• Journal of Preventive Medicine and Public Health
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• 제12권1호
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• pp.13-23
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• 1979

A study was carried out from October 1977 to September 1978 in order to develope health care delively system which will meet to rural area in Korea. For the study objective a model of health care delivery system of Myun (township) area was developed which is adopted the net-work of village health voluntary worker who will play the role of bridge for communication related with health and illness between families or village people and health subcenter, and :he model health care delivery system net-work was set in the area of Soodong Myun, Yangju Gun. which is the rural health demonstration area of Ewha Womans University since 1972. The activities and attitude of 22 village health voluntary workers were observed and analized. during the study period. The results are as follows; 1. For the field activities of village health voluntary workers. a guide line which is described with specific behavioral objectives was developed and used for not only training of the workers but also evaluation of their field activities. 2. During the study period, the number of 971 village people were served primary health care service by village health voluntary worker and the service was classified largely into symptomatic medications (92%) and preventive measures (8%). 3. Comparative percentage of the number of 894 symptomatic cases cared by village health voluntary workers to 5,695 cases of patient treated by Soodong Health Subcenter during the same period was 15.7%. 4. Annual utility rate of village health voluntary worker by Myun total people was 16.1% but utility rate by Rie was varied from 38.2% to 2.8% which shown there were considerable differences in each Rie. In order to settle the village health care service, the obstructive factors of utility should be detected and their counter measure must be taken. 5. As the health need of village people increases, it is expected that the supplement of drug excluding present sit basic drugs is inevitable, but considering the ability of village health voluntary worker, the selection of additional drugs and education, plan should be carefully studied. 6. It is desirable that a financial resource for supplementary purchase of first aid kit, drugs and materials whould be alloted from village public fund like Saemaeul Women's Club fund, which has already practiced in a few villages in the study area. 7. As pointed out by village health voluntary workers, in order to improve the village health, village leaders should be in the center of it and the cooperation of whole village people is a core of healthful village development, and it is reasonable that the health subcenter backs up these voluntary health activities by village people in techniques. 8. It seems effective that a supplementary education for village health voluntary worker be accomplished by a planned education through regular meetings like worker's monthly meeting and irregular post guide when Myun Health Workers can handle the problems found during the round trip of villages. 9. It is desirable that village health voluntary workers, who are recommended by a civil voluntary organization like Saemael Woman's Club, are charged by natural villagc unit, are given a function of village health care service and used through basic education at health subcenter. 10. It is advisable that the village health voluntary worker's service is compensated not by a form of money, but by other way such as an exemption of medical fee of worker herself or her families in health subcenter can be one method. 11. Daily health activities of each village health voluntary worker should be reported to health subcenter by biweekly or monthly in order to get not only for basic data of the program but also for evaluation the program. It is recomandable that the report form should be simple and clear enough for village health voluntary worker to fill it effectively. 12. Village health care service should be developed into a Saemaeul Movement in which village people actively participate. For this, the appointed function of village health voluntary worker should be absorbed into those of living Environment Betterment Section or Family Planning Section of Saemaeul Women's Club or it is desirable that establish a new section, Village Health Promoting Section and make it involve the appointed functions of those sections mentioned above.

• Journal of Preventive Medicine and Public Health
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• 제11권1호
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• pp.24-30
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• 1978

This study was designed to analyse effects of Family Health Workers' activities on the performance of a child immunization program as part of the evaluative research in the community health demonstration project in Kang Wha. Frequent shortcomings of evaluative research are problems in setting evaluative indices, difficulties in interpreting influences of socioeconomic changes due to lack of control and failure of demonstrating association between activity input and program performance. Specific objectives of this study was to improve the frequent shortcoming of evaluative research by isolating the effects of Family Health Workers' activities on the performance of the program through controlling other variables which also influenced the program performance. The target population consisted of 1240 children who were born between Jan. 1971 and Dec. 1975 in Sunwon Myun, and Naega Myun in Kwang Wha Gun, Kyonggi Province. The data were collected in part through 20 Family Health Workers who interviewed the mothers of these children in their villages during Nov. 1977. Part of the data were obtained by summarizing Family Health Workers daily activity records. All data were grouped for each birth cohort according to the 20 villages. Dependent variable of the model is the measle immuinization rate of each village and the independent variables are characteristics of baby, mother, household, travel time to the health subcenter, to Kang Wha Town, and the mean member of visits to the household by Family Health Workers as well as their other related activities and the year of birth of children according to village. The model was analysed by stepwise multiple regression technique. The summarized results show that overall $R^2$ were 39.3% and mean number of Family Health Worker household visits, mean age of mother and mean economic status were significant variables in explaining the immunization rate. Therefore Family Health Workers' activities are one of the significant variables in influencing the increased immunization rate of children in villages of the project area.

• Journal of Preventive Medicine and Public Health
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• 제17권1호
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• pp.85-93
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• 1984

In order to develop some indicies for the evaluation of village health worker's activities and to find out personal characteristics and other factors that affect the activities, an interview survey was conducted to thirty seven village health workers (VHW) in Sunwon, Naega and Bulun townships in Kangwha county, where the Community Health Project of Yonsei University, College of Medicine, has been implemented for the past ten years. In addition, daily activity records of the VHW's were also analyzed. The results are summarized below: First, meeting attendance rates, number of regular family visits, number of antenatal care visits and number of family planning visits were identified as the most meaningful criterion for the evaluation of the village health worker's activities. Second, personal factors that significantly affect the village health worker's activities were identified as age, educational background, living with in-laws, religion, presence of preschool child in the family, holding leader's position of village woman's association concurrently, and duration serving as a VHW. The more aged and the more educated VHWs were the more effective. Those VHWs who were living with in-laws, without preschool child in the family, holding the leader's position of the village woman's association, and the longer service duration were the more effective. Other factors that affect the VHW's activities were the number of households in the target village and the number of natural villages in the target villages. It showed that the smaller the size of number of households and natural villages, the higher the degrees of the effectiveness of the VHW.

• Child Health Nursing Research
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• 제25권4호
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• pp.406-416
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• 2019

Purpose: Children in migrant villages in Kyrgyzstan have a high incidence of anemia and need effective health promotion programs. The purpose of this study was to evaluate a pilot study of a health promotion project for infants and toddlers based on community participation. Methods: This was a retrospective study conducted to evaluate the effectiveness of the project. The project was carried out by nurses at a public health center, community health workers, and local residents in a migrant village. After the operational system of the project was established, health assessments, child-care education, provision of vouchers for iron supplements, and activities to improve residents' awareness were conducted during 6 months among 100 children, of whom 85 were finally analyzed. Results: In international health projects, close cooperation of the project team with community residents and health workers is important. Access to the community-based program was feasible in the socially and economically poor migrant village, and improvements were shown in children's anemia and awareness of health care. Conclusion: By focusing on the effective aspects of this preliminary project, plans to utilize community health workers and promotion strategies can be added to the main project to improve health promotion among children in this area.

• 보건행정학회지
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• 제2권2호
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• pp.90-111
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• 1992

Community involvement is to be the keystone of primary health care, Unfortunately, efforts to promote it failed in many countries. Author inquired into the reasons why such efforts fail, and the alternative strategies for effectively promoting it in Korean situation today. In doing so, the concept of community involvement is clarified as an amalgamation of two different concepts; one is that of the community development, and the other is that of approaches for overcoming the alienation of the people from the health care process. Stategies of community involvement in Korea so far followed the line of the community development, e.g. village health worker. It loses, however, the feasibility as Korea has experinced so cial and economic developpment. The strategies of the second line of thought is now more feasible; empowering the people by providing more information and enhancing comitment to health, improving acceptabilty of community involvemt on the part of the health professionals and the bureaucrats, and building the mechanism of community involvement into the health policy-making process.

• 농촌의학ㆍ지역보건
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• 제17권1호
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• pp.34-45
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• 1992

In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.

• 보건교육건강증진학회지
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• 제5권1호
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• pp.42-46
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• 1988

마을건강원의 개념은 단순하나. 그 의의는 크다고 말할 수 있다. 마을건강원이란 자기가 살고 있는 지역사회에서 일할 수 있도록 단기간의 훈련을 받은후 보건의병체계와 밀접한 관계를 가지고 자기 지역사회 주민을 위하여 봉사하는 사람을 지칭한다. 우리나라에서 마을건강원이란 용어로 이 같은 유의 요원을 최초로 호칭한 것은 1977-1980년간에 한국보건 개발연구원(한국인구보건연구원의 전신)이 농촌지역에서 지역사회보건사업을 전개할 당시부터라고할 수 있다. 물론 이전에도 이와 비슷한 명칭이 없었던 것은 아니다. 예를 들면 가정건강요원(연세의대), 마을보건임원(이화의대), 그리고 마을건강요원(여수병원) 등을 열거할 수 있겠다.

• 대한간호학회지
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• 제8권2호
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• pp.63-77
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• 1978

Studies pertaining to influential factors on adoption and practice of family planning are very much needed to lower fertility, for family planning has regarded as only one social acceptable means to curb the accelerated population growth. One of the influential factors is known as rumors on family planning methods that hinder the actual practice of family planning. This study generally aimed at disclosing rumors on family planning methods prevalent in rural communities so that one could gain some in sights to cope with the ill effects of rumors to promote family planning Practice in rural communities in Korea. In order to accomplish the general aims this study formulated following four specific objectives; 1. Find out types and frequencies of rumors exposed of contraceptive methods. 2. Find out the relationship between the rumors exposed and socio-economic and demographic characteristics of new village leaders and health workers. 3. Examine the relationship between family planing rumors and family planning practices. The materials for this study were drawn from the two different sets of data gathered in July and Octorber 1977 respectivily by Center for Population ＆ family Planning, Yon sei University. One is current family planning practice among eligible women reaiding in 4 Myuns in Kwang Wha country and the other is Survey on Rumor on family planning method heard by new village leaders and health workers in the four myuns. The four Myuns were divided into 60 small areas. Current family planning practice rate in each small area and as a whole were calculated. The unit of analysis in this study was not the indviduel person but the 55 small areas. Percentage, average, F-Test t-test and a coefficient of correlation were used for statistical analysis. Results of this study could be summarized as follows: 1. Rumors by different method of contraception: Medical complications, gastro-intestinal disorders, and difficulty in usage one most prevalent rumors about oral pills. Around 49% -77% of the 55 areas were often heard and the most frequent rumor was related medical complications of oral pills. Rumors on medical complications and incomplete effect of intrauterines as contraceptive were heard 51-66% of the 55 small areas. Rumors that vasectomy resulted in family problems, for instance infiedelity of spouse were often heard to 44% of the 55 small areas. 2. Rumors by socio-economic and demographic characteristic of new village leader and health workers: Among the demographic characteristics such as sex, age and sex composition of children, sex and age differentials in frequency of rumors heard more observed, Female new village health workers have heard more frequently than male new village leader. (t = 7.137, p> 0.01, d.f. = 53, a coefficient of correlation 0.27, p>0.05) The Younger age group less than 40 years of age have heard rumors of than the group over 40 years old. (t = 7.18, p>0.01, d.f. = 53, a coefficient of correlation 0.27, p>0.05) However, it was not observable that a consistent sex and age differentials in frequency of rumors heard of each contraceptive mettled, But, more female new village health works heard of rumors about intrauterine device than male new village leaders. (t = 0.497, p> 0.01, d.f. = 53, a coefficient of correlatin 0.32, p>0.01) 3. It was found that there was no statistically significant relationship between the frequency of rumors heard and current family planning practices on the whole, However, frequency of rumors heard about vasectomy appeared to have a positive relationship with current practice of vasectomy. A rather consistent pattern of relationship between“requency of rumors heard”and current family practice rate was demonstrated of 10 graphes which showed the relation between the two variagles. The current family planning practice rate in the“never heard”group and “frequently heard”group was equally lower than that in“often heard”group. The relatively consistent ∩ pattern of relationship needs to be farther investigated, for this pattern is different from the relationship that has been assumed to exist between these two variables.

• 보건행정학회지
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• 제4권1호
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• pp.1-24
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• 1994

Recently, two main changes were observed in relation to activities of District Health Centers. One is the rapid increase in the quantity and variety of people's demands for health services due to improvement of income level and the other is an introduction of autonomy in local administration. Unitl recently, the District Health Services were mostly depended on the instructions and orders given by Central Governments, and it would be necessary to prepare for the future implementation of autonomous local administration. Especially, the urban health centers may need more attention than those in rural areas because of their complexity and it would be more difficult in choosing and implementing a most suitable health programs for urban communities. This study was made to find out a feasibl developmental model which could be applicable for the urban bealth centers in Kyeongnam- do area. The most studies relating to health centers activities in the past were made by saking questions to current health center workers, but this study has made an effort to find out the opinions of those who are representing the people in the community. For this study, therefore, the Members of Gity Parliament and Village Headmen from 10 cities is Kyeongnam- do were interviewed for the study and the results obtained were compared to those of health officers. It was found that both Parliament Members and Village Headmen were well aware of the need of health centers, however, they tend to put lower priority for health services in compare with other community activities, and pointed out poor quality of services and lack of public understanding as the problems to be overcome. As to the desirable body for policy decision and implementation of health programs, the Members of Local Parliament think the Local Parliament as ideal, where as Village Headmen prefer health experts, and health officenr prefer District Health Center respectively. The most urgent problems of the District health Centers are mentioned as lack of health manpower. As the results of his study, the followings are suggested for improvement of District Health Services; First : reinforcement of professional health workers, Second : establishment of Community Health Council, Third : strengthening of public health education and support, Fourth : flexibility in Local Autonomy and target system relating to health activities.

• 한국보건간호학회지
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• 제3권1호
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• pp.18-37
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• 1989

This study was done in order to analyze the factors which influenced the performance level of community health practitioners' task. Interview survey was done during the period from August to October, 1986. Interviewee were 166 CHPs among total of 217 CHPs in Kyonggi province area. Multiple stepwise regression and canonical correlation analysis were used to identify major factors influenced to perform community health practitioners' task. The results of this study were summarized as follows: 1. General characteristics of CHPs 1) Personal characteristics The average age of CHPs was 37.8 years and their marital status was $77.6\%$ of married, educational back-ground was $65.3\%$ of junior college graduation. Their job career was $38.6\%$ of between 1-3 years, $33.3\%$ of between 3-5 years, $22.2\%$ of less than 1 years. Most of CHPs$(62.8\%)$ were fully satisfied with their job, $33.3\%$ were moderately, and $3.8\%$ were not satisfied. 2) Working environmental condition Only $31.7%$ of CHPs were satisfied with their working condition of primary health post, $26.6\%$ were not satisfied. Half of CHPs$(52.5\%)$ replied having good cooperation with health center, $10.1\%$ replied bad. Cooperation with health subcenter was good in $32.9\%$, and bad in $21.9%$. Cooperation with private health institutions was good in $34.2\%$, bad in $21.6%$. 2. Performance level of community health practitioners' task Among a total of 52 contents of their functions medical history taking. physical examination, referral of diagnostic laboratory work-up($(86.4\%)$, health assessment of pregnant women$(82.1\%)$, development of health information system$(79.4\%)$, supervision of health workers $(78.4\%)$, follow-up of family planning acceptors$(77.3\%)$, and follow-up of family planning acceptors' side effects$(77.3\%)$ were actively performed. Diagnosis of pregnancy$(62.1\%)$, sampling of drinking water for quality test$(52.5\%)$, making list of equipment' & supplies $(51.5\%)$, evaluation of primary health post activities $(37.6\%)$, organization of village health workers$(32.4\%)$ and management of village health workers $(30.1\%)$ were poorly performed. 3. Stepwise multiple regression analysis of job function The factors which influenced the performance level of community health practitioners' function were age, marital status, educational level, job career, job satisfaction, satisfaction of working environment of primary health post, cooperation of health center, cooperation of health center, cooperation of private health instiutions in orders. These 9 variables were able to explain job function from $25.7\%$ of program planning to $6.7\%$ of management of common disease. 4. Canonical correlation analysis between the performance of function and general characteristics of CHPs. Cooperation of private health institutions was found to be the factor influencing task performance of community organization, management of primary health post, technical supervision of health personnels. Job satisfaction of CHPs was also found to be the factor influencing task performance of family planning, management of common disease and maintenance of health information system.