• Title/Summary/Keyword: Knowledge-based economic growth

Search Result 135, Processing Time 0.029 seconds

A Study on the Influence of Young Entrepreneurs' Entrepreneurship and Entrepreneurial preparation upon the Entrepreneurial Performance: Centered on Mediated Effect of Entrepreneurial infra system using (기업가정신과 창업준비가 사업성과에 미치는 영향에 관한 연구: 창업인프라 활용 매개효과 중심으로)

  • Park, Jaehwan;Ahn, Taeuk
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
    • /
    • v.11 no.1
    • /
    • pp.39-47
    • /
    • 2016
  • Younger starters to be ready on the entrepreneurial performance and raising and producing potential creative person who demonstrates entrepreneurial spirit are not only important factor for added value creation along with national growth but also economic development to join the ranks of advanced countries. Thereby, a lots of interests and supports are focused in entrepreneurship and the startup activities. However, to create business achievement, we should nurture successful entrepreneurship based on using infrastructure in entrepreneurial ecosystem induced by aggressive investments and supports of the policy. Therefore, this study is empirical test of 203 young CEO of techniques which possibly create added value and national development, inventive type in knowledge service and opportunity type. Research finding is that entrepreneurship and entrepreneurial preparation have meaningful effects on the performance and the ready state. Entrepreneurship has no direct effects on entrepreneurial infra system. Entrepreneurial preparation has meaningful effects on entrepreneurial infra system. We induced that it is hard to earn business achievement by only using entrepreneurial infra system in that entrepreneurial infra system has no effect on business achievement. Lastly, entrepreneurship infra system has no relationship as mediating effects with effects of entrepreneurship on business achievement in mediating effect test. While young CEOs with entrepreneurship create business achievement without using entrepreneurship infra, entrepreneurship infra has relationship as mediating effect with effect of entrepreneurial preparation on business achievement. Namely, we induced the result that using entrepreneurship infra aggressively improve achievement in entrepreneurial preparation. Through this study, we need entrepreneurship education for young CEOs and effort to develop entrepreneur's competence to improve achievement and we concluded that approaching systematically in entrepreneurial preparation and using various entrepreneurship infra aggressively are important factors to improve achievement.

  • PDF

Study on the effect of small and medium-sized businesses being selected as suitable business types, on the franchise industry (중소기업적합업종선정이 프랜차이즈산업에 미치는 영향에 관한 연구)

  • Kang, Chang-Dong;Shin, Geon-Chel;Jang, Jae Nam
    • Journal of Distribution Research
    • /
    • v.17 no.5
    • /
    • pp.1-23
    • /
    • 2012
  • The conflict between major corporations and small and medium-sized businesses is being aggravated, the trickle down effect is not working properly, and, as the controversy surrounding the effectiveness of the business limiting system continues to swirl, the plan proposed to protect the business domain of small and medium-sized businesses, resolve polarization between these businesses and large corporations, and protect small family run stores is the suitable business type designation system for small and medium-sized businesses. The current status of carrying out this system of selecting suitable business types among small and medium-sized businesses involves receiving applications for 234 items among the suitable business types and items from small and medium-sized businesses in manufacturing, and then selecting the items of the consultative group by analyzing and investigating the actual conditions. Suitable business type designation in the service industry will involve designation with priority on business types that are experiencing social conflict. Three major classifications of the service industry, related to the livelihood of small and medium-sized businesses, will be first designated, and subsequently this will be expanded sequentially. However, there is the concern that when designated as a suitable business type or item, this will hinder the growth motive for small to medium-sized businesses, and designation all cause decrease in consumer welfare. Also it is highly likely that it will operate as a prior regulation, cause side-effects by limiting competition systematically, and also be in violation against the main regulations of the FTA system. Moreover, it is pointed out that the system does not sufficiently reflect reverse discrimination factor against large corporations. Because conflict between small to medium sized businesses and large corporations results from the expansion of corporations to the service industry, which is unrelated to their key industry, it is necessary to introduce an advanced contract method like a master franchise or local franchise system and to develop local small to medium sized businesses through a franchise system to protect these businesses and dealers. However, this method may have an effect that contributes to stronger competitiveness of small to medium sized franchise businesses by advancing their competitiveness and operational methods a step further, but also has many negative aspects. First, as revealed by the Ministry of Knowledge Economy, the franchise industry is contributing to the strengthening of competitiveness through the economy of scale by organizing existing individual proprietors and increasing the success rate of new businesses. It is also revealed to be a response measure by the government to stabilize the economy of ordinary people and is emphasized as a 'useful way' to revitalize the service industry and improve the competitiveness of individual proprietors, and has been involved in contributions to creating jobs and expanding the domestic market by providing various services to consumers. From this viewpoint, franchises fit the purpose of the suitable business type system and is not something that is against it. Second, designation as a suitable business type may decrease investment for overseas expansion, R&D, and food safety, as well negatively affect the expansion of overseas corporations that have entered the domestic market, due to the contraction and low morale of large domestic franchise corporations that have competitiveness internationally. Also because domestic franchise businesses are hard pressed to secure competitiveness with multinational overseas franchise corporations that are operating in Korea, the system may cause difficulty for domestic franchise businesses in securing international competitiveness and also may result in reverse discrimination against these overseas franchise corporations. Third, the designation of suitable business type and item can limit the opportunity of selection for consumers who have up to now used those products and can cause a negative effect that reduces consumer welfare. Also, because there is the possibility that the range of consumer selection may be reduced when a few small to medium size businesses monopolize the market, by causing reverse discrimination between these businesses, the role of determining the utility of products must be left ot the consumer not the government. Lastly, it is desirable that this is carried out with the supplementation of deficient parts in the future, because fair trade is already secured with the enforcement of the franchise trade law and the best trade standard of the Fair Trade Commission. Overlapping regulations by the suitable business type designation is an excessive restriction in the franchise industry. Now, it is necessary to establish in the domestic franchise industry an environment where a global franchise corporation, which spreads Korean culture around the world, is capable of growing, and the active support by the government is needed. Therefore, systems that do not consider the process or background of the growth of franchise businesses and harm these businesses for the sole reason of them being large corporations must be removed. The inhibition of growth to franchise enterprises may decrease the sales of franchise stores, in some cases even bankrupt them, as well as cause other problems. Therefore the suitable business type system should not hinder large corporations, and as both small dealers and small to medium size businesses both aim at improving competitiveness and combined growth, large corporations, small dealers and small to medium sized businesses, based on their mutual cooperation, should not include franchise corporations that continue business relations with them in this system.

  • PDF

A Study on the Effect of Technological Innovation Capability and Technology Commercialization Capability on Business Performance in SMEs of Korea (우리나라 중소기업의 기술혁신능력과 기술사업화능력이 경영성과에 미치는 영향연구)

  • Lee, Dongsuk;Chung, Lakchae
    • Korean small business review
    • /
    • v.32 no.1
    • /
    • pp.65-87
    • /
    • 2010
  • With the advent of knowledge-based society, the revitalization of technological innovation type SMEs, termed "inno-biz" hereafter, has been globally recognized as a government policymakers' primary concern in strengthening national competitiveness, and much effort is being put into establishing polices of boosting the start-ups and innovation capability of SMEs. Especially, in that the inno-biz enables national economy to get vitalized by widening world markets with its superior technology, and thus, taking the initiative of extremely competitive world markets, its growth and development has greater significance. In the case of Korea, the government has been maintaining the policies since the late 1990s of stimulating the growth of SMEs as well as building various infrastructures to foster the start-ups of the SMEs such as venture businesses with high technology. In addition, since the enactment of "Innovation Promotion Law for SMEs" in 2001, the government has been accelerating the policies of prioritizing the growth and development of inno-biz. So, for the sound growth and development of Korean inno-biz, this paper intends to offer effective management strategies for SMEs and suggest proper policies for the government, by researching into the effect of technological innovation capability and technology commercialization capability as the primary business resources on business performance in Korean SMEs in the light of market information orientation. The research is carried out on Korean companies characterized as inno-biz. On the basis of OSLO manual and prior studies, the research categorizes their status. R&D capability, technology accumulation capability and technological innovation system are categorized into technological innovation capability; product development capability, manufacturing capability and marketing capability into technology commercialization capability; and increase in product competitiveness and merits for new technology and/or product development into business performance. Then the effect of each component on business performance is substantially analyzed. In addition, the mediation effect of technological innovation and technology commercialization capability on business performance is observed by the use of the market information orientation as a parameter. The following hypotheses are proposed. H1 : Technology innovation capability will positively influence business performance. H1-1 : R&D capability will positively influence product competitiveness. H1-2 : R&D capability will positively influence merits for new technology and/or product development into business performance. H1-3 : Technology accumulation capability will positively influence product competitiveness. H1-4 : Technology accumulation capability will positively influence merits for new technology and/or product development into business performance. H1-5 : Technological innovation system will positively influence product competitiveness. H1-6 : Technological innovation system will positively influence merits for new technology and/or product development into business performance. H2 : Technology commercializing capability will positively influence business performance. H2-1 : Product development capability will positively influence product competitiveness. H2-2 : Product development capability will positively influence merits for new technology and/or product development into business performance. H2-3 : Manufacturing capability will positively influence product competitiveness. H2-4 : Manufacturing capability will positively influence merits for new technology and/or product development into business performance. H2-5 : Marketing capability will positively influence product competitiveness. H2-6 : Marketing capability will positively influence merits for new technology and/or product development into business performance. H3 : Technology innovation capability will positively influence market information orientation. H3-1 : R&D capability will positively influence information generation. H3-2 : R&D capability will positively influence information diffusion. H3-3 : R&D capability will positively influence information response. H3-4 : Technology accumulation capability will positively influence information generation. H3-5 : Technology accumulation capability will positively influence information diffusion. H3-6 : Technology accumulation capability will positively influence information response. H3-7 : Technological innovation system will positively influence information generation. H3-8 : Technological innovation system will positively influence information diffusion. H3-9 : Technological innovation system will positively influence information response. H4 : Technology commercialization capability will positively influence market information orientation. H4-1 : Product development capability will positively influence information generation. H4-2 : Product development capability will positively influence information diffusion. H4-3 : Product development capability will positively influence information response. H4-4 : Manufacturing capability will positively influence information generation. H4-5 : Manufacturing capability will positively influence information diffusion. H4-6 : Manufacturing capability will positively influence information response. H4-7 : Marketing capability will positively influence information generation. H4-8 : Marketing capability will positively influence information diffusion. H4-9 : Marketing capability will positively influence information response. H5 : Market information orientation will positively influence business performance. H5-1 : Information generation will positively influence product competitiveness. H5-2 : Information generation will positively influence merits for new technology and/or product development into business performance. H5-3 : Information diffusion will positively influence product competitiveness. H5-4 : Information diffusion will positively influence merits for new technology and/or product development into business performance. H5-5 : Information response will positively influence product competitiveness. H5-6 : Information response will positively influence merits for new technology and/or product development into business performance. H6 : Market information orientation will mediate the relationship between technology innovation capability and business performance. H7 : Market information orientation will mediate the relationship between technology commercializing capability and business performance. The followings are the research results : First, as for the effect of technological innovation on business performance, the technology accumulation capability and technological innovating system have a positive effect on increase in product competitiveness and merits for new technology and/or product development, while R&D capability has little effect on business performance. Second, as for the effect of technology commercialization capability on business performance, the effect of manufacturing capability is relatively greater than that of merits for new technology and/or product development. Third, the mediation effect of market information orientation is identified to exist partially in information generation, information diffusion and information response. Judging from these results, the following analysis can be made : On Increase in product competitiveness, directly related to successful technology commercialization of technology, management capability including technological innovation system, manufacturing capability and marketing capability has a relatively strong effect. On merits for new technology and/or product development, on the other hand, capability in technological aspect including R&D capability, technology accumulation capability and product development capability has relatively strong effect. Besides, in the cast of market information orientation, the level of information diffusion within an organization plays and important role in new technology and/or product development. Also, for commercial success like increase in product competitiveness, the level of information response is primarily required. Accordingly, the following policies are suggested : First, as the effect of technological innovation capability and technology commercialization capability on business performance differs among SMEs; in order for SMEs to secure competitiveness, the government has to establish microscopic policies for SMEs which meet their needs and characteristics. Especially, the SMEs lacking in capital and labor are required to map out management strategies of focusing their resources primarily on their strengths. And the government needs to set up policies for SMEs, not from its macro-scaled standpoint, but from the selective and concentrative one that meets the needs and characteristics of respective SMEs. Second, systematic infrastructures are urgently required which lead technological success to commercial success. Namely, as technological merits at respective SME levels do not always guarantee commercial success, the government should make and effort to build systematic infrastructures including encouragement of M&A or technology trade, systematic support for protecting intellectual property, furtherance of business incubating and industrial clusters for strengthening academic-industrial network, and revitalization of technology financing, in order to make successful commercialization from technological success. Finally, the effort to innovate technology, R&D, for example, is essential to future national competitiveness, but its result is often prolonged. So the government needs continuous concern and funding for basic science, in order to maximize technological innovation capability. Indeed the government needs to examine continuously whether technological innovation capability or technological success leads satisfactorily to commercial success in market economic system. It is because, when the transition fails, it should be left to the government.

The Effect of Mutual Trust on Relational Performance in Supplier-Buyer Relationships for Business Services Transactions (재상업복무교역중적매매관계중상호신임대관계적효적영향(在商业服务交易中的买卖关系中相互信任对关系绩效的影响))

  • Noh, Jeon-Pyo
    • Journal of Global Scholars of Marketing Science
    • /
    • v.19 no.4
    • /
    • pp.32-43
    • /
    • 2009
  • Trust has been studied extensively in psychology, economics, and sociology, and its importance has been emphasized not only in marketing, but also in business disciplines in general. Unlike past relationships between suppliers and buyers, which take considerable advantage of private networks and may involve unethical business practices, partnerships between suppliers and buyers are at the core of success for industrial marketing amid intense global competition in the 21st century. A high level of mutual cooperation occurs through an exchange relationship based on trust, which brings long-term benefits, competitive enhancements, and transaction cost reductions, among other benefits, for both buyers and suppliers. In spite of the important role of trust, existing studies in buy-supply situations overlook the role of trust and do not systematically analyze the effect of trust on relational performance. Consequently, an in-depth study that determines the relation of trust to the relational performance between buyers and suppliers of business services is absolutely needed. Business services in this study, which include those supporting the manufacturing industry, are drawing attention as the economic growth engine for the next generation. The Korean government has selected business services as a strategic area for the development of manufacturing sectors. Since the demands for opening business services markets are becoming fiercer, the competitiveness of the business service industry must be promoted now more than ever. The purpose of this study is to investigate the effect of the mutual trust between buyers and suppliers on relational performance. Specifically, this study proposed a theoretical model of trust-relational performance in the transactions of business services and empirically tested the hypotheses delineated from the framework. The study suggests strategic implications based on research findings. Empirical data were collected via multiple methods, including via telephone, mail, and in-person interviews. Sample companies were knowledge-based companies supplying and purchasing business services in Korea. The present study collected data on a dyadic basis. Each pair of sample companies includes a buying company and its corresponding supplying company. Mutual trust was traced for each pair of companies. This study proposes a model of trust-relational performance of buying-supplying for business services. The model consists of trust and its antecedents and consequences. The trust of buyers is classified into trust toward the supplying company and trust toward salespersons. Viewing trust both at the individual level and the organizational level is based on the research of Doney and Cannon (1997). Normally, buyers are the subject of trust, but this study supposes that suppliers are the subjects. Hence, it uniquely focused on the bilateral perspective of perceived risk. In other words, suppliers, like buyers, are the subject of trust since transactions are normally bilateral. From this point of view, suppliers' trust in buyers is as important as buyers' trust in suppliers. The suppliers' trust is influenced by the extent to which it trusts the buying companies and the buyers. This classification of trust using an individual level and an organization level is based on the suggestion of Doney and Cannon (1997). Trust affects the process of supplier selection, which works in a bilateral manner. Suppliers are actively involved in the supplier selection process, working very closely with buyers. In addition, the process is affected by the extent to which each party trusts its partners. The selection process consists of certain steps: recognition, information search, supplier selection, and performance evaluation. As a result of the process, both buyers and suppliers evaluate the performance and take corrective actions on the basis of such outcomes as tangible, intangible, and/or side effects. The measurement of trust used for the present study was developed on the basis of the studies of Mayer, Davis and Schoorman (1995) and Mayer and Davis (1999). Based on their recommendations, the three dimensions of trust used for the study include ability, benevolence, and integrity. The original questions were adjusted to the context of the transactions of business services. For example, a question such as "He/she has professional capabilities" has been changed to "The salesperson showed professional capabilities while we talked about our products." The measurement used for this study differs from those used in previous studies (Rotter 1967; Sullivan and Peterson 1982; Dwyer and Oh 1987). The measurements of the antecedents and consequences of trust used for this study were developed on the basis of Doney and Cannon (1997). The original questions were adjusted to the context of transactions in business services. In particular, questions were developed for both buyers and suppliers to address the following factors: reputation (integrity, customer care, good-will), market standing (company size, market share, positioning in the industry), willingness to customize (product, process, delivery), information sharing (proprietary information, private information), willingness to maintain relationships, perceived professionalism, authority empowerment, buyer-seller similarity, and contact frequency. As a consequential variable of trust, relational performance was measured. Relational performance is classified into tangible effects, intangible effects, and side effects. Tangible effects include financial performance; intangible effects include improvements in relations, network developing, and internal employee satisfaction; side effects include those not included either in the tangible or intangible effects. Three hundred fifty pairs of companies were contacted, and one hundred five pairs of companies responded. After deleting five company pairs because of incomplete responses, one hundred five pairs of companies were used for data analysis. The response ratio of the companies used for data analysis is 30% (105/350), which is above the average response ratio in industrial marketing research. As for the characteristics of the respondent companies, the majority of the companies operate service businesses for both buyers (85.4%) and suppliers (81.8%). The majority of buyers (76%) deal with consumer goods, while the majority of suppliers (70%) deal with industrial goods. This may imply that buyers process the incoming material, parts, and components to produce the finished consumer goods. As indicated by their report of the length of acquaintance with their partners, suppliers appear to have longer business relationships than do buyers. Hypothesis 1 tested the effects of buyer-supplier characteristics on trust. The salesperson's professionalism (t=2.070, p<0.05) and authority empowerment (t=2.328, p<0.05) positively affected buyers' trust toward suppliers. On the other hand, authority empowerment (t=2.192, p<0.05) positively affected supplier trust toward buyers. For both buyers and suppliers, the degree of authority empowerment plays a crucial role in the maintenance of their trust in each other. Hypothesis 2 tested the effects of buyerseller relational characteristics on trust. Buyers tend to trust suppliers, as suppliers make every effort to contact buyers (t=2.212, p<0.05). This tendency has also been shown to be much stronger for suppliers (t=2.591, p<0.01). On the other hand suppliers trust buyers because suppliers perceive buyers as being similar to themselves (t=2.702, p<0.01). This finding confirmed the results of Crosby, Evans, and Cowles (1990), which reported that suppliers and buyers build relationships through regular meetings, either for business or personal matters. Hypothesis 3 tested the effects of trust on perceived risk. It has been found that for both suppliers and buyers the lower is the trust, the higher is the perceived risk (t=-6.621, p<0.01 for buyers; t=-2.437, p<0.05). Interestingly, this tendency has been shown to be much stronger for buyers than for suppliers. One possible explanation for this higher level of perceived risk is that buyers normally perceive higher risks than do suppliers in transactions involving business services. For this reason, it is necessary for suppliers to implement risk reduction strategies for buyers. Hypothesis 4 tested the effects of trust on information searching. It has been found that for both suppliers and buyers, contrary to expectation, trust depends on their partner's reputation (t=2.929, p<0.01 for buyers; t=2.711, p<0.05 for suppliers). This finding shows that suppliers with good reputations tend to be trusted. Prior experience did not show any significant relationship with trust for either buyers or suppliers. Hypothesis 5 tested the effects of trust on supplier/buyer selection. Unlike buyers, suppliers tend to trust buyers when they think that previous transactions with buyers were important (t=2.913 p<0.01). However, this study did not show any significant relationship between source loyalty and the trust of buyers in suppliers. Hypothesis 6 tested the effects of trust on relational performances. For buyers and suppliers, financial performance reportedly improved when they trusted their partners (t=2.301, p<0.05 for buyers; t=3.692, p<0.01 for suppliers). It is interesting that this tendency was much stronger for suppliers than it was for buyers. Similarly, competitiveness was reported to improve when buyers and suppliers trusted their partners (t=3.563, p<0.01 for buyers; t=3.042, p<0.01 for suppliers). For suppliers, efficiency and productivity were reportedly improved when they trusted buyers (t=2.673, p<0.01). Other performance indices showed insignificant relationships with trust. The findings of this study have some strategic implications. First and most importantly, trust-based transactions are beneficial for both suppliers and buyers. As verified in the study, financial performance can be improved through efforts to build and maintain mutual trust. Similarly, competitiveness can be increased through the same kinds of effort. Second, trust-based transactions can facilitate the reduction of perceived risks inherent in the purchasing situation. This finding has implications for both suppliers and buyers. It is generally believed that buyers perceive higher risks in a highly involved purchasing situation. To reduce risks, previous studies have recommended that suppliers devise risk-reducing tactics. Moving beyond these recommendations, the present study uniquely focused on the bilateral perspective of perceived risk. In other words, suppliers are also susceptible to perceived risks, especially when they supply services that require very technical and sophisticated manipulations and maintenance. Consequently, buyers and suppliers must solve problems together in close collaboration. Hence, mutual trust plays a crucial role in the problem-solving process. Third, as found in this study, the more authority a salesperson has, the more he or she can be trusted. This finding is very important with regard to tactics. Building trust is a long-term assignment; however, when mutual trust has not been developed, suppliers can overcome the problems they encounter by empowering a salesperson with the authority to make certain decisions. This finding applies to suppliers as well.

  • 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