991. The kinds of journals related to occupational health management were The Korean Journal of Occupational Medicine(18.2%), Several Kinds of Medical Colloge Journal(17.0%), The Korean Journal Occupational Health(15.1%), The Korean Journal of Preventive Medicine(15.1%) and others(34.6%). As for the contents, the number of journals on occupational health management systems was 33(6.5%) and occupational health services 477(93.5%). Of the journals on occupational health management systems, the number of journals on the occupational health resource system was 15(45.5%), occupational finance system 8(24.2%), occupational health management system 6(18.2%), occupational organization 3(9.1%) and occupational health delivery system 1 (3.0%). Of the journals on occupational health services, the number of journals on disease management was 269(57.2%), health management 116(24.7%), working environmental management 85(18.1%). As for the subjects, the number of journals on general workers was 185(71.1%), followed by women worker, white coiler workers and so on. 4. Respondents made occupational health service(such as health management, working environmental management and health education) the first priority of occupational health management. Tied for the second are quality analysis(such as education, training and job contents of occupational health manager) and occupational health systems(such as the recommendation of systems of occupational and general disease and occupational health organization). 5. Thirty seven respondents suggested 48 ideas about the future research of occupational health management. The results were as follows: (1) Study of occupational health service 40.5%; (2) Study of organization system 27.1%; (3) Study of occupational health system (e.g. information network) 8.3%; (4) Study of working condition 6.2%; and (5) Study of occupational health service analysis 4.2%.

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A Study on the Entrepreneurial Intention of College Students in the Entertainment Industry with Idea Education and Support for Startup Infrastructure (아이디어 교육 및 창업 인프라 지원이 엔터테인먼트 산업 분야에 대한 대학생 창업의도 연구)

  • Lee, Ji-Hun
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.19-31
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    • 2021
  • This study tried to identify the characteristics of college students' entrepreneurial intentions in the entertainment industry, focusing on existing literature studies. Based on this, it was intended to suggest realistic educational alternatives for university student start-ups and implications for start-up management to university start-up officials and those in charge of national start-up support policy. Therefore, the implications of this study are as follows. First, technology(item) for idea creation education, which is an essential element in the entertainment industry, how to connect ideas and products, technology methods that can increase content value, and user characteristics education within the entertainment industry will need to be continued. In addition, along with the idea education, it is necessary to increase the understanding of start-up business management such as financing, human resource management, marketing, and operation management, and furthermore, confidence education should be provided so that the possibility of success in an entertainment start-up and a sense of adventure in a new job can be developed. Second, the space and equipment necessary for start-up (club room, student start-up room, entertainment-related equipment, etc.) should be provided centering on the opinion survey of students who are interested in starting a business, and various regulations of universities and government for student start-up should be relaxed. will have to In addition, education for the formation of entrepreneurial knowledge inside and outside of the school, special lectures and consultations by experts, and on-the-spot education, etc., should be made to create more practical entrepreneurial knowledge. something to do. Third, for students wishing to start a business in the entertainment industry, it is necessary to inform their families about the field situation of the entertainment industry accurately so that their children can develop a positive perception rather than a negative perception when choosing a business field. In addition, by promoting various successful cases of college students to their families after starting a business, families should be encouraged so that their children can develop a challenging spirit about starting a business. Fourth, it should be possible to form continuous clubs or gatherings with friends who wish to start a business in the entertainment industry, and furthermore, an opportunity to listen to the opinions of friends who actually started a business through these meetings should be provided. In addition, the meeting and the formation of friends should create a place for discussion about writing a business plan, how to succeed in starting a business, and management of startups, and psychological stimulation activities should be conducted so that each other's will to start a business arises. Fifth, various knowledge related to start-up (methods for securing funds, management of start-up organizations, grasping information about the market in which they want to start a business, etc.) should be cultivated, and how to write a business plan for the various entertainment industry fields they want to start up. You will also need to train them to be practical. Also, based on this knowledge formation, students themselves should be able to respond to risks and changes that may occur in entrepreneurship. Lastly, it is necessary to increase the understanding of business start-up management, and various psychological stimulation activities are needed to make the confidence and fear of starting a business disappear.

The Effects of Self-Determination on Entrepreneurial Intention in Office Workers: Focusing on the Dual Mediation of Innovativeness and Prception of the Startup Support System (직장인의 자기결정성이 창업의지에 미치는 영향: 혁신성과 창업지원정책인식의 이중매개를 중심으로)

  • Lim, Jae Sung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.19 no.1
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    • pp.75-91
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    • 2024
  • Recently, global business environment is changing dramatically along with the acceleration of technological innovation amid the war, climatic change, and geopolitical instability. Accordingly, it is difficult to predict or plan for the future as the volatility, complexity, ambiguity, and uncertainty of the industrial ecosystem continue to increase. Therefore, organizations are undergoing inevitable restructuring in accordance with their survival strategy, for instance, removing marginal businesses or firing. Accordingly, office workers are seeking a startup as an alternative for their continuous economic activity amid rising anxiety factors that make them think they would lose their jobs unintentionally. Here, this study is aimed to verify through what paths office workers' self-determination influences the process of converting to a startup. For this study, an online survey was carried out, and 310 respondents' valid data were analyzed through SPSS and AMOS. To sum up the results, first, office workers' self-determination did not have significant effects on entrepreneurial intention. However, it was confirmed that self-determination had positive (+) effects on innovativeness and perception of the startup support system. This result shows that their psychology works to prepare step by step by accumulating innovative experiences and increasing perception of the startup support system from a long-term life path perspective rather than challenging startups right way. Second, innovativeness is found to have positive (+) effects on entrepreneurial intention. Also, perception of the startup support system had positive (+) effects on entrepreneurial intention. This implies that when considering startups, they are highly aware of the government's various startup support systems. Third, innovativeness is found to have positive (+) effects on perception of the startup support system. It is judged that perception of the startup support system is valid for prospective founders to exhibit their innovativeness and realize new ideas. Fourth, it was confirmed that innovativeness and perception of the startup support system mediated correlation between self-determination and entrepreneurial intention, and perception of the startup support system mediated correlation between innovativeness and entrepreneurial intention, which shows that it is a crucial factor in entrepreneurial intention. Although previous studies related to startups deal with students mostly, this study targets office workers who form a great part in economic activities, which makes it academically valuable in terms of being differentiated from others and extending the scope of research. Also, when we consider the fact that the motivation for self-determination alone fails to stimulate entrepreneurial intention and the complete mediation of innovativeness and the startup support system, it has great implications in practical aspects such as the government's human and material support systems. In the selection and analysis of samples, this study exhibits a limitation that the problem of common method bias is not completely resolved. Also, additional definitive research is needed on whether entrepreneurial intention is formed and converted into startup behavior. Academically and practically, this study deals with the relationship between humans' psychological motives and startups which has not been handled sufficiently in previous studies. The conversion of office workers to startups is expected to have effects on individuals' economic stability and the state's job creation; therefore, it needs to be investigated continuously for its great value.

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An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea (가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고-)

  • Bang, Sook;Han, Seung-Hyun;Lee, Chung-Ja;Ahn, Moon-Young;Lee, In-Sook;Kim, Eun-Shil;Kim, Chong-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.1 s.21
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    • pp.165-203
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    • 1987
  • This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

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