• Title/Summary/Keyword: Government intervention

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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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Related to Supporting Art Therapy for Children and Youth in Korea Survey of State Projects (국내 아동·청소년 대상 미술치료 지원 관련 국가사업 실태 조사)

  • Ahn, Yi-jeong;Chung, Yeo-Ju;Kim, Seo-Young;Jang, Jeong-Ja
    • The Journal of the Korea Contents Association
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    • v.20 no.11
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    • pp.314-322
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    • 2020
  • The purpose of this study is to investigate the state projects related to psychological sentiment for child and youth in Korea, examine the current status of art treatment-related projects for child and youth, and seek ways to improve them, focusing on projects supported by the Ministry of Health and Welfare, the Ministry of Gender Equality and Family, and the Ministry of Culture, Sports and Tourism. The results examined through this study were firstly, mental health promotion projects conducted in the public sector in Korea are mainly carried out on consignment to affiliated organizations, and are promoted not only for diagnosis, mediation, and therapeutic intervention but also for care and prevention. Second, psychological and emotional support projects are being attempted with various approaches such as reading, playing, gardening, and art, and art therapy is actively used as a part of art programs. In addition, it is suggested that the government should provide efficient welfare and utilize it as a common goal through linkage and cooperation with other ministries for the continuous and stable implementation of state-led psychological support projects. In addition, it is hoped that this research will be used as a research material to explore specific strategies for effectiveness of national policy projects on the overall psychological sentiment of child and youth.

A Study on the Possibility of Self-Correction in the Market for Protecting Internet Privacy (인터넷 개인정보보호의 시장자체해결가능성에 대한 연구)

  • Chung, Sukkyun
    • Journal of Digital Convergence
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    • v.10 no.9
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    • pp.27-37
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    • 2012
  • Internet privacy has become a significant issue in recent years in light of the sharp increase in internet-based social and economic activities. The technology which collects, processes and disseminates personal information is improving significantly and the demand for personal information is rising given its inherent value in regard to targeted marketing and customized services. The high value placed on personal information has turned it into a commodity with economic worth which can be transacted in the marketplace. Therefore, it is strongly required to approach the issue of privacy from economic perspective in addition to the prevailing approaches. This article analyzes the behaviors of consumers and firms in gathering personal information, and shielding it from unauthorized access, using a game theory framework in which players strive to do their best under the given conditions. The analysis shows that there exist no market forces which require all firms to respect consumer privacy, and that government intervention in the form of a nudging incentive for information sharing and/or strict regulation is necessary.

Clinical Nutrition Services of a Long-term Care Hospital in Korea (전국 요양병원에서의 임상영양서비스 실태 조사)

  • Um, Mi Hyang;Lyu, Eun Soon;Lee, Song Mi;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Park, Yoo Kyoung
    • Korean Journal of Community Nutrition
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    • v.20 no.3
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    • pp.220-235
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    • 2015
  • Objectives: The purpose of this study was to investigate how clinical nutrition services is provided at a long term care hospital in Korea and to investigate job satisfaction levels of the clinical dietitians. Methods: Survey questionnaire was sent to dietitians working at a long term care hospital in Korea. The participating hospitals (n=240) were randomly selected from 1,180 long- term care hospitals using a stratified sampling method. A total of 134 long term care hospital s and 223 dietitians completed the survey of clinical nutrition service s and job satisfaction questionnaires The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas. Results: The average nutritional screening rate was 17.9% and the rate of computerized nutritional screening system was 9.7% in the participating hospitals. Nutritional intervention rate was only 3.2% of all patients. KOIHA (Korea Institute for Healthcare Accreditation) accreditated hospitals showed only 50% performance rate of nutrition service evaluation area. This shows that after achieving KOIHA accredition, many hospitals do not emphasize the performance of nutritional services. The job satisfaction scores in all four areas ranged from 2/5 to 3/5, implying generally low job satisfaction level in hospital dietitians. Linear regression analysis results showed that the "hospital adequacy grade" type was a significant predictor of job satisfaction level for two areas (working conditions & relationship). Conclusions: There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service s in long term care hospitals. Therefore, government and local hospitals have to work on implementing nutritional programs and policies for improved service and care.

Money and Capital Accumulation under Imperfect Information: A General Equilibrium Approach Using Overlapping Generations Model (불완전(不完全)한 정보하(情報下)의 통화(通貨)의 투자증대효과분석(投資增大效果分析): 중복세대모형(重複世代模型)을 이용한 일반균형적(一般均衡的) 접근(接近))

  • Kim, Joon-kyung
    • KDI Journal of Economic Policy
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    • v.14 no.1
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    • pp.191-212
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    • 1992
  • This paper discusses the role of money in the process of capital accumulation where financial markets are impeded by contract enforcement problems in the context of overlapping generations framework. In particular, in less developed countries (LDCs) creditors may know little about the repayment capability of potential debtors due to incomplete information so that financial instruments other than money may not acceptable to them. In this paper the impediments to the operation of the private finanical markets are explicitly modelled. We argue that creditors cannot observe actual investment decisions made by the potential borrowers, and as a result, loan contracts may not be fully enforceable. Therefore, a laissez-faire regime may fail to provide the economy with the appropriate financial instruments. Under these circumstances, we introduce a government operated discount window (DW) that acts as an open market buyer of private debt. This theoretical structure represents the practice of governments of many LDCs to provide loans (typically at subsidized interest rates) to preferred borrowers either directly or indirectly through the commercial banking system. It is shown that the DW can substantially overcome impediments to trade which are caused by the credit market failure. An appropriate supply of the DW loan enables producers to purchase the resources they cannot obtain through direct transactions in the credit market. This result obtains even if the DW is subject to the same enforcement constraint that is responsible for the market failure. Thus, the DW intervention implies higher investment and output. However, the operation of the DW may cause inflation. Furthermore, the provision of cheap loans through the DW results in a worse income distribution. Therefore, there is room for welfare enhancing schemes that utilize the higher output to develop. We demonstrate that adequate lump sum taxes-cum-transfers along with the operation of the DW can support an allocation that is Pareto superior to the laissez-faire equilibrium allocation.

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Provisional National Nutrition Targets and Strategies for Health Promotion of Koreans (국민건강증진을 위한 영양 부문의 2000년 잠정목표와 전략)

  • 김혜련
    • Korean Journal of Community Nutrition
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    • v.1 no.2
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    • pp.161-177
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    • 1996
  • This study attempts to propose a priority of national nutrition targets and strategies for health promotion by the year 2000 in Korea, as a part of the task set for national health promotion objectives and strategies. Among all of the important health issues raised, ten were chosen, nutrition was one priority area. In the first part, the current status of the nutrition-related health problems and risk factors are reviewed, in conjunction with the newly arisen health phenomena, such as changes in prevalence of lifestyle disease and causes of death, changes of food consumption patterns in our country. In the second section this study suggests six feasible national nutrition targets, eight implementing strategies and current major tasks on the basis of the assessment of present status and in consideration of the other health promotion goals and strategies, with reference to that of other developed countries. The main targets and strategies are suggested as follows ; Firstly, the national nutrition monitoring and surveillance system should be established for identifying the nutritional problems for our people, and current National Nutrition Survey is a strong need for improvement to a more comprehensive and reliable one. Secondly, effective administrative mechanism should be operation at national level for the development of nutrition policy. Ministry of Health and Welfare (MOHW) as well as local health department must be remarkably renewed and strengthened the nutrition section. And it is recommended that MOHW organize and operate “The Council of Nutrition”, in which all government authorities related with foodstuffs and nutrition would incorporated. The Council of Nutrition would act as an adjustor as well as a coordinator in nutrition related policy-making. Thirdly, healthy eating pattern will be supported by activities of introducing a nutrition labeling for providing consumers with the necessary information and skills for food selection. Fourthly, nutrition education, and nutrition intervention programs will be carried out in various settings such as health centers, schools, and clinical fields and workplace. Fifthly, the current dietary guidelines shall be continuously improved in detail, and publicly circulated to particular levels of people by age group and by health condition. And finally, researches and epidemiological studies particularly in regard to diet for development of chronic diseases are needed for more investigation and up-to-date national health and nutrition data should be collected with the support and cooperation from the various medical professional teams . (Korean J Community Nutrition 1(2) : 161-177, 1996)

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A Research on the Relationship between Duty Free' Locations and Sales of its Product Attributes at Airport : a Case of Departure and On-Arrival Duty Free at Incheon International Airport (공항 면세점 위치와 판매품목별 매출액 간 관계성 연구: 인천국제공항 출국장 및 입국장 면세점 사례를 중심으로)

  • Yoon, Han-Young;Cho, Sung-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.2
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    • pp.103-114
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    • 2020
  • On-arrival duty free will prevent Korean outbound passengers from keeping the duty free items they purchased at the departure during their travel. Most Korean tourists have requested the airport authority to install on-arrival duty free since the grand-opening of Incheon int'l airport. Considering the fierce hub airport competition in the North East Asian region, the Korean government's decision to install on-arrival duty free is regarded as a well-timed intervention. The purpose of the research was to analyze sales correlation based on a comparison of sales of both departure and on-arrival duty free and to propose an administrative implication. Compared to business conglomerates running departure duty free, on-arrival duty free operators, who are small or medium companies, have weakness in product composition, marketing, and merchandising capabilities. According to the analysis, outbound passengers, who purchased fashion accessories and leather products at the departure duty free, tended to purchase cosmetics/perfume or liquor on the arrival duty free. Such complementary purchasing behavior of passengers showed there is barely a negative correlation between departure and on-arrival duty free.

Major Factors Influencing the Usage Needs for the Adult Guardianship System in Parents of People with Developmental Disabilities (발달장애인 부모의 성년후견제도 이용욕구에 영향을 미치는 요인)

  • Lee, Yong-Pyo;Song, Seung-Yeon
    • The Journal of the Korea Contents Association
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    • v.16 no.6
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    • pp.334-344
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    • 2016
  • The purpose of this research is to investigate usage related predictors to activate Adult Guardianship System of People with Developmental Disabilities. To achieve the purpose of this research, we have analyzed the survey of parents of People with Developmental Disabilities usage needs for Adult Guardianship System which is based on the Andersen's behavioral model. The study utilized data from 2011 Welfare Needs Assessment of Seoul middle and senior-aged Family with Developmental Disabilities, and the analysis method, the study applied used SPSS 22.0, frequency analysis, descriptive statistics analysis, logistic regression analysis. According to the result, the usage needs for Adult Guardianship System increases meaningfully if the parents does not have occupation, and the subject of Adult Guardianship System is male. In income and the social security system wise, the usage needs for Adult Guardianship System show remarkably large rating if the average income is high and the desire to be cared by others is high. But in case of People with Developmental Disabilities, communication skills, the degree of disability, burden of caring does not have effect on the usage needs for Adult Guardianship System. The conclusion for this research is, first, to activate vigorous usage of Adult Guardianship System, the government intervention is required. Second, the following study is needed to explain to the concept of the needs caring by others and the cultural factors relating to the usage needs for Adult Guardianship System.

Knowledge Production Function in South Korea : An Empirical Analysis (우리나라 지식생산함수 : 실증분석)

  • Cho, Sang-Sup;Jung, Dong-Jin
    • Journal of Korea Technology Innovation Society
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    • v.10 no.3
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    • pp.383-405
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    • 2007
  • In this paper we estimate knowledge production function for 15 South Korean industry sectors using panel data. To accommodate the influence of inter-sectoral interactions on the creation of knowledge, we estimate parameters for related knowledge production functions using the Dynamic Seemingly Unrelated Regression(DSUR) model proposed by Mark et al. (2005). We find the elasticity of knowledge production with respect to the size of research staff to be 0.25 and that with respect to the existing stock of knowledge to be 0.35. The fact that the elasticity of new knowledge creation with regard to the existing knowledge stock is below 1 in South Korea corroborates the view that the rate of long-term growth of her economy is chiefly determined by the elasticity related to production functions of goods and services and the rate of population growth, and that her government policy, to ensure a continued growth for the Korean economy, must shift the focus of R&D policies from the current direct intervention-centered model to one consisting of indirect measures, namely supporting knowledge management and diffusion and the creation of a knowledge sharing system. In terms of R&D policy implications it could be consider that the national knowledge production system should strengthen the cumulative process of knowledge accumulation and population for research and development. Our country R&D policy, also, need to adopt a global approach to increase knowledge stock at the highest levels of a country.

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Determinants of Smoking Initiation and Susceptibility to Future Smoking among School-Going Adolescents in Lagos State, Nigeria

  • Odukoya, Oluwakemi Ololade;Odeyemi, Kofoworola Abimbola;Oyeyemi, Abisoye Sunday;Upadhyay, Ravi Prakash
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1747-1753
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    • 2013
  • Background: It is projected that low and middle-income countries will bear a major burden of tobacco related morbidity and mortality, yet, only limited information is available on the determinants of smoking initiation among youth in Africa. This study aimed to assess the determinants of smoking initiation and susceptibility to future smoking among a population of high school school students in Lagos, Nigeria. Materials and Methods: Baseline data from an intervention study designed to assess the effect of an anti-smoking awareness program on the knowledge, attitudes and practices of adolescents was analyzed. The survey was carried out in six randomly selected public and private secondary schools in local government areas in Lagos state, Nigeria. A total of 973 students completed self-administered questionnaires on smoking initiation, health related knowledge and attitudes towards smoking, susceptibility to future smoking and other factors associated with smoking. Results: Of the respondents, 9.7% had initiated smoking tobacco products with the predominant form being cigarettes (7.3%). Males (OR: 2.77, 95%CI: 1.65-4.66) and those with more pro-smoking attitudes (OR: 1.44, 95%CI: 1.34-1.54) were more likely to have initiated smoking. Those with parents and friends who are smokers were 3.47 (95%CI: 1.50-8.05) and 2.26 (95%CI: 1.27-4.01) times more likely to have initiated smoking. Non-smoking students, in privately owned schools (OR: 5.08), with friends who smoke (5.09), with lower knowledge (OR: 0.87) and more pro-smoking attitudes (OR 1.13) were more susceptible to future smoking. In addition, respondents who had been sent to purchase cigarettes by an older adult (OR: 3.68) were also more susceptible to future smoking. Conclusions: Being male and having parents who smoke are predictors of smoking initiation among these students. Consistent with findings in other countries, peers not only influence smoking initiation but also influence smoking susceptibility among youth in this African setting. Prevention programs designed to reduce tobacco use among in-school youth should take these factors into consideration. In line with the recommendations of article 16 of the WHO FCTC, efforts to enforce the ban on the sales of cigarettes to minors should be also emphasised.