• 제목/요약/키워드: Rural Village Planning

검색결과 484건 처리시간 0.021초

충북(忠北) 옥천군(沃川郡) 청산(靑山) 정기시(定期市) 출시자(出市者)의 공간적(空間的) 특성(特性) (Spatial Characteristics of Travelling Merchants and Consumers in Chongsan Periodic Markets of Okchon County, Korea)

  • 한주성;김봉겸
    • 한국지역지리학회지
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    • 제2권1호
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    • pp.133-150
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    • 1996
  • 농촌의 최하위 계층 중심지에 발달한 정기시의 이동상인과 소비자의 공간적 특성을 파악하기 위하여 오래 전부터 개시(開市)된 옥천군 청산 정기시를 대상으로 출시자를 조사하여 분석한 결과 다음과 같은 점이 밝혀졌다. 이동상인은 장년 내지 노년층으로 구성되어 있으며, 일용잡화와 농산물을 취급하고, 정기시 출시(出市)의 주된 유형은 청산$\rightarrow$원남$\rightarrow$보온의 유형과 청산$\rightarrow$영동$\rightarrow$용산의 유형이다. 상인의 거주지는 정기시가 입지한 지역이 가장 많고 이어서 인접해 있는 하위 중심지인 청성면, 상위계층 중심지인 보은 영동읍과 대전시, 그리고 보은군 원남면으로, 이들은 정기시를 매일 자기 집에서 5일에 3일 이상 출시하거나 특정한 하나의 정기시만을 5일에 하루 출시하는 형태를 취하고 있다. 정기시를 이용하는 소비자는 $30{\sim}50$대가 대부분이고, 한달에 $2{\sim}6$회 정기시에서 재화를 구입하며, 이용하는 교통수단은 주로 버스이다. 그리고 생활필수품을 구입하기 위하여 출시하는데, 구입하는 상품은 주로 식료품이고 전문계도 고차 중심지보다 이 지역의 상위 중심지인 청산에서 구입하는데 이는 타 지역과 교통이 불편하고 거리도 밀어 상품을 구입할 매 비용이 추가되며, 상품을 구입한 후에도 아프터서비스를 받는데에도 불리하기 때문이다. 그러나 청산 정기시에서 구입하지 못하는 선매재나 전문재는 거리가 가까운 보은읍보다는 상위 중심지인 영동읍이나 대전시에서 구입하고 있다. 최하위 중심지의 정기시는 농촌인구의 감소, 주민의 소득증대와 생활수준의 향상, 중심지의 상설 상업시설의 등장, 유통기구의 변화, 교통기관의 발달 등 정기시의 외적 환경들이 변화됨에 따라 이동상인의 출시형태가 변화되었으나 상대적으로 교통이 불편한 지역의 소비자는 편의(便宜) 선매재(選買財)뿐만 아니라 전문재(專門財)도 최저차 중심지에서 많이 구입하고 있다는 점이 밝혀졌다.

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농촌(農村)에 있어서 분만개조요원(分娩介助要員)의 봉사(奉仕)에 의(依)한 모자보건(母子保健)rhk 가족계획(家族計劃)에 관(關) 연구(硏究) (A Study on Maternity Aids Utilization in the Maternal and Child Health and Family Planning)

  • 예민해;이성관
    • Journal of Preventive Medicine and Public Health
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    • 제5권1호
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    • pp.57-95
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    • 1972
  • This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

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

  • 방숙;한성현;이정자;안문영;이인숙;김은실;김종호
    • Journal of Preventive Medicine and Public Health
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    • 제20권1호
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    • pp.165-203
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    • 1987
  • This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

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강원도(江原道) 화전정리사업(火田整理事業)에 수반(隨伴)되는 문제점분석(問題點分析)에 관(關)한 연구(硏究) (An Analytical Study of the Problems Involved in the Project to Rehabilitate the Illegal Field Burning Cultivators in Gangweon Do)

  • 호을영
    • 한국산림과학회지
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    • 제28권1호
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    • pp.50-66
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    • 1975
  • 화전경작(火田耕作)은 산림(山林)을 황폐화(荒廢化)하고 국토(國土)를 침식(浸蝕)하여 한수해(旱水害)를 유발(誘發)시키며 국가발전(國家發展)과 국민경제향상(國民經濟向上)에 일대저해요인(一大沮害要因)의 작용(作用)을 하고 있음으로 이를 근절(根絶)시킴은 국가적사명(國家的使命)으로 되어 있다. 강원도(江原道)는 전도면적(全道面積)의 8할(割)이 산림(山林)으로 점(占)하고 있어 화전면적(火田面積)이 타지(他道)에 비(比)하여 가장 많이 분포(分布)되고 있다. 이로 인(因)한 산림피해(山林被害)는 막심(莫甚)하며 도민(道民)의 경제발전(經濟發展)이 지연(遲延)되고 있어 65년(年)부터 7개년계획(個年計劃)으로 화전정리사업(火田整理事業)에 착수(着手)하였으나 68년(年) 삼척(三陟), 울진공비침투사건(蔚珍共匪浸透事件)으로 산악지대(山岳地帶)의 독가촌정리사업(獨家村整理事業)이 국가안보상(國家安保上) 시급(時急)을 요(要)하게 되어 본사업(本事業)은 부득이(不得已) 중단(中斷)되었다. 그 후(後) 새로운 화전(火田)을 모경(冒耕)하는 자(者)가 속출(續出)하여 산림파괴(山林破壞)가 심(甚)함으로 73년(年)을 준비년도(準備年度)로 하고 74~76년(年)의 3개년계획(個年計劃)으로 화전정리사업(火田整理事業)을 완결(完結)할 목표하(目標下)에 도행정력(道行政力)을 총동원(總動員)하여 강력(强力)하게 추진(推進)하고 있다. 본사업(本事業)의 성패(成敗)는 화전정리(火田整理)로 생계위협(生計危脅)에 직면(直面)하는 화전민(火田民)에 대(對)한 자립기반조성여부(自立基盤造成與否)에 달려있으며 다음과 같은 문제점(問題點)이 해결(解決) 되어야 한다. 1) 이주화전민(移住火田民)에 대(對)한 취업정착(就業定着)이 성취(成就)되어야 한다. 2) 현지정착화전민(現地定着火田民)에 대(對)한 자립기반조성(自立基盤造成)에 필요(必要)한 최소한도(最小限度)의 지원(支援)이 보장(保障)되어야 한다. 3) 공공기관(公共機關) 및 기업체(企業體)는 화전민(火田民)에 대(對)한 취업취로(就業就勞)를 우선적(優先的)으로 수용(受容)하여야 한다. 4) 화전민(火田民)은 취업취로(就業就勞)로 생활기반(生活基盤)이 확립(確立)되어야 한다. 5) 화전민자신(火田民自身)이 자조(自助) 자립정신(自立精神)이 확립(確立)되어야 한다. 6) 새마을 사업(事業)과 연결(連結)된 자조근로사업(自助勤勞事業)을 확장(擴張)시켜 취로(就勞)의 기회(機會)를 주어야 한다. 7) 도민(道民)은 화전민(火田民)에 대(對)한 물심양면(物心兩面)의 지원(支援)으로 동포애(同胞愛)를 발휘(發揮)하여야 한다. 8) 화전지조림(火田地造林)은 적지적수(適地適樹)가 이행(履行)되어야 한다. 9) 산주(山主)가 원(願)는 수종(樹種)의 묘목(苗木)을 확보공합(確保供給)하여야 한다. 10) 산림계(山林契)의 조직기능(組織機能)을 강화(强化)하여 화전조림지(火田造林地)의 관리(管理)에 철저(徹底)를 기(期)하여야 한다.

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