• Title/Summary/Keyword: job variables

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Teacher's Perception and Related Factors on the Purpose of High School Vocational Education (고교 직업교육 목적에 대한 교사의 인식 차이와 관련 요인)

  • Lim, Eon;Lee, Sujung;Yun, Hyunghan;Jung, Hyeryung
    • Journal of vocational education research
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    • v.36 no.2
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    • pp.1-22
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    • 2017
  • The purpose of this study was to examine how the vocational high school teachers perceive the direction of the ideal high school vocational education when suggesting mutual contrast positions on the desirable direction of high school vocational education. 1253 teachers from 25 specialization high schools nationwide participated in the survey. Through the review of previous research, we confirmed the axis of new vocationalism, vocationalism, and humanism on the purpose of vocational education. As a result of investigating the perception of vocational high school teachers about the purpose of vocational education, they tended to recognize the purpose of high vocational education toward vocationalism. In other words, rather than acquiring transferable skills, it is important to acquire concrete skills in specific areas, and it is more important to acquire specific skills that can be utilized immediately after graduation rather than coping with the changing job world. Teachers also recognized that it is more important to organize the contents of education according to the needs of industries and companies than to construct education contents for student 's holistic development. There was also a tendency for teachers to recognize that it is important to prepare them for work immediately after graduation rather than preparing them for as wide a career choice as possible. There was a tendency for the male teacher to perceive the purpose of vocational education more pro vocationalism than the female teacher. In addition, professional subject teachers recognized more pro vocationalism than general subject teachers. As a result of the regression analysis, it was found that gender and subject(professional subject vs. general subject) were significant variables related to vocationalism. And suggested that a careful approach is needed in the policy decision making process when considering the limitations of overly vocationally oriented education and the risks of frequent changes in the purpose and direction of high school vocational education.

An Empirical Study on Classification, Business Type, Organizational Culture on Performance of Korean IT SMEs·Venture (중소·벤처기업의 업종, 영업형태, 조직문화가 기업성과에 미치는 영향에 관한 연구: 삼원분산분석(3-way ANOVA)을 중심으로)

  • Roh, Doo-Hwan;Hwang, Kyung-Ho
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.2
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    • pp.221-233
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    • 2019
  • In Korea, small and medium sized domestic enterprises(SMEs) play an pivotal role in the national economy, accounting for 99.9% of all enterprises, 87.9% of total employment, and 48.3% of production. and SMEs was driving a real force of the development of national economy in many respects such as innovation, job creation, industrial diversity, balanced regional development. Despite their crucial role in the national development, most of SMEs suffer from a lack of R&D capabilities and equipments as well as funding capacity. Public R&D institutes can provide SMEs with valuable supplementary technological knowledge and help them build technological capacity. so, In order to effectively support SMEs, government and public R&D institutes must be a priority to know about the factors influencing the performance related to technology transfer and technological collaborations. In particular, SMEs are not only taking up a large portion of the national economy, but also their influence in politics and economy so strong that raising the competitiveness of small and medium-sized companies is a national policy goal that must be achieved in order to achieve sustained economic growth. For this reason, it is necessary to look specifically at the relationship between concepts such as the environment, strategy, and organizational culture surrounding the enterprise to enhance the competitiveness of SMEs. The paper analyzes 665 companies to find out which organizational culture affects their performance by classification and type of business of SMEs. This study demonstrated that when SMEs seek consistency in their external environment, strategies, and organizational structure to maintain their continued competitiveness. According to three-way analysis of variance (3-way ANOVA) indicates that classification of industries in SMEs has statistically significant main effects, but the type of business and organizational culture do not have significant effects. However, the company's organizational performance (operating profit) of SMES were found to differ significantly in comparison between groups according to classification standards of industries, and therefore adopted some parts. In addition, an analysis of the effect of interaction between the three independent variables of small and medium-sized enterprises has shown that there are statistically significant interaction effects among classification, types of business, and organizational cultures. The results shows that there is an organizational culture suitable for each industry classification and type of business of an entity, and is expected to be used as a basis for establishing promotion policies related to the incubation and commerciality of small and medium-sized venture companies in the future.

Factors that Influence Physician Salary Payment through Analyzing on Internet Invitation Webpage in Korea (초빙광고 자료를 활용한 봉직 의사의 급여수준과 관련요인)

  • Kang, Hyun Goo;Lee, Ji Hyung;Jung, Da-Doo;Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.46 no.1
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    • pp.12-22
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    • 2021
  • Backgrounds: Proper distribution and supply of physicians are factors that affect national health care systems. This study investigated the payment distribution levels and the determinants that influence the salary levels of hospital hired physicians. Methods: We analyzed 4,014 job advertisements posted on an internet invitation information site about physician recruitment from May 2016 to May 2019. We used univariate analysis to determine the relationship between average monthly salary and the other related variables. Multiple regression analysis was used to determine the predictors of physician salary level. Results: The average monthly salary for the service physician was 15.4 million won, highest for orthopedic surgeons with 22.24 million won, and lowest for diagnostic laboratory physician with 11.4 million won. The factors significantly associated with average monthly salary were; non-major specialty, housing provision, no severance pay, and incentives(p<0.05). Non-major specialty, incentives, and the regions were predictors of the average standardized monthly salary(p<0.05). Conclusion: Factors associated with average monthly salary as revealed by this study were; medical specialty, hospital regional location, housing provision, payment of retirement allowance, and payment of other incentives respectively. However, this study was a cross-sectional study, and further studies will be required.

The Factors Influencing of Professional Consciousness of Long-term Care Workers (요양보호사의 직업의식과 영향요인)

  • Kim, Hyang Soo;Kim, Hee Kyung;Park, Yeon Suk
    • 한국노년학
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    • v.31 no.3
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    • pp.591-606
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    • 2011
  • The purpose of this study was to propose basis data to nursing intervention development in order to raise the professional consciousness of long-term care workers grasping influence factor and professional consciousness. The subjects were about 185 long-term care workers at D megalopolis and 4 cities of 3 provinces from November to December, 2009. The data were analyzed using the SPSS program for descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple regression. The correlated factors of professional consciousness included self-efficacy(r=.420, p=.000), sense of the calling(r=.636, p=.000), education training effectiveness(r=.441, p=.000), internal locus control(r=.378, p=.000), and external locus control(r=-.356, p=.000). Factors influencing of professional consciousness of them were to show in order of sense of the calling(B=.329, p=.000), education training effectiveness(B=.250, p=.000), internal locus control(B=.216, p=.000), external locus control (B=-.165, p=.002), consideration and opplicable job choose characteristic(B=.207, p=.004), these variables accounted for 57.5% of the variance of professional consciousness. Further research needs to develop well organized educational program, training of enhancing internal locus control, and clear examination about roles and tasks of long-term care workers. Also, it suggests education and research that can enhance professional consciousness by utilizing these factors.

A Case Study on the Success Factors of Overseas Agricultural Startup: Focusing on the Case of Banana Farm in Cote d'Ivoire (해외 농업스타트업(Agricultural Startup) 성공요인에 관한 사례연구: 'C사'의 제2창업기(바나나 팜 개발사례)를 중심으로)

  • Jin hwan Park;Sang soon Kim
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.3
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    • pp.61-79
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    • 2023
  • This study is a case study of overseas banana farms as a global agricultural startup that has hardly been attempted so far in terms of paradigm shift in the industry, beyond regional limitations. It was researched for the purpose of revealing the success factors of 'global agricultural startup' in terms of business process, entrepreneurship, and management dimensions learned through direct participation and observation at the local level. In order to study global agricultural startups, this study also conducted a comparative analysis of global startups (global startups) and global agricultural startups(global agricultural startups). In fact, the analysis consists of 'definition', 'components', and 'success factors', and we want to confirm the difference between the two concepts that can be distinguished. The case analysis tried to maximize the advantages of 'participatory action research' by directly observing and experiencing banana farms. In the case of banana farm cases, by dividing them into preparation process for farm development and farm development and management process, various variables considered in farm management were explained through the whole process of farm management. Through the process of overcoming and responding to specific failure cases, we tried to secure the reliability and validity of the research, and the case studies related to entrepreneurship, management, and organization analyzed by applying them by subdividing them into theoretical areas belonging to components and management that were theorized in existing preceding studies. This study is almost the first study on the process of creating a local entry business by directly moving the head office overseas rather than entering overseas agriculture as a subsidiary, joint venture or overseas corporation. In particular, it is a unique case that corresponds to agriculture in terms of region(Africa), scale(startup), and industry that have not been introduced so far as a global agricultural startup. In terms of entrepreneurship, it also concretely exemplified how entrepreneurship components such as innovativeness, risk-taking propensity, proactiveness, vision sharing, social contribution, leadership, etc., which have not been attempted so far in agricultural cases, are manifested and effective. The management and cultural aspects also went beyond the argument that only cultural aspects are important in overseas business, and also confirmed individual failure cases and their responses in recruitment, job, wage, retirement, development, organizational structure management, etc. As a result, there is significance and implications of this study in that it provides theoretical confirmation as well as practical and responsive basis for 'entrepreneurship', 'farming management', and 'management' aspects in overseas agricultural startup business operation.

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The Effect of Entrepreneurial Knowledge Acquisition on Entrepreneurial Intention via Entrepreneurial Self-Efficacy: The Moderated Mediation Effect of Family Entrepreneurship Background (창업지식습득이 창업자기효능감을 매개로 창업의도에 미치는 영향: 창업자 가족배경의 조절된 매개효과를 중심으로)

  • Lee, Juyon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.17 no.4
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    • pp.219-232
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    • 2022
  • Empirical studies on entrepreneurial intentions have been conducted from various perspectives over the past few decades. The unemployment rate has increased as the global economy stagnates in the aftermath of the COVID-19 pandemic, and entrepreneurship is emerging as an alternative to job creation. Although numerous antecedent variables have positive effects on entrepreneurial intention, this study focuses on entrepreneurial self-efficacy as an individual factor and the entrepreneur's family background as an environmental factor. This study analyzed the survey results of 300 global respondents through the online survey platform Prolific. The respondents were screened by asking a question about having had entrepreneurial education. Since the effects of entrepreneurial self-efficacy on entrepreneurial intention have been proved in numerous domestic studies, this study aims to generalize these results by investigating global samples. The moderated mediation analysis was performed using PROCESS to verify the research hypotheses. This research investigated the effect of entrepreneurial knowledge acquisition on entrepreneurial intention via entrepreneurial self-efficacy and the moderated mediation effect of the family background of entrepreneurs. The results of this study are summarized as follows. First, acquisition of entrepreneurial knowledge had a positive effect on entrepreneurial intention. Second, entrepreneurial self-efficacy mediated the relationship between entrepreneurship knowledge acquisition and entrepreneurial intention. Third, the entrepreneurship family background moderated this relationship. Specifically, when the family entrepreneurship background is strong (vs. weak), the positive effect of entrepreneurial knowledge acquisition on entrepreneurial intention via entrepreneurial self-efficacy significantly increased. The implications of this study are as follows. First, in the process of preparing for a own business, entrepreneurial education is a necessary condition to improve the entrepreneurial intention. Second, the higher the level of acquisition of entrepreneurial knowledge, the more positive attitudes toward entrepreneurial intention can be induced. Third, strong family background of entrepreneurship further promotes entrepreneurship intention by increasing entrepreneurial self-efficacy. In conclusion, in order to revitalize entrepreneurship, it is important to provide various entrepreneurial education programs. These educational programs will be able to improve entrepreneurial self-efficacy by providing more opportunities for students to acquire entrepreneurial knowledge, and thereby promote entrepreneurial intention. In addition, it is important to develop and provide advanced educational curriculum for those who have start-up business experiences in their families.

Distributors' Preference for the Flextime System (유통업체 종사자의 유동근무제에 대한 선호성향에 대한 연구)

  • Lee, Won-Haeng
    • Journal of Distribution Science
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    • v.10 no.4
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    • pp.13-20
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    • 2012
  • The "flextime" system, which was initially designed to maintain a balance between work and personal life, has recently received much attention as an alternative form of work, enabling employees to fully exert their creativity. Most studies show that the effects of flextime on performance, productivity, attitude toward the organization, absenteeism, and turnover differ between managerial and non-managerial workers. This suggests that workers' personal characteristics affect their preference for flextime by directly or indirectly influencing its result variables. As most Korean companies have not adopted the flextime system, little research has been conducted on it in Korea. Recently, Korean companies have been discussing flextime as one of several measures for enhancing international competitiveness. Therefore, this study aims to offer a theoretical framework for the introduction of the system by analyzing the effects of the precedent factors on the preference for flextime. Though not statistically significant, a higher preference for flextime is noted among workers over the age of 36. Older workers usually are more conservative and less adaptable to change but here the older Korean workers may be anxious and resistant. Additional research on workers in different types of businesses using improved research methods will lead to more meaningful results. Married workers display a lower preference to flextime than single workers. In Korea, the current atmosphere focused on a happy home encourages married workers to prefer regular work hours, enabling them to go to and from work on a regular schedule. This means that normal working hours, from morning to evening, are preferred as it is the most suitable system for families. However, this is not so in the case of single workers. Unmarried singles tend to prefer flextime for investing in self-development toward future prosperity, over the benefits of regular working-hours. Flextime is designed to meet their needs to some extent as it is helpful in maintaining a balance between work life and self-development. If flextime is selected, workers can spend mornings on self-development and work in the afternoons. Therefore, when flextime is introduced in Korea, it would be desirable to start with unmarried workers, to increase corporate creativity and productivity and develop individual potential. In particular, when the five-day workweek, the main concern for companies and labor unions, is adopted, synergy with flextime could be expected and a gradual implementation of flextime will be effective. Gender difference shows similar results to marital status with male workers displaying a higher preference for flextime. It is inferred that male workers' attitudes toward flextime are more favorable than female workers' because flextime enables self-development and work life to coexist. A relatively weak, though statistically significant, correlation exists between control position and flextime preference with inner-control-oriented workers displaying favorable attitudes toward flextime. Generally, inner-control-oriented workers tend to attribute the consequences caused by any person or partner relationship to themselves. Thus, when a new system is introduced they are likely to have less reluctance and fear than outer-control-oriented workers, because they think it is important to deal with the new system. A weak but slight correlation exists between the desire for achievement and flextime preference. People who have a higher desire for achievement are willing to consider the new system, especially if significant success is reasonably expected. This result is derived from a reasonable judgment that flextime offers an individual the time for self-development while the organization benefits from the resulting creativity and performance enhancements. Although not the primary analysis, a high correlation is found between control position and the desire for achievement, which is consistent with the results of previous research. The regression analysis not only supports the preceding ANOVA and correlation analysis but also shows the existence of a causal relationship. Married workers have a weak preference for flextime, which is consistent with the results of the preceding ANOVA. Relative to men, women have a weak preference for flextime. No statistically significant correlation was noticed for age. Inner-control-oriented workers prefer flextime more than outer-control-oriented workers as the former view the consequences of change to be their own responsibility. However, the preference for flextime seems to be weak. As expected, people with a higher desire for achievement have a stronger preference for flextime, presumably because the greater the desire for achievement, the stronger the spirit of challenging an uncertain future. No significant correlation exists between job satisfaction and flextime preference.

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An Empirical Study in Relationship between Franchisor's Leadership Behavior Style and Commitment by Focusing Moderating Effect of Franchisee's Self-efficacy (가맹본부의 리더십 행동유형과 가맹사업자의 관계결속에 관한 실증적 연구 - 가맹사업자의 자기효능감의 조절효과를 중심으로 -)

  • Yang, Hoe-Chang;Lee, Young-Chul
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.49-71
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    • 2010
  • Franchise businesses in South Korea have contributed to economic growth and job creation, and its growth potential remains very high. However, despite such virtues, domestic franchise businesses face many problems such as the instability of franchisor's business structure and weak financial conditions. To solve these problems, the government enacted legislation and strengthened franchise related laws. However, the strengthening of laws regulating franchisors had many side effects that interrupted the development of the franchise business. For example, legal regulations regarding franchisors have had the effect of suppressing the franchisor's leadership activities (e.g. activities such as the ability to advocate the franchisor's policies and strategies to the franchisees, in order to facilitate change and innovation). One of the main goals of the franchise business is to build cooperation between the franchisor and the franchisee for their combined success. However, franchisees can refuse to follow the franchisor's strategies because of the current state of franchise-related law and government policy. The purpose of this study to explore the effects of franchisor's leadership style on franchisee's commitment in a franchise system. We classified leadership styles according to the path-goal theory (House & Mitchell, 1974), and it was hypothesized and tested that the four leadership styles proposed by the path-goal theory (i.e. directive, supportive, participative and achievement-oriented leadership) have different effects on franchisee's commitment. Another purpose of this study to explore the how the level of franchisee's self-efficacy influences both the franchisor's leadership style and franchisee's commitment in a franchise system. Results of the present study are expected to provide important theoretical and practical implications as to the role of franchisor's leadership style, as restricted by government regulations and the franchisee's self-efficacy, which could be needed to improve the quality of the long-term relationship between the franchisor and franchisee. Quoted by Northouse(2007), one problem regarding the investigation of leadership is that there are almost as many different definitions of leadership as there are people who have tried to define it. But despite the multitude of ways in which leadership has been conceptualized, the following components can be identified as central to the phenomenon: (a) leadership is a process, (b) leadership involves influence, (c) leadership occurs in a group context, and (d) leadership involves goal attainment. Based on these components, in this study leadership is defined as a process whereby franchisor's influences a group of franchisee' to achieve a common goal. Focusing on this definition, the path-goal theory is about how leaders motivate subordinates to accomplish designated goals. Drawing heavily from research on what motivates employees, path-goal theory first appeared in the leadership literature in the early 1970s in the works of Evans (1970), House (1971), House and Dessler (1974), and House and Mitchell (1974). The stated goal of this leadership theory is to enhance employee performance and employee satisfaction by focusing on employee motivation. In brief, path-goal theory is designed to explain how leaders can help subordinates along the path to their goals by selecting specific behaviors that are best suited to subordinates' needs and to the situation in which subordinates are working (Northouse, 2007). House & Mitchell(1974) predicted that although many different leadership behaviors could have been selected to be a part of path-goal theory, this approach has so far examined directive, supportive, participative, and achievement-oriented leadership behaviors. And they suggested that leaders may exhibit any or all of these four styles with various subordinates and in different situations. However, due to restrictive government regulations, franchisors are not in a position to change their leadership style to suit their circumstances. In addition, quoted by Northouse(2007), ssubordinate characteristics determine how a leader's behavior is interpreted by subordinates in a given work context. Many researchers have focused on subordinates' needs for affiliation, preferences for structure, desires for control, and self-perceived level of task ability. In this study, we have focused on the self-perceived level of task ability, namely, the franchisee's self-efficacy. According to Bandura (1977), self-efficacy is chiefly defined as the personal attitude of one's ability to accomplish concrete tasks. Therefore, it is not an indicator of one's actual abilities, but an opinion of the extent of how one can use that ability. Thus, the judgment of maintain franchisee's commitment depends on the situation (e.g., government regulation and policy and leadership style of franchisor) and how it affects one's ability to mobilize resources to deal with the task, so even if people possess the same ability, there may be differences in self-efficacy. Figure 1 illustrates the model investigated in this study. In this model, it was hypothesized that leadership styles would affect the franchisee's commitment, and self-efficacy would moderate the relationship between leadership style and franchisee's commitment. Theoretically, quoted by Northouse(2007), the path-goal approach suggests that leaders need to choose a leadership style that best fits the needs of subordinates and the work they are doing. According to House & Mitchell (1974), the theory predicts that a directive style of leadership is best in situations in which subordinates are dogmatic and authoritarian, the task demands are ambiguous, and the organizational rule and procedures are unclear. In these situations, franchisor's directive leadership complements the work by providing guidance and psychological structure for franchisees. For work that is structured, unsatisfying, or frustrating, path-goal theory suggests that leaders should use a supportive style. Franchisor's Supportive leadership offers a sense of human touch for franchisees engaged in mundane, mechanized activity. Franchisor's participative leadership is considered best when a task is ambiguous because participation gives greater clarity to how certain paths lead to certain goals; it helps subordinates learn what actions leads to what outcome. Furthermore, House & Mitchell(1974) predicts that achievement-oriented leadership is most effective in settings in which subordinates are required to perform ambiguous tasks. Marsh and O'Neill (1984) tested the idea that organizational members' anger and decline in performance is caused by deficiencies in their level of effort and found that self-efficacy promotes accomplishment, decreases stress and negative consequences like depression and emotional instability. Based on the extant empirical findings and theoretical reasoning, we posit positive and strong relationships between the franchisor's leadership styles and the franchisee's commitment. Furthermore, the level of franchisee's self-efficacy was thought to maintain their commitment. The questionnaires sent to participants consisted of the following measures; leadership style was assessed using a 20 item 7-point likert scale developed by Indvik (1985), self-efficacy was assessed using a 24 item 6-point likert scale developed by Bandura (1977), and commitment was assessed using a 6 item 5-point likert scale developed by Morgan & Hunt (1994). Questionnaires were distributed to Korean optical franchisees in Seoul. It took about 20 days to complete the data collection. A total number of 140 questionnaires were returned and complete data were available from 137 respondents. Results of multiple regression analyses testing the relationships between the each of the four styles of leadership shown by the franchisor as independent variables and franchisee's commitment as the dependent variable showed that the relationship between supportive leadership style and commitment ($\beta$=.13, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.07, p<.001)were significant. However, when participants divided into high and low self-efficacy groups, results of multiple regression analyses showed that only the relationship between achievement-oriented leadership style and commitment ($\beta$=.14, p<.001) was significant in the high self-efficacy group. In the low self-efficacy group, the relationship between supportive leadership style and commitment ($\beta$=.17, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.10, p<.001) were significant. The study focused on the franchisee's self-efficacy in order to explore the possibility that regulation, originally intended to protect the franchisee, may not be the most effective method to maintain the relationships in a franchise business. The key results of the data analysis regarding the moderating role of self-efficacy between leadership behavior style as proposed by path-goal and commitment theory were as follows. First, this study proposed that franchisor should apply the appropriate type of leadership behavior to strengthen the franchisees commitment because the results demonstrated that supportive and participative leadership styles by the franchisors have a positive influence on the franchisee's level of commitment. Second, it is desirable for franchisor to validate the franchisee's efforts, since the franchisee's characteristics such as self-efficacy had a substantial, positive effect on the franchisee's commitment as well as being a meaningful moderator between leadership and commitment. Third, the results as a whole imply that the government should provide institutional support, namely to put the franchisor in a position to clearly identify the characteristics of their franchisees and provide reasonable means to administer the franchisees to achieve the company's goal.

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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
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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.

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