• Journal of Venture Innovation
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• v.6 no.1
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• pp.181-198
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• 2023

This study aims to analyze the influence of organizational support perception of workers in medical institutions on intrinsic job motivation, and to check whether there is significance in the mediating effect of work-family conflict and work-family balance factors in this process. The results of empirical analysis through the questionnaire are as follows. First, it was confirmed that organizational support recognition had a significant positive effect on work-family balance as well as intrinsic job motivation, and work-family balance had a significant positive effect on intrinsic job motivation. Second, it was confirmed that organizational support recognition had a significant negative effect on work-family conflict, but work-family conflict had no significant influence on intrinsic job motivation. Third, in order to reduce job stress for medical institution workers, it is necessary to reduce job intensity, assign appropriate workload for ability. And in order to improve manpower operation and job efficiency, Job training and staffing in the right place are needed. Fourth, in order to improve positive organizational support perception and intrinsic job motivation, It is necessary to induce long-term service by providing support and institutional devices to increase attachment to the current job and recognize organizational problems as their own problems with various incentive systems. The limitations of this study and future research directions are as follows. First, it is believed that an expanded analysis of medical institution workers nationwide by region, gender, medical institution, academic, and income will not only provide more valuable results, but also evaluate the quality of medical services. Second, it is necessary to reflect the impact of the work-life balance support system on each employee depending on the environmental uncertainty or degree of competition in the hospital to which medical institution workers belong. Third, organizational support perception will be recognized differently depending on organizational culture and organizational type, and organizational size and work characteristics, working years, and work types, so it is necessary to reflect this. Fourth, it is necessary to analyze various new personnel management techniques such as hospital's organizational structure, job design, organizational support method, motivational approach, and personnel evaluation method in line with the recent change in the government's medical institution policy and the global business environment. It is also considered important to analyze by reflecting recent and near future medical trends.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.18 no.3
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• pp.17-32
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• 2023

In recent years, the need for social ventures that aim to grow while solving social problems through the efficiency and effectiveness of commercial organizations in the market has increased, while there is a limit to how much the government and the public can do to solve social problems. Against this background, the number of social venture startups is increasing in the domestic startup ecosystem, and interest in impact investors, which are investors in social ventures, is also increasing. Therefore, this research utilized judgment analysis technology to objectively analyze the validity and weight of judgment information based on the cognitive process and decision-making environment in the investment decision-making of impact investors. We proceeded with the research by constructing three classifications; first, investment priorities at the initial investment stage for financial benefit and return on investment as an investor, second, the political skills of the entrepreneurs (teams) for the social impact and ripple power, and social venture coexistence and solidarity, third, the social mission of a social venture that meets the purpose of an impact investment fund. As a result of this research, first of all, the investment decision-making priorities of impact investors are the expertise of the entrepreneur (team), the potential rate of return when the entrepreneur (team) succeeds, and the social mission of the entrepreneur (team). Second, impact investors do not have a uniform understanding of the investment decision-making factors, and the factors that determine investment decisions are different, and there are differences in the degree of the weighting. Third, among the various investment decision-making factors of impact investment, "entrepreneur's (team's) networking ability", "entrepreneur's (team's) social insight", "entrepreneur's (team's) interpersonal influence" was relatively lower than the other four factors. The practical contribution through this research is to help social ventures understand the investment determinant factors of impact investors in the process of financing, and impact investors can be expected to improve the quality of investment decision-making by referring to the judgment cases and analysis of impact investors. The academic contribution is that it empirically investigated the investment priorities and weighting differences of impact investors.

• Journal of Korean Dental Hygiene Science
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• v.7 no.1
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• pp.39-52
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• 2024

Background: Dental hygienists provide direct dental care in the closest proximity to the patient, and each practice requires a high level of focus and concentration. These skills are an important human resource that can impact the quality of dental care services. Since more than half of dental clinics provide as overtime work in addition to regular hours, this study aims to determine the association between working overtime and job performance for dental hygienists. Methods: The study was conducted using a combination of online and in-person surveys via Google Forms among 131 employed dental hygienists. The survey consisted of 7 questions on demographic and work characteristics, 16 questions on characteristics related to overtime and the effect of overtime on job security, health, and life, and 10 questions on job performance, for a total of 33 questions. Chi-square analysis and independent samples t-test were used to identify the characteristics of demographic and work characteristics, and descriptive statistics analysis was used for the characteristics of overtime. Independent samples t-test was used to test the difference in the mean of job performance according to whether or not they worked overtime, and linear regression analysis was used to show the association of working overtime and job performance. Results: The study found that 71% of dental clinics worked overtime. The average number of overtime per week was once (78.5%), and the most common problems with overtime were fatigue (52.7%) and lack of personal and leisure time (41.9%). The appropriate number of overtime per week considered by dental hygienists was once a week, which was confirmed to be 94.6%. When comparing job performance by overtime status, those who worked overtime were 3.38 points higher than those who did not (35.45 vs. 32.07). Multiple linear regression analysis of the association of working overtime night and job performance showed that a one-unit increase in worked overtime was associated with a statistically significant increase in job performance of about 3.1 (p<0.01). Conclusion: Working overtime was found to have a positive effect on job performance among dental hygienists. Therefore, as a way to improve the working environment, providing appropriate compensation or welfare for overtime can reduce the negative aspects of overtime and turn it into a positive influence on job performance. This could ultimately raise awareness of the dental hygienist as a professional and effect the efficiency of dental care services.

• Journal of the Korean Geographical Society
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• v.30 no.1
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• pp.68-92
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• 1995

Recentry the structure of the retail trade have been chanaed with its environmantal changes. Some studies may be necessary on the changing process of environment and fundamental structure analyses of the retail trade. This study analyzes the location of retail trades, inhabitants' behavior in retail tredes and their desirable utilization scheme of them in Kwangju-si. Some study methods, contents and coming-out results are as follows: 1. Retail trades can be classified into independent stores, chain-stores (supermarket, voluntary chain and frenchiise system and convenience store), department stores, cooperative associations, traditional, markets mail-order marketing, automatic vending and others by service levels, selling-items, prices, managements, methods of retailing and store or nonstore type. 2. In Kwangju, the environment of retail trades is related to the consumers of population structure: chanes in consumers pattern, trends toward agings and nuclear family, increase of leisur: time and female advances to society. Rapid structural shift in retail trade has also been occurred due to these social changes. Traditionl and premodern markets until 1970s altere to supermarkets or department stores in 1980s, and various types, large enterprises and foreign capitals came into being in 1990s. 3. The locational characteristics of retail trades are resulted from the spatial analysis of the total population distribution, and from the calculation of segregation index in the light of potential demand. The densely-populated areas occurs in newly-built apartment housing complex which is distributed with a ring-shaped pattern around the old urban core. The numbers and rates of the aged over sixty in Kwangsan-gu and the circumference area of Mt.Moodeung, are larger and higher where rural elements are remarkable. A relation between population distribution and retail trade are analysed by the index of population per shop. The index of the population number per shop is lower in urban center, as a whole, being more convenient for consumers. In newly-formed apartment complex areas, on the other, the index more than 1,000 per shop, meeting not the demands for consumers. Because both the younger and the aged are numerous in these areas, the retail trade pattern pertinent to both are needed. Urban fringes including Kwangsan-gu and the vicinity of Mt.Moodeung have some problems owing to the most of population number per shop (more than 1, 500) and the most extensive as well. 4. The regional characteristic of retail trade is analyzed through the location quotient of shops by locational patterns and centerality index. Chungkum-dong is the highest-order central place in CBD. It is the core of retail trades, which has higher-ordered specialty store including three big department stores, supermarkets and large stores. Taegum-dong, Chungsu-dong, Taeui-dong, and Numun-dong that are neiahbored to Chungkum-dong fall on the second group. They have a central commercial section where large chain stores, specialty shopping streets, narrow-line retailing shops (furniture, amusement service, and gallary), supermarkets and daily markets are located. The third group is formed on the axis of state roads linking to Naju-kun, Changseong-kun, Tamyang-kun, Hwasun-kun and forme-Songjeong-eup. It is related to newly, rising apartment housing complex along a trunk road, and characterized by markets and specialty stores. The fourth group has neibourhood-shopping centers including older residential area and Songjeong-eup area with independent stores and supermarkets as main retailing functions. The last group contains inner residential area and outer part of a city including Songjeong-eup. Outer part of miscellaneous shops being occasionally found is rural rather than urban (Fig. 7). 5. The residents' behaviors using retail trade are analyzed by factors of goods and facilities. Department stores are very high level in preference for higher-order shopping-goods such as clothes for full dress in view of both diversity and quality of goods(28.9%). But they have severe traffic congestions, and high competitions for market ranges caused by their sma . 64.0% of respondents make combined purpose trips together with banking and shopping. 6. For more efficiency of retail-trading, it is necessary to induce spatial distribution policy with regard to opportunity frequency of goods selection by central place, frontier regions and age groups. Also we must consider to analyze competition among different types of retail trade and analyze the consumption behaviors of working females and younger-aged groups, in aspects of time and space. Service improvement and the rationalization of management should be accomplished in such as cooperative location (situation) must be under consideration in relations to other functions such as finance, leisure & sports, and culture centers. Various service systems such as installment, credit card and peremium ticket, new used by enterprises, must also be carried service improvement. The rationalization and professionalization in for the commercial goods are bsically requested.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.3
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• pp.234-240
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• 2007

Purpose: In this study we propose a block-iterative method for reconstructing Compton scattered data. This study shows that the well-known expectation maximization (EM) approach along with its accelerated version based on the ordered subsets principle can be applied to the problem of image reconstruction for Compton camera. This study also compares several methods of constructing subsets for optimal performance of our algorithms. Materials and Methods: Three reconstruction algorithms were implemented; simple backprojection (SBP), EM, and ordered subset EM (OSEM). For OSEM, the projection data were grouped into subsets in a predefined order. Three different schemes for choosing nonoverlapping subsets were considered; scatter angle-based subsets, detector position-based subsets, and both scatter angle- and detector position-based subsets. EM and OSEM with 16 subsets were performed with 64 and 4 iterations, respectively. The performance of each algorithm was evaluated in terms of computation time and normalized mean-squared error. Results: Both EM and OSEM clearly outperformed SBP in all aspects of accuracy. The OSEM with 16 subsets and 4 iterations, which is equivalent to the standard EM with 64 iterations, was approximately 14 times faster in computation time than the standard EM. In OSEM, all of the three schemes for choosing subsets yielded similar results in computation time as well as normalized mean-squared error. Conclusion: Our results show that the OSEM algorithm, which have proven useful in emission tomography, can also be applied to the problem of image reconstruction for Compton camera. With properly chosen subset construction methods and moderate numbers of subsets, our OSEM algorithm significantly improves the computational efficiency while keeping the original quality of the standard EM reconstruction. The OSEM algorithm with scatter angle- and detector position-based subsets is most available.

• Journal of Intelligence and Information Systems
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• v.17 no.3
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• pp.63-77
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• 2011

The World Wide Web is a very large distributed digital information space. From its origins in 1991, the web has grown to encompass diverse information resources as personal home pasges, online digital libraries and virtual museums. Some estimates suggest that the web currently includes over 500 billion pages in the deep web. The ability to search and retrieve information from the web efficiently and effectively is an enabling technology for realizing its full potential. With powerful workstations and parallel processing technology, efficiency is not a bottleneck. In fact, some existing search tools sift through gigabyte.syze precompiled web indexes in a fraction of a second. But retrieval effectiveness is a different matter. Current search tools retrieve too many documents, of which only a small fraction are relevant to the user query. Furthermore, the most relevant documents do not nessarily appear at the top of the query output order. Also, current search tools can not retrieve the documents related with retrieved document from gigantic amount of documents. The most important problem for lots of current searching systems is to increase the quality of search. It means to provide related documents or decrease the number of unrelated documents as low as possible in the results of search. For this problem, CiteSeer proposed the ACI (Autonomous Citation Indexing) of the articles on the World Wide Web. A "citation index" indexes the links between articles that researchers make when they cite other articles. Citation indexes are very useful for a number of purposes, including literature search and analysis of the academic literature. For details of this work, references contained in academic articles are used to give credit to previous work in the literature and provide a link between the "citing" and "cited" articles. A citation index indexes the citations that an article makes, linking the articleswith the cited works. Citation indexes were originally designed mainly for information retrieval. The citation links allow navigating the literature in unique ways. Papers can be located independent of language, and words in thetitle, keywords or document. A citation index allows navigation backward in time (the list of cited articles) and forwardin time (which subsequent articles cite the current article?) But CiteSeer can not indexes the links between articles that researchers doesn't make. Because it indexes the links between articles that only researchers make when they cite other articles. Also, CiteSeer is not easy to scalability. Because CiteSeer can not indexes the links between articles that researchers doesn't make. All these problems make us orient for designing more effective search system. This paper shows a method that extracts subject and predicate per each sentence in documents. A document will be changed into the tabular form that extracted predicate checked value of possible subject and object. We make a hierarchical graph of a document using the table and then integrate graphs of documents. The graph of entire documents calculates the area of document as compared with integrated documents. We mark relation among the documents as compared with the area of documents. Also it proposes a method for structural integration of documents that retrieves documents from the graph. It makes that the user can find information easier. We compared the performance of the proposed approaches with lucene search engine using the formulas for ranking. As a result, the F.measure is about 60% and it is better as about 15%.

• Journal of Distribution Science
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• v.9 no.1
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• pp.17-27
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• 2011

As the world becomes more globalized, business competition becomes fiercer, while consumers' needs for less expensive quality products are on the increase. Business operations make an effort to secure a competitive edge in costs and services, and the logistics industry, that is, the industry operating the storing and transporting of goods, once thought to be an expense, begins to be considered as the third cash cow, a source of new income. Logistics centers are central to storage, loading and unloading of deliveries, packaging operations, and dispensing goods' information. As hubs for various deliveries, they also serve as a core infrastructure to smoothly coordinate manufacturing and selling, using varied information and operation systems. Logistics centers are increasingly on the rise as centers of business supply activities, growing beyond their previous role of primarily storing goods. They are no longer just facilities; they have become logistics strongholds that encompass various features from demand forecast to the regulation of supply, manufacturing, and sales by realizing SCM, taking into account marketability and the operation of service and products. However, despite these changes in logistics operations, some centers have been unable to shed their past roles as warehouses. For the continuous development of logistics centers, various measures would be needed, including a revision of current supporting policies, formulating effective management plans, and establishing systematic standards for founding, managing, and controlling logistics centers. To this end, the research explored previous studies on the use and effectiveness of logistics centers. From a theoretical perspective, an evaluation of the overall introduction, purposes, and transitions in the use of logistics centers found issues to ponder and suggested measures to promote and further advance logistics centers. First, a fact-finding survey to establish demand forecast and standardization is needed. As logistics newspapers predicted that after 2012 supply would exceed demand, causing rents to fall, the business environment for logistics centers has faltered. However, since there is a shortage of fact-finding surveys regarding actual demand for domestic logistic centers, it is hard to predict what the future holds for this industry. Accordingly, the first priority should be to get to the essence of the current market situation by conducting accurate domestic and international fact-finding surveys. Based on those, management and evaluation indicators should be developed to build the foundation for the consistent advancement of logistics centers. Second, many policies for logistics centers should be revised or developed. Above all, a guideline for fair trade between a shipper and a commercial logistics center should be enacted. Since there are no standards for fair trade between them, rampant unfair trades according to market practices have brought chaos to market orders, and now the logistics industry is confronting its own difficulties. Therefore, unfair trade cases that currently plague logistics centers should be gathered by the industry and fair trade guidelines should be established and implemented. In addition, restrictive employment regulations for foreign workers should be eased, and logistics centers should be charged industry rates for the use of electricity. Third, various measures should be taken to improve the management environment. First, we need to find out how to activate value-added logistics. Because the traditional purpose of logistics centers was storage and loading/unloading of goods, their profitability had a limit, and the need arose to find a new angle to create a value added service. Logistic centers have been perceived as support for a company's storage, manufacturing, and sales needs, not as creators of profits. The center's role in the company's economics has been lowering costs. However, as the logistics' management environment spiraled, along with its storage purpose, developing a new feature of profit creation should be a desirable goal, and to achieve that, value added logistics should be promoted. Logistics centers can also be improved through cost estimation. In the meantime, they have achieved some strides in facility development but have still fallen behind in others, particularly in management functioning. Lax management has been rampant because the industry has not developed a concept of cost estimation. The centers have since made an effort toward unification, standardization, and informatization while realizing cost reductions by establishing systems for effective management, but it has been hard to produce profits. Thus, there is an urgent need to estimate costs by determining a basic cost range for each division of work at logistics centers. This undertaking can be the first step to improving the ineffective aspects of how they operate. Ongoing research and constant efforts have been made to improve the level of effectiveness in the manufacturing industry, but studies on resource management in logistics centers are hardly enough. Thus, a plan to calculate the optimal level of resources necessary to operate a logistics center should be developed and implemented in management behavior, for example, by standardizing the hours of operation. If logistics centers, shippers, related trade groups, academic figures, and other experts could launch a committee to work with the government and maintain an ongoing relationship, the constraint and cooperation among members would help lead to coherent development plans for logistics centers. If the government continues its efforts to provide financial support, nurture professional workers, and maintain safety management, we can anticipate the continuous advancement of logistics centers.

• The Journal of Korean Philosophical History
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• no.23
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• pp.99-128
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• 2008

This research analyzes some Korean historical figures and presents the core values of their leaderships so that we can bring up the theory of leadership which would be compatible with the current circumstances around Korea. Through this work, we expected that we would not only find out typical examples among historical leaders but also reaffirm our identities in our history. As a result of the research, it was possible to classify some figures in history into several patterns and discover their archetypal qualities. Those qualities were 'transform(實事)', 'challenge(決死)', 'energize(風流)', 'create(創案)', and 'envision(開新)' respectively. Among the qualities, this research concentrated on the quality of 'challenge', exclusively 'death-defying spirit'. This spirit is the one with which historical leaders could sacrifice their lives for their great causes. This research selected twelve figures as incarnations of death-defying spirit, who are Gyebaek(階伯), Ganggamchan(姜邯贊), Euljimundeok(乙支文德), Choeyoung(崔瑩),ChungMongju(鄭夢周), Seongsammun (成三問), Yisunsin(李舜臣), Gwakjaewoo(郭再祐), Choeikhyeon(崔益鉉), Anjunggeun(安重根), Yunbonggil(尹奉吉), Yijun(李儁). Through analyzing their core values and abilities and categorizing some historical cases into four spheres such as a private sphere, relations sphere, a community sphere, and a society sphere, we came to find a certain element in common among those figures. It was that they eventually took the lead by showing the goal and the ideal to their people at all times. Moreover, their goals were always not only obvious but also unwavering. In the second chapter, I described the core value in a private sphere, so called '志靑靑'. It implies that a leader should set his ultimate goal and then try to attain it with an unyielding will. Obvious self-confidence and unfailing self-creed are core values in a private sphere. In the third chapter, I described the core value in a relative sphere, the relationship between one and others. It is '守信結義'. It indicates that a leader should win confidence from others by discharging his duties in the relation with others. Confidence is the highest leveled affection to others. Thus, mutual reliance should be based on truthful sincerity and affection toward others. Stubbornness and strictness are needed not to be prompted by pity simultaneously. In the fourth chapter, I described the core value in a community sphere. It is '丹心合力'. For this value, what are required to a leader are both his community spirit and his loyalty to one's community. Moreover, the strong sense of responsibility and the attitude of taking an initiative among others are also required. Thus, it can be said that the great power to conduct the community is so called fine teamwork. What's more, the attitude of the leader can exert a great influence on his community. In the fifth chapter, I described the core value of death defying spirit in the society sphere. This value might be more definite and explicit than other ones described above. A leader should prepare willingly for one's death to fulfill his great duties. 'What to do' is more important for a leader than 'how to do'. That is to say, a leader should always do righteous things. Efficiency is nothing but one of his interests. A leader must be the one who behaves himself always according to righteousness. Unless a leader's behaviors are based on righteousness, it is absolutely impossible that a leader exerts his leadership toward people very efficiently. Thus, it can be said that a true leader is the one not only who is of morality and but also who tries to fulfill his duties.

• Asia Marketing Journal
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• v.12 no.4
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• pp.27-54
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• 2011

This research attempted to present the efficiency of culture marketing to the organizations producing culture-art products and to the companies utilizing art and suggest the practical viewpoints to the culture and art policy agencies. The methodology used was to take an in-depth look at the consumer value cognition and benefits of culture-art products in contemporary consumption culture from a social context by conducting a total of 12 Focus Group Interviews, consisting of 58 males and females in their 10s~50s who can represent culture-art product consumers. The culture-art products refer to the artist's spiritual, actual act of creating or to the end products with economic exchange value. They are also sense goods and merit goods that affect the mental state of consumers. By looking at culture-art products as consumer merit goods, this research examined consumer value cognition of culture-art products based on the characteristics culture-art products. As a result, this research determined that consumers view culture-art products largely as 'aesthetic and sensuous merit goods', 'actual and individual merit goods', and 'social public property'. As 'aesthetic and sensuous merit goods', culture-art products are considered as the products of an artist's creative activities; as 'social public property', culture-art products have a public value in terms of ownership; and as 'actual and individual merit goods', culture-art products act on the spirit and reality of a consumer in terms of consumption. As a result of analyzing the benefits of culture-art products based on the above-mentioned consumer value cognition, it was observed that the benefits of culture-art-product consumption are chiefly divided into 'aesthetic character-oriented', 'social relationships-oriented', and 'individual benefits-oriented' depending on how consumers see culture-art products. A 3-conceptional structures model was constructed according to the relationship between consumer value cognition of culture-art products and the benefits. This research revealed that consumers who pursue the aesthetic value or sense of beauty as the central reason experience culture-art products themselves, enjoy intellectual quests, and pursue their satisfaction by expressing affection for and interests in culture-art products. On the other hand, consumers who pursue social value as the central reason as a means of communication by perceiving culture-art products as a public property of society, pursue sympathy with people close to them through the symbolic power of culture-art product consumption or the joy of self-display. Consumers who perceive art products as spiritual and actual merit goods and pursue consumer value as a central reason want to express their own personality, develop themselves, and differentiate themselves or identify themselves with others in the context of social relations for the ultimate goal of living a happy and satisfied life while pursuing to satisfy imminent and actual necessities as emotional stability and rest. The fact that culture-art product benefits could vary according to how a consumer perceives them implies that consumer value cognition of culture-art products and their benefits significant affect consumers' decision in choosing and consuming various culture-art products. It turned out that such benefits from the consumption of culture-art products reflect the complex contemporary consumption culture of rational consumption, symbolic consumption, experiential consumption, and social reflective consumption. This research identified conceptional structures of consumer value cognition on culture-art products and benefits that can be used for studying and understanding culture-art products consumers who pursue a variety of consumption values. They can also be used by private companies in utilizing art, as well as by national agencies in enhancing the population's quality of life. However, since this research could only conceptually grasp consumer perception of culture-art products and reveal the dimension of classification due to its own limitations arising from characteristic investigation, quantitative data on the benefits of culture-art product consumers should be measured in future studies through a quantitative investigation, while using the value cognition of culture-art products and the individual characteristics of consumers as variables based on this research.

• 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.