• Journal of Preventive Medicine and Public Health
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• v.47 no.6
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• pp.298-308
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• 2014

Objectives: To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs. Methods: We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts ('gu's) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer. Results: The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively. Conclusions: Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.

• Health Policy and Management
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• v.2 no.2
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• pp.33-56
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• 1992

The objectives of this research are (i) to review the functional and financial distribution of public health adminstration between central and local governments, (ii) to find out, based on economic criteria, optimal distribution required to fullfil local need for public health, and finally, (iii) to suggest policy implications in health area in face of the newly arising local autonomy system in Korea. Judging from data on government expenditures and tax revenues, public health administration in Korea is highly concentrated into central government, both functionlally and financially. High dependency of public health on central government has often been critisized that local residents can not participate in the decision making process for local health problems. This study, however, shows that localization of public health administration does not necessarily result in efficient and equitable allocation of resource to satisfy local demand for public health. From this point of view, two eccnomic criteria are suggested, i.e. external effect and economies of scle, as distributive criteria of roles in public health administration between local and central government. In addition, superiority of central concentration of public health administration to localization is emphasized in that public health in a wide sense contains the nature of public good and is part of compulsory socil security system. As a consequence, planned intervention by government is desirable.

• Health Policy and Management
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• v.26 no.4
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• pp.265-270
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• 2016

Public health system for more prevention-oriented health promotion rather than hospital-based curative service, focusing population rather than individual, and comprehensive health management in the local community strongly needs to be constructed to solve major issues on efficiencies and equity problems which Korean healthcare system is facing nowadays. Public health promotes and protects the health of people and the communities where they live, learn, work, and play. Medical care tries to cure those who have diseases, but public health tries not to become ill and not to be injured. Debates on how we build or rebuild public health system, which is contrasted with medical care system, are needed in Korea, focusing how needs for healthy community and right to health are fulfilled. Public health specialists for practising population health at local community level should be systematically recruited, the function of public health centers should be strengthened, and new government organization should be established for place-based health management.

• Health Policy and Management
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• v.9 no.2
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• pp.55-76
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• 1999

In order to understand the local council members' attitudes to the health policy, we conducted mail surveys using self-administered questionaire for 2 months(February and March. 1995). The study subjects were 2.312 local council members in Korea, but only about 11% among whom. 257 persons, responded to 2 times mail survey. This response rate revealed that the local council members was not interested in health care fields. The main results were as follows; The respondents thought that the economic and income development was most important among 15 regional policy agendas and the health care was the 5th or 7th important agenda. They. who had more health needs of and poor access to health care, tended to think that the health care was more important. They considered lobbying to and persuading the civil servants as the best method to tackle the local health care policy agenda. The respondents, who had poor access to health care facilities. tended to set the highest priority for the expansion of public and private health care resources. They expected that the election of local governor would activate the public health program more than thought that the program was implemented more actively than other region. The main opinion of respondents was that the central government had to take over planning and financing for the public health program, and the basic local government had to implment the program and budgeting. The majority of respondents agreed the private dominant medical care delivery system and nation-wide uniformed financing mechanism. Over 60% of them suggested that they were ready to suffer environmental pollution inducing health hazards for the purpose of regional economic and income development. About 75% of them favour the campaign for antismoking regardless of reducing local government's revenue from sale tax.

• Health Policy and Management
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• v.30 no.2
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• pp.142-150
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• 2020

The purpose of this study is to analyze the long-term plans of the central and local governments in order to plan policy and implementing programs. Through this, the governments is find out to reduce administrative burden. Based on the national health plan, evidence and related laws were collected and analyzed. As a quantitative methodology analyzed the contents of related laws in the overall plan. The qualitative methodologies analyzed and categorized the planning status of cities and provinces in the plan and were collated. There are a total of 39 plans for long-term plans by laws. The role of the central and local governments in the public health sector, there are a total of four plans (10.3%) that need to establish long-term and annual plans for the central and local (cities, provinces) government. A total of seven plans (17.9%) were required to establish a plan by the only local government. In terms of the public health sector on the local governments, 20 plans (51.3%) by cities and 12 plans (30.8%) by provinces were established by law. And in the health sector should be established 9 plans (40.9%) by cities and 7 plans (31.8%) by provinces. The plan needs to be reformed and merged between plans so that governments can focus on the program through planning central government policies, reducing local government administration.

• Health Policy and Management
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• v.6 no.1
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• pp.1-28
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• 1996

The paper analyzes OECD health systems from the perspective of historical institutionalism. Criticizing the dependence of Korea's national health program on Pacific countries such as Japan and the U.S., it suggests that European experiences of national health programs can be a model of the Korean health system in the future. Based on an inquiry into Italian and British cases of national health systems, the author emphasizes (1) the role of local governemts in national health programs, and (2) the integration of a national health program with public health programs.

• Korean Journal of Health Education and Promotion
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• v.16 no.2
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• pp.187-203
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• 1999

This paper will discuss about how we can foster educational support mechanisms to facilitate health promotion programs at the local level. Health promotion in Korea is in the early developmental stage; it has only been since the Health Promotion Act was legislated in 1995, the health promotion programs have been planned and implemented. In the context of the recent decentralization process, local health departments have a major responsibility for developing and implementing health promotion programs at the local level. The short history of health promotion in Korea has meant that local public health departments have limited experience and organizational capacity for health promotion planning ＆ practice. The results of one survey for investigating the progress of health promotion at the local level are instructive. The survey demonstrated that the public health workers recognized that the lack of personnels, insufficient budget, the lack of policy ＆ the organizational support, the lack of skill ＆ knowledge to be effective health promotors, the lack of guidance for health promotion practice were major barriers to implementing health promotion programs at the local level. The object of this paper is to suggest some ways of overcoming barriers to implementing health promotion programs at the local level This paper emphasizes on the importance of educational supports as well as environmental supports - legislative, policy, organizational, economical - in building the organizational capacity and infrastructure of local health department for health promotion. It suggests some ways of providing educational supports to the public health workers at the local level. and supports the positions that educational opportunities for training in health promotion can be better provided to the public health workers at the provincial level rather than at the national level. It argues that the educational ＆ training programs should be developed and based on the educational need assessment; that the application of the main educational principles ＆ theoretical models for health promotion be used to develop educational programs for the public health workers; and that professional health organizations should make plans to provide more educational programs at their annual conferences or at other convenient times. These kinds of educational supports facilitate the ability of public health workers to improve their capacity for health promotion practice at the local level and help to alleviate some of the pressure on state resources.

• Proceedings of The Korean Society of Health Promotion Conference
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• 1999.07a
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• pp.165-183
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• 1999

This paper will discuss about how we can foster educational support mechanisms to facilitate health promotion programs at the local level. Health promotion in Korea is in the early developmental stage; it has only been since the Health Promotion Act was legislated in 1995, the health promotion programs have been planned and implemented. In the context of the recent decentralization process, local health departments have a major responsibility for developing and implementing health promotion programs at the local level. The short history of health promotion in Korea has meant that local public health departments have limited experience and organizational capacity for health promotion planning ＆ practice. The results of one survey for investigating the progress of health promotion at the local level are instructive. The survey demonstrated that the public health workers recognized that the lack of personnels, insufficient budget, the lack of policy ＆ the organizational support, the lack of skill ＆ knowledge to be effective health promotors, the lack of guidance for health promotion practice were major barriers to implementing health promotion programs at the local level. The object of this paper is to suggest some ways of overcoming barriers to implementing health promotion programs at the local level This paper emphasizes on the importance of educational supports as well as environmental supports - legislative, policy, organizational, economical - in building the organizational capacity and infrastructure of local health department for health promotion. It suggests some ways of providing educational supports to the public health workers at the local level. and supports the positions that educational opportunities for training in health promotion can be better provided to the public health workers at the provincial level rather than at the national level. It argues that the educational ＆ training programs should be developed and based on the educational need assessment; that the application of the main educational principles ＆ theoretical models for health promotion be used to develop educational programs for the public health workers; and that professional health organizations should make plans to provide more educational programs at their annual conferences or at other convenient times. These kinds of educational supports facilitate the ability of public health workers to improve their capacity for health promotion practice at the local level and help to alleviate some of the pressure on state resources.

• Journal of agricultural medicine and community health
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• v.46 no.4
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• pp.266-279
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• 2021

Objectives: The purpose of the study was to classify the health and medical service affairs of local governments, and to analyze the proportions of non-matching fund by local governments and central government subsidies for local government health budget. Methods: First of all, health affairs of local governments were classified to categories based on health-related laws and previous studies by review of the authors. In order to specify the scale of local government-led health affairs, we allocated 1,916 budget units into 6 main and 24 sub categories of the health and medical service affairs of local governments for the 2020 health budget of Jeju Special Self-Governing Province. For each categories, we compared the total amounts and the percentages of the 'central government subsidies', 'local government budget - matching fund', and 'local government budget - non-matching fund'. Results: The total health budget of Jeju Special Self-Governing Province accounts for 1.2% of the total budget. Of the total health budget of Jeju Special Self-Governing Province, the proportion of central government subsidies was 39.6% and the proportions of local government budget-matching fund and non-matching fund were 33.8% and 26.6%, respectively. The proportions of non-matching fund by provincial and basic local governments were 37.3% and 19.9%, respectively. Conclusion: In order for local governments to deal with the health problems of residents, it is necessary to secure and spend more local government budget(i.e., non-matching fund by local government) for health affairs in their administrative jurisdiction.

• Journal of Preventive Medicine and Public Health
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• v.52 no.6
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• pp.427-432
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• 2019

Objectives: In Indonesia, 61 million adults smoked in 2018, and 59 million were exposed to secondhand smoke at offices or restaurants in 2011. The Presidential Decree 109/2012 encouraged local governments to implement a smoke-free policy (SFP), and the city of Jayapura enacted a local bill (1/2015) to that effect in 2015. This study aimed to evaluate compliance with this bill and to explore challenges in implementing it. Methods: We conducted a mixed-methods study. Quantitatively, we assessed compliance of facilities with 6 criteria (per the bill): the presence of signage, the lack of smoking activity, the lack of sale of tobacco, the lack of tobacco advertisements, the lack of cigarette smoke, and the lack of ashtrays. We surveyed 192 facilities, including health facilities, educational facilities, places of worship, government offices, and indoor and outdoor public facilities. Qualitatively, we explored challenges in implementation by interviewing 19 informants (government officers, students, and community members). Results: The rate of compliance with all 6 criteria was 17% overall, ranging from 0% at outdoor public facilities to 50% at health facilities. Spatial patterning was absent, as shown by similar compliance rates for SFP facilities within a 1-km boundary around the provincial and city health offices compared to those outside the boundary. Implementation challenges included (1) a limited budget for enforcement, (2) a lack of support from local non-governmental organizations and universities, (3) a lack of public awareness at the facilities themselves, and (4) a lack of examples set by local leaders. Conclusions: Overall compliance was low in Jayapura due to many challenges. This information provides lessons regarding tobacco control policy in underdeveloped areas far from the central government.