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A Study on Improvement of Laws regarding Welfare for the Aged (노인복지 관련법제의 발전방향)

  • Park, Ji-Soon
    • Journal of Legislation Research
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    • no.41
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    • pp.87-123
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    • 2011
  • Korea is expected to become an 'aged society' with more than 14 percent of the public aged 65 years or more by 2018. The rapid aging is giving rise to various problems within the society along with falling birthrate in a short period of time. In this context, the role and function of laws on welfare for the aged must be particularly emphasized. Also the Senior Citizens Welfare Act is of great importance as it provides social welfare service on the basis of functional connection with social insurance and public assistance. First, this paper looks into the history of laws related to welfare for the elderly such as the Senior Welfare Act, the Act on Long-term Care Insurance for Senior Citizens and the Basic Old Age Pension Act as well as the findings of earlier studies. In the second place, it will break down such laws by main components aiming to examine details of the laws and questions raised regarding them and to seek ways to achieve improvement with an emphasis on health care, old age income security, housing welfare(assisted living facilities), job security for the aged. The Senior Welfare Act offers substance of social welfare service for the elderly. Income security, health and medical care, welfare measures through long-term care and assisted living facilities, social participation by working are the key elements and all of them should be closely associated to ensure citizens get sufficient public support in their old age. For this purpose, the Senior Welfare Act is under a normative network with laws such as Act on Long-term Care Insurance for Senior Citizens and Basic Old Age Pension Act. Current laws on welfare for the aged including Senior Welfare Act are not sufficiently responsive to the aged society of the 21st century. Income security combined with decent social participation, health and medical care closely connected with long-term care system, efficient expense sharing between government and local government, enhancement of effectiveness of welfare measures can be considered as means to improve current welfare system so that the elderly can enjoy their old age with dignity and respect.

Social Worker's Experience of NEET Youth Support Project : Focusing on the Vision Plan (청년니트(NEET) 지원 사업에 대한 종합사회복지관 사회복지사의 경험 : 희망플랜 사업을 중심으로)

  • Noh, Hyejin;Lee, Bongjoo;Park, Mihee;Park, Hojun
    • Korean Journal of Social Welfare Studies
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    • v.49 no.2
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    • pp.125-157
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    • 2018
  • In the reality that the seriousness and concern about the youth problem is increasing, this study focuses on the vision plan project supporting the NEET youth in the social welfare field. Therefore, this study analyzed how the social workers recognized the NEET problem before participating in the project, what difficulties they experienced in the process of the project, and how they coped with these difficulties. The results of the study are as follows. Social workers were saddened by the seriousness of the youth problem before their participation, but they recognized that there was no way to solve it and many social workers were not fully aware of the youth or NEET issues. In this context, in the course of running a project with NEET youth, social workers experienced difficulties due to the nature of the NEET youth, difficulty in forming a relationship with NEET youth, and difficulties for young people not to spend time in the program. And social workers also faced difficulties due to the lack of know-how in the project, difficulties in operating the center alone, and difficulty in achieving employment goals. In the process of coping with these difficulties, social workers have actively sought, persuaded and supported the NEET youths to participate in the project, adapted the time, place and method to the youth, and removed the stigmatization element in the project. They also worked closely with local residents, local institutions and municipalities, formed networks, and changed the viewpoint of providing work experience rather than getting young people, but seeing long-term outcome. As a result, social workers have experienced not only individual change but also social welfare organization, field, community and local institutional change. Based on these results, this study suggested that the social welfare practice field should provide various activities in the process of supporting the youth gap year policy. In addition, this study suggests that the social workers play a role in connecting various actors rather than suppliers when working with young people, and that the social welfare field should expand the scope of project to include youth.

The Phenomenological Study on School Dropout of Specialized Vocational High School Students (특성화고등학교 학생의 학업중단에 대한 현상학적 연구)

  • Lee, Myung-Hun
    • 대한공업교육학회지
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    • v.44 no.1
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    • pp.23-51
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    • 2019
  • The purpose of this study was to analysis school dropout of specialized vocational high school students using phenomenological research method. The interview for the research was carried out with 10 adolescents who dropped out specialized vocational high school from December 8 to 23, 2018. According to the result of the research, 31 themes were extracted from interviews with 10 research participants. And 10 theme clusters were categorized from these. And these clusters were divided into 3 domains : 'before school dropout', 'causes & process of school dropout, feeling about school dropout', 'after school dropout' Based on the finding of the study, major conclusions of this study were as follow: First, adolescents who dropped out specialized vocational high school suffered from hard school life, disappointing lead from teachers, stereotypical lesson. And they committed misdeeds, and had psychological difficulties. Some of them kept up the good relationship with their friends, teachers, parents, some of them did not. Some of them kept up the good relationship with their friends, teachers and parents, while some of them did not. Second, they chose dropout due to various different causes. The procedures of school dropout proceeded with comparative ease. The effect of dropout prevention program is very limited. The feeling they felt at the time of school dropout varied individually. Some adolescents who dropped out specialized vocational high school were satisfied while others were stressed out, regretting their decision. Third, they lived diligently working part-time jobs or preparing General Equivalency Diploma (GED) test after dropout. They experienced positive changes in their daily lives after dropout. But sometimes they experienced various difficulties and negative changes. Most of them had their goals, and they were preparing for them. Their expectation was low that their life will succeed if they returned to school. They wanted people to understand their decision about dropout. And multiple institutions are supporting adolescents who dropped out specialized vocational high school. They need practical support : Various information, activity for career experience, counseling etc.

Considerations of Countermeasure Tasks in the Fields of Forest and Forestry in Korea through Case Study on "The Nagoya Protocol (Access to Genetic Resources and Benefit Sharing)" ("유전자원의 접근과 이익공유(ABS)" 사례연구를 통한 국내 산림·임업분야 대응과제 고찰)

  • Lee, Gwan Gyu;Kim, Jun Soon;Jung, Haw young
    • Journal of Korean Society of Forest Science
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    • v.100 no.3
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    • pp.522-534
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    • 2011
  • The aim of this study is to draw forth the tasks for establishing the right of native biology in Korea through the case study on 'Access on genetic resources and Benefit Sharing'. For this purpose, this study decided on its research subject by selecting Hoodia, on which ABS treaty was made the most recently, through the examination of the representative ABS precedents on plant species. This study analyzed the process background of ABS on Hoodia, and compared & analyzed the ABS procedures of 'Bonn Guidelines' adopted by the 6th Conference of the Parties of the Convention on Biological Diversity in 2002 and Hoodia case. Together with the ABS major issues in common drawn as a result of this analysis, and "Nagoya Protocol" adopted by the 10th Conference of the Parties of the Convention on Biological Diversity, this study intended to shed a light on the impending tasks which Korea faces at present and its role relationship. The research results are as follows: 1. It is required that species habitats should be divided based on biological classification and its subsequent community should be established with the development of infrastructure such as a community's independent production, management and monitoring of bio-species. 2. There needs to be a designation of ABS National Focal Point for sharing of ABS-related general information, boosting of implementation of the relevant convention. 3. There needs to be the establishment of ABS convention system consequent on legislative, administrative, political procedures, and designation of the Competent National Authorities for the provision of the format of Prior Informed Consent (PIC) and Mutually Agreed Terms (MAT) and their contents assessment and confirmation. 4. There should be the establishment of integrated management system of ABS-related research and development of forest biological resources and its relevant research projects. 5. There should be information development through the distribution of responsibility and role between the ministries and offices concerned according to bio-resources, and there needs to be efforts in aiming for opening a working group of academic-industrial institutions for developing a mutually interchangeable system. 6. It's required that the efficient access between industrial circles and the people should be promoted by setting up ABS support center of biological resources in ministry and office's charge. 7. There should be a selection of a national supervisory organization for securement of the right of a local community and monitoring of ABS convention implementation, and a countermeasure system for preventing outflow of forest bioresources. Conclusively, it's judged that it will be possible to inquire into the countermeasures for the establishment of the native forest biology dominion through such research results.

An Exploratory Study on Female Caregivers' Experiences of Aggression by Older Residents in Nursing Homes (노인요양시설 입소노인에 의한 여성요양보호사의 폭력 경험에 대한 탐색적 연구)

  • Yoo, Seong Ho;Kim, Bo Kyung;Moon, Yu Jin;Shim, Il Kwang;Cho, Hee Ju
    • 한국노년학
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    • v.36 no.4
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    • pp.1037-1058
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    • 2016
  • This study aims to investigate the female caregivers'experiences of aggression by nursing home residents, and to identify the policy strategies for violence prevention referred by the female caregivers. A total of 121 female caregivers with more than 6 months of working experiences had participated in this study. Of these, 56.2% had experienced verbal aggression, 51.2% physical aggression, and 27.3% sexual aggression, which reveals that client violence toward caregivers in nursing homes was at an alarming level. Although, physical and verbal violences were mostly caused unintentionally, about a half of the sexual aggression were caused deliberately. Aggression occurred the most when caregivers were providing the following services: changing the diapers or clothes, giving a bath, and serving meals. It was found that 'hitting' was the most common form of physical aggression and it was 'swearing' and 'touching or physical contacting' in the case of verbal and sexual aggression, respectively. Though there was a difference depending on the type of aggression, the most frequent reactions against client violence were to start a conversation or calm down the nursing home residents, and to leave the scene or ignore the incident. This means that the caregivers are coping very passively through resolving the aggressions by themselves, or overlooking the situation. The most frequently recommended strategy to prevent resident aggression was to provide educational programs on violence prevention to nursing home residents and caregivers(42.7%). Compared to the previous studies, this study indicates some differentiated strategies to prevent violence in nursing homes, which include hiring male caregivers, assuring directors to pay closer attention toward caregivers, using refined language between caregivers and residents, and keeping caregivers to wear appropriate clothes. Based on the study results, some policy recommendations on the prevention of client violence in nursing homes were suggested.

A Case Study on Psychological Burnout and Self-care of Childcare Teachers for Emotional Labor -Song psychotherapy- (감정노동 보육교직원의 심리적 소진과 자기 돌봄의 관한 사례연구 -노래심리치료-)

  • Lee, Ji-Hoon;Shin, Soo-Won
    • Industry Promotion Research
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    • v.6 no.3
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    • pp.9-17
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    • 2021
  • Childcare teacher experience emotional labor that suppresses, exaggerates, controls and regulates their emotions in order to produce the positive image required in the nursery field. The working environment for infants and toddlers has a problem of lowering the quality of life as a cause of psychological exhaustion of the emotional labor childcare teacher. Because singing helps to improve the quality of human life, research is needed to enable emotional labor childcare teacher to recover from psychological exhaustion and plan a positive life in the process of self-care. First, how is the psychological exhaustion of the emotional labor childcare teacher through song psychotherapy? Second, how is the process of self-care of the emotional labor childcare teacher through song psychotherapy? The study was conducted from March 2017 to May 2020, and through qualitative case studies, data such as in-depth interviews, direct observations, and participation observations were collected at the ○○○ daycare center for 50 minutes every 12 sessions. Based on the above findings, the following conclusions were drawn: First, through singing psychotherapy, emotional labor and childcare staff were able to discover, understand, recognize, face, communicate, and insight into their will to live, psychologically exhausted themselves. Emotional support from others can reduce the experience of emotional depletion and demonstrate a recovery of experience and an improvement in achievement due to frustration at work. Second, the self-care of the emotional labor child care teacher through song psychotherapy proved the temporal, spatial, relational, and emotional caring process, while maintaining the balance between caring for others and caring for oneself, body, mind, and spirituality are organic change. In this study, the psychological exhaustion and self-care process provides an opportunity to discover the essence of life, explore and express one's inner self, take care of others and oneself in a balanced manner, and provide insights for a whole person and healthy self. It is significant in providing opportunities to improve the quality of life through growth.

A Study on the Current State of Pediatric Dentists and the Adequacy of Supply and Demand Based on Covered Services (소아치과 전문의 인력 현황 및 공급 적정성에 관한 연구 - 급여 진료 항목을 기준으로)

  • Yeo Won Lim;Yong Kwon Chae;Ko Eun Lee;Ok Hyung Nam;Hyoseol Lee;Sung Chul Choi;Mi Sun Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.3
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    • pp.360-372
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    • 2023
  • The aim of this study was to identify the current state of pediatric dentists, evaluate the adequacy of pediatric dentist supply and demand, and find out the perception of all pediatric dentists on the current state of pediatric dentists and policy establishment. An Online survey was conducted among pediatric dentists. The questionnaire was subdivided into 'general characteristics', 'number of dental treatments and working days per year', 'proportion of covered services', 'perceptions of supply and demand of pediatric dentists'. Through the Korean Academy of Pediatric Dentistry, the Health Insurance Review and Assessment Services, the National Health Insurance Service (NHIS), and the Korean Statistical Information Service, the current state of pediatric dentists, the number of claims for covered services, and the decrease in births per year were investigated. Dental clinics claiming to be pediatric dentistry reached half of all medical institutions, but only 3.78% of pediatric dentists actually worked. 61.36% of all pediatric dentists were concentrated in the metropolitan area, showing a national imbalance. Although the population of children and adolescents have continuously decreased over the past 20 years, the number of NHIS-covered services has shown a continuous increase. Over the past 10 years, the optimal supply of pediatric dentists has been maintained at around 4,000. According to the analysis, 92.15% of pediatric dentists thought that it was necessary to prepare policies and support measures at the government level. This study is expected to be used as basic data for establishing a demand estimation method for pediatric dentistry specialists in the future.

Assessment of Food Service Management at Childcare Facilities According to the Number of People Eating Meals (식수인원에 따른 보육시설 급식소 위생관리 수준 평가)

  • Dong Soo Kim;Hyuk Sung Kwon;Pyeong Won Kim;Ja Yeong Lee;Sang Gu Kim;Sang Yun Lee
    • Journal of Food Hygiene and Safety
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    • v.39 no.1
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    • pp.26-34
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    • 2024
  • In this study, the food service management levels of cafeterias in childcare facilities were investigated based on the number of meal recipients and the working status of the kitchen staff. The study included 199 childcare facilities nationwide that received food supplies from the food ingredients distribution company, Pulmuone Foodmerce, from 2021 to 2022. The assessment was conducted using 61 inspection items. The analysis revealed that, as the number of meal recipients and kitchen staff members decreased, the documentation of inspection results was less likely to be conducted (P<0.05). Facilities with fewer meal recipients showed less adequate health status checks for kitchen staff, and those with fewer kitchen staff showed insufficient compliance with hygienic clothing (P<0.05). Additionally, facilities with fewer meal recipients showed a higher frequency of lapses in checking the expiration dates of stored ingredients (P<0.05), requiring increased management attention. They also exhibited the absence of internal temperature measurement records during heating processes (P<0.05). Furthermore, facilities with fewer meal recipients demonstrated inadequate maintenance of kitchen facilities (P<0.05). Significantly higher adenosine triphosphate (ATP) levels were detected on the hands and cutting boards of the kitchen staff in facilities with fewer meal recipients and fewer kitchen staff (P>0.05). Overall, facilities with fewer meal recipients exhibited insufficient infrastructure management for kitchen operations and inadequate hygiene management. These results are expected to provide foundational data for the selection of national support programs for childcare facilities in the future.

A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours (병원 간호사의 선호근무시간대에 관한 연구)

  • Lee, Gyeong-Sik;Jeong, Geum-Hui
    • The Korean Nurse
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    • v.36 no.1
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    • pp.77-96
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    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

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Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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