• Journal of Agricultural Extension & Community Development
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• v.17 no.2
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• pp.279-304
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• 2010

한국의 농촌개발정책은 지난 50년에 걸쳐서 많은 변화를 겪어왔다. 농촌개발정책은 국내외의 정책 환경인자와 관련성을 맺는 가운데, 농업 농촌이 처한 시대별 과제를 해결해나가는 과정의 결과라고 여겨진다. 농촌개발정책은 1960년 이후 현재까지의 기간 동안에 4단계의 시기별, 정책구성요소별로 의미 있는 변화가 일어나고 있다. 2000년을 전후하여 국가발전을 위한 행정이념이 효율성에서 형평성으로 전환됨에 따라 농촌개발정책은 전반적이고 근본적인 변화에 직면하고 있다. 농촌지역은 국가발전을 위한 새로운 가치와 자원을 가지고 있는 공간으로 재인식되고 있다. 농촌은 곧 마을이라는 으로 변화되고, 농촌의 소도읍이 새로운 농촌지역의 삶의 미시적인 관점에서 접근되던 정책이 인근의 도시와 연계를 맺는 방향 공간으로 접근되고 있다. 농촌개발정책은 농업을 중심으로 하는 정책에서 비농업부문의 개발을 중시하는 방향으로, 지역농업과 공간정책을 통합하여 개발하는 방향으로 나아가고 있다. 이 과정에서 농촌개발과 관련이 있는 중앙정부 부처의 수가 증가하는 가운데, 지방정부와 지역주민의 역할이 강조되면서, 수직적 수평적인 분권화와 협치 체제의 구축이 중요해지고 있다. 또한 지역의 고유성과 지역단위사업의 연계성에 대한 강조는 자연히 지역단위 계획제도의 정착과 이를 현실적으로 뒷받침할 수 있는 예산제도의 변화를 가져오고 있다.

• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.86-97
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• 1978

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.