• Title/Summary/Keyword: Participatory method

Search Result 138, Processing Time 0.022 seconds

An Ethnography of Child-Rearing Experiences of Korean Mothers Living on Koje Island (우리나라 어머니의 자녀 양육의 의미 - 거제지역을 대상으로 -)

  • Lee, Soo-Yeon
    • Women's Health Nursing
    • /
    • v.7 no.4
    • /
    • pp.518-535
    • /
    • 2001
  • Nursing practices should be based on the understanding of human beings. In order to understand human beings, it is important to study the lifestyles and thoughts of people in their natural environment. In this sense, the cultural aspects of a society need to be studied for a culture-bound nursing service. Child care, which is an important element of nursing, is also strongly influenced by the culture of a society. Therefore, a cultural study is necessary to understand the child-rearing practices of any society. The major purpose of this dissertation is to provide basic foundations for developing a culture-based theory for nursing intervention through studying traditional cultural elements of child care in Korean society. The study examined child-rearing practices in a small village on Koje Island in the southern part of Korea. It utilized ethnographic methodologies including participatory observations and in-depth interviews. The study participants were 9 Korean mothers living on Koje Island. The average age was 52. The data were collected between July in 1998 and December in 1999. The average number of interviews per person was 7-8, and the duration of each interview was approximately 2 hours. The data were analyzed using the Spradley Analytical Method. The following 9 major child-rearing aspects of mothers on Koje Island were discovered as a result of the study: 1. Firstly, mothers on Koje Island were mostly concerned about the "Old Birth Goddess' Curse", especially during their child's early years. This concern was evidenced by their careful behavior when their child was very young and by their praying to the Old Birth Goddess not to be jealous of their babies. 2. Secondly, they wished their children to live a different and better life than themselves. It was represented by their strong motivation toward their children's education as well as their expectation for their children's success. In traditional Korean culture, Korean people think that the rise and fall of the household depend on their offsprings. Therefore, Korean mothers wish their children attain to a higher level of social status through education. 3. Third, mothers are concerned about their children's righteousness. Mothers on Koje island expect their children to live with discretion, justice, strength, respect, harmony, and to do their best in life. 4. Next was an 'anticipation of their children's happy marriage'. The attributes of this category were an 'anxiety about their children's married life', and 'an expectation of a good spouse for their children'. Because Korean people believe that only a son can continue the bloodline of a family, especially Korean mothers have a great concern of the possibility of their daughters not having a son after marriage. Also they have different expectations toward their daughter-in-laws than son-in-laws. 5. Korean mothers also derived their satisfaction from their son. It was characterized by 'excessive affection toward their son', 'dependency on their son', and 'being afraid of their married daughter having a girl like themselves'. Korean society has been a patriarchy. Therefore, a son is beloved as someone who will take care of his old parents, be in charge of ancestral rites, and provide a daughter-in-law who can conceive a son. 6. The sixth category concerned 'the differences in their expectations for their children'. The attributes in this category were 'different expectations depending on their children's gender', 'different expectations depending on their children's ability', and a 'great sympathy toward children with low abilities'. Korean mothers expect their son to become better than their daughter. 7. The seventh category was related to their 'roles in child-caring practices'. Traditionally a child was raised in an extended family system in Korea So it was not the sole duty of a mother to bring up the child. Korean mothers used to receive much help rasing children from their in-laws, and family members. On the other hand, many children grew up by themselves, because their mothers were very busy taking care of housework. Furthermore, many children also grew up in poverty. 8. Mothers also had issues related to 'conflicts in child rearing'. They were characterized by 'lack of understanding', 'rudeness of children', and 'giving vent to one's anger'. 9. Finally, mothers regretted not doing their best in child-rearing practices. It was characterized by a 'bitter feeling of repentance', 'feeling irritated', and 'feeling of unsatisfaction'.

  • PDF

The Reinforcing Mechanism of Sustaining Participations in Open Source Software Developers: Based on Social Identity Theory and Organizational Citizenship Behavior Theory (오픈 소스 개발자들의 참여 의도 강화 기제 및 참여 지속 의도에 관한 연구: 사회 정체성 이론과 조직시민행동 이론에 기반하여)

  • Choi, Junghong;Choi, Joohee;Lee, Hye Sun;Hwangbo, Hwan;Lee, Inseong;Kim, Jinwoo
    • Asia pacific journal of information systems
    • /
    • v.23 no.3
    • /
    • pp.1-23
    • /
    • 2013
  • Open Source Software Development (OSSD) differentiates itself from traditional closed software development in that it reveals its source codes online and allows anyone to participate in projects. Even though its success was in doubt, many of the open collaborative working models produced successful results. Academia started to get interested in how developers are willing to participate even when there are no extrinsic rewards for their efforts. Many studies tried to explain developers' motivations, and the pursuit of ideology, reputation, and altruism are found to be the answers. Those studies, however, focused mostly on how the first contribution is made out of a certain motivation. Nowadays, OSSD reaches at its maturity and 70% of professional developers have used or utilized open source software or code in their works. As the proportion of people experiencing OSS, the accounts from previous studies are expected to be weakened. Also, extant literature fails to explain how the motivation of participating in OSS evolves over time and experiences. Given that changing over time or over experiences is the natural in the perception of motivation, studies in an attempt to understand how the motivation changes or evolves are in need. In this study, we aimed to explain how the perception about OSS from past usage or related experiences leads to the intention to sustain OSS participations. By doing so, we try to bridge the gap between previous studies and the actual phenomenon. We argued that perceived instrumentality about OSS learned from past experiences will first affect the formation of organizational identity towards general OSS community. And once the organizational identity is formed, it will affect the one's following behaviors related to OSS development, most likely to sustain the favoring stance toward OSS community. Our research distinguishes itself from previous one in that it divides the paths from organizational identity formed to the intention to sustain the voluntary helping behaviors, by altruistic and conforming intentions. Drawing on this structural model, we could explain how organizational identity engages in forming the sustaining intention from past experiences, and that the intention to help at individual level and organizational level works at different level in OSS community. We grounded our arguments on Social identity theory and Organizational Citizenship theory. We examined our assumption by constructing a structural equation model (SEM) and had 88 developers to answer our online surveys. The result is analyzed by PLS (partial least square) method. Consequently, all paths but one in our model are supported, the one which assumed the association between perceived instrumentality and altruistic intention. Our results provide directions in designing online collaborative platforms where open access collaboration is meant to occur. Theoretically, our study suggests that organizational citizenship behavior can occur from organizational identity, even in bottom-up organizational settings. More specifically, we also argue to consider both organizational level and individual level of motivation in inducing sustained participations within the platforms. Our result can be interpreted to indicate the importance of forming organizational identity in sustaining the participatory behaviors. It is because there was no direct association between perceived instrumentality from past experiences and altruistic behavior, but the perception of organizational identity bridges the two constructs. This means that people with no organizational identity can sustain their participations through conforming intention from only the perception of instrumentality, but it needs little more than that for the people to feel the intention to directly help someone in the community-first to form the self-identity as a member of the given community.

The Future of Radio and its Role in the Era of Smart Media (스마트미디어 시대 속 라디오의 미래와 역할 고찰)

  • KWON, Youngsung;SONG, Haeryong
    • Trans-
    • /
    • v.1
    • /
    • pp.117-139
    • /
    • 2016
  • Radio, the first broadcasting medium in history, is also the first mobile medium that meets the currently mobile ecology based on mobile communications network. As a result, it is easily approachable to consumers, can easily engage individual consumers, and its program contents have a huge appealing power to individual listeners, allowing it to form intimacy with audiences at the closest distance. However, the listening rating of radio has decreased greatly because it has experienced various changes by many other competitive media such as TV and internet and it has been influenced by relative constant hypothesis. Also, radio now faces a bigger competition due to the emergence of smartphone. In this circumstance, radio showed movements to evolve into a digital radio that presents improved sound, strengthened reception power, and increased number of channels, but it suddenly changed to DMB and portable multimedia DMB is having huge problems in its marketability due to smartphone. Yet, the listening rating of analogue radio broadcasting that remained unchanged was 13.99% in 2014, an increase by 47% from 2011, and the percentage of listeners under the age of 18 increased by 2.4 times from 2011 to 2014, which was a unique and interesting phenomenon. Accordingly, this paper compared the characteristics of internet and radio that have the traits of daily life, information, individuality, participatory, adventurousness, alternative media, expertise, and sound media. The paper then examined the listening method of radio, in which the direct groundwave antenna reception through a vehicular device is the most common form during the use of transportation means. Finally, it sought to investigate the future of radio based on the understanding of the increase in radio listening ratings, especially by comparing it to the characteristics of smart generation that focus on smartphone and the internet The study results demonstrated that entertainment and amusements are attempting at changes while they used to be obtained selectively by the smart generation from fragmentary information. In addition, radio is expected to become an influential medium in the future through its advantages of 'selected information' and reliability. However, considering such possibilities, radio needs to build the expertise and reliability of broadcasting contents much more at the same time as its digitalization, and it will be able to have its own competitiveness by focusing on various experiences and cultural exposures.

  • PDF

SSI Education and Scientific Literacy from a Lifelong Learning Perspective (평생학습적 시각을 통해 바라본 SSI 교육과 과학적 소양)

  • Park, Shin-Hee;Kim, Chan-Jong
    • Journal of The Korean Association For Science Education
    • /
    • v.42 no.1
    • /
    • pp.61-75
    • /
    • 2022
  • Recently, lifelong learning ability was newly proposed as scientific literacy, the goal of the science curriculum. To solve various science-related problems students encounter in life, lifelong learning abilities related to science beyond school science education are required, but empirical evidence shows that students can solve problems they actually face through scientific literacy. It is not easy to find in the existing science education research. In addition, there is a lack of discussion on how to cultivate lifelong learning ability suggested in the curriculum through school science education. In this study, attention was paid to SSI education as a method for students to cultivate lifelong learning ability through school science education and to develop their ability to solve science-related problems encountered in life. In this context, statements in the existing SSI education studies were reviewed to discover discourses related to lifelong learning, and their types and characteristics were distinguished. It was possible to confirm lifelong learning and its applicability with focus on science education research through this. For the study, 18 literature materials on the subject of SSI education were selected, and the discourses related to lifelong learning in the SSI education research were discovered by examining the statements revealed in the data. As a result of the study, there are four categories of discourses related to lifelong learning: 'awareness of science,' 'connection between science and everyday life', 'promotion of participatory citizenship', and 'construction of identity'. Various SSI education studies have already had lifelong learning perception in various contexts, and the four types of discourses related to lifelong learning could be linked to the four types of learning presented in the UNESCO Lifelong Learning Report. SSI education tends to view students' life experiences as part of their learning and aims to help students develop the character and capacity to make responsible decisions on social issues related to science and put them into practice. This competency can be continuously connected to the real-life of students outside of school as a lifelong learning ability. This study requires expanding the discourse related to lifelong learning in science education and operating and managing the overall educational system to foster students' lifelong learning ability.

A Study on the Place Identity of Shin-Cheorwon with the Intrinsic Everydayness -By Using Photovoice Methodology- (일상성이 내재된 신철원 장소정체성 연구 - 포토보이스 방법론을 활용하여 -)

  • Suh, Joon Won;Chung, Da Ae;Park, Yunju
    • Journal of the Korean Institute of Landscape Architecture
    • /
    • v.50 no.1
    • /
    • pp.53-67
    • /
    • 2022
  • This study started from recognizing the need to study place identity from the perspective of residents experiencing the place in daily life. The subject area of the study, Shin-Cheorwon, Galmal-eup, Cheorwon-gun, Gangwon-do area, had a low population until the division of Korea in 1945. Since then, the residents have created the milieu under Shin-Cheorwon's regional historic and cultural context. Thus, the study on this area can show the formation of the interrelationship of the region and residents. The purpose of this study is to understand the meaning and identity of the everyday places of Shin-Cheorwon. Photovoice was chosen as the method for successful Participatory Research; Participant's active intervention stage, 'Documentation (4th step)', Narration (5th step), researcher's analysis stage 'Ideation (6th step)' were specifically used. As a result, the following characteristic of the places chosen by participants could be found: the meaning and relationship with the residents, similarities, and differences in people shown based on their age, length of residence, etc. Through this, participants recollected the past places, found the meaning of the place of the present, and deduced the placeness that Shin-Cheorwon should have in the future. The study identified the place identity that holds the perspective of the residents in their daily life and provides implications on the follow-up studies of place identity. In addition, it is expected that it will apply to urban planning and spatial design in further studies of how residents perceive the space formed by urban development using photovoice methodology.

A case study of blockchain-based public performance video platform establishment: Focusing on Gyeonggi Art On, a new media art broadcasting station in Gyeonggi-do (블록체인 기반 공연영상 공공 플랫폼 구축 사례 연구: 경기도 뉴미디어 예술방송국 경기아트온을 중심으로)

  • Lee, Seung Hyun
    • Journal of Service Research and Studies
    • /
    • v.13 no.1
    • /
    • pp.108-126
    • /
    • 2023
  • This study explored the sustainability of a blockchain-based cultural art performance video platform through the construction of Gyeonggi Art On, a new media art broadcasting station in Gyeonggi-do. In addition, the technical limitations of video content transaction using block chain, legal and institutional issues, and the protection of personal information and intellectual property rights were reviewed. As for the research method, participatory observation methods such as in-depth interviews with developers and operators and participation in meetings were conducted. The researcher participated in and observed the entire development process, including designing and developing blockchain nodes, smart contracts, APIs, UI/UX, and testing interworking between blockchain and content distribution services. Research Question 1: The results of the study on 'Which technology model is suitable for a blockchain-based performance video content distribution public platform?' are as follows. 1) The blockchain type suitable for the public platform for distribution of art performance video contents based on the blockchain is the private type that can be intervened only when the blockchain manager directly invites it. 2) In public platforms such as Gyeonggi ArtOn, among the copyright management model, which is an art based on NFT issuance, and the BC token and cloud-based content distribution model, the model that provides content to external demand organizations through API and uses K-token for fee settlement is suitable. 3) For public platform initial services such as Gyeonggi ArtOn, a closed blockchain that provides services only to users who have been granted the right to use content is suitable. Research question 2: What legal and institutional problems should be reviewed when operating a blockchain-based performance video distribution public platform? The results of the study are as follows. 1) Blockchain-based smart contracts have a party eligibility problem due to the nature of blockchain technology in which the identities of transaction parties may not be revealed. 2) When a security incident occurs in the block chain, it is difficult to recover the loss because it is unclear how to compensate or remedy the user's loss. 3) The concept of default cannot be applied to smart contracts, and even if the obligations under the smart contract have already been fulfilled, the possibility of incomplete performance must be reviewed.

The Policy of Win-Win Growth between Large and Small Enterprises : A South Korean Model (한국형 동반성장 정책의 방향과 과제)

  • Lee, Jang-Woo
    • Korean small business review
    • /
    • v.33 no.4
    • /
    • pp.77-93
    • /
    • 2011
  • Since 2000, the employment rate of small and medium enterprises (SMEs) has dwindled while the creation of new jobs and the emergence of healthy SMEs have been stagnant. The fundamental reason for these symptoms is that the economic structure is disadvantageous to SMEs. In particular, the greater gap between SMEs and large enterprises has resulted in polarization, and the resulting imbalance has become the largest obstacle to improving SMEs' competitiveness. For example, the total productivity has continued to drop, and the average productivity of SMEs is now merely 30% of that of large enterprises, and the average wage of SMEs' employees is only 53% of that of large enterprises. Along with polarization, rapid industrialization has also caused anti-enterprise consensus, the collapse of the middle class, hostility towards establishments, and other aftereffects. The general consensus is that unless these problems are solved, South Korea will not become an advanced country. Especially, South Korea is now facing issues that need urgent measures, such as the decline of its economic growth, the worsening distribution of profits, and the increased external volatility. Recognizing such negative trends, the MB administration proposed a win-win growth policy and recently introduced a new national value called "ecosystemic development." As the terms in such policy agenda are similar, however, the conceptual differences among such terms must first be fully understood. Therefore, in this study, the concepts of win-win growth policy and ecosystemic development, and the need for them, were surveyed, and their differences from and similarities with other policy concepts like win-win cooperation and symbiotic development were examined. Based on the results of the survey and examination, the study introduced a South Korean model of win-win growth, targeting the promotion of a sound balance between large enterprises and SMEs and an innovative ecosystem, and finally, proposing future policy tasks. Win-win growth is not an academic term but a policy term. Thus, it is less advisable to give a theoretical definition of it than to understand its concept based on its objective and method as a policy. The core of the MB administration's win-win growth policy is the creation of a partnership between key economic subjects such as large enterprises and SMEs based on each subject's differentiated capacity, and such economic subjects' joint promotion of growth opportunities. Its objective is to contribute to the establishment of an advanced capitalistic system by securing the sustainability of the South Korean economy. Such win-win growth policy includes three core concepts. The first concept, ecosystem, is that win-win growth should be understood from the viewpoint of an industrial ecosystem and should be pursued by overcoming the issues of specific enterprises. An enterprise is not an independent entity but a social entity, meaning it exists in relationship with the society (Drucker, 2011). The second concept, balance, points to the fact that an effort should be made to establish a systemic and social infrastructure for a healthy balance in the industry. The social system and infrastructure should be established in such a way as to create a balance between short- term needs and long-term sustainability, between freedom and responsibility, and between profitability and social obligations. Finally, the third concept is the behavioral change of economic entities. The win-win growth policy is not merely about simple transactional relationships or determining reasonable prices but more about the need for a behavior change on the part of economic entities, without which the objectives of the policy cannot be achieved. Various advanced countries have developed different win-win growth models based on their respective cultures and economic-development stages. Japan, whose culture is characterized by a relatively high level of group-centered trust, has developed a productivity improvement model based on such culture, whereas the U.S., which has a highly developed system of market capitalism, has developed a system that instigates or promotes market-oriented technological innovation. Unlike Japan or the U.S., Europe, a late starter, has not fully developed a trust-based culture or market capitalism and thus often uses a policy-led model based on which the government leads the improvement of productivity and promotes technological innovation. By modeling successful cases from these advanced countries, South Korea can establish its unique win-win growth system. For this, it needs to determine the method and tasks that suit its circumstances by examining the prerequisites for its success as well as the strengths and weaknesses of each advanced country. This paper proposes a South Korean model of win-win growth, whose objective is to upgrade the country's low-trust-level-based industrial structure, in which large enterprises and SMEs depend only on independent survival strategies, to a high-trust-level-based social ecosystem, in which large enterprises and SMEs develop a cooperative relationship as partners. Based on this objective, the model proposes the establishment of a sound balance of systems and infrastructure between large enterprises and SMEs, and to form a crenovative social ecosystem. The South Korean model of win-win growth consists of three axes: utilization of the South Koreans' potential, which creates community-oriented energy; fusion-style improvement of various control and self-regulated systems for establishing a high-trust-level-oriented social infrastructure; and behavioral change on the part of enterprises in terms of putting an end to their unfair business activities and promoting future-oriented cooperative relationships. This system will establish a dynamic industrial ecosystem that will generate creative energy and will thus contribute to the realization of a sustainable economy in the 21st century. The South Korean model of win-win growth should pursue community-based self-regulation, which promotes the power of efficiency and competition that is fundamentally being pursued by capitalism while at the same time seeking the value of society and community. Already existing in Korea's traditional roots, such objectives have become the bases of the Shinbaram culture, characterized by the South Koreans' spontaneity, creativity, and optimism. In the process of a community's gradual improvement of its rules and procedures, the trust among the community members increases, and the "social capital" that guarantees the successful control of shared resources can be established (Ostrom, 2010). This basic ideal can help reduce the gap between large enterprises and SMEs, alleviating the South Koreans' victim mentality in the face of competition and the open-door policy, and creating crenovative corporate competitiveness. The win-win growth policy emerged for the purpose of addressing the polarization and imbalance structure resulting from the evolution of 21st-century capitalism. It simultaneously pursues efficiency and fairness on one hand and economic and community values on the other, and aims to foster efficient interaction between the market and the government. This policy, however, is also evolving. The win-win growth policy can be considered an extension of the win-win cooperation that the past 'Participatory Government' promoted at the enterprise management level to the level of systems and culture. Also, the ecosystemic development agendum that has recently emerged is a further extension that has been presented as a national ideal of "a new development model that promotes the co-advancement of environmental conservation, growth, economic development, social integration, and national and individual development."

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