• Title/Summary/Keyword: Formal communication

Search Result 258, Processing Time 0.022 seconds

Using the METHONTOLOGY Approach to a Graduation Screen Ontology Development: An Experiential Investigation of the METHONTOLOGY Framework

  • Park, Jin-Soo;Sung, Ki-Moon;Moon, Se-Won
    • Asia pacific journal of information systems
    • /
    • v.20 no.2
    • /
    • pp.125-155
    • /
    • 2010
  • Ontologies have been adopted in various business and scientific communities as a key component of the Semantic Web. Despite the increasing importance of ontologies, ontology developers still perceive construction tasks as a challenge. A clearly defined and well-structured methodology can reduce the time required to develop an ontology and increase the probability of success of a project. However, no reliable knowledge-engineering methodology for ontology development currently exists; every methodology has been tailored toward the development of a particular ontology. In this study, we developed a Graduation Screen Ontology (GSO). The graduation screen domain was chosen for the several reasons. First, the graduation screen process is a complicated task requiring a complex reasoning process. Second, GSO may be reused for other universities because the graduation screen process is similar for most universities. Finally, GSO can be built within a given period because the size of the selected domain is reasonable. No standard ontology development methodology exists; thus, one of the existing ontology development methodologies had to be chosen. The most important considerations for selecting the ontology development methodology of GSO included whether it can be applied to a new domain; whether it covers a broader set of development tasks; and whether it gives sufficient explanation of each development task. We evaluated various ontology development methodologies based on the evaluation framework proposed by G$\acute{o}$mez-P$\acute{e}$rez et al. We concluded that METHONTOLOGY was the most applicable to the building of GSO for this study. METHONTOLOGY was derived from the experience of developing Chemical Ontology at the Polytechnic University of Madrid by Fern$\acute{a}$ndez-L$\acute{o}$pez et al. and is regarded as the most mature ontology development methodology. METHONTOLOGY describes a very detailed approach for building an ontology under a centralized development environment at the conceptual level. This methodology consists of three broad processes, with each process containing specific sub-processes: management (scheduling, control, and quality assurance); development (specification, conceptualization, formalization, implementation, and maintenance); and support process (knowledge acquisition, evaluation, documentation, configuration management, and integration). An ontology development language and ontology development tool for GSO construction also had to be selected. We adopted OWL-DL as the ontology development language. OWL was selected because of its computational quality of consistency in checking and classification, which is crucial in developing coherent and useful ontological models for very complex domains. In addition, Protege-OWL was chosen for an ontology development tool because it is supported by METHONTOLOGY and is widely used because of its platform-independent characteristics. Based on the GSO development experience of the researchers, some issues relating to the METHONTOLOGY, OWL-DL, and Prot$\acute{e}$g$\acute{e}$-OWL were identified. We focused on presenting drawbacks of METHONTOLOGY and discussing how each weakness could be addressed. First, METHONTOLOGY insists that domain experts who do not have ontology construction experience can easily build ontologies. However, it is still difficult for these domain experts to develop a sophisticated ontology, especially if they have insufficient background knowledge related to the ontology. Second, METHONTOLOGY does not include a development stage called the "feasibility study." This pre-development stage helps developers ensure not only that a planned ontology is necessary and sufficiently valuable to begin an ontology building project, but also to determine whether the project will be successful. Third, METHONTOLOGY excludes an explanation on the use and integration of existing ontologies. If an additional stage for considering reuse is introduced, developers might share benefits of reuse. Fourth, METHONTOLOGY fails to address the importance of collaboration. This methodology needs to explain the allocation of specific tasks to different developer groups, and how to combine these tasks once specific given jobs are completed. Fifth, METHONTOLOGY fails to suggest the methods and techniques applied in the conceptualization stage sufficiently. Introducing methods of concept extraction from multiple informal sources or methods of identifying relations may enhance the quality of ontologies. Sixth, METHONTOLOGY does not provide an evaluation process to confirm whether WebODE perfectly transforms a conceptual ontology into a formal ontology. It also does not guarantee whether the outcomes of the conceptualization stage are completely reflected in the implementation stage. Seventh, METHONTOLOGY needs to add criteria for user evaluation of the actual use of the constructed ontology under user environments. Eighth, although METHONTOLOGY allows continual knowledge acquisition while working on the ontology development process, consistent updates can be difficult for developers. Ninth, METHONTOLOGY demands that developers complete various documents during the conceptualization stage; thus, it can be considered a heavy methodology. Adopting an agile methodology will result in reinforcing active communication among developers and reducing the burden of documentation completion. Finally, this study concludes with contributions and practical implications. No previous research has addressed issues related to METHONTOLOGY from empirical experiences; this study is an initial attempt. In addition, several lessons learned from the development experience are discussed. This study also affords some insights for ontology methodology researchers who want to design a more advanced ontology development methodology.

The relation between Movement working as a Grouping clue in Moving Picture and Semantic structure forming (동영상에서 그룹핑(grouping) 단서로 작용하는 움직임(Movement)과 의미구조 형성의 관계)

  • Lee, Soo-Jin
    • Archives of design research
    • /
    • v.19 no.5 s.67
    • /
    • pp.119-128
    • /
    • 2006
  • The scale of visual expression has expanded from freeze frame to motion picture as media have developed. Moving pictures such as animation, movies, TV CM and GUI become formative elements whose movement is necessary compared to freeze frame as apparent movement phenomenon and unit structure such as short and scene appear. Therefore, of formative elements such as a shape, color, space, size and movement, movement is importantly distinguished in the moving image. The expression and form of image as a relationship between the signified and signifier explained by Saussure are accepted as a sign by mutual complement even though they limit the content. This makes it possible to infer that the formal feature of movement participates in the message content. To verify this, the result of moving picture visual perception experiment based on the gestalt grouping principle result shows that 70-80 percent of subjects think that 'movement' is the important grouping clue in perception. Movement affects the maintenance of the context of message content in the communication process when the meaning structure of moving picture is analyzed based on the structural feature. The identity can be maintained with if there is a movement with similar directive point even if the color and shape of people, things and background are changed. Second, the clarity of the content is elevated by a distinguished object as a figure by movement. Third, it acts as a knowledge representation which can predict similar movement process of next information processing. Forth, movement gives the content consistency even though more than two scenes have fast switch and complicated editing structure like cross-cutting. Movement becomes a clue which can make grouping information input by visual perception reaction. Also, it gives the order to the visual expression which can be used improperly by formation of structural frame of image message and has the effectiveness which elevates the clarity of signification. Moving picture has discourse with several mixed unit structures because it fundamentally contains time and the common and distinguished expression is needed by media-mix circumstances. Therefore, by the application of gestalt grouping principle to moving picture field, movement becomes the more distinguished than other formative elements and affects the formation of meaning structure. This study propose a viewpoint that develops structural formative beauty and new image expression in the media image field.

  • PDF

The Adoption and Diffusion of Semantic Web Technology Innovation: Qualitative Research Approach (시맨틱 웹 기술혁신의 채택과 확산: 질적연구접근법)

  • Joo, Jae-Hun
    • Asia pacific journal of information systems
    • /
    • v.19 no.1
    • /
    • pp.33-62
    • /
    • 2009
  • Internet computing is a disruptive IT innovation. Semantic Web can be considered as an IT innovation because the Semantic Web technology possesses the potential to reduce information overload and enable semantic integration, using capabilities such as semantics and machine-processability. How should organizations adopt the Semantic Web? What factors affect the adoption and diffusion of Semantic Web innovation? Most studies on adoption and diffusion of innovation use empirical analysis as a quantitative research methodology in the post-implementation stage. There is criticism that the positivist requiring theoretical rigor can sacrifice relevance to practice. Rapid advances in technology require studies relevant to practice. In particular, it is realistically impossible to conduct quantitative approach for factors affecting adoption of the Semantic Web because the Semantic Web is in its infancy. However, in an early stage of introduction of the Semantic Web, it is necessary to give a model and some guidelines and for adoption and diffusion of the technology innovation to practitioners and researchers. Thus, the purpose of this study is to present a model of adoption and diffusion of the Semantic Web and to offer propositions as guidelines for successful adoption through a qualitative research method including multiple case studies and in-depth interviews. The researcher conducted interviews with 15 people based on face-to face and 2 interviews by telephone and e-mail to collect data to saturate the categories. Nine interviews including 2 telephone interviews were from nine user organizations adopting the technology innovation and the others were from three supply organizations. Semi-structured interviews were used to collect data. The interviews were recorded on digital voice recorder memory and subsequently transcribed verbatim. 196 pages of transcripts were obtained from about 12 hours interviews. Triangulation of evidence was achieved by examining each organization website and various documents, such as brochures and white papers. The researcher read the transcripts several times and underlined core words, phrases, or sentences. Then, data analysis used the procedure of open coding, in which the researcher forms initial categories of information about the phenomenon being studied by segmenting information. QSR NVivo version 8.0 was used to categorize sentences including similar concepts. 47 categories derived from interview data were grouped into 21 categories from which six factors were named. Five factors affecting adoption of the Semantic Web were identified. The first factor is demand pull including requirements for improving search and integration services of the existing systems and for creating new services. Second, environmental conduciveness, reference models, uncertainty, technology maturity, potential business value, government sponsorship programs, promising prospects for technology demand, complexity and trialability affect the adoption of the Semantic Web from the perspective of technology push. Third, absorptive capacity is an important role of the adoption. Fourth, suppler's competence includes communication with and training for users, and absorptive capacity of supply organization. Fifth, over-expectance which results in the gap between user's expectation level and perceived benefits has a negative impact on the adoption of the Semantic Web. Finally, the factor including critical mass of ontology, budget. visible effects is identified as a determinant affecting routinization and infusion. The researcher suggested a model of adoption and diffusion of the Semantic Web, representing relationships between six factors and adoption/diffusion as dependent variables. Six propositions are derived from the adoption/diffusion model to offer some guidelines to practitioners and a research model to further studies. Proposition 1 : Demand pull has an influence on the adoption of the Semantic Web. Proposition 1-1 : The stronger the degree of requirements for improving existing services, the more successfully the Semantic Web is adopted. Proposition 1-2 : The stronger the degree of requirements for new services, the more successfully the Semantic Web is adopted. Proposition 2 : Technology push has an influence on the adoption of the Semantic Web. Proposition 2-1 : From the perceptive of user organizations, the technology push forces such as environmental conduciveness, reference models, potential business value, and government sponsorship programs have a positive impact on the adoption of the Semantic Web while uncertainty and lower technology maturity have a negative impact on its adoption. Proposition 2-2 : From the perceptive of suppliers, the technology push forces such as environmental conduciveness, reference models, potential business value, government sponsorship programs, and promising prospects for technology demand have a positive impact on the adoption of the Semantic Web while uncertainty, lower technology maturity, complexity and lower trialability have a negative impact on its adoption. Proposition 3 : The absorptive capacities such as organizational formal support systems, officer's or manager's competency analyzing technology characteristics, their passion or willingness, and top management support are positively associated with successful adoption of the Semantic Web innovation from the perceptive of user organizations. Proposition 4 : Supplier's competence has a positive impact on the absorptive capacities of user organizations and technology push forces. Proposition 5 : The greater the gap of expectation between users and suppliers, the later the Semantic Web is adopted. Proposition 6 : The post-adoption activities such as budget allocation, reaching critical mass, and sharing ontology to offer sustainable services are positively associated with successful routinization and infusion of the Semantic Web innovation from the perceptive of user organizations.

A study on the menarche of middle school girls in Seoul (여학생의 초경에 관한 조사 연구 (서울시내 여자중학생을 대상으로))

  • Kim, Mi-Hwa
    • Korean Journal of Health Education and Promotion
    • /
    • v.1 no.1
    • /
    • pp.21-36
    • /
    • 1983
  • It is assumed that menarche is affected not only by the biological factors such as nutrition and genetic heritage, but also it is affected by other socio-cultural environmental factors including weather, geographic location, education and level of modernization. Also recent trend of menarche in Korea indicates that a lot of discussion are being generated to the need of sex education as a part of formal school education. The purpose of this study is to develop the school health education program by determine the age of menarche, the factors relavant to time of menarche and psycho-mental state of students at the time in menarche and investigate the present state of school health education relate to menarche of adolescents. The total number of 732 girls was drown from first, second and third grades of 4 middle schools in Seoul. For the data collection the survey was conducted during the period from May 1 to May 20, 1982 by using prepared questionair. The major results are summarized as follow; 1. Mean age at menarche and the percent distribution of menarche experienced. It was observed that about 68.7% of sampled students have been experienced menarche at the time interviewed. For the each group, age at menarche is revealed that among the students about 37.8% are experienced menarche for under 12 years old group, 62.1% for 13 year-old group, 80.6% for 14 year-old group and 95.5% for over 15 years old. In sum it was found that the mean age at menarche was 12.3 years old, ranged from age at 10 as earlist the age at 15 as latest. 2. Variables associated with age at menarche. 1) There was tendency those student who belong to upper class economic status have had menarche earlier than those student who belong to lower class. Therefore, economic status is closely related to age at menarche. 2) In time of mother's education level, it is also found that those students whose mother's education levels from high school and college are experienced menarche earlier than those students whose mother's education levels from primary school and no-education. 3) However, in connection with home discipline, there was no significant relationship between age at menarche and home disciplines which are being treated "Rigid", "Moderated ", "Indifferent". 4) Degree of communication between parents and daughter about sex matters was found to be associated each others in determination of age at menarche. 5) It was found that high association between mother's menarche age and their daughter's menarche age was observed. Mother's age at menarche earlier trend to be shown also as earlier of their daughters. 6) Those students belong to "D & E" of physical substantiality index are trend to be earlier in menarche than those students in the index "A & B". 3. Psycho-mental state at the time of menarche. Out of the total students 68.2% had at least one or more than one of subjective symptoms. Shyness was shown as most higher prevalent symptom and others are fear, emotional instability, unpleasant feeling, depression, radical behavior, inferior complex and satisfaction appeared. Very few cases are appeared be guilty and stealing feeling. 4. The present status of school health education program related to menarche. As to the source of information about menarche, teacher was a main source with average index 5.88 and the other informants were mother & family member, friends, books and magagines, movies, television, and radio. For the problem solving at menarche, mother & family members were subject to discussion with an average index 6.02 as high. The others for discuss and knowledge about menarche were books, magagine, friends, teachers, and self-learning based on own experienced. The time of learning about menarche, it was learned as highest percentage with 43.2% at a 6 grades of primary school, middle school with 34.4%, 5 grade of primary school with 18.2%, and 4 grade of primary school with 4.0% respectively.

  • PDF

An Analysis of the Uses of External Representations in Matter Units of 7th-Grade Science Digital Textbooks Developed Under the 2015 Revised National Curriculum (2015 개정 교육과정에 따른 중학교 1학년 디지털교과서의 물질 단원에서 나타난 외적 표상의 활용 실태 분석)

  • Song, Nayoon;Hong, Juyeon;Noh, Taehee
    • Journal of the Korean Chemical Society
    • /
    • v.64 no.6
    • /
    • pp.416-428
    • /
    • 2020
  • This study analyzed the uses of external representations presented in the matter units of the 7th-grade science digital textbooks developed under the 2015 revised national curriculum. The level, form, presentation, and interactivity of external representations presented in 5 types of digital textbooks were analyzed. As for the level, the macroscopic level of representations was mainly presented. The macroscopic level and microscopic level of representations were presented together in the particle description. As for the form, visual-verbal and visual-nonverbal representations were usually presented across the board. Very few audial-verbal and audial-nonverbal representations were presented. Visual-verbal and audial-verbal representations were mostly presented in formal form, and visual-nonverbal representations were mostly presented in illustration without movement. The presentation of representations was analyzed in three aspects. First, visual-verbal and visual-nonverbal representations were mainly presented together and none of audial-verbal and visual-nonverbal representations were presented together. When the representations of the audial-verbal, visual-nonverbal, and visual-verbal were presented together, some of the information presented in audial-verbal representations was repeatedly presented in the visual-verbal representations. Second, audial-nonverbal representations not related to learning content were presented along with other representations. Third, there were few cases of arranging visual-verbal and visual-nonverbal representations on the next pages. Audialverbal and visual-nonverbal representations were always presented synchronized. As for the interactivity, the manipulation level was mainly presented in the main area, and the feedback level was mainly presented in the activity area. The adaptation level and the communication level of interactivity were presented very few. Based on the results, the implications for the direction of constructing digital textbooks were discussed.

Dokdo of Korea, A Chance for Peace and Co-Prosperity A Study Using Perspectives of Public Diplomacy and Negotiation Strategies (Memorial Lesson from fisherman, An Yong-bok as a Supreme Negotiator) (한국의 독도, 평화와 상생의 기회: 공공외교 및 협상 관점의 연구 (탁월한 소시민 협상가, 어부 안용복을 기리며))

  • Mi-ae Hwang
    • Journal of Public Diplomacy
    • /
    • v.2 no.2
    • /
    • pp.27-52
    • /
    • 2022
  • Objectives: The neighboring countries of South Korea and Japan in Northeast Asia have interacted in both positive and negative ways, at times as close partners and other times adversaries, throughout their long and thorny history of extensive dynamics. The controversial dispute over Dokdo is one of the most critical issues evoking harsh tensions and arguments asserting wholly opposite claims. Dokdo is a small island between two coastal states, but significant in terms of territorial, botanical, and marine resources, and thus ownership of the island has become a point of conflict accompanied by a troubled history. But why has Dokdo been a source of conflicts and how should the controversial Dokdo issue be addressed in a way that fosters positive influence and co-prosperity? Methods: This study provides comprehensive and critical insights from a wealth of previous research and strategic suggestions for the Korean government. It utilizes the three perspectives of historical documents and political context, international regulations and legal frames, and public diplomacy. Furthermore, it applies these resources to negotiation theories and strategies to propose reasonable solutions. Results: This study suggests that it is important for Korea and Japan to try to build mutual trust through more active communication and interaction in order to understand each other before attempting to create a formal resolution via negotiation. In addition to these efforts, Korea needs to be ready for the inevitable need to take decisive action in terms of negotiation, using analytic and efficient strategies. The study proposes three solutions: 1) Strong Action Strategy, 2) International Legal Strategy, and 3) Public Diplomacy Strategy. Conclusions: From the perspective of public diplomacy, the Dokdo issue needs to be converted from a symbol of conflicts between Korea and Japan into a symbol of peace and co-prosperity. In addition to promoting a positive relationship between the two states, it can also contribute to the security environment of the Northeast Asian region and global peace.

A study on The U.S.-Korean Trade Friction Prevention and Settlement in the Fields of Information and Telecommunication Industries (한미간(韓美間) 정보통신분야(情報通信分野) 통상마찰예방(通商摩擦豫防)과 해소방안(解消方案)에 관한 연구(硏究))

  • Jung, Jay-Young
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
    • /
    • v.13
    • /
    • pp.869-895
    • /
    • 2000
  • The US supports the Information and Communication (IC) industry as a strategic one to wield a complete power over the World Market. However, several other countries are also eager to have the support for the IC industry because the industry produces a high added value and has a significant effect on other industries. Korea is not an exception. Korea recently succeeded in the commercialization of CDMA for the first time in the world, after the successful development of TDX. Hence, it is highly likely to get tracked by the US. Although the IC industry is a specific sector of IT, there is a concern that there might be a trade friction between the US and Korea due to a possible competition. It will be very important to prepare a solution in advance so that Korea could prevent the friction and at the same time increase its share domestically and globally. It will be our important task to solve the problem with the minimum cost if the conflict arises unfortunately in the IT area. The parties that have a strong influence on the US trade policy are the think tank group and the IT-related interest group. Therefore, it would be important to have a close relationship with them. We found some implications by analyzing the case of Japan, which has experienced trade frictions with the US over the long period of time in the high tech industry. In order to get rid of those conflicts with the US, the Japanese did the following things : (1) The Japanese government developed supporting theories and also resorted to international support so that the world could support the Japanese theories. (2) Through continual dialogue with the US business people, the Japanese business people sought after solutions to share profits among the Japanese and the US both in the domestic and in the worldwide markets. They focused on lobbying activities to influence the US public opinion to support the Japanese. The specific implementation plan was first to open culture lobby toward opinion leaders who were leaders about the US opinion. The institution, Japan Society, were formed to deliver a high quality lobbying activities. The second plan is economic lobby. They have established Japanese Economic Institute at Washington. They provide information about Japan regularly or irregularly to the US government, research institution, universities, etc., that are interested in Japan. The main objective behind these activities though is to advertise the validity of Japanese policy. Japanese top executives, practical interest groups on international trade, are trying to justify their position by direct contact with the US policy makers. The third one is political lobby. Japan is very careful about this political lobby. It is doing its best not to give impression that Japan is trying to shape the US policy making. It is collecting a vast amount of information to make a correct judgment on situation. It is not tilted toward one political party or the other, and is rather developing a long-term network of people who understand and support the Japanese policy. The following implications were drawn from the experience of Japan. First, the Korean government should develop a long-term plan and execute it to improve the Korean image perceived by American people. Second, the Korean government should begin public relation activities toward the US elite group. It is inevitable to make an effort to advertise Korea to this elite group because this group leads public opinion in the USA. Third, the Korean government needs the development of a relevant policy to elevate the positive atmosphere for advertising toward the US. For example, we need information about to whom and how to about lobbying activities, personnel network who immediately respond to wrong articles about Korea in the US press, and lastly the most recent data bank of Korean support group inside the USA. Fourth, the Korean government should create an atmosphere to facilitate the advertising toward the US. Examples include provision of incentives in tax on the expenses for the advertising toward the US and provision of rewards to those who significantly contribute to the advertising activities. Fifth, the Korean government should perform the role of a bridge between Korean and the US business people. Sixth, the government should promptly analyze the policy of IT industry, a strategic area, and timely distribute information to industries in Korea. Since the Korean government is the only institution that has formal contact with the US government, it is highly likely to provide information of a high quality. The followings are some implications for business institutions. First, Korean business organization should carefully analyze and observe the business policy and managerial conditions of US companies. It is very important to do so because all the trade frictions arise at the business level. Second, it is also very important that the top management of Korean firms contact the opinion leaders of the US. Third, it is critically needed that Korean business people sent to the USA do their part for PR activities. Fourth, it is very important to advertise to American employees in Korean companies. If we cannot convince our American employees, it would be a lot harder to convince regular American. Therefore, it is very important to make the American employees the support group for Korean ways. Fifth, it should try to get much information as early as possible about the US firms policy in the IT area. It should give an enormous effort on early collection of information because by doing so it has more time to respond. Sixth, it should research on the PR cases of foreign enterprise or non-American companies inside the USA. The research needs to identify the success factors and the failure factors. Finally, the business firm will get more valuable information if it analyzes and responds to, according to each medium.

  • PDF

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
    • /
    • v.20 no.1 s.21
    • /
    • pp.165-203
    • /
    • 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.

  • PDF