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A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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Studies on the Varietal Difference in the Physiology of Ripening in Rice with Special Reference to Raising the Percentage of Ripened Grains (수도 등숙의 품종간차이와 그 향상에 관한 연구)

  • Su-Bong Ahn
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.14
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    • pp.1-40
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    • 1973
  • There is a general tendency to increase nitrogen level in rice production to insure an increased yield. On the other hand, percentage of ripened grains is getting decreased with such an increased fertilizer level. Decreasing of the percentage is one of the important yield limiting factors. Especially the newly developed rice variety, 'Tongil' is characterized by a relatively low percentage of ripened grains as compared with the other leading varieties. Therefore, these studies were aimed to finding out of some measures for the improvement of ripening in rice. The studies had been carried out in the field and in the phytotron during the period of three years from 1970 to 1972 at the Crop Experiment Station in Suwon. The results obtained from the experiments could be summarized as follows: 1. The spikelet of Tongil was longer in length, more narrow in width, thinner in thickness, smaller in the volume of grains and lighter in grain weight than those of Jinheung. The specific gravity of grain was closely correlated with grain weight and the relationship with thickness, width and length was getting smaller in Jinheung. On the other hand, Tongil showed a different pattern from Jinheung. The relationship of the specific gravity with grain weight was the greatest and followed by that with the width, thickness and length, in order. 2. The distribution of grain weight selected by specific gravity was different from one variety to another. Most of grains of Jinheung were distributed over the specific gravity of 1.12 with its peak at 1.18, but many of grains of Tongil were distributed below 1.12 with its peak at 1.16. The brown/rough rice ratio was sharply declined below the specific gravity of 1.06 in Jinheung, but that of Tongil was not declined from the 1.20 to the 0.96. Accordingly, it seemed to be unfair to make the specific gravity criterion for ripened grains at 1.06 in the Tongil variety. 3. The increasing tendency of grain weight after flowering was different depending on varieties. Generally speaking, rice varieties originated from cold area showed a slow grain weight increase while Tongil was rapid except at lower temperature in late ripening stage. 4. In the late-tillered culms or weak culms, the number of spikelets was small and the percentage of ripened grains was low. Tongil produced more late-tillered culms and had a longer flowering duration especially at lower temperature, resulting in a lower percentage of ripened grains. 5. The leaf blade of Tongil was short, broad and errect, having light receiving status for photosynthesis was better. The photosynthetic activity of Tongil per unit leaf area was higher than that of Jinheung at higher temperature, but lower at lower temperature. 6. Tongil was highly resistant to lodging because of short culm length, and thick lower-internodes. Before flowering, Tongil had a relatively higher amount of sugars, phosphate, silicate, calcium, manganese and magnesium. 7. The number of spikelets of Tongil was much more than that of Jinheung. The negative correlation was observed between the number of spikelets and percentage of ripened grains in Jinheung, but no correlation was found in Tongil grown at higher temperature. Therefore, grain yield was increased with increased number of spikelets in Tongil. Anthesis was not occurred below 21$^{\circ}C$ in Tongil, so sterile spikelets were increased at lower temperature during flowering stage. 8. The root distribution of Jinheung was deeper than that of Tongil. The root activity of Tongil evaluated by $\alpha$-naphthylamine oxidation method, was higher than that of Jinheung at higher temperature, but lower at lower temperature. It is seemed to be related with discoloration of leaf blades. 9. Tongil had a better light receiving status for photosynthesis and a better productive structure with balance between photosynthesis and respiration, so it is seemed that tongil has more ideal plant type for getting of a higher grain yield as compared with Jinheung. 10. Solar radiation during the 10 days before to 30 days after flowering seemed enough for ripening in suwon, but the air temperature dropped down below 22$^{\circ}C$ beyond August 25. Therefore, it was believed that air temperature is one of ripening limiting factors in this case. 11. The optimum temperature for ripening in Jinheung was relatively lower than that of Tongil requriing more than $25^{\circ}C$. Air temperature below 21$^{\circ}C$ was one of limiting factors for ripening in Tongil. 12. It seemed that Jinheung has relatively high photosensitivity and moderate thermosensitivity, while Tongil has a low photosensitivity, high thermosensitivity and longer basic vegetative phase. 13. Under a condition of higher nitrogen application at late growing stage, the grain yield of Jinheung was increased with improvement of percentage of ripened grains, while grain yield of Tongil decreased due to decreasing the number of spikelets although photosynthetic activity after flowering was. increased. 14. The grain yield of Jinheung was decreased slightly in the late transplanting culture since its photosynthetic activity was relatively high at lower temperature, but that of Tonil was decreased due to its inactive photosynthetic activity at lower temperature. The highest yield of Tongil was obtained in the early transplanting culture. 15. Tongil was adapted to a higher fertilizer and dense transplanting, and the percentage of ripened grains was improved by shortening of the flowering duration with increased number of seedlings per hill. 16. The percentage of vigorous tillers was increased with a denser transplanting and increasing in number of seedlings per hill. 17. The possibility to improve percentage of ripened grains was shown with phosphate application at lower temperature. The above mentioned results are again summarized below. The Japonica type leading varieties should be flowered before August 20 to insure a satisfactory ripening of grains. Nitrogen applied should not be more than 7.5kg/10a as the basal-dressing and the remained nitrogen should be applied at the later growing stage to increase their photosynthetic activity. The morphological and physiological characteristics of Tongil, a semi-dwarf, Indica $\times$ Japonica hybrid variety, are very different from those of other leading rice varieties, requring changes in seed selection by specific gravity method, in milling and in the cultural practices. Considering the peculiar distribution of grains selected by the method and the brown/rough rice ratio, the specific gravity criterion for seed selection should be changed from the currently employed 1.06 to about 0.96 for Tongil. In milling process, it would be advisable to bear in mind the specific traits of Tongil grain appearance. Tongil is a variety with many weak tillers and under lower temperature condition flowering is delayed. Such characteristics result in inactivation of roots and leaf blades which affects substantially lowering of the percentage of ripened grains due to increased unfertilized spikelets. In addition, Tongil is adapted well to higher nitrogen application. Therefore, it would be recommended to transplant Tongil variety earlier in season under the condition of higer nitrogen, phosphate and silicate. A dense planting-space with three vigorous seedlings per hill should be practiced in this case. In order to manifest fully the capability of Tongil, several aspects such as the varietal improvement, culural practices and milling process should be more intensively considered in the future.he future.

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A Study on the Curriculum for Record Management Science Education - with focus on the Faculty of Cultural Information Resources, Surugadai University; Evolving Program, New Connections (기록관리학의 발전을 위한 교육과정연구 -준하태(駿河台)(스루가다이)대학(大學)의 경우를 중심(中心)으로-)

  • Kim, Yong-Won
    • Journal of Korean Society of Archives and Records Management
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    • v.1 no.1
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    • pp.69-94
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    • 2001
  • The purpose of this paper is to provide an overview of the current status of the records management science education in Japan, and to examine the implications of the rapid growth of this filed while noting some of its significant issues and problems. The goal of records management science education is to improve the quality of information services and to assure an adequate supply of information professionals. Because records management science programs prepare students for a professional career, their curricula must encompass elements of both education and practical training. This is often expressed as a contrast between theory and practice. The confluence of the social, economic and technological realities of the environment where the learning takes place affects both. This paper reviews the historical background and current trends of records management science education in Japan. It also analyzes the various types of curriculum and the teaching staff of these institutions, with focus on the status of the undergraduate program at Surugadai University, the first comprehensive, university level program in Japan. The Faculty of Cultural Information Resources, Surugadai University, a new school toward an integrated information disciplines, was opened in 1994, to explore the theory and practice of the management diverse cultural information resources. Its purpose was to stimulate and promote research in additional fields of information science by offering professional training in archival science, records management, and museum curatorship, as well as librarianship. In 1999, the school introduced a master program, the first in Japan. The Faculty has two departments and each of them has two courses; Department of Sensory Information Resources Management; -Sound and Audiovisual Information Management, -Landscape and Tourism Information Management, Department of Knowledge Information Resources Management; -Library and Information Management, -Records and Archives Management The structure of the entire curriculum is also organized in stages from the time of entrance through basic instruction and onwards. Orientation subjects which a student takes immediately upon entering university is an introduction to specialized education, in which he learns the basic methods of university education and study, During his first and second years, he arranges Basic and Core courses as essential steps towards specialization at university. For this purpose, the courses offer a wide variety of study topics. The number of courses offered, including these, amounts to approximately 150. While from his third year onwards, he begins specific courses that apply to his major field, and in a gradual accumulation of seminar classes and practical training, puts his knowledge grained to practical use. Courses pertaining to these departments are offered to students beginning their second year. However, there is no impenetrable wall between the two departments, and there are only minor differences with regard requirements for graduation. Students may select third or fourth year seminars regardless of the department to which they belong. To be awarded a B.A. in Cultural Information Resources, the student is required to earn 34 credits in Basic Courses(such as, Social History of Cultural Information, Cultural Anthropology, History of Science, Behavioral Sciences, Communication, etc.), 16 credits in Foreign Languages(including 10 in English), 14 credits on Information Processing(including both theory and practice), and 60 credits in the courses for his or her major. Finally, several of the issues and problems currently facing records management science education in Japan are briefly summarized below; -Integration and Incorporation of related areas and similar programs, -Curriculum Improvement, -Insufficient of Textbooks, -Lack of qualified Teachers, -Problems of the employment of Graduates. As we moved toward more sophisticated, integrated, multimedia information services, information professionals will need to work more closely with colleagues in other specialties. It will become essential to the survival of the information professions for librarians to work with archivists, record managers and museum curators. Managing the changes in our increasingly information-intensive society demands strong coalitions among everyone in cultural Institutions. To provide our future colleagues with these competencies will require building and strengthening partnerships within and across the information professions and across national borders.

Dynamic Virtual Ontology using Tags with Semantic Relationship on Social-web to Support Effective Search (효율적 자원 탐색을 위한 소셜 웹 태그들을 이용한 동적 가상 온톨로지 생성 연구)

  • Lee, Hyun Jung;Sohn, Mye
    • Journal of Intelligence and Information Systems
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    • v.19 no.1
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    • pp.19-33
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    • 2013
  • In this research, a proposed Dynamic Virtual Ontology using Tags (DyVOT) supports dynamic search of resources depending on user's requirements using tags from social web driven resources. It is general that the tags are defined by annotations of a series of described words by social users who usually tags social information resources such as web-page, images, u-tube, videos, etc. Therefore, tags are characterized and mirrored by information resources. Therefore, it is possible for tags as meta-data to match into some resources. Consequently, we can extract semantic relationships between tags owing to the dependency of relationships between tags as representatives of resources. However, to do this, there is limitation because there are allophonic synonym and homonym among tags that are usually marked by a series of words. Thus, research related to folksonomies using tags have been applied to classification of words by semantic-based allophonic synonym. In addition, some research are focusing on clustering and/or classification of resources by semantic-based relationships among tags. In spite of, there also is limitation of these research because these are focusing on semantic-based hyper/hypo relationships or clustering among tags without consideration of conceptual associative relationships between classified or clustered groups. It makes difficulty to effective searching resources depending on user requirements. In this research, the proposed DyVOT uses tags and constructs ontologyfor effective search. We assumed that tags are extracted from user requirements, which are used to construct multi sub-ontology as combinations of tags that are composed of a part of the tags or all. In addition, the proposed DyVOT constructs ontology which is based on hierarchical and associative relationships among tags for effective search of a solution. The ontology is composed of static- and dynamic-ontology. The static-ontology defines semantic-based hierarchical hyper/hypo relationships among tags as in (http://semanticcloud.sandra-siegel.de/) with a tree structure. From the static-ontology, the DyVOT extracts multi sub-ontology using multi sub-tag which are constructed by parts of tags. Finally, sub-ontology are constructed by hierarchy paths which contain the sub-tag. To create dynamic-ontology by the proposed DyVOT, it is necessary to define associative relationships among multi sub-ontology that are extracted from hierarchical relationships of static-ontology. The associative relationship is defined by shared resources between tags which are linked by multi sub-ontology. The association is measured by the degree of shared resources that are allocated into the tags of sub-ontology. If the value of association is larger than threshold value, then associative relationship among tags is newly created. The associative relationships are used to merge and construct new hierarchy the multi sub-ontology. To construct dynamic-ontology, it is essential to defined new class which is linked by two more sub-ontology, which is generated by merged tags which are highly associative by proving using shared resources. Thereby, the class is applied to generate new hierarchy with extracted multi sub-ontology to create a dynamic-ontology. The new class is settle down on the ontology. So, the newly created class needs to be belong to the dynamic-ontology. So, the class used to new hyper/hypo hierarchy relationship between the class and tags which are linked to multi sub-ontology. At last, DyVOT is developed by newly defined associative relationships which are extracted from hierarchical relationships among tags. Resources are matched into the DyVOT which narrows down search boundary and shrinks the search paths. Finally, we can create the DyVOT using the newly defined associative relationships. While static data catalog (Dean and Ghemawat, 2004; 2008) statically searches resources depending on user requirements, the proposed DyVOT dynamically searches resources using multi sub-ontology by parallel processing. In this light, the DyVOT supports improvement of correctness and agility of search and decreasing of search effort by reduction of search path.

Comparative Analysis of Community Health Practitioner's Activities and Primary Health Post Management Before and After Officialization of Community Health practitioner (보건진료원의 정규직화 전과 후의 보건진료원 활동 및 보건진료소 관리운영체계의 비교 분석)

  • Yun, Suk-Ok;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.19 no.2
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    • pp.141-158
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    • 1994
  • 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.

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