• The Korean Journal of Pain
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• 제35권1호
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• pp.14-21
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• 2022

The coronavirus disease 2019 (COVID-19) pandemic, which has been rampant since the end of 2019, has evidently affected pain management in clinical practice. Fortunately, a COVID-19 vaccination program is currently in progress worldwide. There is an ongoing discussion that pain management using steroid injections can decrease COVID-19 vaccine efficacy, although currently there is no direct evidence to support this statement. As such, the feeling of pain in patients is doubled in addition to the co-existing ill-effects of social isolation associated with the pandemic. Thus, in the COVID-19 era, it has become necessary that physicians be able to provide high quality pain management without negatively impacting COVID-19 vaccine efficacy. Steroids can alter the entire process involved in the generation of adaptive immunity after vaccination. The period of hypophysis-pituitary-adrenal axis suppression is known to be 1 to 4 weeks after steroid injection, and although the exact timing for peak efficacy of COVID-19 vaccines is slightly different for each vaccine, the average is approximately 2 weeks. It is suggested to avoid steroid injections for a total of 4 weeks (1 week before and after the two vaccine doses) for the double-shot vaccines, and for 2 weeks in total (1 week before and after vaccination) for a single-shot vaccine. This review focuses on the basic concepts of the various COVID-19 vaccines, the effect of steroid injections on vaccine efficacy, and suggestions regarding an appropriate interval between the administration of steroid injections and the COVID-19 vaccine.

• 한국가금학회지
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• 제8권2호
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• pp.77-89
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• 1981

The experimental study was undertaken to confirm the effect of vaccination of birds with Newcastle disease (ND) vaccines on the Market by use of th. various vaccination programs. Sixteen groups of birds varying from 2 to f days of age, which were originated from hyper-immunised hens against ND were immunised by three different ways, a live vaccine only, a killed vaccine only, and the combination of a live and killed vaccine according to the each schedule of employed programs. In the administration of a live vaccine only, birds were immunized by one of following methods, the combination of intranasal and intraocular inoculation, intramuscular inoculation, via drinking water and the double inoculation by spray and drinking water application. Except for the double application, all the birds were vaccinated 2,3 or 4 times with two volumes of the virus dose (drinking water application) instructed by the commercial vaccine laboratory, until 21, 28 or 30 days of age, and all the immunized birds 19, 21 or 28 days postvaccination were challenged intramuscularly with 1.0$m\ell$ of 10,000 MLD per $m\ell$ of a virulent ND virus. In the administration of the combination of a live and killed vaccine, birds were immunized 2 or 3 times intranasally at first until 14 or 28 days of age with the same dose of the above experiment of a live vaccine, and then inoculated intramuscularly 1 or 2 times until 60 days of age with 1.0 $m\ell$ of a killed vaccine. And all immunized birds 11 days postvaccination were challenged with the same procedure of the above experiment. In the administration of a killed vaccine only, birds were immunized 3 times intramuscularly until 28 days of age with varied dose (0.2-0.5 $m\ell$) of a killed vaccine and all immunized birds 33 days postvaccination were challenged with the same procedure of the above experiment. The results obtained are summerised as follows: All birds vaccinated by using the combination of a live and killed vaccine program or a killed vaccin only appeared to be refractory. without any sign of illness, to the challenge exposure with 1.0$m\ell$ of 10,000 MLD per $m\ell$ of a virulent ND virus. On the other hand, the survival rates of birds of live vaccine groups immunized by a number of vaccine program such as Salsbury's day old program, 3-3-3 program, the Institute of Veterinary Reserch program and Multiple inoculation program, were 39.58%, 43.7%, 43.75% and 47.80%, respectively. And the survival rates of birds vaccinated with a live vaccine by 4 different ways of administration, i.e., double inoculation by water and aerosol application, intramuscular injection, intranasal instillation and via 4.inking water were 87.50%, 64.06%, 42.18% and 25.00%, respectively.

• 한국가금학회지
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• 제8권1호
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• pp.15-24
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• 1981

우리나라 뉴캣슬병 (ND) 면역상의 문제점을 파악하고 명확한 예방접종지침을 제시하는 목적의 일환으로 우선 ND 유행이 극심하였던 지역의 일반양계농장에서 사육되는 건강면역군의 예방접종경력과 혈구응집억제항체가(HI 가)를 조사하여 야외에서 실시된 ND예방접종결과에 따르는 면역효과를 간접적으로 파악하는 한편 동일지역 내에서 ND발생계군과 비발생계군에 대한 예방접종경력과 발생계군의 피해상황을 조사함으로서 야외에서 실시한 ND예방약의 응용방법과 본병발생과의 관계를 조사한 추구 결과는 다음과 같다. 1. ND 유행지역에서 조사한 26건강면역계군의 예방접종경력은 각양계농장 임의대로의 예방접종 프로그램에 따라서 22계군은 LV와 LV병용. 잔여 4계군은 KV단용에 의해서 각각 면역되었다. 이들의 HI가는 일반적으로 전자가 높았고 후자는 낮은 경향을 보였으며, 그 평균치는 각각 146. 50이었다. 그리고 전자의 22계군 중 특히 낮은 역치(10, 23)를 보였던 그계군은 추후 ND발생을 보았으나 잔여 20계군 및 KV 단용 4계군은 모두 무사히 경과하였다. 2. ND유행지역에서 조사한 ND발생14계군의 예방접종경영은 무접종이 1계군이고 잔여 13계군은 각양계농장 임의대로의 접종프로그램에 따라서 LV단용이 8계군, LV와 KV병용이 5계군이었다. 폐사율에 있어서 후자는 5.1%인데 반하여 전자는 32.5%의 피해 즉 후자에 비하여 6.28배의 월등히 높은 폐사율을 보였다. 한편 ND비발생 4계군은 LV와 KV병용 혹은 KV단용 예방접종프로그램에 의해서 면역되었으며 LV단용계군은 1예도 없었다. 3. 야외에서 조사한 면역계군들의 LV응용은 거의가 ND면역상 불리하다고 보여지는 음수 투여에 의해서 면역되었으며 극히 소수예가 비질내적하 혹은 일정 희척 LV병독액 속에 파면역추의 입, 코, 눈까지 침지하는 특이한 방법으로 면역되었다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7459-7466
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• 2013

Background: Some 60 years after introduction of the Papanicolaou smear worldwide, cervical cancer remains a burden in developing countries where >85% of world new cases and deaths occur, suggesting a failure to establish comprehensive cervical-cancer control programs. Effective interventions are available to control cervical cancer but are not all affordable in low-income settings. Disease awareness saves lives by risk-reduction as witnessed in reducing mortality of HIV/AIDS and smoking-related cancers. Subjects and Methods: We initiated a community-based awareness program on cervical cancer in two low-income Muslim Uyghur townships in Kashi (Kashgar) Prefecture, Xinjiang, China in 2008. The education involved more than 5,000 women from two rural townships and awareness was then evaluated in 2010 and 2011, respectively, using a questionnaire with 10 basic knowledge questions on cervical cancer. Demographic information was also collected and included in an EpiData database. A 10-point scoring system was used to score the awareness. Results: The effectiveness and feasibility of the program were evaluated among 4,475 women aged 19-70 years, of whom >92% lived on/below US$1.00/day. Women without prior education showed a poor average awareness rate of 6.4% (164/2,559). A onetime education intervention, however, sharply raised the awareness rate by 4-fold to 25.5% (493/1,916). Importantly, low income and illiteracy were two reliable factors affecting awareness before or after education intervention. Conclusions: Education intervention can significantly raise the awareness of cervical cancer in low-income women. Economic development and compulsory education are two important solutions in raising general disease awareness. We propose that implementing community-based awareness programs against cervical cancer is realistic, locally affordable and sustainable in low-income countries, which may save many lives over time and, importantly, will facilitate the integration of comprehensive programs when feasible. In this context, adopting this strategy may provide one good example of how to achieve "good health at low cost".

• Child Health Nursing Research
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• 제19권3호
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• pp.216-227
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• 2013

목적 예방접종은 국민건강증진에 많은 기여를 함에도 불구하고 백신의 안정성 문제로 부모는 아동 예방접종을 망설이거나 거부하는 경향이 증가하고 있다. 그러므로 본 연구의 목적은 자녀 예방접종을 실시하고 있지 않은 부모의 주관성을 조사하여 이들의 생각과 태도를 파악한 후 각 유형별 간호중재 프로그램을 개발하는 데 기초자료를 제공하고자 함이다. 방법 예방접종을 거부하는 부모의 주관적인 견해를 알아보기 위해 Q-방법론을 적용하였다. 개별 심층면담 기법과 개방형 질문지, 국내외 문헌 고찰을 통해 42개의 Q 표본을 도출하였으며 소표본 이론을 근거로 35명의 P 표본을 선출한 후 9점 척도에 강제로 분포하도록 Q-sorting 과정을 실행하였다. 강제 분포된 카드의 점수는 1-9점으로 변환하여 점수를 배정한 후 PC-QUANAL 프로그램을 이용하여 분석하였다. 결과 자녀 예방접종 거부에 대한 부모의 태도와 관련된 주관성을 Q 요인 분석한 결과 '예방접종 불신형', '예방접종 부작용 염려형', '예방접종 불필요형' 등의 3개 유형으로 분류되었다. 이들 3개 유형은 전체 변량의 67%를 설명하고 있는데, 제1유형은 54%, 제2유형은 8%, 제3유형은 5%로 나타나 제1유형이 대상자의 주관적인 견해를 가장 많이 설명하고 있었다. 결론 본 연구를 통해 도출된 3개 유형을 토대로 예방접종에 대한 정확한 정보를 제공할 수 있는 간호사로 구성된 전문 상담가를 정부 정책 하에 양성할 필요가 있으며, 예방접종에 대한 부정적인 견해를 전환할 수 있는 각 유형별 맞춤형 교육 프로그램 또한 개발될 필요가 있다.

• Pediatric Infection and Vaccine
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• 제24권1호
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• pp.7-15
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• 2017

목적: 예방접종 정책과 프로그램 수립에 있어 청소년의 인플루엔자 백신접종률은 중요한 정보를 제공한다. 본 연구는 국내 청소년의 인플루엔자 예방접종률을 파악하고 이에 영향을 미치는 요인을 파악하고자 하였다. 방법: 2007년부터 2012년 그리고 2014년에 시행된 제4-6기 국민건강영양조사에 참여한 만 12-18세 청소년 중 인플루엔자 백신 예방접종 여부에 유, 무를 응답한 5,213명을 대상으로 건강설문 자료를 활용하여 분석하였다. 결과: 연구 대상자의 인플루엔자 예방접종률은 23.2% (범위, 21.1%-24.7%)였다. 연구 대상자들 중, 초등학생인 경우(odds ratio [OR], 1.706; 95% confidence interval [CI], 1.526-1.906)와 주관적 건강 인식에서 건강 인식이 좋을수록(OR, 1.192; 95% CI, 1.057-1.344) 더 높은 접종률을 보였다. 음주를 하지 않고(OR, 1.769; 95% CI, 1.474-2.122) 흡연 경험이 없는 청소년(OR, 1.459; 95% CI, 1.144-1.860)에서 접종률이 높았고, 폐렴으로 의사에게 진단받은 경험이 있는 경우(OR, 1.469; 95% CI, 1.076-2.006) 접종을 많이 하는 것으로 확인되었다. 결론: 국내 청소년 중 예방접종률이 낮은 집단인 중, 고등학생과 주관적으로 건강상태가 나쁘다고 생각하는 그룹 및 음주, 흡연을 하는 청소년들을 대상으로 한 적극적인 예방접종 홍보 정책이 요구된다.

• 대한간호학회지
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• 제22권2호
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• pp.207-226
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• 1992

This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.

• 보건행정학회지
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• 제8권2호
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• pp.125-148
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• 1998

Accurate vital statistics are essential for a national health planning and evaluation. Among various vital statistics, birth and death rates, and infant and matemal mortality rates together with the causes of death are the very basic ones for above purposes as well as for the maternal and child health management. These statistics are based on the birth and death reports. It is required by law to report every birth and death within one month after its occurrence. However, in case of a neonatal death occurring prior to the birth report, most of the birth and death are not reported. Thus accurate infant and maternal mortality rates are not available yet in Korea. The main objective of this study is to develop a birth and infant death reporting system via computer network. We designed a new birth report form based on the current form and data from the analysis of medical record forms of 14 hospitals. A new form is basically addition of essential medical information to the current birth report form. Since a revision of the rules and regulations related wtih the birth report is necessary to use a new form, we kept the current from intact to make it acceptable to the government office for a field trial. We also developed computer programs for data input for birth and death reports at a medical faciltiy, data processing for production of maternal and child health indices at a health center, and management of maternal and child health services including immunization and postantal care at health center. The birth certificate and birth report can be printed out at a medical facility. The computer packages were programmed by Borland Delphi 3.0 and can be run under Windows 95 system. We proposed a new birth and death reporting system via computer network after a field trial for data input, transmission, and processing. The medical and demographic data o birth and death at medical facilities will be sent to health centers directly via computer network. The health center will retain the medical data for analysis and forward only the data for birth and death reports required by current regulations to the Dong, Up, or Myun Office. Once the birth or death is reported via computer network to the Dong Office, then the Dong Office will notify the baby's mother of the birth report and request to submit the baby's name by mail. When the baby's name its submitted. the Dong Office will forward the birth reports to the Common Court and Statistics Agency in the same way as the current system, Upon the completion of birth registration of the Common Court, the court will issue the birth certificate to mother which will be used in lieu of the family record. The advantages of proposed birth and death reporting system via computer network ar as follows ; I) The accuracy, timing, and completeness of reporting will be improved and more accurate maternal and child health indices can be obtained, ii) The maternal and child health services of health center will be obtained, iii) Epidemiologic data for pregnancy and birth can be obtained, iv) Manpower for birth and death reporting will be saved.

• Pediatric Infection and Vaccine
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• 제16권2호
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• pp.167-174
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• 2009

목 적: 과거에는 비교적 흔했던 백일해는 DTP백신의 사용 이후 경험하기 어려운 질환이 되었다. 이 같은 상황은 DTP백신의 높은 방어효과에 의한 것이기도 하지만 실제로는 알고 있는 것보다 많은 환자가 발생하고 있으나 확진을 위한 검사법이 용이하지 않아 생기는 현상일 수도 있다. 따라서 본 연구에서는 발작적 기침을 주증상으로 입원한 영아들에게 백일해에 대한 검사를 적극적으로 수행하여 백일해로 진단되는 비율을 얻음과 동시에, 백일해로 확진된 환자들과 비백일해 대조군의 임상양상을 비교함으로써 본 질환에 대한 보다 높은 관심을 이끌고자 하였다. 방 법: 2006년 6월부터 11월까지 가톨릭대학교 성빈센트병원 소아청소년과에 입원한 생후 15-90일의 영아 중 1주일 이상 기침이 지속되고, 발작적 기침이나 흡기 시 '흡' 소리, 기침 후 구토가 있었던 환자 27명의 비인두 가검물로 백일해에 대한 PCR 및 배양검사를 시행하였다. 백일해에 대한 PCR 양성이나 배양검사에서 균이 자란 경우를 백일해 환자군, PCR음성이면서 배양검사에서 균이 자라지 않은 경우를 비백일해 대조군으로 정의하고 두 군간의 임상양상을 비교하였다. 결 과 : 연구 대상 27명의 입원시 진단명은 세기관지염 20명, 기관지 폐렴 1명, 백일해양 증후군 6명이었다. 백일해로 확진된 5명 중 1명(20%)만이 입원 시의 진단명이 백일해양 증후군이었다. 백일해 환자군과 비백일해 대조군의 임상양상을 비교한 결과 환자군에서 의미 있게 높은 빈도를 보였던것은 무발열(P =0.043), 발작적 기침(P =0.040), 청색증(P =0.001), DTaP백신 미접종(P =0.003), 정상 청진소견(P =0.028), 가슴 X-선 사진의 정상소견(P =0.027), 절대 림프구수(P =0.039), 낮은 CRP 수치(P =0.046)이었으며, 총 기침기간은 백일해 환자군에서 비백일해 대조군에 비해 길었다 (27.2${\pm}$10.6 vs. 12.6${\pm}$5.6일, P =0.039). 결 론: 백일해로 확진된 영아의 일부만이 입원 시의 진단명이 백일해양 증후군이었다. 따라서 전형적인 백일해 증상이 있는 경우는 물론, 열이 없이 1주일 이상 발작적 기침이 지속되거나 청색증이 동반되는 DTaP 백신 접종력이 없는 영아들에서는 백일해의 가능성을 반드시 염두에 두어 이에 대한 적극적인 검사를 고려해야 하겠다.

• Journal of Preventive Medicine and Public Health
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• 제16권1호
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• pp.163-192
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• 1983

In order to facilitate the Korean government's efforts in integrating family planning and maternal & child health at the primary health care level (or township level), the Soon Chun Hyang College of Medicine, with the financial and technical assistance of WHO, has under-taken a service research project. The project has employed a quasi-experimental study design introducing interventions tat provide crucial factors lacking in the ongoing government programs such as midwives and qualified referral physicians. The study is being conducted in three locations, one control area and two study areas. Before introducing trained Nurse/Midewives into the study areas, a baseline prevalence survey was undertaken from 15 July 1981 to 10 August 1981 in selelcted townships of Seosan County. In this sample survey of bath the study and control areas, 2,484 eligible women (97% reponse rate) were interviewed to obtain benchmark data on basic evaluation indicators related to family planning and maternal and child health. The salients results were summarized as follows.: 1. CONTACT RATES WITH HEALTH WORKERS; During the year preceding the survey, 12% of women were visited by government health workers. The primary reason for such visits by health workers was family planning (45% of the visits). About 34% of the women visited the health centers during the year. The primary reason for visiting health centers was immunizations for their children (45% of the visits). 3. FAMILY PLANNING USE RATE; The baseline data showed little difference between women in the study area and the control area on contraceptive use. Approximately 59% were currently using some methods. However, among those current users, almost half were practicing less effective methods of birth control such as rhythm or withdrawal. Among other methods, the tubectomy was the most popular (16%), while use of the IUD, oral pill and condom together reached only 14%. 3. PRENATAL CARE RATE; About 75% of the women reported no prenatal care for their last births (the youngest child of each women), Additionally, among women received prenatal care, over half had only one visit. 4. ATTENDANCE AT DELIVERY; Most of the women surveyed (over 80%) were attended by a non-medical person during their last delivery. These figures are somewhat comparable to the national figure of 84% for remote areas. 5. POSTNATAL CARE; The proportion of women reporting postnatal care was only 4.5%, and postnatal care was not received by the majority of women surveyed. 6. CHILD HEALTH CARE: In contrast to the low rate of maternity care for women themselves, most women reported obtaining immunization care for their children. About 75% of the women obtained Polio and/or DPT, 58% BCG, and 44% Measles vaccine for their children. However, in terms of illness care, while 35% of the women stated that their youngest child had been sick during the month preceding the survey, only 28% of these women took their child to the clinic for treatment. 7. COMPLICATIONS OF PREGNANCY AND DELIVERY AND ABNORMALITIES IN THE NEWBORN; Among all last deliveries, 18% of the women had pregnancy complications and 9% of the women had complications during delivery About 5% of the women reported abnormality in their most recent newborn. 8. REPRODUCTION EFFICIENCY; PERINATAL MORTALITY AND INFANT MORTALITY Based on data from the pregnancy history in this survey, reproduction efficiency was estimated. Out of the 11,154 pregnancies reported by all women surveyed, foetal loss was 21% (almost 16% were induced abortions) and infant deaths before reaching one year old were 3.1%. The reproduction efficiency was, therefore, reduced to 76%. In terms of perinatal and infant mortality rates, the former was 40.2 per 1,000 total births and the latter was 39.3 per 1,000 live births. Both rates described J shaped relationships with age of mothers and parity, and they were also correlated with birth interval and mother's education. In summary, this baseline survey data indicated a need for (1) improving contraceptive practices with more effective methods to prevent unwanted pregnancies and (2) providing better services for maternal and child care to protect wanted pregancies. In the Korean rural setting. the author believes that the latter is more important as the value of each child has increased as a result of the family planning campaign for the past two decades. This calls for more effective integration of Family Planning and MCH programmes to meet the needs of the family in each stage of the child bearing and rearing period with deploying more qualified personnel than the current government program personnel.