To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.
This study aimed at contributing to the improvement of cropping systems after finding out the effects of excrements and components of crop root influence on other crops as well as themselves. The following forage crops suitable for our country were selected for the present study. Aqueous extracts of fresh roots, aqueous extracts of rotting roots and aqueous solutions of excrements of red clover, orchard grass and brome grass were studied for the effects influencing the germination and growth of seedlings of red clover, ladino clover, lespedeza, soybean, orchard grass, Italian ryegrass, brome grass, barley, wheat, sorghum, corn and Hog-millet. In view of the possibility that the organic acid might be closely related to the excrements and components of crop root connected with soil sickness, the acid components of three species of roots were analysed by paper chromatography and gas chromatography method. The following results were obtained: 1. Effects of Aqueous Extracts of Fresh Roots : Aqueous extracts of red clover: The extracts inhibited the growth of seedlings of the ladino clover and lespedeza and also inhibited the development of most crops except that of sorghum among the Graminaceae. Aqueous extracts of orchard grass: The extracts promoted the seedlings growth of red clover and soybean, while it inhibited the germination and growth of orchard grass. There were no noticeable effects influencing other crops while it inhibited the growth of barley and Hog-millet. Aqueous extracts of brome grass: There was no effect on Italian ryegrass but there was an inhibiting effect on the other crops. 2. Effects of Aqueous Extracts of Rotting Roots : Aqueous extracts of red clover: The extracts promoted the seedling growth of red clover. But it reflected the inhibiting effects on other crops except sorghum. Aqueous extracts of orchard grass: The extracts promoted the growth of red clover, ladino clover, soybean and sorghun, while it inhibited the germination and rooting of barley and Hog-millet. Aqueous extracts of brome grass: The extracts gave the promotive effects to the growth of red clover, soybean and sorghum, but caused inhibiting effects on orchard grass, brome grass, barley and Hog-millet. 3. Effects of Aqueous Solutions of Excrements : The aqueous solution of excrements of red clover reflected the inhibition effects to the growth of Graminaceae, while the aqueous solutions of excrements of orchard grass and Italian ryegrass caused the promotive effects on the growth of red clover. 4. Results of Organic Acid Analysis : The oxalic acid, citric acid, tartaric acid, malonic acid, malic acid and succinic acid were included in the roots of red clover as unvolatile organic acid, and in the orchard grass and brome grass there were included the oxalic acid, citric acid, tartaric acid and malic acid. And formic acid was confirmed in the red clover, orchard grass and brome grass as volatile organic acid. In consideration of the results mentioned in above the effects of excrements and components of roots found in this studies may be summarized as follows. 1) The red clover generally gave a disadvantageous effect on the Graminaceae. Such trend was considered chiefly caused by the presence of many organic acids, namely oxalic, citric, tartaric, malonic, malic, succinic and formic acid. 2) The orchard grass generally gave an advantageous effect on the Leguminosae. This may be due to a few kinds of organic acid contained in the root, namely oxalic, citric, tartaric, malic and formic acid. Furthermore a certain of promotive materials for growth was noted. 3) As long as the root of brome grass are not rotten, it gave a disadvantageous effect on the Leguminosae and Graminaceae. This may be due to the fact that several unidentified volatile organic acid were also included besides the confirmed organic acid, namely oxalic, citric, tartaric, malic and formic acid. 5. Effects of Components in Roots to the Soil Sickness : 1) It was considered that the cause of alleged red clover's soil sickness did not result from the toxic components of the roots. 2) It was recognized that the toxic components of roots might be the cause of soil sickness in case the orchard grass and brome grass were put into the long-term single cropping. 6. Effects of Rooted Components to the Companion Crops in the Cropping System : a) In case of aqueous extracts of fresh roots and aqueous excrements (Inter cropping and mixed cropping) : 1) Advantageous combinations : Orchard grass->Red clover, Soybean, Italian ryegrass->Red clover, 2) Disadvantageous combinations : Red clover->Ladino clover, Lespedeza, Orchard grass, Italian ryegrass, Fescue Ky-31, Brome grass, Barley, Wheat, Corn and Hog.millet, Orchard grass->Lespedeza, Orchard grass, Barley and Hog-millet, Brome grass->Red clover, Ladino clover, Lespedeza, Soybean, Orchard grass, Brome grass, Barley, Wheat, Sorghum, Corn and Hog-millet, 3) Harmless combinations : Red clover->Red clover, Soybean and Sorghum, Orchard grass->Ladino clover, Italian ryegrass, Brome grass, Wheat, Sorghum and Corn, Brome grass->Italian ryegrass, b) In case of aquecus extracts of rotting roots(After cropping) : 1) Advantageous combinations : Red clover->Red clover and Sorghum, Orchard grass->Red clover, Ladino clover, Soybean, Sorghum, and Corn, Brome grass->Red clover, Soybean and Sorghum, 2) Disadvantageous combinations : Red clover->Lespedeza, Orchard grass, Italian ryegrass, Brome grass, Barley, Wheat, and Hog-millet Orchard grass->Barley and Hog-millet, Brome grass->Orchard grass, Brome grass, Barley and Hog-millet, 3) Harmless combinations : Red clover->Ladino clover, Soybean and Corn, Orchard grass->Lespedeza, Orchard grass, Italian ryegrass, Brome grass and Wheat Brome gass->Ladino clover, Lespedeza, Italian ryegrass and Wheat.