• 한국지역지리학회지
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• 제3권2호
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• pp.163-193
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• 1997

복지사회를 지향하는 오늘날, 건강 중진에 직접 관계되는 의료시설의 접근성 문제는 주요 과제이다. 특히 삶의 질이라는 측면에서 질병의 치료 외에 건강진단, 예방과 회복, 요양 및 응급서비스의 비중이 커지고, 인구의 노령화 현상이 진전되면서 의료시설의 효율적인 입지가 주 관심사로 대두되고 있다. 의료시설은 주민의 생존과 직접 관계되는 기본적이고도 필수적인 중심시설로, 지역 주민은 균등한 혜택을 받을 수 있어야 한다. 이를 실현시키기 위해서는 기본적으로는 효율성과 평등성을 기반으로 1차 진료기관이 균등 분포해야 한다. 이에 본 연구에서는, 광주시를 사례지역으로 선정하여 의료시설의 입지와 그에 대한 주민의 효율적 이용에 관하여 분석하였다. 분석에 있어서는 통계자료와 기존의 연구 성과 외에 설문 및 현지조사 자료를 기반으로 시설 측면과 이용자 측면을 동시에 고찰하였다. 우선 의료 환경의 변화 및 의료시설의 변화 과정을 고찰하고, 이어서 의료시설의 유형별 입지 특성과 주민의 분포 특성을 고려한 지역별 의료수준을 분석하였다. 그리고 유형별 의료시설의 이용행태와 그 요인을 구명한 후, 마지막으로 장래 이용 유형의 예측과 문제지역의 추출, 나아가서는 시설의 합리적인 입지와 경영 방향을 제시하였다. 본 연구 결과는, 앞으로 신설될 의료시설의 적정 입지에 관한 기본 자료로서는 물론 지역 주민의 불평등성 해소라는 응용적 측면에서 의의를 지닌다.

• 농촌의학ㆍ지역보건
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• 제12권1호
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• pp.80-93
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• 1987

Mass chemotherapy of Clonorchis sinensis infection in Korea was started in 1982 with 40mg/kg body weight single dose administration scheme of praziquantel. The purpose of this study was to investigate the efficiency of current mass chemotherapy project and compare the epidemiological changes in endemic area of Ckmorchis sinensis. This study was performed at Kimhae-city and Samrangjin-eup of Miryang-gun, Kyongnam province, highly endemic area of C. sinensis located southeastern part of Korea from July to October of 1986. The therapy project of Kimhae area was performed in 1984, whereas that of Samrangjin was done in 1985 by stool examination of the Korea Association for Parasite Eradication(KAPE) and drug administration of local health centre. The results obtained were as follows; 1) As a results of stool examination from 234 specimens obtained in Kimhae area, the infection rate has decreased to 34.2%from 45.6p in 1983, but the infection rate of C. sinensis from 341 specimens obtained in Samrangjin area did not decrease (58.1%in 1986 490%in 1983). 2) The study in Kimhae area showed that the average EPG decreased remarkably from 4,858 to 1,340 and those classified above the category of heavy infection decreased also from 14.0pp to 1.7%. The study in Samrangjin area showed that the average EPG did decrease drastically from 9,597 to 6,498 and those classified above the category of heavy infection did not go down drastically from 25.2% to 14.2%. 3) The study in Kimhae area showed decrease of Cs.$D._{50}$ in comparison to that in 1983, wheareas Cs.$D._{50}$ in Samrangjin area showed no much difference compared to that in 1983. The intensities of endemicity were represented with the regression equation calculated with the cumulative percentages of EPG count. Regression equation was Y=4.49+1.19 log x in Kimhae area and Y=3.66+127 log x in Samrangjin area. 4) The two stage catalytic model was applied and the calculation lead to the equation $Y=5.33(e^{-0.018t}-e^{-0.016t})$ in Kimhae area and $Y=1.25(e^{-0.010t}-e^{-0.018t})$ in Kimhae area and $Y=125(e^{-0.010t}-e^{-0.050t})$ in Samrangjin area 5) The infection rate of cercaria in P.manchouric-us studied in Kimhae area showed 1.25% which is not much different from that in previous years, wheareas the infection rate of metacercaria in P. parva studied in the same area this year showed 2.5-20.2/gm of flesh in comparison to 64/gm of flesh in 1983. 6) Data of C. sinensis infection on the reservoir host in Kimhae area showed 4 out of 18 dogs, 1 out of 18 rats and that in Samrangjin area showed 2 out of 18 dogs respectively. 7) Among the inhabitants who were under mass chemotherapy in Kimhae area, 71out of them, upon stool examination, showed infection rate of 66.2% and those classified above the category of heavy infection, 2.4%. In comparison to infection rate of 33.7% and those classified above the category of heavy infection, which is 1.0%, obtained from those not under mass chemotherapy showed higher infection rate and somewhat equal distribution of intensity of infection. The above statements reflect the fact that individual therapy besides mass chemotherapy was prevalent in that area. 8) On the other side, the studies in Samrangjin area showed infection rate of 68.7% and those above the category of heavy infection, which is 6.1%, in comparison to infection rate of 58.3% and those above the category of heavy infection, which is 16.5%, in those not under mass chemotherapy. the above reflects that although a good deal of inhabit-ants were classified under light or moderate infection category, those above the category of heavy infection, yet, numbered a lot, and individual chemotherapy has not been going on. In conclusion, it was suggested that the number of reinfected inhabitants among those under mass chemotherapy were numerous. Accordingly, the reinforcement of health education should be followed with mass chemotherapy. The facts of high infection rate exemplified by 65% and high number of those above the category of heavy infection in Samrangjin area say that reevaluation of dosage, number of medication and intervals should be necessarily made.

• 농촌의학ㆍ지역보건
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• 제20권2호
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• pp.157-168
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• 1995

This study was carried out, through analyzing the annual reports(year of 1973-1993) on health status of Su Dong-Myun, and specific survey data of 332 households(Su Dong-Myun 209, Byul Nae-Myun 123), located in Nam Yang Ju-Si, Kyung Gi-Do, from July 20 to July 31, 1995, to find out more effective means for primary medical care in a rural area. The results were as fellows : 1. Number of population in Su Dong-Myun was 5,419 in 1973, 4,591(the lowest) in 1987 and 5,707 in 1995. In the composition rate of population, "0-14" of age group showed markedly decreasing tendency from 43.1% in 1975, to 19.1% in 1995, however "65 and over" markedly in creasing tendency form 5.3% in 1975 to 9.8% in 1995. 2. Annual utilization rate per 1,000 inhabitants in Su Dong-Myun showed markedly increasing tendency from 1973 to 1977 such as 343 in 1973, 540 in 1975, 900 in 1977. However, since 1979, the rate showed rapidly decreasing tendency, such as 846 in 1979, 519 in 1985, 190 in 1991 and 1993. 3. The morbid household rate per year was 53.6% of respondents and the rate per 15 days was 48.2%. In disease classification rate of morbid household per year, Arthralgia & Neuralgia was the highest rate(33.9%) and gastro-intestinal disorder(19.3%), Cough(11,9%), Hypertension(7.8%), Accident(3.2%) in next order. 4. In the utilizing facilities for Primary Medical Care, Medical facilities was showed the highest rate(58.1% of respondents) and Pharmacy and Drug Shp(33.1%), Tradition Method(4.0%) in next order. In the Medical facilities, General private clinic was showed the highest rate(34.3%) and specific private Clinic(22.3%), Hospital(19.0%), Health (Sub)center(16.3%), Nurse practitioner (3.3%), Oriental hospital and clinic(2.7%) in next order. 5. Experience rate, utilizing health subcenter was 51.8% of the respondents, and it was 55.0% in Su Dong-Myun and 46.3% in Byul Nae-Myun. In utilization times of health subcenter, times-rate showed next orders such as 1-2 times/6months(31.6%), 1-2 times/year (22.1%), 1-2 times/months(19.2%), 1-2 times/3months(15.6%). 6. In objectives, visiting Health Subcenter, Medical Care was the highest rate(59.8% of the respondents) and health control(23.3%) was in next order. In Medical Care, Primary Care by general physician was higher rate(51.1%) almost all. In the Health control, Immunization too was high rate(18.0%) in health control activities. 7. The reasons rate, utilizing health subcenter showed next order, such as distance to Medical facilities(33.0% of the respondents), Medical Cost(28.1%), Simple process of consultation (10.8%), Effectiveness of cure(7.6%), Function of primary medical care(7.0%) and Attitude of physician(6.5%). 8. In the affecting factors to utilization of primary medical facilities, medical needs was showed the highest rate(29.5% of the respondents) and medical cost(15.4%), distance to medical facilities(14.2%), traffic vehicle(14.2%) and farm work(6.9%) in next order. 9. In the priority between 'daily farm work,' and 'primary medical care', only 46.4% of respondents answered that primary health care is more important than the daily farm work The 22.6% of respondents answered 'daily farm work', and the 12.3% answered 'the equal of the both'. 10. In the criterion of medical facilities choice, medical knowledge and technical quality was showed the highest rate(56.3%), distance or time to medical facilities(10.9%), sincerity and kindness of physician(9.4%), medical cost(8.7%) and traffic vehicle(6.5%) in next order 11. In the advise for improvement of health subcenter function, the 36.1% of respondents answered that 'enforcement of medical personnel and equipment' was required, and then 'improved medical technology'(25.5%), 'good attitude of physician'(14.9%), 'improved medical system'(13.3%), 'enforced drug'(6.7%) in next order. 12. The study on affecting factors to utilization of primary medical facilities was very difficult subject to systematize the analyzed results, due to a prejudice of protocol planner, surveyer and respondent, and variety and overlapping of subject matter.

• Parasites, Hosts and Diseases
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• 제28권2호
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• pp.109-114
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• 1990

한국 가톨릭의사협회는 남미 에꽈돌국 과야스주의 해안 지방인 빨말 본당에서 운영하는 "빠띠마 성녀 기념 본당 진료소"의 의료사업을 지원하고 있다. 그 사업의 하나로 이 지역 메스띠조인의 보건 실태를 관찰하고 앞으로의 중점 보건 사업을 파악하기 의하여 1989년 8월 6일부터 8월 19일까지 주민 진료와 합께 대변검사를 실시하고 기생충 감염 실태를 조사하였다. 이 지역은 동부 태평양에 연한 해안 어촌 마을인 빨말(본당), 아양게, 함벨리(공소)와 해안에서 떨어져 있고 목축을 주업으로 하는 바빌 데세초, 리오세꼬, 밤빌꼬자오, 마난띠 알 데 꼴론체 및 세비자 등 공소마을로 구성되어 있고 주민은 모두 약 20,000명으로 추산된다. 대변검사는 직접 도말법(요드염색 후) 1매와 셀로판후층도말법 1매를 각각 검경하여 장내 원충 포낭 및 윤충 충란 배출을 검사하였다. 검사 대상자는 진료소를 찾은 주민이며 빨말 본당 지역의 주민 160명을 포함한 해안 마을 주민 226명과 내륙 공소 마을 주민 99명 등 모두 325명이었다. 대변검사 결과 충란 및 포낭 양성률이 66.1%이었고 윤충 충란 양성률은 38.2%, 원충 포낭 양성률은 56.1%이었다. 기생충별 양성률은 회충 18.1%, 편충 19.4%, 구충 0.6%, 왜소조충 3.7%, 유구 및 무구조충 1.8%, 이질아메바 19.4%, 대장아메바 28.6%, 소형아매바 5.5%, 요드아메바 1.5%, 람블편모충 11.1%, 킬로마스틱 스메니리 0.6%이었다. 이상의 결과를 종합하여 보면 이 지역에서 가장 중요한 기생충 감염은 이질 아메바와 람블편모충이며 따라서 위생적인 식수를 마련하는 것이 가장 중요한 보건사업이라고 판단되었다. 목축을 주로 하는 내륙 마을중에는 조충증과 유구낭미충증이 유행하는 지역이 있었다.

• Journal of Nutrition and Health
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• 제37권10호
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• pp.908-916
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• 2004

Due to the common dietary practice of preparing foods in various ways using the same food item, in addition to rather a large number of food items that average Koreans consume, it is difficult to accurately assess the nutritional adequacy. In an effort to identify a reliable means of assessing the nutritional adequacy of Korean adults, we analyzed the association between the scores of dietary diversity (DDS) and dietary variety (DVS), and the quality of nutrient intake as assessed by Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR). A three day-dietary record was obtained from each of 324 inhabitants, aged 40 to 69 years (mean :t SD,52.4 $\pm$ 8.7), of a rural area (Ansung) and a mid-sized city (Ansan) of Korea. These individuals were randomly selected among the participants of the Korean Health and Genome Study. The number of consumed foods and food groups were assesses by DDS (scored 1 to 5) and DVS (ranked 30 $\leq$,31 - 40, 41 - 50, 51 - 60, and 60 <) over three-day period, respectively. As DDS/DVS increased, mean daily food intakes tended to increase, and NARIMAR was improved. Thus, DDS and DVS were significantly correlated with the quality of nutrient intake. Over 95% of the subjects scored less than 2 in DDS for the first one-day period, whilst over 62% recorded 4 during the full three-day period (p < .0001). The mean number of consumed food items increased from 24.9 to 44.4 as a function of days of the record period (p < .0001). We also analyzed the association of DDS and DVS with MAR, using regression analysis, controlling age and sex as covariates. For DDS, the adjusted coefficient determination (adj $R^2$) values were 8.7%,15.8%,23.3% of MAR, also increasing as a function of the record duration, whereas they were 27.3%, 33.3%, 37.6% for DVS, respectively, demonstrating that NAR/MAR has a better correlation with DVS than DDS. Our data show that DDS, and DVS in particular, are useful parameters for evaluating nutrient intake in the Korean population. Our data also support that one day-dietary records are by no means adequate for accurately describing a wide variety of food choices offered for average Koreans, and that dietary assessment at least for 3 days or longer should be obtained for a reliable evaluation of dietary quality using DDS or DVS.

• 농촌의학ㆍ지역보건
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• 제7권1호
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• pp.50-56
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• 1982

This study was undertaken to evaluate the present status of parasitic infection and swine pen human latrine system in Cheju Do, from July to September 1982. The 663 stool specimens (male 323 and female 340) and 579 scotch tape anal swabs collected from 161 households of 2 areas in Cheju Do were examined. The methods employed were formalin-ether technique for the prevalence rate of various helminthic and protozoan infection, and scotch tape anal swab technique for the prevalence rates of Enterobius vermicularis. In addition to these, questionaire was used to evaluate the present status of swine pen human latrine system and prevalence rates of taeniasis in these areas. The results are as follows ; 1) Prevalence rates of parasitic infections of any kind was 33.9%. It was 35.7% in Cheju City in contrast to 32.1% in North Cheju Gun. The infection rates of Trichuris trichiura was 10.0% and it was the highest prevalence rate in this survey. The prevalence rates of the other parasites were as follows ; Ascaris lumbricoides 2,3%, Hookworm 0.2%, Clonorchis sinensis 0.5%, Hymenolepis nana 1.5%, Entamoeba coli 3.2%, and Giardia lamblia 0.5%. 2) The infection rates of Enterobius vermicularis in 579 peoples (male 285, female 294) by applying scotch tape anal swab technique was 13.1% through the survey. It was 16.9 in Cheju City and 8.5% in North Cheju Gun. 3) The Infection rate of Taenia species by applying the stool examination and making up a question was 19.2%(21.4% in Cheju City and 16.7% in North Cheju Gun). 4) Sexual distribution of the parasitic infections showed slightly higher rate in female than that of male. 5) The positive rates of parasitic infection by the stool examination and questionaire positive cases of taeniasis were higher in 0-9 and over 60 year old than any other age group. 7) The swine pen human latrine systems were used in 46 households (28.6%). 7) Relationship between swine pen human latrine system and taeniasis was not noted.

• 농촌의학ㆍ지역보건
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• 제7권1호
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• pp.66-73
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• 1982

Paragonimus westermani is one of the most popular endemic parasitic diseases in Korea. The nation-wide prevalence survey were carried out by Gobayashi (1921) with sputum examination and by Walton and Chyu (1959) with the intradermal skin test respectively. Recent studies showed the decline of positive rate in intradermal skin test of the local inhabitants and also showed the less distribution of intermediate host. The fact seemed that caused by economic improvement of village people, decrease of intermediate host by increasing use of pesticides, becoming lower water level at streams and rivers and better irrigation and finally by better community health education etc. Gangwha area of Gyeonggi-Do was found out as an endemic area of Paragonimus westermani through some studies in the past, however, in the vicinity area of Gangwha, the study in Kyodong island (myon) was carried out in 1965 by Yun et al. Therefore author carried out the intradermal skin test for 2,380 students of primary, middle and high school in Kyodong island and Samsan island. The results showed as follows : 1) The positive rate of intradermal test for paragonimus westermani infection showed positive in 152 among 1,845 students (8.2%) in Kyodong island, and 21 among 637 students (3.3%) in Samsan island respectively. 2) According to grade levels, 49 among 973 students (5.0%) in primary school, 62 among 962 students (6.4%) in middle school and 53 among 445 students (11.9%) in high school showed positive rate. This showed the higher grade the higher positive rate. 3) Among these total 164 positive cases in the intradermal skin test, only in 3 cases eggs were found in sputum. 4) Finding out the intermediate host, only 28 crayfishes from Kyodong island and 12 from Samsan island were collected and examined for metacercaria infection, however, none of metacercaria was found. 5) As a control group, 2 primary schools from the main island were selected. In these schools from the sixth grade students showed positive rate of 4.8% in Naega primary school and 0% in Hajeom Primary school respectively. Those results showed much decrease than studies carried out in the past. 6) The survey for food habit showed that 15 among 1,274 students (1.2%) had experiences of eating raw intermediate host(crayfish) and 266 among 988 students (27.0%) ate cooked.

• 농촌의학ㆍ지역보건
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• 제34권1호
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• pp.135-142
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• 2009

섬진강 유역 일개 군지역에서 1999년부터 2005년까지 간흡충 관리사업 결과 간흡충 감염률과 감염관련요인의 변화를 알아보기 위해 체계적 확률표본추출한 8개 마을주민 699명 중 416명에 대해 간흡충 충란검사를 위해 대변검사와 관련요인들의 특성을 파악하기 위해 설문조사를 하였으며, 1999년의 선행 연구와 비교하여 다음과 같은 성적을 얻었다 1. 간흡충 감염률은 1999년의 19.0%에서 2005년 11.3%로 유의하게 감소하였다 (P(Z)=0.000). 2. 간흡충 감염과 관련된 요인별 감염률은 남자와, 44세 이상자, 강변지역 거주자, 음주자 및 흡연자에서 유의하게 감소하였고, 그 결과로써 1999년에 성별, 연령별, 지역별, 생식습관, 음주여부와 같은 요인에 따라 감염률이 통계적으로 유의한 차이를 보였으나, 2005년에는 그러한 차이를 보이지 않았다. 3. 이전 간흡충 검사여부와 검사결과, 치료후 재섭취 여부에 관계없이 감염률이 유의하게 감소하였다. 4. 간흡충에 대한 인식 항목에서 간흡충증을 ‘잘안다’거나 ‘들어본적 있음’군에서 유의하게 감소하였고, 건강행위 실천여부에 에서는 안 한다고 하는 군에서 감염률이 유의하게 감소하였다. 결론적으로 간흡충 감염률은 5년 전에 비해 크게 감소하였다. 그 원인으로서는 지속적인 보건사업과 민물고기 생식률이 감소하고, 민물고기의 수나 종류가 감소하는 등 환경적인 변화가 작용한 것으로 보인다. 그러나 아직도 전국평균에 비하면 많이 높아서 간흡충 관리사업을 더욱 강화해야 할 것으로 생각된다. 또한 지속적인 간흡층관리사업의 결과, 감염 관련 요인으로 파악되었던 성별, 연령, 지역, 생식습관, 음주여부와 상관 없이 감염률이 감소되는 것으로 밝혀져 이와 같은 특성에 관계없이 전체 주민을 대상으로 간흡충 관리 사업이 확대되어야 할 것으로 사료된다.

• 농촌의학ㆍ지역보건
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• 제25권2호
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• pp.441-448
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• 2000

This study was performed to investigate the prevalence and its related factors on the Clonorchis sinensis(C.S.) of inhabitants at Goksung-gun, Chollanam-do. After the population was stratified by gender, age, resident area, 651 residents living in eight villages were sampled by cluster sampling method. We interviewed the subjects to survey the various characteristics using the questionnaire, and examined stools to confirm the infection of C.S. from November to December, 1998. The prevalence of C.S. was 19.0%. The factors related with the infection of C.S. were male(adjusted odds ratio, of female=1.71, 95% confidence interval=1.07-2.72), 45-64 year old group(aOR of under 45 year old group=2.16. 95% CI=1.21-3.85), above 65 year old group(aOR of under 45 year old group=2.34, 95% CI=1.31-4.15), basin villagers(aOR of inland villagers=2.34, 95% CI=1.31-4.15), current drinker(aOR of nondrinker=1.83, 95% CI=1.12-2.98), those who took raw fish(aOR of persons who didn't it or take cooked fish=2.09, 95% CI=1.21-3.88) and persons who know the infection status(aQR of the persons who didn't know it=0.57, 95% CI=0.37-0.89). In conclusion, these results suggest that several life styles such as ingestion of raw fish, drinking habit. So we think that it is necessary to set up the efficient management programs for the treatment and prevention of C.S. infection.

• Journal of Preventive Medicine and Public Health
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• 제29권4호
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• pp.721-732
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• 1996

생활수준과 교육수준이 매우 낮은 저개발국가에서의 임신분만 환경을 알아보고 건강관련 행위 실천(산전진찰, 시설분만, 제대기구소독)과 지식과 태도와의 관계를 알아보기 위하여 네팔 돌카 마을에서 지난 1년간(1994년 4월 13일$\sim$1995년 4월 12일)출산한 경험이 있는 산모를 대상으로 일반적 특성, 임신과 분만에 관련된 지식, 태도, 산전진찰률, 분만환경 등을 조사하였다. 이 지역의 임신과 분만에 관련된 지식수준은 낮은 편으로 대상자의 87.5%가 보건교육을 받은 경험이 없었다. 대상자의 29.6%는 임신시 흡연이 태아에 해가 없다고 하였으며, 42.8%는 임신시 음주와 약의 복용이 태아에 해가 없다고 답하였고, 17.1%가 제대절단시 소독하지 않은 기구를 사용해도 유해하지 않다고 응답하였는데, 교육을 받은 적이 없는 경우, 보건교육을 받은 경험이 없는 경우, 그리고 보건기관까지의 거리가 멀 수록 올바르지 못한 지식을 가지고 있었다. 응답자의 56.6%가 산전진찰이 필요없다는 태도를 보였고, 42.8%가 질출혈시 병원을 방문할 필요가 없다는 태도를 보였는데, 교육을 받은 적이 없는 경우, 보건 교육을 받은 경험이 없는 경우, 그리고 보건기관까지의 거리가 멀수록 바람직하지 못한 태도를 가지고 있었다. 또한 82.9%가 분만과정 자체가 불결한 것이라고 여기고 있었다. 한번이라도 산전진찰을 받은 경험이 있는 산전진찰 경험률은 28.3%였는데 교육을 받은 적이 없는 경우, 보건교육을 받은 경험이 없는 경우에 산전진찰 미경험률이 높았다. 시설분만율은 5.3%로 매우 저조하였고, 시설 외 분만인 경우 82.6%가 제대절단기구를 소독하지 않고 사용하고 있었는데 교육을 받은 적이 없는 경우, 보건교육을 받은 경험이 없는 경우, 그리고 보건기관까지의 거리가 멀수록 소독을 하지 않고 사용하고 있었다. 지식과 태도와의 관계에 있어서는 지식이 많은 군이 산전진찰의 필요성을 더 느끼며 질출혈시 병원방문의 필요성을 더 느끼고 있어, 임신과 분만에 관련하여 더 바람직한 태도를 가지고 있었다. 태도와 실천과의 관계에 있어서는 바람직한 태도를 가진 산모군이 산전진찰 경험률이 높았으며, 시설분만이 많아 실천율이 높았다. 다변량 분석에서도 지식이 태도에 양(陽)의 영향을 미치는 변수였으며, 태도는 실천에 영향을 미치는 유의한 양(陽)의 변수여서 실천을 위해서는 긍정적인 태도가 선행되어야 하고, 그러기 위하여는 먼저 올바른 지식을 가지고 있어야 함을 알 수 있었다. 이상의 연구결과로 볼 때, 저개발국가에서의 분만환경은 매우 열악한 편으로 모자의 건강수준 향상을 위해서는 예방적 기능으로서 보건교육 활동이 더욱 중요 성을 가지게 된다. 효율적 보건교육활동을 위해서는 보건교육을 보다 긴요하게 요하는 인구군이 어떤 계층이냐 하는 대상파악에 특별히 유념하여야 하는데 주로 교육수준이 낮고 생활이 어려운 인구층, 그리고 보건기관으로부터 멀리 떨어져 있는 사람들에게 중점적으로 교육을 시도하여야 하겠는데 이들 나라는 대부분의 국민이 교육수준이 낮고 생활수준이 낮은 편으로 보건교육시 단순한 지식의 전달에 그칠 것이 아니라 동기 유발을 가져와 행위변화를 할 수 있도록 보다 세밀한 연구노력이 필요하다. 또한 순회진료와 보건교육을 하는 의료캠프가 활성화되어야 하겠다. 향후 저개발국에 의료단을 파견하여 그 지 역의 보건문제 해결에 도움을 주기 위하여는 이와 같은 연구가 계속 진행되어 실천에 영향을 주는 요인들을 밝혀 지역보건의료 프로그램에 적극 활용해야 할 것으로 생각된다.