• Title/Summary/Keyword: supervision system

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History of Biology Education in Korea During the Periord of 1880-1945 (1880-1945 년간의 한국 생물교육의 역사)

  • 김훈수
    • Animal Systematics, Evolution and Diversity
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    • v.10 no.1
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    • pp.97-123
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    • 1994
  • The author devided th period of 1876-1945 into three epochs ; the Opening of Ports in 1876 -before the Political Reform in 1894 , the Political Reform- the Japanese annexation of Korea in 1910 , and the Epoch of Japanese Colony during 1910-1945. As civilization through including educational reform rised. The modern school system began to be introduced nongovernmentally and governmentally to Korea in the 1880's without any school laws. Were chronologycally established school regulation by Korea Government in 1895-1893, school laws by Korean Government under the supervision of the Japanese Residency-General of Korea in 1906-1910, and the educational laws of Korea by the Japanese Government-General of Korea in 1911-1943. In these epochs, the numbers of elementary , secondary and higher educational institutions and the numbers of pupils and students had increased slowly. Japanese had developed sonwhat primary education and secondary technical education, but it had checked extremely the Korean peoples to receive secondary liberal education and higher education, On the epoch of Japanese colony, Japanese occupied nearly half of elementary school teachers, almost of public secondary school teachers educated in Japan, and nearly all of professor educated in Japan in public and national colleges which were technical, and in one imperial university . Forty or more Korean teachers taught natural history chief at private secondary schools for Koreans , more than half of them being graduates of colleges of agriculture and forestry in Korea and Japan. The author mentioned curricula , and subjects and textbooks connected with biology of elementary, secondary and higher educational institutions. The pup8ls and students received biological knowledge through learning sciences at primary schools ; natural history (plants, animals and minerals ) at secondary schools including normal schools ; botany, zoology, genetics and major subjects related with biology such as anatomy, physiology, bacteriology, pland breeding at medical colleges and colleges of agriculture and forestry. There were no departments of biology , botany or zoology in Korea. Only seven Koreas graduated from departments of biology, botany or zoology at imperial universities in Japan. Some of them played the leading parts to develop education and researches of biology in the universities after 1945 Liberation.

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An Institutional Approach for Application of the Contracting-out in City Parks - Focused on the Case Study of City Park Management of Seongnam City - (도시공원의 민간위탁 적용을 위한 제도적 방안 - 성남시 도시공원 운영사례를 중심으로 -)

  • Byeon, Jae-Sang;Kim, In-Ho;Shin, Sang-Hyun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.39 no.5
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    • pp.33-47
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    • 2011
  • One of the most fundamental jobs of contemporary government is to look into various ways of providing its citizens with the best service work. This study aims to establish a procedure through which to consign the management of city parks to private companies, thus inviting participation and satisfaction on the part of citizens. In particular, this procedure includes creating a system of selecting private managing companies, for instance, specifying standards of selection and assembling selection committees. The results of this study can be summarized as follows. First, city parks can be managed better by private companies than by local governments in terms of cost cuts, personnel training, business efficiency, and know-how accumulation. The legal background for this is found in central and local legal articles. Second, it is recommended that the selection committee be composed of 6 to 9 members, both insiders and outsiders. In addition to selecting private managing companies for contracting-out, the committee should under take the role of consulting on how to perform and revise selecting standards, so that they can continue to improve these procedures. Third, the decision on private management should be noticed in advance and be made based on standards considering each local government's condition. These standards should consider the aspects of the public good, cost saving, quality of service, managing supervision, and citizen participation. The committee's assessment takes into account both the quality and the quantity of the standards. Fourth, the contracting-out for city park management should follow the order of: announcing consignment and receiving applicants, organizing selection committees and assessing applications, selecting and contracting, midterm evaluation, and re-announcement and re-consignment. To run city parks through the contracting-out is expected to increase the number of park visitors. Additionally, private consignment will involve a participation of diverse citizenship, thus playing an important role in city parks' building of a green-culture community.

Study on the Legal Issues of New Draft of Civil Aviation Law in China (중국 민용항공법 개정 최근 동향과 주요 법적쟁점)

  • Lee, Hwa
    • The Korean Journal of Air & Space Law and Policy
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    • v.31 no.2
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    • pp.177-214
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    • 2016
  • During more than 20 years of practice, Civil Aviation Law has experienced three times of amendments since it was enacted in 1995. But these revisions are limited to the technical level. The problems and limitations have become increasingly prominent in its implementation. Firstly, the civil aviation law is the result of interests game among several departments and some legal issues was left behind and the regulation was very vague as a result. Secondly, the process of aviation legislation is the process that the country has undergone profound changes and social transformation. The 20 years is long enough for the society to undergo tremendous changes and 1995 version of civil aviation law does not keep pace of development of economy. There was a serious lag between reality and the law. In order to actively promote the development of the aviation industry and overcome implementation issues of the Civil Aviation Law, Civil Aviation Administration of China (CAAC) initiated modification procedure the law and published new draft of Civil Aviation Law in August 2016. The spirit of this modification is to learn and absorb new achievements of domestic and foreign legislation and the International Convention on civil aviation. Furthermore, the purpose of the revision is to provide favorable policy for the development of civil aviation industry and improve aviation safety and supervision, strengthen and protection of consumer rights and interests, to enhance the safety of civil aviation activities, and promote the development of general aviation. This revision concerned to the 78 articles which are revised or deleted and 24 articles added. The highlights of the draft include but not limited to the enhancement of security management, clarification of the main responsibility for production safety. And also it added the provisions related to the construction of effective tracking capability of public air transport enterprises and license system on the transport of dangerous goods. Compared with the existing civil aviation law, the draft has made a great improvements. But there are several deficiencies and limitations in the drafts. These problems need to be supplemented and perfected through further amendments in near future.

Art Therapy and Hospice & Palliative Care in Korea (한국의 예술치료와 호스피스 완화의료)

  • Kim, Chang Gon
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.85-96
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    • 2015
  • In Korea, modern art therapy was developed in the 1960s and 1970s in the form of supplementary activities for patients in psychiatry. Along with the foundation of the Korean Association for Clinical Art in 1982 by psychiatric doctors, the therapy involved more various arts forms such as music, art, dance, poetry therapy, and psychodrama. More organizations with specific expertise opened such as the Korean Art Therapy Association, Korean Art Therapy Association, etc. in the 1990s and the Korea Arts Therapy Institute in 2001. As of April 2015, the members of the Korean Art Therapy Association total 15,000, including 6,200 regular members. The arts in integrative arts therapy (IAT) is an individual's creative activity which is related to his inner world, and the forms of IAT include music, drawing, dance and poetry therapy. From the aspect of phenomenology, IAT is psychophysical therapy involving the arts that helps patients recognize and perceive their experiences with an aim of at a recovery of the body and creativity from the phenomenological aspect. It is also a therapeutic activity that targets growth and development of the body and mind. Meta-analysis of the effects of art therapy with a focus on that involving music, drawing, dance movement and IAT in recent years in Korea, significant effects were observed in all factors but physical function. The biggest effect was mentality adaptation followed by activity adaptation and physiology. In the run up to the implementation of the daily flat-rate system for the health insurance reimbursement for palliative care in July 2015, the Ministry of Health and Welfare is reviewing the coverage of music therapy, drawing therapy and flower therapy, which are currently practiced by 56 hospice institutes in Korea. This is a meaningful step because the coverage of hospice and palliative care came after that of art therapy for psychiatric patients was approved in 1977. Still, there is a need clarify the therapeutic mechanism by exploring causality among the treatment media, mediation type and treatment effects. To address the issue of indiscriminately issued licenses, more efforts are needed to ensure expertise and identity of the licensed therapists through education, training and supervision.

A Study on the Continuing Education of Dental Technicians (치과기공사의 보수교육에 관한 연구(I) -보수교육 실태와 인식을 중심으로 -)

  • Moon, Je-Hyuk
    • Journal of Technologic Dentistry
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    • v.22 no.1
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    • pp.179-198
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    • 2000
  • Since dental prosthesis is made possible only when dental technicians give themselves to the study of knowledge and the acquisition of updated skills, continuing education is of great importance in that it makes up for the efforts of dental technicians. Accordingly, continuing education relates to a system designed to contribute to the enhancement of the talents of dental technicians and the dental health of the nation. Specialized knowledge and information may work as the best weapon to preserve their jbs. This is true of this modern society where no one can expecth to survive without acquiring knowledge and information constantly for work is getting more classified and more divirsifide. This paper is dedicated to take a look at the current condition of the continuing education of dental technicians and to come up with measure to make general evaluation and to improve continuing education. This research resorts to 609 questionnaires among 6433 copies save unfaithfully responded 34 copos with 6.431 dental technicians as the subjects enrolled in the Dental technician Association. The collected questionnaires consist of 365 dental technicians living in Seoul and of 244 ones, Which account for 11.8 percent of dental technicians enrolled in the association. Because dental technicians live more in local areas than Seoul, the generalization of this survey leaves something to be desired. I have come up with the following findings. 1. 6,431 dental technicians, or 36.3 percent of an total of 14,956 licensed dental technicians, were admitted as numbers of the Dental Tachnician Association as of October 31, 1999. In the '98 continuing education. 4,141 dental technicians among 4,711 dental technicians got relevant training, and in the '99 continuing education, 4,075 technicians, or 75.9 percent of 5,365 technicians got relevant training while 1,290 technicians or 24.2 percent, fail to get relevant training. 2. The survey has it that 38.1 percent of dental technicians are ignorant of the laws on continuing education, and that technicians staying in local communities(146 persons, or 61.6%) take more part in education than those living in the capital of Korea(159 persons, or 146%), and that the older they are, the more money they earn, the more carrer they have, the higher position they hold, the more part they take in education 3. According to the survey, those who have the experience of getting training more than three times account for 52 persons(16.8%) in Seoul and 47 persons(22.4%) in local districts(p<0.01). In terms of sanctions in relation to continuing education, 26 dental technicians(4.6%) say that they have ever gotten sanctions, and 533 dental technicians(95.4%) say that they haven't. And those who were absent from continuing education(72 technicians : 13.51%) didn't get any sanction. 4. In terms of the degree of understanding continuing education, local technicians(46.8% : 110 persons) have a higher understanding of continuing education than their countparts staying in Seoul(36.0% : 130). Continuing education is not the ultimate goal itself. It should be changed to motivate those who get education to be willing to take part in contunuing education, and to help dental technicians in a practical and specific way. And the branch societies should be developde to engage in more specialized and classified expert fields. Of course, the curriculum should be so selected that the conceptions of dental technicians may be reflected to the maximum extent, and the ultimate effores should be made to effect diversity in the ways of educational methods and to perfect the preparation of continuing education on the part of instructors. Regulations should be established in relation to continuing education with a veiew to enhancing the participation of continuing education and its effectiveness. The supervision of the Ministry of Health and Welfare is of great importance in this context. The regulation of continuing education is not administrative regulation, but the expression of national will to guarantee the medical service of the nation at highest level. Therefore, it is necessary that the Ministry of Health and Welfare should change their understanding of the needs for the continuing education of dental experts, and that the expertise of government employees in charge of continuing education should be expanded. It goes without saying that the government should suppory continuing education in a financial way so as to supply the person in charge of public welfare and control the quality of national medicine.

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A Study on the Working Environment Recognition and the Caracter Disposition of Nurse Aides (간호조무사의 근무환경인식과 성격성향에 관한 연구)

  • Lee Sun Yi
    • Journal of Korean Public Health Nursing
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    • v.4 no.1
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    • pp.57-74
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    • 1990
  • As the whole world took on the tendency to be highly industrialized, it became necessary for each field of occupation to require professional man power. Especially, since the World War n, the participation of woman power in economic activities has been continually increasing. In our country also, because of the rapid economic growth, change in the way of thinking of women as well as their participation in economic activities are increasing. Thus, woman power is being utilized in various occupational fields from simple physical labor to those that require high-professional skill. Also, continued economic development policies, by setting the establishment of welfare society as the ideology to be fulfilled, brought expansion of medical facilities in the field of public health and increase in man power in that field. As for the nursing specialists, more than 6000 have been being produced per year and as of the end of 1988, the total number of nursing specialists, reached 123, 115. Therefore, this study is done to recognize the professional knowledge and ability of nursing specialists, who take up $40\%$ of the total public-health related man power in our country, through evaluating their working environment and their disposition of character. This study, which was done from September 18th to September 30th 1989, took on the method of using formed questionnaires that had been amended and supplemented during two preparatory investigations, 322 of such questionnaires were used as an analytical material. In the formation of questionnaires, 12 questions were related to the working environment, and 26 in fortotal were related to the disposition of character, 5 for wise-disposition, 11 for activedisposition and 10 for open-disposition. The measuring method, which used 5-point-standard, allowed 5 points for affirmative recognition of the working environment, also 5 points for showing wise, active and open disposition of character and only point in opposite cases. Collected materials were analyzed, through an electronic calculation, into the average value, the standard deflection percentage, pearson corelative number and stepwise multiple regression. Summarizing the results from this study is as follows: 1. It was shown that the nursing specialists with the average of 3.07 have affirmative recognition of their working environment. The questions which drew most affirmative reaction were those concerning finance-management system such as hand, the questions that received negative reaction were those concerning communication method with the average of 2.49. Such reaction seems to have resulted from the cramming regulation by the superior authorities. Concerning the recognition of working environment in relation to employment conditions, more affirmative recognition is shown with the average of 3.14. at hospitals where injection job is not performed. The nursing specialists working at regular hospitals show more affirmative recognition than those at general hospitals, the averages being respectiely 3.16 and 3.03. 2. As for the disposition of character of the nursing specialists, active-disposition was highest with the average of 3.38, next was wise-disposition with 3.20 and the lowest was open-diposition with 2.98. Variable-wise disposition of character shows that wise-disposition and academic background are beneficially correlated by 0.12. Ative-disposition and open-disposition show correlation to the office term by respectively 0.16 and 0.21. In other words. better academic background leads to higher wise-disposition and more - experience results in higher active and open disposition. Also, the class that performs the injection job, in relation to the working environment, might cause change in the self-conceit that identify those in that class with the nurses; however, as far as professional judgment and action, in dealing with nursing job, being wise, active and open is concerned, not much effect is made. 3. The relation between the recognition of the working environment and the disposition of character is that more afirmative recognition- a nursing specialist has about her working environment, the higher the active-disposition becomes by 0.13. The degrees of the relation between recongnition of environment and wise and open dispositions show respectively 0.06 and -0.06 and -0.06. That is to say that when having more affirmative recognition of the working environment, a nursing specialist shows wise but closed disposition of character. This, howerver, didn't mean much statistically. When observing the results mentioned above, it is conspicuous that the nursing specialists, working as substitutes for the nurse at medical institutions of various sizes, get the feeling of being somewhat equal to the nurses and to some extent, fulfill their desire to accomplish their ego; however, as far as professional ability expansion if concerned. they lack wise and open dispositions. Therefore, considiering upon the results of this study, in medical institutions where the work of nursing specialists is regaded equal to that of the nurses, as a medical member who deals with human lives, it is desirable to make the nursing specialists work under the supervision of the nurses and to offer them continuous education to strengthen and improve their natural dispositions.

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A Study on Major Safety Problems and Improvement Measures of Personal Mobility (개인형 이동장치의 안전 주요 문제점 및 개선방안 연구)

  • Kang, Seung Shik;Kang, Seong Kyung
    • Journal of the Society of Disaster Information
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    • v.18 no.1
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    • pp.202-217
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    • 2022
  • Purpose: The recent increased use of Personal Mobility (PM) has been accompanied by a rise in the annual number of accidents. Accordingly, the safety requirements for PM use are being strengthened, but the laws/systems, infrastructure, and management systems remain insufficient for fostering a safe environment. Therefore, this study comprehensively searches the main problems and improvement methods through a review of previous studies that are related to PM. Then the priorities according to the importance of the improvement methods are presented through the Delphi survey. Method: The research method is mainly composed of a literature study and an expert survey (Delphi survey). Prior research and improvement cases (local governments, government departments, companies, etc.) are reviewed to derive problems and improvements, and a problem/improvement classification table is created based on keywords. Based on the classification contents, an expert survey is conducted to derive a priority improvement plan. Result: The PM-related problems were in 'non-compliance with traffic laws, lack of knowledge, inexperienced operation, and lack of safety awareness' in relation to human factors, and 'device characteristics, road-drivable space, road facilities, parking facilities' in relation to physical factors. 'Management/supervision, product management, user management, education/training' as administrative factors and legal factors are divided into 'absence/sufficiency of law, confusion/duplication, reduced effectiveness'. Improvement tasks related to this include 'PM education/public relations, parking/return, road improvement, PM registration/management, insurance, safety standards, traffic standards, PM device safety, PM supplementary facilities, enforcement/management, dedicated organization, service providers, management system, and related laws/institutional improvement', and 42 detailed tasks are derived for these 14 core tasks. The results for the importance evaluation of detailed tasks show that the tasks with a high overall average for the evaluation items of cost, time, effect, urgency, and feasibility were 'strengthening crackdown/instruction activities, education publicity/campaign, truancy PM management, and clarification of traffic rules'. Conclusion: The PM market is experiencing gradual growth based on shared services and a safe environment for PM use must be ensured along with industrial revitalization. In this respect, this study seeks out the major problems and improvement plans related to PM from a comprehensive point of view and prioritizes the necessary improvement measures. Therefore, it can serve as a basis of data for future policy establishment. In the future, in-depth data supplementation will be required for each key improvement area for practical policy application.

Optimum Management Plan for Soil Contamination Facilities (특정토양오염관리대상시설의 최적 관리방안에 관한 연구)

  • Park, Jae-Soo;Kim, Ki-Ho;Kim, Hae-Keum;Choi, Sang-Il
    • Korean Journal of Soil Science and Fertilizer
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    • v.45 no.2
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    • pp.293-300
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    • 2012
  • This study was to investigate the unsuitable rate of the storage facilities, the changes in corrosion process over time after installation according to the status, the time to install the facilities, years elapsed after facilities installation, inspection of methods and motivation, and so on, based on the results of the inspection at the petroleum storage facilities conducted by domestic soil-relate specialized agency to derive optimal management plans which meet the status of soil contamination facilities. The results showed that the facilities more than 5 years after the initial leak test at the time of the installation need to be inspected periodically by considering costs of leak test and remediation of polluted soil. The inspection period can be decided by cost and leak test methods showing discrepancies for the results obtained from individual test whether it was direct or indirect. To compensate these matters, we suggested that the direct inspection method on regular schedule is recommended. On the other hand, the inspection can be voluntarily completed to ease burden of the results by inspection or equivalent level to this inspection method. Also, it may need improved construction supervision and performance test system to minimize the occurrence of the nature defects in installing the facilities as well as the upgrade program for the facilities during intervals of inspection period.

A Study on the Meaning and Strategy of Keyword Advertising Marketing

  • Park, Nam Goo
    • Journal of Distribution Science
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    • v.8 no.3
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    • pp.49-56
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    • 2010
  • At the initial stage of Internet advertising, banner advertising came into fashion. As the Internet developed into a central part of daily lives and the competition in the on-line advertising market was getting fierce, there was not enough space for banner advertising, which rushed to portal sites only. All these factors was responsible for an upsurge in advertising prices. Consequently, the high-cost and low-efficiency problems with banner advertising were raised, which led to an emergence of keyword advertising as a new type of Internet advertising to replace its predecessor. In the beginning of 2000s, when Internet advertising came to be activated, display advertisement including banner advertising dominated the Net. However, display advertising showed signs of gradual decline, and registered minus growth in the year 2009, whereas keyword advertising showed rapid growth and started to outdo display advertising as of the year 2005. Keyword advertising refers to the advertising technique that exposes relevant advertisements on the top of research sites when one searches for a keyword. Instead of exposing advertisements to unspecified individuals like banner advertising, keyword advertising, or targeted advertising technique, shows advertisements only when customers search for a desired keyword so that only highly prospective customers are given a chance to see them. In this context, it is also referred to as search advertising. It is regarded as more aggressive advertising with a high hit rate than previous advertising in that, instead of the seller discovering customers and running an advertisement for them like TV, radios or banner advertising, it exposes advertisements to visiting customers. Keyword advertising makes it possible for a company to seek publicity on line simply by making use of a single word and to achieve a maximum of efficiency at a minimum cost. The strong point of keyword advertising is that customers are allowed to directly contact the products in question through its more efficient advertising when compared to the advertisements of mass media such as TV and radio, etc. The weak point of keyword advertising is that a company should have its advertisement registered on each and every portal site and finds it hard to exercise substantial supervision over its advertisement, there being a possibility of its advertising expenses exceeding its profits. Keyword advertising severs as the most appropriate methods of advertising for the sales and publicity of small and medium enterprises which are in need of a maximum of advertising effect at a low advertising cost. At present, keyword advertising is divided into CPC advertising and CPM advertising. The former is known as the most efficient technique, which is also referred to as advertising based on the meter rate system; A company is supposed to pay for the number of clicks on a searched keyword which users have searched. This is representatively adopted by Overture, Google's Adwords, Naver's Clickchoice, and Daum's Clicks, etc. CPM advertising is dependent upon the flat rate payment system, making a company pay for its advertisement on the basis of the number of exposure, not on the basis of the number of clicks. This method fixes a price for advertisement on the basis of 1,000-time exposure, and is mainly adopted by Naver's Timechoice, Daum's Speciallink, and Nate's Speedup, etc, At present, the CPC method is most frequently adopted. The weak point of the CPC method is that advertising cost can rise through constant clicks from the same IP. If a company makes good use of strategies for maximizing the strong points of keyword advertising and complementing its weak points, it is highly likely to turn its visitors into prospective customers. Accordingly, an advertiser should make an analysis of customers' behavior and approach them in a variety of ways, trying hard to find out what they want. With this in mind, her or she has to put multiple keywords into use when running for ads. When he or she first runs an ad, he or she should first give priority to which keyword to select. The advertiser should consider how many individuals using a search engine will click the keyword in question and how much money he or she has to pay for the advertisement. As the popular keywords that the users of search engines are frequently using are expensive in terms of a unit cost per click, the advertisers without much money for advertising at the initial phrase should pay attention to detailed keywords suitable to their budget. Detailed keywords are also referred to as peripheral keywords or extension keywords, which can be called a combination of major keywords. Most keywords are in the form of texts. The biggest strong point of text-based advertising is that it looks like search results, causing little antipathy to it. But it fails to attract much attention because of the fact that most keyword advertising is in the form of texts. Image-embedded advertising is easy to notice due to images, but it is exposed on the lower part of a web page and regarded as an advertisement, which leads to a low click through rate. However, its strong point is that its prices are lower than those of text-based advertising. If a company owns a logo or a product that is easy enough for people to recognize, the company is well advised to make good use of image-embedded advertising so as to attract Internet users' attention. Advertisers should make an analysis of their logos and examine customers' responses based on the events of sites in question and the composition of products as a vehicle for monitoring their behavior in detail. Besides, keyword advertising allows them to analyze the advertising effects of exposed keywords through the analysis of logos. The logo analysis refers to a close analysis of the current situation of a site by making an analysis of information about visitors on the basis of the analysis of the number of visitors and page view, and that of cookie values. It is in the log files generated through each Web server that a user's IP, used pages, the time when he or she uses it, and cookie values are stored. The log files contain a huge amount of data. As it is almost impossible to make a direct analysis of these log files, one is supposed to make an analysis of them by using solutions for a log analysis. The generic information that can be extracted from tools for each logo analysis includes the number of viewing the total pages, the number of average page view per day, the number of basic page view, the number of page view per visit, the total number of hits, the number of average hits per day, the number of hits per visit, the number of visits, the number of average visits per day, the net number of visitors, average visitors per day, one-time visitors, visitors who have come more than twice, and average using hours, etc. These sites are deemed to be useful for utilizing data for the analysis of the situation and current status of rival companies as well as benchmarking. As keyword advertising exposes advertisements exclusively on search-result pages, competition among advertisers attempting to preoccupy popular keywords is very fierce. Some portal sites keep on giving priority to the existing advertisers, whereas others provide chances to purchase keywords in question to all the advertisers after the advertising contract is over. If an advertiser tries to rely on keywords sensitive to seasons and timeliness in case of sites providing priority to the established advertisers, he or she may as well make a purchase of a vacant place for advertising lest he or she should miss appropriate timing for advertising. However, Naver doesn't provide priority to the existing advertisers as far as all the keyword advertisements are concerned. In this case, one can preoccupy keywords if he or she enters into a contract after confirming the contract period for advertising. This study is designed to take a look at marketing for keyword advertising and to present effective strategies for keyword advertising marketing. At present, the Korean CPC advertising market is virtually monopolized by Overture. Its strong points are that Overture is based on the CPC charging model and that advertisements are registered on the top of the most representative portal sites in Korea. These advantages serve as the most appropriate medium for small and medium enterprises to use. However, the CPC method of Overture has its weak points, too. That is, the CPC method is not the only perfect advertising model among the search advertisements in the on-line market. So it is absolutely necessary that small and medium enterprises including independent shopping malls should complement the weaknesses of the CPC method and make good use of strategies for maximizing its strengths so as to increase their sales and to create a point of contact with customers.

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An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea (가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고-)

  • Bang, Sook;Han, Seung-Hyun;Lee, Chung-Ja;Ahn, Moon-Young;Lee, In-Sook;Kim, Eun-Shil;Kim, Chong-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.1 s.21
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    • pp.165-203
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    • 1987
  • This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

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