• 한국노년학
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• v.29 no.4
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• pp.1361-1381
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• 2009

There have lately been a variety of social issues in our society due to rapid social changes. Specifically, how to approach elderly people who suffer from dementia is never an easy task, and few in-depth studies have ever focused on their quality of life due to that. The purpose of this study was to examine the quality of life of elderly people with dementia and the relationship between their quality of life and the environments of facilities for them in an attempt to lay the foundation for the development of compatible programs tailored to the environments of the facilities and for relevant policy setting. It's ultimately meant to improve the quality of life of the elderly with dementia and the environments of facilities for them. The subjects in this study were elderly people with dementia who were housed in senior residential and medical welfare facilities in Daegu and Gyeongsangbukdo. The collected data were analyzed with a SPSS 12.0 program, and frequency analysis, cross-tabs and multiple logistic regression analysis were utilized. As a result, facility environments were identified as one of the variables that had a significant impact on the quality of life of the elderly people with dementia. There are some suggestions about how to boost their quality of life: First, good environments should be prepared in consideration of the characteristics of elderly people with dementia in order for themto be satisfied with their own quality of life, and the way of looking at their potentials should be changed. Second, it's found that main caregivers affected the quality of life of the elderly people with dementia, and the kind of programs that focus on the improvement of the relationship between elderly people with dementia and their main caregivers is required. Third, there should be a change in the environments of the facilities. The facilities should be well equipped to successfully respond to the symptoms of elderly people with dementia. To redress their poor accessibility to the facilities, infrastructure involving nursing homes and professional personnels should be built by utilizing the Internet, and the facilities and local community should make concerted efforts to provide quality care to elderly people in want of it.

• Journal of Wetlands Research
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• v.25 no.4
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• pp.353-365
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• 2023

The effects of climate change on green infrastructure and environmental media remain uncertain and context-specific despite numerous climate projections globally. In this study, the extreme weather conditions in seven major cities in South Korea were characterized through statistical analysis of 20-year daily meteorological data extracted fro m the Korea Meteorological Administration (KMA). Additionally, the impacts of extreme weather on Nature-based Solutions (NbS) were determined through a comprehensive review. The results of the statistical analysis and comprehensive review revealed the studied cities are potentially vulnerable to varying extreme weather conditions, depending on geographic location, surface imperviousness, and local weather patterns. Temperature extremes were seen as potential threats to the resilience of NbS in Seoul, as both the highest maximum and lowest minimum temperatures were observed in the mentioned city. Moreover, extreme values for precipitation and maximum wind speed were observed in cities from the southern part of South Korea, particularly Busan, Ulsan, and Jeju. It was also found that extremely low temperatures induce the most impact on the resilience of NbS and environmental media. Extremely cold conditions were identified to reduce the pollutant removal efficiency of biochar, sand, gravel, and woodchip, as well as the nutrient uptake capabilities of constructed wetlands (CWs). In response to the negative impacts of extreme weather on the effectiveness of NbS, several adaptation strategies, such as the addition of shading and insulation systems, were also identified in this study. The results of this study are seen as beneficial to improving the resilience of NbS in South Korea and other locations with similar climate characteristics.

• Journal of agricultural medicine and community health
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• v.49 no.1
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• pp.37-49
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• 2024

Objectives: This study aimed to explore whether there are differences in smoking status between two regions of Wonju-City and Chuncheon-City, Gangwon State, and to determine whether the experience of smoking cessation programs in the region affects quit attempts. Methods: The study design was a cross-sectional study in which adults aged 19 and older living in two cities were surveyed using a pre-developed mobile app to investigate social capital for smoking cessation, and a total of 600 citizens were participated, including 310 in Wonju-City and 290 in Chuncheon-City. The statistical analysis was conducted using chi-square test and logistic regression analysis. Results: Wonju-City had a higher prevalence of current smoking than Chuncheon-City. Among smoking cessation programs operated by local public health centers, Wonju-City had a lower odds ratio for experience with smoking cessation education than Chuncheon-City (OR=0.52, 95% CI=0.33 to 0.81). When examining the effect of smoking cessation program experience on quit attempts, in Wonju-City, citizens who had completed smoking cessation education and used a smoking cessation clinic were more likely to attempt to quit than those who had not (OR=2.31 and OR=2.29, respectively). In Chuncheon-City, citizens who were aware of smoking cessation support services were 2.26 times more likely to attempt to quit smoking than those who were not, but statistical significance was not reached due to the small sample size. Conclusion: Therefore, healthcare organizations in both regions should develop more practical intervention strategies to increase smokers' quit attempts, reduce smoking rates in the community, and address regional disparities.

• Journal of Global Scholars of Marketing Science
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• v.20 no.3
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• pp.231-238
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• 2010

The anthropomorphism of brands, defined as seeing human beings in brands (Puzakova, Kwak, and Rosereto, 2008) is the focus of this study. Specifically, the research objective is to understand the ways in which brands are rendered humanlike. By analyzing consumer readings of stories found on food product packages we intend to show how marketers and consumers humanize a spectrum of brands and create meanings. Our research question considers the possibility that a single brand may host multiple or single meanings, associations, and personalities for different consumers. We start by highlighting the theoretical and practical significance of our research, explain why we turn our attention to packages as vehicles of brand meaning transfer, then describe our qualitative methodology, discuss findings, and conclude with a discussion of managerial implications and directions for future studies. The study was designed to directly expose consumers to potential vehicles of brand meaning transfer and then engage these consumers in free verbal reflections on their perceived meanings. Specifically, we asked participants to read non-nutritional stories on selected branded food packages, in order to elicit data about received meanings. Packaging has yet to receive due attention in consumer research (Hine, 1995). Until now, attention has focused solely on its utilitarian function and has generated a body of research that has explored the impact of nutritional information and claims on consumer perceptions of products (e.g., Loureiro, McCluskey and Mittelhammer, 2002; Mazis and Raymond, 1997; Nayga, Lipinski and Savur, 1998; Wansik, 2003). An exception is a recent study that turns its attention to non-nutritional packaging narratives and treats them as cultural productions and vehicles for mythologizing the brand (Kniazeva and Belk, 2007). The next step in this stream of research is to explore how such mythologizing activity affects brand personality perception and how these perceptions relate to consumers. These are the questions that our study aimed to address. We used in-depth interviews to help overcome the limitations of quantitative studies. Our convenience sample was formed with the objective of providing demographic and psychographic diversity in order to elicit variations in consumer reflections to food packaging stories. Our informants represent middle-class residents of the US and do not exhibit extreme alternative lifestyles described by Thompson as "cultural creatives" (2004). Nine people were individually interviewed on their food consumption preferences and behavior. Participants were asked to have a look at the twelve displayed food product packages and read all the textual information on the package, after which we continued with questions that focused on the consumer interpretations of the reading material (Scott and Batra, 2003). On average, each participant reflected on 4-5 packages. Our in-depth interviews lasted one to one and a half hours each. The interviews were tape recorded and transcribed, providing 140 pages of text. The products came from local grocery stores on the West Coast of the US and represented a basic range of food product categories, including snacks, canned foods, cereals, baby foods, and tea. The data were analyzed using procedures for developing grounded theory delineated by Strauss and Corbin (1998). As a result, our study does not support the notion of one brand/one personality as assumed by prior work. Thus, we reveal multiple brand personalities peacefully cohabiting in the same brand as seen by different consumers, despite marketer attempts to create more singular brand personalities. We extend Fournier's (1998) proposition, that one's life projects shape the intensity and nature of brand relationships. We find that these life projects also affect perceived brand personifications and meanings. While Fournier provides a conceptual framework that links together consumers’ life themes (Mick and Buhl, 1992) and relational roles assigned to anthropomorphized brands, we find that consumer life projects mold both the ways in which brands are rendered humanlike and the ways in which brands connect to consumers' existential concerns. We find two modes through which brands are anthropomorphized by our participants. First, brand personalities are created by seeing them through perceived demographic, psychographic, and social characteristics that are to some degree shared by consumers. Second, brands in our study further relate to consumers' existential concerns by either being blended with consumer personalities in order to connect to them (the brand as a friend, a family member, a next door neighbor) or by distancing themselves from the brand personalities and estranging them (the brand as a used car salesman, a "bunch of executives.") By focusing on food product packages, we illuminate a very specific, widely-used, but little-researched vehicle of marketing communication: brand storytelling. Recent work that has approached packages as mythmakers, finds it increasingly challenging for marketers to produce textual stories that link the personalities of products to the personalities of those consuming them, and suggests that "a multiplicity of building material for creating desired consumer myths is what a postmodern consumer arguably needs" (Kniazeva and Belk, 2007). Used as vehicles for storytelling, food packages can exploit both rational and emotional approaches, offering consumers either a "lecture" or "drama" (Randazzo, 2006), myths (Kniazeva and Belk, 2007; Holt, 2004; Thompson, 2004), or meanings (McCracken, 2005) as necessary building blocks for anthropomorphizing their brands. The craft of giving birth to brand personalities is in the hands of writers/marketers and in the minds of readers/consumers who individually and sometimes idiosyncratically put a meaningful human face on a brand.

• Journal of Intelligence and Information Systems
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• v.16 no.3
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• pp.77-97
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• 2010

Market timing is an investment strategy which is used for obtaining excessive return from financial market. In general, detection of market timing means determining when to buy and sell to get excess return from trading. In many market timing systems, trading rules have been used as an engine to generate signals for trade. On the other hand, some researchers proposed the rough set analysis as a proper tool for market timing because it does not generate a signal for trade when the pattern of the market is uncertain by using the control function. The data for the rough set analysis should be discretized of numeric value because the rough set only accepts categorical data for analysis. Discretization searches for proper "cuts" for numeric data that determine intervals. All values that lie within each interval are transformed into same value. In general, there are four methods for data discretization in rough set analysis including equal frequency scaling, expert's knowledge-based discretization, minimum entropy scaling, and na$\ddot{i}$ve and Boolean reasoning-based discretization. Equal frequency scaling fixes a number of intervals and examines the histogram of each variable, then determines cuts so that approximately the same number of samples fall into each of the intervals. Expert's knowledge-based discretization determines cuts according to knowledge of domain experts through literature review or interview with experts. Minimum entropy scaling implements the algorithm based on recursively partitioning the value set of each variable so that a local measure of entropy is optimized. Na$\ddot{i}$ve and Booleanreasoning-based discretization searches categorical values by using Na$\ddot{i}$ve scaling the data, then finds the optimized dicretization thresholds through Boolean reasoning. Although the rough set analysis is promising for market timing, there is little research on the impact of the various data discretization methods on performance from trading using the rough set analysis. In this study, we compare stock market timing models using rough set analysis with various data discretization methods. The research data used in this study are the KOSPI 200 from May 1996 to October 1998. KOSPI 200 is the underlying index of the KOSPI 200 futures which is the first derivative instrument in the Korean stock market. The KOSPI 200 is a market value weighted index which consists of 200 stocks selected by criteria on liquidity and their status in corresponding industry including manufacturing, construction, communication, electricity and gas, distribution and services, and financing. The total number of samples is 660 trading days. In addition, this study uses popular technical indicators as independent variables. The experimental results show that the most profitable method for the training sample is the na$\ddot{i}$ve and Boolean reasoning but the expert's knowledge-based discretization is the most profitable method for the validation sample. In addition, the expert's knowledge-based discretization produced robust performance for both of training and validation sample. We also compared rough set analysis and decision tree. This study experimented C4.5 for the comparison purpose. The results show that rough set analysis with expert's knowledge-based discretization produced more profitable rules than C4.5.

• Journal of Intelligence and Information Systems
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• v.24 no.4
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• pp.1-32
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• 2018

In addition to stakeholders including managers, employees, creditors, and investors of bankrupt companies, corporate defaults have a ripple effect on the local and national economy. Before the Asian financial crisis, the Korean government only analyzed SMEs and tried to improve the forecasting power of a default prediction model, rather than developing various corporate default models. As a result, even large corporations called 'chaebol enterprises' become bankrupt. Even after that, the analysis of past corporate defaults has been focused on specific variables, and when the government restructured immediately after the global financial crisis, they only focused on certain main variables such as 'debt ratio'. A multifaceted study of corporate default prediction models is essential to ensure diverse interests, to avoid situations like the 'Lehman Brothers Case' of the global financial crisis, to avoid total collapse in a single moment. The key variables used in corporate defaults vary over time. This is confirmed by Beaver (1967, 1968) and Altman's (1968) analysis that Deakins'(1972) study shows that the major factors affecting corporate failure have changed. In Grice's (2001) study, the importance of predictive variables was also found through Zmijewski's (1984) and Ohlson's (1980) models. However, the studies that have been carried out in the past use static models. Most of them do not consider the changes that occur in the course of time. Therefore, in order to construct consistent prediction models, it is necessary to compensate the time-dependent bias by means of a time series analysis algorithm reflecting dynamic change. Based on the global financial crisis, which has had a significant impact on Korea, this study is conducted using 10 years of annual corporate data from 2000 to 2009. Data are divided into training data, validation data, and test data respectively, and are divided into 7, 2, and 1 years respectively. In order to construct a consistent bankruptcy model in the flow of time change, we first train a time series deep learning algorithm model using the data before the financial crisis (2000~2006). The parameter tuning of the existing model and the deep learning time series algorithm is conducted with validation data including the financial crisis period (2007~2008). As a result, we construct a model that shows similar pattern to the results of the learning data and shows excellent prediction power. After that, each bankruptcy prediction model is restructured by integrating the learning data and validation data again (2000 ~ 2008), applying the optimal parameters as in the previous validation. Finally, each corporate default prediction model is evaluated and compared using test data (2009) based on the trained models over nine years. Then, the usefulness of the corporate default prediction model based on the deep learning time series algorithm is proved. In addition, by adding the Lasso regression analysis to the existing methods (multiple discriminant analysis, logit model) which select the variables, it is proved that the deep learning time series algorithm model based on the three bundles of variables is useful for robust corporate default prediction. The definition of bankruptcy used is the same as that of Lee (2015). Independent variables include financial information such as financial ratios used in previous studies. Multivariate discriminant analysis, logit model, and Lasso regression model are used to select the optimal variable group. The influence of the Multivariate discriminant analysis model proposed by Altman (1968), the Logit model proposed by Ohlson (1980), the non-time series machine learning algorithms, and the deep learning time series algorithms are compared. In the case of corporate data, there are limitations of 'nonlinear variables', 'multi-collinearity' of variables, and 'lack of data'. While the logit model is nonlinear, the Lasso regression model solves the multi-collinearity problem, and the deep learning time series algorithm using the variable data generation method complements the lack of data. Big Data Technology, a leading technology in the future, is moving from simple human analysis, to automated AI analysis, and finally towards future intertwined AI applications. Although the study of the corporate default prediction model using the time series algorithm is still in its early stages, deep learning algorithm is much faster than regression analysis at corporate default prediction modeling. Also, it is more effective on prediction power. Through the Fourth Industrial Revolution, the current government and other overseas governments are working hard to integrate the system in everyday life of their nation and society. Yet the field of deep learning time series research for the financial industry is still insufficient. This is an initial study on deep learning time series algorithm analysis of corporate defaults. Therefore it is hoped that it will be used as a comparative analysis data for non-specialists who start a study combining financial data and deep learning time series algorithm.

• Journal of Intelligence and Information Systems
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• v.26 no.4
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• pp.149-171
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• 2020

The period at university is to make decision about getting an actual job. As our society develops rapidly and highly, jobs are diversified, subdivided, and specialized, and students' job preparation period is also getting longer and longer. This study analyzed the log data of college students to see how the various activities that college students experience inside and outside of school might have influences on employment. For this experiment, students' various activities were systematically classified, recorded as an activity data and were divided into six core competencies (Job reinforcement competency, Leadership & teamwork competency, Globalization competency, Organizational commitment competency, Job exploration competency, and Autonomous implementation competency). The effect of the six competency levels on the employment status (employed group, unemployed group) was analyzed. As a result of the analysis, it was confirmed that the difference in level between the employed group and the unemployed group was significant for all of the six competencies, so it was possible to infer that the activities at the school are significant for employment. Next, in order to analyze the impact of the six competencies on the qualitative performance of employment, we had ANOVA analysis after dividing the each competency level into 2 groups (low and high group), and creating 6 groups by the range of first annual salary. Students with high levels of globalization capability, job search capability, and autonomous implementation capability were also found to belong to a higher annual salary group. The theoretical contributions of this study are as follows. First, it connects the competencies that can be extracted from the school experience with the competencies in the Human Resource Management field and adds job search competencies and autonomous implementation competencies which are required for university students to have their own successful career & life. Second, we have conducted this analysis with the competency data measured form actual activity and result data collected from the interview and research. Third, it analyzed not only quantitative performance (employment rate) but also qualitative performance (annual salary level). The practical use of this study is as follows. First, it can be a guide when establishing career development plans for college students. It is necessary to prepare for a job that can express one's strengths based on an analysis of the world of work and job, rather than having a no-strategy, unbalanced, or accumulating excessive specifications competition. Second, the person in charge of experience design for college students, at an organizations such as schools, businesses, local governments, and governments, can refer to the six competencies suggested in this study to for the user-useful experiences design that may motivate more participation. By doing so, one event may bring mutual benefits for both event designers and students. Third, in the era of digital transformation, the government's policy manager who envisions the balanced development of the country can make a policy in the direction of achieving the curiosity and energy of college students together with the balanced development of the country. A lot of manpower is required to start up novel platform services that have not existed before or to digitize existing analog products, services and corporate culture. The activities of current digital-generation-college-students are not only catalysts in all industries, but also for very benefit and necessary for college students by themselves for their own successful career development.

• Asia Marketing Journal
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• v.12 no.2
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• pp.27-52
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• 2010

It is not new that today's business organizations are expected to exhibit ethical and moral management and to carry out social responsibility as a good corporate citizen. Since South Korea emerged as a newly industrialized country during the 1980s, Korean corporations have become active in carrying out their social responsibility as a good corporate citizen to society. In spite of the short history of corporate social responsibility, Korean companies have actively participated in corporate philanthropy. Corporations' significant donations to various social causes, no-lay-off policies, corporate volunteerism and green marketing are evidences of their commitment to corporate citizenship. Corporate social responsibility is now an essential management practice whereby corporation can strengthen its sustainable value creation processes by enhancing the trust assets underlying the relationships between the business and the stakeholders. Much of the conceptual work in the area of corporate social responsibility(CSR) has originated from researches conducted in the management field. Carroll(1979) proposed that corporations have four types of social responsibilities: economic, legal, ethical and philanthropic responsibility. Most past research has investigated CSR and its impact on consumers' attitudes toward the corporations and corporate performances. Although there exists a large body of literature on how consumers perceive and respond to CSR, the majority of past studies were conducted in the United States. The stability and applicability of past findings need to be tested across different national/cultural settings, especially since corporate social responsibility is a reflection of implicit conformation with the expectations and criticism that society may have toward a corporation(Matten and Moon, 2004). In this study, we explored whether people in Korea perceive CSR of Korean corporations in the same four dimensions as done in the United States and what were the measurement items tapping each of these four dimensions. In order to investigate the dimensions of CSR and the measurement items for CSR perceived by Korean people, nine focus group interviews were conducted with several stakeholder groups(two with undergraduate students, two with graduate students, three with general consumers, and two with NGO groups). Scripts from the interviews revealed that the Korean stakeholders perceived four types of CSR which are the same as those proposed by Carroll(1979). However we found CSR issues unique to Korean corporations. For example for the economic responsibility, Korean people mentioned that the corporation needed to contribute to the economic development of the country by generating corporate profits. For the legal responsibility, Koreans included the "corporation need to follow the consumer protection law." For the ethical responsibility, they considered that the corporation needed to not promote false advertisement. In addition, Koreans thought that an ethical company should do transparent management. For the philanthropic responsibility, people in Korea thought that a corporation needed to return parts of its profits to the society for the betterment of society. The 28 items were developed based on the results of the nine focus group interviews, while considering the scale developed by Maignan and Ferrell(2001). Following the procedure proposed by Churchill(1979), we started by developing an item poll consisting of 28 items and purified the initial pool of items through exploratory, confirmatory factor analyses. 176 samples were sued for this analysis. Confirmatory factor analysis was performed on the 28 items in order to verify the underlying four factor structure. Study 1 provided new measurement items for tapping the Korean CSR dimensions, which can be useful for the future studies exploring the effects of CSR on Korean consumers' attitudes toward the corporations and corporate performances. And we found the CSR scale(17 items) has good reliability, discriminant validity and nomological validity. Economic Responsibility: "XYZ company continuously improves the quality of our products", "XYZ company has a procedure in place to respond to customer complaint", "XYZ company contributes to the economic development of our country by generating profits", "XYZ company is eager to hire people". Legal Responsibility: "XYZ company's products meet legal standards", "XYZ company seeks to comply with all laws regulating hiring and employee benefits", "XYZ company honors contractual obligations to its suppliers", "XYZ company's managers try to comply with the law related to the business operation". Ethical Responsibility: "XYZ company has a comprehensive code of conduct", "XYZ company does not promote a false or misleading advertisement", "XYZ company seems to conduct a transparent business", "XYZ company does a fair business with its suppliers or sub-contractors". Philanthropic Responsibility: "XYZ company encourages partnerships with local businesses and schools", "XYZ company supports sports and cultural activities", "XYZ company gives adequate contributions to charities considering its business size", "XYZ company encourages employees to support our community". Study 2 was condusted for comprehensive validity. 655 samples were used for this anlysis. Collected samples were tested by factor analysis and Crnbach's Alpha coefficiednts and were found to be satisfactory in terms of validity and reliability. Furthermore, fitness of the measurement model was tested by using conformatory factor analysis. χ²=880.73(df=160), GFI=0.891, AGFI=0.854, NFI=0.908, NNFI=0.913, RMR=0.059, RMESA=0.070. We hope that CSR scale could greatly facilitate research on Corporate social resposibility, it is by no means the final answer.

• 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.

• 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.