• The Korean Nurse
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• v.36 no.1
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• pp.77-96
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• 1997

The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

• Proceedings of the Korea Technology Innovation Society Conference
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• 2015.05a
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• pp.545-570
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• 2015

Korea is among the ten countries with the largest R&D budget and the highest R&D investment-to-GDP ratio, yet the subject of security and protection of R&D results remains relatively unexplored in the country. Countries have implemented in their legal systems measures to properly protect cutting-edge industrial technologies that would adversely affect national security and economy if leaked to other countries. While Korea has a generally stable legal framework as provided in the Regulation on the National R&D Program Management (the "Regulation") and the Act on Industrial Technology Protection, many difficulties follow in practice when determining details on security management and obligations and setting standards in carrying out national R&D projects. This paper proposes to modify and improve security level classification standards in the Regulation. The Regulation provides a dual security level decision-making system for R&D projects: the security level can be determined either by researcher or by the central agency in charge of the project. Unification of such a dual system can avoid unnecessary confusions. To prevent a leakage, it is crucial that research projects be carried out in compliance with their assigned security levels and standards and results be effectively managed. The paper examines from a practitioner's perspective relevant legal provisions on leakage of confidential R&D projects, infringement, injunction, punishment, attempt and conspiracy, dual liability, duty of report to the National Intelligence Service (the "NIS") of security management process and other security issues arising from national R&D projects, and manual drafting in case of a breach. The paper recommends to train security and technological experts such as industrial security experts to properly amend laws on security level classification standards and relevant technological contents. A quarterly policy development committee must also be set up by the NIS in cooperation with relevant organizations. The committee shall provide a project management manual that provides step-by-step guidance for organizations that carry out national R&D projects as a preventive measure against possible leakage. In the short term, the NIS National Industrial Security Center's duties should be expanded to incorporate national R&D projects' security. In the long term, a security task force must be set up to protect, support and manage the projects whose responsibilities should include research, policy development, PR and training of security-related issues. Through these means, a social consensus must be reached on the need for protecting national R&D projects. The most efficient way to implement these measures is to facilitate security training programs and meetings that provide opportunities for communication among industrial security experts and researchers. Furthermore, the Regulation's security provisions must be examined and improved.

• Journal of Intelligence and Information Systems
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• v.20 no.3
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• pp.151-171
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• 2014

Firms today have sought management effectiveness and efficiency utilizing information technologies (IT). Numerous firms are outsourcing specific information systems functions to cope with their short of information resources or IT experts, or to reduce their capital cost. Recently, Software-as-a-Service (SaaS) as a new type of information system has become one of the powerful outsourcing alternatives. SaaS is software deployed as a hosted and accessed over the internet. It is regarded as the idea of on-demand, pay-per-use, and utility computing and is now being applied to support the core competencies of clients in areas ranging from the individual productivity area to the vertical industry and e-commerce area. In this study, therefore, we seek to quantify the value that SaaS has on business performance by examining the relationships among firm strategies, SaaS technology maturity, and business performance of SaaS providers. We begin by drawing from prior literature on SaaS, technology maturity and firm strategy. SaaS technology maturity is classified into three different phases such as application service providing (ASP), Web-native application, and Web-service application. Firm strategies are manipulated by the low-cost strategy and differentiation strategy. Finally, we considered customer acquisition as a business performance. In this sense, specific objectives of this study are as follows. First, we examine the relationships between customer acquisition performance and both low-cost strategy and differentiation strategy of SaaS providers. Secondly, we investigate the mediating and moderating effects of SaaS technology maturity on those relationships. For this purpose, study collects data from the SaaS providers, and their line of applications registered in the database in CNK (Commerce net Korea) in Korea using a questionnaire method by the professional research institution. The unit of analysis in this study is the SBUs (strategic business unit) in the software provider. A total of 199 SBUs is used for analyzing and testing our hypotheses. With regards to the measurement of firm strategy, we take three measurement items for differentiation strategy such as the application uniqueness (referring an application aims to differentiate within just one or a small number of target industry), supply channel diversification (regarding whether SaaS vendor had diversified supply chain) as well as the number of specialized expertise and take two items for low cost strategy like subscription fee and initial set-up fee. We employ a hierarchical regression analysis technique for testing moderation effects of SaaS technology maturity and follow the Baron and Kenny's procedure for determining if firm strategies affect customer acquisition through technology maturity. Empirical results revealed that, firstly, when differentiation strategy is applied to attain business performance like customer acquisition, the effects of the strategy is moderated by the technology maturity level of SaaS providers. In other words, securing higher level of SaaS technology maturity is essential for higher business performance. For instance, given that firms implement application uniqueness or a distribution channel diversification as a differentiation strategy, they can acquire more customers when their level of SaaS technology maturity is higher rather than lower. Secondly, results indicate that pursuing differentiation strategy or low cost strategy effectively works for SaaS providers' obtaining customer, which means that continuously differentiating their service from others or making their service fee (subscription fee or initial set-up fee) lower are helpful for their business success in terms of acquiring their customers. Lastly, results show that the level of SaaS technology maturity mediates the relationships between low cost strategy and customer acquisition. That is, based on our research design, customers usually perceive the real value of the low subscription fee or initial set-up fee only through the SaaS service provide by vender and, in turn, this will affect their decision making whether subscribe or not.

• Journal of Intelligence and Information Systems
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• v.22 no.3
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• pp.23-43
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• 2016

As a result of the growth of Internet data and the rapid development of Internet technology, "big data" analysis has gained prominence as a major approach for evaluating and mining enormous data for various purposes. Especially, in recent years, people tend to share their experiences related to their leisure activities while also reviewing others' inputs concerning their activities. Therefore, by referring to others' leisure activity-related experiences, they are able to gather information that might guarantee them better leisure activities in the future. This phenomenon has appeared throughout many aspects of leisure activities such as movies, traveling, accommodation, and dining. Apart from blogs and social networking sites, many other websites provide a wealth of information related to leisure activities. Most of these websites provide information of each product in various formats depending on different purposes and perspectives. Generally, most of the websites provide the average ratings and detailed reviews of users who actually used products/services, and these ratings and reviews can actually support the decision of potential customers in purchasing the same products/services. However, the existing websites offering information on leisure activities only provide the rating and review based on one stage of a set of evaluation criteria. Therefore, to identify the main issue for each evaluation criterion as well as the characteristics of specific elements comprising each criterion, users have to read a large number of reviews. In particular, as most of the users search for the characteristics of the detailed elements for one or more specific evaluation criteria based on their priorities, they must spend a great deal of time and effort to obtain the desired information by reading more reviews and understanding the contents of such reviews. Although some websites break down the evaluation criteria and direct the user to input their reviews according to different levels of criteria, there exist excessive amounts of input sections that make the whole process inconvenient for the users. Further, problems may arise if a user does not follow the instructions for the input sections or fill in the wrong input sections. Finally, treating the evaluation criteria breakdown as a realistic alternative is difficult, because identifying all the detailed criteria for each evaluation criterion is a challenging task. For example, if a review about a certain hotel has been written, people tend to only write one-stage reviews for various components such as accessibility, rooms, services, or food. These might be the reviews for most frequently asked questions, such as distance between the nearest subway station or condition of the bathroom, but they still lack detailed information for these questions. In addition, in case a breakdown of the evaluation criteria was provided along with various input sections, the user might only fill in the evaluation criterion for accessibility or fill in the wrong information such as information regarding rooms in the evaluation criteria for accessibility. Thus, the reliability of the segmented review will be greatly reduced. In this study, we propose an approach to overcome the limitations of the existing leisure activity information websites, namely, (1) the reliability of reviews for each evaluation criteria and (2) the difficulty of identifying the detailed contents that make up the evaluation criteria. In our proposed methodology, we first identify the review content and construct the lexicon for each evaluation criterion by using the terms that are frequently used for each criterion. Next, the sentences in the review documents containing the terms in the constructed lexicon are decomposed into review units, which are then reconstructed by using the evaluation criteria. Finally, the issues of the constructed review units by evaluation criteria are derived and the summary results are provided. Apart from the derived issues, the review units are also provided. Therefore, this approach aims to help users save on time and effort, because they will only be reading the relevant information they need for each evaluation criterion rather than go through the entire text of review. Our proposed methodology is based on the topic modeling, which is being actively used in text analysis. The review is decomposed into sentence units rather than considering the whole review as a document unit. After being decomposed into individual review units, the review units are reorganized according to each evaluation criterion and then used in the subsequent analysis. This work largely differs from the existing topic modeling-based studies. In this paper, we collected 423 reviews from hotel information websites and decomposed these reviews into 4,860 review units. We then reorganized the review units according to six different evaluation criteria. By applying these review units in our methodology, the analysis results can be introduced, and the utility of proposed methodology can be demonstrated.

• Journal of the Korean Association of Geographic Information Studies
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• v.18 no.2
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• pp.174-189
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• 2015

The objective of this study was to reconstruct spatial information using the results of the investigation and evaluation of the health of the living organisms, habitat, and water quality at the investigation points for the aquatic ecosystem health of the Nakdong River basin, to support the rational decision making of the aquatic ecosystem preservation and restoration policies of the Nakdong River basin using spatial analysis techniques, and to present efficient management methods. To analyze the aquatic ecosystem health of the Nakdong River basin, punctiform data were constructed based on the position information of each point with the aquatic ecosystem health investigation and evaluation results of 250 investigation sections. To apply the spatial analysis technique, the data need to be reconstructed into areal data. For this purpose, spatial influence and trends were analyzed using the Kriging interpolation(ArcGIS 10.1, Geostatistical Analysis), and were reconstructed into areal data. To analyze the spatial distribution characteristics of the Nakdong River basin health based on these analytical results, hotspot(Getis-Ord Gi, $G^*_i$), LISA(Local Indicator of Spatial Association), and standard deviational ellipse analyses were used. The hotspot analysis results showed that the hotspot basins of the biotic indices(TDI, BMI, FAI) were the Andong Dam upstream, Wangpicheon, and the Imha Dam basin, and that the health grades of their biotic indices were good. The coldspot basins were Nakdong River Namhae, the Nakdong River mouth, and the Suyeong River basin. The LISA analysis results showed that the exceptional areas were Gahwacheon, the Hapcheon Dam, and the Yeong River upstream basin. These areas had high bio-health indices, but their surrounding basins were low and required management for aquatic ecosystem health. The hotspot basins of the physicochemical factor(BOD) were the Nakdong River downstream basin, Suyeong River, Hoeya River, and the Nakdong River Namhae basin, whereas the coldspot basins were the upstream basins of the Nakdong River tributaries, including Andong Dam, Imha Dam, and Yeong River. The hotspots of the habitat and riverside environment factor(HRI) were different from the hotspots and coldspots of each factor in the LISA analysis results. In general, the habitat and riverside environment of the Nakdong River mainstream and tributaries, including the Nakdong river upstream, Andong Dam, Imha Dam, and the Hapcheon Dam basin, had good health. The coldspot basins of the habitat and riverside environment also showed low health indices of the biotic indices and physicochemical factors, thus requiring management of the habitat and riverside environment. As a result of the time-series analysis with a standard deviation ellipsoid, the areas with good aquatic ecosystem health of the organisms, habitat, and riverside environment showed a tendency to move northward, and the BOD results showed different directions and concentrations by the year of investigation. These aquatic ecosystem health analysis results can provide not only the health management information for each investigation spot but also information for managing the aquatic ecosystem in the catchment unit for the working research staff as well as for the water environment researchers in the future, based on spatial information.

• Journal of Intelligence and Information Systems
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• v.19 no.1
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• pp.95-110
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• 2013

Recently, the amount of unstructured data being generated through a variety of social media has been increasing rapidly, resulting in the increasing need to collect, store, search for, analyze, and visualize this data. This kind of data cannot be handled appropriately by using the traditional methodologies usually used for analyzing structured data because of its vast volume and unstructured nature. In this situation, many attempts are being made to analyze unstructured data such as text files and log files through various commercial or noncommercial analytical tools. Among the various contemporary issues dealt with in the literature of unstructured text data analysis, the concepts and techniques of opinion mining have been attracting much attention from pioneer researchers and business practitioners. Opinion mining or sentiment analysis refers to a series of processes that analyze participants' opinions, sentiments, evaluations, attitudes, and emotions about selected products, services, organizations, social issues, and so on. In other words, many attempts based on various opinion mining techniques are being made to resolve complicated issues that could not have otherwise been solved by existing traditional approaches. One of the most representative attempts using the opinion mining technique may be the recent research that proposed an intelligent model for predicting the direction of the stock index. This model works mainly on the basis of opinions extracted from an overwhelming number of economic news repots. News content published on various media is obviously a traditional example of unstructured text data. Every day, a large volume of new content is created, digitalized, and subsequently distributed to us via online or offline channels. Many studies have revealed that we make better decisions on political, economic, and social issues by analyzing news and other related information. In this sense, we expect to predict the fluctuation of stock markets partly by analyzing the relationship between economic news reports and the pattern of stock prices. So far, in the literature on opinion mining, most studies including ours have utilized a sentiment dictionary to elicit sentiment polarity or sentiment value from a large number of documents. A sentiment dictionary consists of pairs of selected words and their sentiment values. Sentiment classifiers refer to the dictionary to formulate the sentiment polarity of words, sentences in a document, and the whole document. However, most traditional approaches have common limitations in that they do not consider the flexibility of sentiment polarity, that is, the sentiment polarity or sentiment value of a word is fixed and cannot be changed in a traditional sentiment dictionary. In the real world, however, the sentiment polarity of a word can vary depending on the time, situation, and purpose of the analysis. It can also be contradictory in nature. The flexibility of sentiment polarity motivated us to conduct this study. In this paper, we have stated that sentiment polarity should be assigned, not merely on the basis of the inherent meaning of a word but on the basis of its ad hoc meaning within a particular context. To implement our idea, we presented an intelligent investment decision-support model based on opinion mining that performs the scrapping and parsing of massive volumes of economic news on the web, tags sentiment words, classifies sentiment polarity of the news, and finally predicts the direction of the next day's stock index. In addition, we applied a domain-specific sentiment dictionary instead of a general purpose one to classify each piece of news as either positive or negative. For the purpose of performance evaluation, we performed intensive experiments and investigated the prediction accuracy of our model. For the experiments to predict the direction of the stock index, we gathered and analyzed 1,072 articles about stock markets published by "M" and "E" media between July 2011 and September 2011.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.165-203
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• 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.