• 한국시조학회지:시조학논총
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• 제24집
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• pp.5-46
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• 2006

시조는 발생초기부터 당대의 역사 시대적 배경에 따라 그 틀과 내용이 조금씩 변하면서 융통성 있고 유연하게 적응해 왔다. 이런 점이 당대의 시대적 배경이나 사상, 실태 등을 반영해서 당시의 독자들의 공감대를 이끌어낼 수 있었으며, 그러면서도 시조를 시조답게 하는 시조성만은 그대로 고수해 왔기에 '시조'라는 장르가 현재까지도 생존할 수 있었다. 어느 시대나 어떤 배경에서나 어떤 상황에서도 3장이라는 정형성은 지켜졌으며, 3, 3조나 3, 4조를 유지했고, 또 종장의 첫 구 3자도 고수했다. 이러한 시조성은 시대적인 간극에도 불구하고 '시조'라는 공분모 안에 모두 수렴시킬 수 있는 동인을 마련했다. 한국시가에 있어서 시조는, 공적 기능에서 사적 기능으로 변모가 이루어진 최초의 양식으로서. 그 변이과정을 살펴본 결과. 고려말${\sim}$조선조의 평시조는 그 당시 조류에 부합해서 시조 텍스트를 재도지기(載道之器)로 보아 이중적인 의미의 채색, 상징성 부여, 다채로운 문장 수식 등은 나타나지 않지만, 명천도(明天道) 정인륜(正人倫) 지향하는 성현의 가르침을 온유돈후(溫柔敦厚)하게 나타내고자 노력했다. 주제는 주로 그 당시 상황과 부합되는, 송축, 절의, 정쟁, 훈민, 한정, 강호도가, 안빈낙도, 애정 등이었다. 조선조 후기에 오면서는 사설시조(辭說時調)가 활성화하기 시작한다. 사림파의 득세와 양란(兩亂), 실학의 도입 등으로 조선조 후기에는 인식의 변화를 겪게 되었고, 이러한 변화가 시가 양식에도 적용되었기 때문이다. 결국 사설시조는 당대의 봉건주의 파괴, 유교적 모랄에 대한 반발, 근대적 특성 보유 남녀평등등 사상, 지배층에 대한 고발 및 저항정신 둥이 주축을 이루게 된다. 그러므로 저항적 리얼리즘적 현실지향적인 성향을 띠며 특히 고발문학 저항문학의 지반을 형성하는 장르적 특성을 지니고 있었다. 또한 무엇보다도 잡다한 일상사에 대한 상세한 묘사와 현실 생활에 대한 깊은 관심, 그에 대한 사실적, 구체적 표현은 사실주의 정신의 매개항이 된다는 점에서 근대성이 반영되어 있다고 보았다. 1905년 이후 신문에, 형식이나 내용 등, 여러 가지 측면에서 기존의 평시조나 사설시조에서 변이된 형태를 취하는 일군의 시조가 등장했다. 변이된 형태는 시조 텍스트의 형식과 내용뿐만이 아니라, 수용적 측면에서도 일어났다. 이때부터 시조는 '읊고 부르는 형태'에서 주로 '읽는 기록물'로 인식되기 시작하기 때문이다. 변이 된 시조 형태란, 당대의 시대를 풍자하는 '흥, 내지 흐응'이 삽입된 것, 종장의 어미가 생략된 것 등을 말한다 이러한 형식은 긴박한 상태를 효과적으로 전달할 수 있다는 특성을 지니기는 하지만, 고시조의 틀, 즉 율격이나 자수에서 많이 이탈되어서인지, 그 생명은 길지 못했다. 그러다가 1920년대 중반을 기점으로 해서 시조부흥운동이 일어나면서부터 시조 창작은 다시 활기를 띠게 되는데, 시조부흥운동은 최남선에 의해 주도되었다. 시작(詩作) 초기에는 서구지향의 시와 시조들 병행해서 쓰던 육당 최남선이, '조선국민문학(朝鮮國民文學)으로서의시조(時調)'라는 글을 통해 시조의 중요성과, 소중함을 언급하면서 시조부흥 운동을 선도한다. 그는 시조집, '백팔번뇌'도 출간하는데. 그의 전 시조집을 관통하는 것은 '조국 사랑'이라는 일 주제였다. 결국 육당은 고시조를 민족정신의 일환으로 보고, 시조양식을 채택하여 그 당시의 역사 사회적인 상황에 부합되는 주제를 표출한다. 결국 육당도 시조 텍스트를 재도지기(載道之器)로 여겼음을 알 수 있었다. 현대의 시조는 현대성(現代性)과 시조성(時調性)을 모두 만족시켜야 한다는 어려움을 지니고 있는데, 이는 전자에만 치중한다면 자유시와의 변별성이 문제가 되며, 후자를 고수하려니 고루하고. 시적 묘미가 없다는 비난을 감수해야만 하기 때문이다. 그래도 많은 작가들에 의해 평시조가 지속되고 있다는 것은 시조가 지니는 원형성에 대한 매력을 감지해서일 것이라고 보았다. 그들 중 특히 선정주의 작품에 주목했는데, 그 이유는 여러 가지이지만 특히 근대의식, 사회비판정신, 고발의식, 사실주의 정신 구현, 서민의식, 산문체 ·일상어 지향 등, 사설시조의 특징 및 성향을 잘 구현, 반영하면서 그 맥을 잇고 있고 있다는 점 때문이었다 이렇듯이 현대의 시조 작가들은 우리의 고시가 형식을 다양하게 선택해서 다양한 주제를 표출하고 있었다. 여기서 추정할 수 있는 사실은 이러한 시조의 유연성은 앞으로 시조의 생명을 항구적으로 할 것이라는 것, 그리고 역사 시대적 변화와 상황 하에서 다시 새로운 양상을 취할 가능성을 보인다는 것, 그리고 이 '시조'는 한국인의 '영원한 정형시 장르'로 남을 것이라는 사실이었다.

• 중소기업연구
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• 제33권4호
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• pp.77-93
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• 2011

본 연구는 최근 사회경제적 이슈가 되고 있는 동반성장의 개념과 실천 방향에 대해 논의하고자 한다. 이를 위해 동반성장의 정책적 개념을 살펴보고 유사한 개념인 상생협력과 공생발전과도 비교 분석하고자 한다. 또한 동반성장을 통해 글로벌 경쟁력을 만들어 낸 선진국 사례들로부터 교훈을 찾아내고 우리의 사회 문화적 특성에 맞는 한국형 모델을 제안하고자 한다. 한국형 동반성장 모델은 미국의 시장중심형, 일본의 문화기반형, 유럽의 정책주도형 등의 장점을 융합할 필요가 있다. 이를 위해 한국형 모델은 공동체적 에너지를 창출해내는 한국인의 잠재력 활용, 통제와 자율의 융합형 제도 개선, 미래지향적 협력관계를 위한 기업들의 행동변화 등 세 가지 요인을 핵심으로 할 필요가 있다. 한국형 모델의 실현을 위해 필요한 정부의 역할과 과제, 그리고 동반성장위원회의 역할에 대해서도 논의하고자 한다.

• 미술자료
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• 제104권
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• pp.40-69
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• 2023

본고는 조형적으로 일반 그릇과 차별화되는 청자 주기의 형태에 주목하여 왕실 연례 문화와의 관계를 조명하고 조형적 상징성과 시기별 조합의 변화를 살펴보았다. 『고려사(高麗史)』 세가(世家)에서 확인되는 국왕의 재위별, 연례의 유형별 설행 횟수와 설행 목적을 통해서 청자 주기와의 관련성을 살펴보았다. 왕실 연례는 군신(君臣) 간의 위계질서를 확립하고 유대감을 구축하는 왕권 강화의 수단이자 왕의 업적과 성덕을 찬양하여 국왕의 권위와 능력을 보여 주는 통치 행위이기도 하였다. 왕실 연례의 설행 횟수는 실제 왕권 강화를 시도했던 예종대(1105~1122), 의종대(1146~1170), 충렬왕대(1274~1308), 공민왕대(1351~1374)에 늘어나는 상황을 볼 수 있었다. 왕실 연례의 설행이 급증하고 연례 문화가 바뀌는 예종대와 충렬왕대를 기점으로 청자 주기의 기종 및 조형이 변화하는 상황에 주목하였다. 연례에서 국왕과 신하는 다양한 음주 행위를 통해서 국왕의 장수를 기원하거나 태평한 시절을 찬미하였기 때문에 술을 담고 따르는 주기의 조형은 시각적 상징성이 강조될 수밖에 없다. 연례에서 음주 방법은 국왕이 신하에게 또는 신하가 국왕에게 직접 술을 따르기 때문에 주자와 잔의 조형은 참석자들에게 시각적으로 큰 효과가 있었다. 따라서 12세기에 신선, 난(鸞), 귀룡, 어룡, 호로병 등의 도교적 소재나 황촉규와 같은 유교적 소재가 청자 주자와 잔으로 조형화되는 현상은 국왕에 대한 송축(頌祝)과 충성, 불로장생을 기원하는 연례의 목적이 시각화된 것으로 볼 수 있다. 특히 연례에서 부르는 헌선도(獻仙桃)나 환궁악(還宮樂)의 내용이 청자 주기의 조형과 일치하는 점이 주목되었다. 연례에서 사용하는 당악(唐樂)의 가사는 국왕의 불로(不老), 난로(難老), 장생(長生)을 기원하고 왕업의 번창과 태평성대의 모습을 표현하였다. 이러한 가사 내용이 국립중앙박물관 소장 <청자 인물형 주자>나 시카고미술관 소장 <청자 승난인물형 주자> 등의 조형에 반영되었다. 주기의 조형에 연례 문화의 일면이 시각화된 사례는 고려청자에서만 볼 수 있는 특징이다. 주기의 조합은 연례의 분위기나 술의 종류에 따라서 시기별로 변화를 보인다. 고려가 몽골제국으로 편입된 이후에 새로운 술이 유입되고 연례 문화가 변화하면서 주기의 용도와 조합에 큰 변화가 있었다. 충렬왕대부터 원 황실의 영향으로 왕과 공주가 함께 연례를 개최하거나 몽고식 연회인 보르차연[孛兒扎宴]이 열리고 몽고 여인들이 쓰는 고고관(姑姑冠)을 쓰고 연회를 여는 변화를 볼 수 있다. 충렬왕대에 연례 문화가 변하기도 하지만 설행 횟수가 132회로 급증하는 것은 원 황실 공주와의 혼인으로 인한 왕권 강화의 측면도 있다. 급증한 연례에서 이전에는 없었던 포도주, 동락(湩酪), 소주 등의 새로운 술과 함께 고족배(高足杯), 옥호춘병, 이(匜), 용두잔 등 신기종의 청자 주기가 등장하였다. 새롭게 나타난 청자 주기는 모두 원 황실이나 몽골제국의 일원인 칸국에서 사용된 금속기 등을 모본으로 하여 제작된 것이다. 고려 후기에 청자 주기의 변화는 기존 연구보다 시야를 확대하여 유라시아 일대에 위치했던 칸국들의 잔치 모습이나 주기와 비교하여 좀 더 구체적인 접근을 시도하였다. 이전에 없었던 고족배, 이, 용두잔, 옥호춘병 등 새로운 형태의 주기가 유입되었고 이러한 흐름에 맞춰서 청자 주기의 조합과 용도도 자연스럽게 변화하는 상황을 볼 수 있었다. 이러한 새로운 양식의 청자 주기는 공간적, 지리적으로 연결될 것 같지 않은 고려와 몽골제국의 칸국을 연결시키는 매개체 역할을 하였다. 본고는 청자 주기와 왕실 연례 문화와의 관련성을 조명하였지만 이는 고려청자의 용례를 연구하는 시작에 불과할 뿐이다. 앞으로 좀 더 다양하고 폭넓은 관점에서 청자의 사용처와 사용례를 밝히는 연구가 더 많이 진행되기를 기대한다.

• 대한간호학회지
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• 제3권1호
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• pp.13-40
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• 1972

Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

• Journal of Preventive Medicine and Public Health
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• 제20권1호
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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.