• Journal of Korean Classical Literature and Education
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• no.38
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• pp.201-238
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• 2018

As a way of enhancing the intercultural ability needed for diverse cultural eras, this study focuses on the "narration" of the Italian education scholar Maddalena De Carlo in order to determine the "diverse values" created by the "symbolic representation" based on the folktales narrated by immigrants living in Korea. Through this, it specifically presents educational elements and contents that can raise relative sensitivity. The authors of this paper have connected, empathized, and communicated with people of various cultures in order to go beyond Carlo's discussion. The paper discusses the expansion of cultural sensitivity as an element of education through narrative topics using the folktales of immigrant narrators in Korea. It also recognizes the limitations of a desire for a homogeneous union within an intercultural society and thus formulates educational contents for creating a relationship with heterogeneous ideas through the elimination of communication barriers through heterogeneity and a consideration of the surface and the back. This is systemized in six steps. Step 1: Listening to oral folktales of immigrants, Step 2: Finding heterogeneous motifs imprinted in the immigrants' memories, Step 3: Understanding the meaning of the opposing qualities symbolized by heterogeneous motifs, Step 4: Creating narrative topics containing the key motifs, Step 5: Generating the value of symbolic representation as a narrative topic, and Step 6: Expanding the value of life into a cultural symbol. In Chapter 3, this study focuses on educational contents using immigrants' folktales by applying these six steps. The class contents include the recognition of the limitations of desire for a homogeneous union within an intercultural society and the consideration of how to create a relationship with heterogeneous ideas through the elimination of communication barriers through heterogeneity and consideration of the surface and the back. This paper then compares the Indonesian folktale, The Inverted Ship Mountain and the Mom's Mountain, with the world-famous Oedipus myth, to determine what the symbolic representation of these heterogeneous motifs is. In Step 6, when the symbolic system is culturally extended, the incestuous desire that appears in the "inverted ship" is interpreted as a fixation that was created when the character sought to unite with homogenous idea. The Cambodian folktale, The Girl and the Tiger, is a story that is reminiscent of the Korean folktale, The Old Man with a Lump. Through the motif in "Tiger," this paper generates a narrative topic that will enhance the students' intercultural abilities by culturally expanding their skills in how to relate with a heterogeneous being that is usually represented as an animal. The Vietnamese folktale, The Coconut Bowl, similar to the Korean folktale, GureongDeongDeong SinSeonBi, is a story that draws a variety of considerations about the surface and theback, and it shows readers how to build a relationship with a heterogeneous idea and how to develop and grow with such a relationship. Thus, if a narrative topic is generated and readers are able to empathize using an opposing feature formed by the core motif of the folktale, it becomes possible, through immigrant folklore, to construct a possibility of a new life through the formation of a relationship with an unfamiliar and heterogeneous culture.

• Journal of the Korean earth science society
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• v.42 no.3
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• pp.311-324
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• 2021

Recently, ten geosites have been considered in Hwaseong for endorsement as national geoparks, including the Jebudo, Gojeongri Dinosaur Egg Fossils, and Ueumdo geosites. The Jebudo geosite in the southern part of the Seoul metropolitan area has great potential for development as a new geoscience educational site because it has geological, geographical (landscape), and ecological significance. In this study, we described the geological characteristics through field surveys in the Jebudo geosite. We evaluated its potential as a geo-education site based on comparative analysis with other geosites in Hwaseong Geopark. In addition, we reviewed the practical effect of field education at geosites on the essential concepts and critical competence-oriented education emphasized in the current 2015 revised science curriculum. The Jebudo Geosite is geologically diverse, with various metamorphic rocks belonging to the Precambrian Seosan Group, such as quartzite, schist, and phyllite. Various geological structures, such as clastic dikes, faults, joints, foliation, and schistosity have also been recorded. Moreover, coastal geological features have been observed, including depositional landforms (gravel and sand beaches, dunes, and mudflats), sedimentary structures (ripples), erosional landforms (sea cliffs, sea caves, and sea stacks), and sea parting. The Jebudo geosite has considerable value as a new geo-education site with geological and geomorphological distinction from the Gojeongri Dinosaur Egg Fossils and Ueumdo geosites. The Jebudo geosite also has opportunities for geo-education and geo-tourism, such as mudflat experiences and infrastructures, such as coastal trails and viewing points. This geosite can help develop diverse geo-education programs that improve key competencies in the science curriculum, such as critical thinking, inquiry, and problem-solving. Furthermore, by conducting optimized geo-education focused on the characteristics of each geosite, the following can be established: (1) the expansion of learning space from school to geopark, (2) the improvement of understanding of specific content elements and linkage between essential concepts, and (3) the extension of the education scope throughout the earth system. There will be positive impacts on communication, participation, and lifelong learning skills through geopark education.

• Journal of Korean Philosophical Society
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• v.117
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• pp.327-354
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• 2011

This study has a key assumption that 'characteristics of discouse can be found in not its inside, but its outside'. The prism through which we can see those characteristics was provided by Foucault and Bakhtin who were introduced in the study. As an effort co probe the outside of discourse, the study is briefed 'the three attributes of discourse' that were suggested by Foucault First, discourse has the principle of selection and exclusion, which is based on power relations. Second, discourse is not transparent at all since it is always offensive towards other discourses and defensive against selected ones Third, discourse which is naturally accepted because of its dailiness had a deep structure secretly hidden in it. Based on the above attributes, Foucault and Bakhtin paid their attention to the outside of discourse. Specifically, they considered discourse fundamentally and went beyond it, and reflected the procedures of discourse. This study focused on 'Socrates', something common in the two scholars' works with discourse. In dealing with discourse, Bakhtin started with 'Socratic dialogue' that is based on the dialogic nature of human thoughts which purse the truth. For Foucault, it was Socrates who had the 'courage to cell the truth' and practiced 'self-consideration'. According to Foucault, the ethics of self-practice originated from the philosopher. The ethics is neither the precise representation of individual life that is withdrawn towards the inner self, nor the skills of happiness. It is just relational and cross-sectional. For a better understanding, this study pointed out that Kafka created a variety of 'dialogic voices' focusing on the outside of discourse. Dialogues found in his writings are 'interminable dialogues' that truly 'communicate with different times and different spaces'. For example, his novel, 'Der Prozess' opens the possibility of discussing in various ways the court which is look beyond conventions and extraordinary. Kafka's novels have a structure that their starting point found at the introduction reappears at the termination, presenting multi-vocal dialogues.

• (The) Research of the performance art and culture
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• no.36
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• pp.289-312
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• 2018

Pansori has been passed down over several generations and over time have undergone continued change in accordance with the times, as well as the skills and ability of the singer. Policies regarding intangible cultural treasures were established to preserve and promote the continuing tradition of art forms including Pansori and thus must spare no effort in supporting and preserving the genre. As such, for proper implementation of the newly legislated law, it is necessary to review the agents who pass down the tradition of Pansori and whether there are any areas that need to be changed in terms of our perception of culture in general. Pansory in the $21^{st}$ century features both contemporary aspects and mass appeal and have undergone many changes in how it is enjoyed. It is our responsibility therefore, to establish how the art and universality of Pansori should be promoted. From this perspective, this study reviewed the evolution of law on intangible cultural treasures, the current status of intangible cultural treasures being passed down with a focus on national treasures and those of Jeonbuk Province to shed light on issues. Diversification is needed in the number of those who carry this intangible cultural treasure, as well as the number of categories. To that end, a survey index or practical ability index must be taken into account for the application and designation of intangible cultural treasures. The study also noted issues of the categories for designation as intangible cultural treasures and discussed directions for improvement. In the case of Pansori, suggestions for improvement were presented for the designation of skilled artists by school, regular surveys and regular application, increased role of artists for increased mass appeal, survey of regional singers, supervision and monitoring of skilled artists and establishment of a manual for the education on how to pass down the art form. In doing so, efforts should be made to make the passing down of Pansori more active and related education more systematic. Since we are in the early years of the law on intangible cultural treasures being implemented, areas of improvement will continue to be identified. It is however certain that the proper support for the art form to be handed down should be done in a way where law and culture are complementary given that Pansori is not just a Korean tradition, but a tradition of mankind.

• 한국노년학
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• v.40 no.4
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• pp.801-821
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• 2020

There are a number of prior studies on the poverty experience of Korean women, but little is known about the poverty experience of Korean elderly women in the U.S. The purpose of this study is to examine the poverty experiences of Korean elderly women who immigrated to the U. S. Qualitative case study methods were used to achieve these research objectives. Three Korean elderly women living in Oakland of California who received Supplemental Security Income (SSI) from the U.S. federal government were included in the study. The data were collected by conducting a total of six meetings per participant, and the researcher read the consent form directly to the participants and obtained a hand-written signature. The analysis and interpretation began by repeating the interview transcript several times, and the repeated keywords were to be understood in the context, focusing on time, space, and relationships with other people. The contextual understanding of Korean elderly women's experiences in poverty was interpreted in three dimensions: extending poverty in their mother country, double torture as female immigrants, and limiting labor due to aging and diseases. Before moving to the U.S., they had a difficult livelihood by farming and one of them had to live in poverty due to the bereavement to her husband. But even after moving to the U.S., they have continued to live in poverty. As female immigrants with low education and no special skills, they were incorporated into the periphery of the labor market in the industrialized U.S. and were forced to make a living with low wages. Korean elderly women were unable to return to the labor market in the surrounding areas due to aging and diseases, and were continuing their impoverished lives relying on SSI. From the findings, we discussed the role of the Korean immigrants community as a way to improve the quality of life for Korean elderly women in the U.S.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.143-153
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• 2020

Purpose: To evaluate the timing of the improvement in surgical skills of the direct anterior approach for hip arthroplasty through an analysis of the clinical features and learning curve in 58 cases. Materials and Methods: From November 2016 to November 2018, 58 patients, who were divided into an early half and late half, and underwent hip arthroplasty by the direct anterior approach, were enrolled in this retrospective study. The operation time and complications (fracture, lateral femoral cutaneous nerve injury, heterotopic ossification, infection, and dislocation) were assessed using a chi-square test, paired t-test, and cumulative sum (CUSUM) test. Results: The mean operation times in total hip arthroplasty (26 cases) and bipolar hemi-arthroplasty were 132.1 minutes and 79.7 minutes, respectively, demonstrating a significant difference between the two groups. CUSUM analysis based on the results revealed breakthrough points of the operation time, decreasing to less than the mean operation time because of the 16th case in total hip arthroplasty and 14th case in bipolar hemiarthroplasty. Complications were encountered in the early phase and late phase: five cases of fractures in the early phase, no case in the late phase; eight and two cases of lateral femoral cutaneous nerve injury, respectively; three and two cases of heterotopic ossification, respectively; and one case of dislocation, one case of infection and three cases of others in the early phase. The CUSUM chart for the fracture rate during operation in the early phase revealed the following: five cases fracture (17.2%) in the early phase and no case in the late phase (0%). This highlights the learning curve and the need for monitoring the inadequacy of operation based on the complications. Conclusion: Hip arthroplasty performed by the direct anterior approach based on an anatomical understanding makes it difficult to observe the surgical field and requires a learning curve of at least 30 cases.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.18 no.3
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• pp.17-32
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• 2023

In recent years, the need for social ventures that aim to grow while solving social problems through the efficiency and effectiveness of commercial organizations in the market has increased, while there is a limit to how much the government and the public can do to solve social problems. Against this background, the number of social venture startups is increasing in the domestic startup ecosystem, and interest in impact investors, which are investors in social ventures, is also increasing. Therefore, this research utilized judgment analysis technology to objectively analyze the validity and weight of judgment information based on the cognitive process and decision-making environment in the investment decision-making of impact investors. We proceeded with the research by constructing three classifications; first, investment priorities at the initial investment stage for financial benefit and return on investment as an investor, second, the political skills of the entrepreneurs (teams) for the social impact and ripple power, and social venture coexistence and solidarity, third, the social mission of a social venture that meets the purpose of an impact investment fund. As a result of this research, first of all, the investment decision-making priorities of impact investors are the expertise of the entrepreneur (team), the potential rate of return when the entrepreneur (team) succeeds, and the social mission of the entrepreneur (team). Second, impact investors do not have a uniform understanding of the investment decision-making factors, and the factors that determine investment decisions are different, and there are differences in the degree of the weighting. Third, among the various investment decision-making factors of impact investment, "entrepreneur's (team's) networking ability", "entrepreneur's (team's) social insight", "entrepreneur's (team's) interpersonal influence" was relatively lower than the other four factors. The practical contribution through this research is to help social ventures understand the investment determinant factors of impact investors in the process of financing, and impact investors can be expected to improve the quality of investment decision-making by referring to the judgment cases and analysis of impact investors. The academic contribution is that it empirically investigated the investment priorities and weighting differences of impact investors.

• Journal of Korean Academy of Nursing
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• v.2 no.1
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• pp.3-33
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• 1971

Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

• Journal of Korean Academy of Nursing
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• v.4 no.2
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• pp.1-16
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• 1974

This Study involved the development of a survey form and the collection of data in an effort-to provide information which can be used in the improvement of nursing curricula. The data examined were the kinds courses currently being taught in the curricula of nursing education institutions throughout Korea, credits required for course completion, and year in-which courses are taken. For the purposes of this study, curricula were classified into college, nursing school and vocational school categories. Courses were directed into the 3 major categories of general education courses, supporting science courses and professional education course, and further subdirector as. follows: 1) General education (following the classification of Philip H. phoenix): a) Symbolics, b) Empirics, c) Aesthetics. 4) Synthetics, e) Ethics, f) Synoptic. 2) Supporting science: a) physical science, b) biological science, c) social science, d) behavioral science, e) Health science, f) Educations 3) Professional Education; a) basic courses, b) courses in each of the respective fields of nursing. Ⅰ. General Education aimed at developing the individual as a person and as a member of society is relatively strong in college curricula compared with the other two. a) Courses included in the category of symbolics included Korean language, English, German. Chines. Mathematics. Statics: Economics and Computer most college curricula included 20 credits. of courses in this sub-category, while nursing schools required 12 credits and vocational school 10 units. English ordinarily receives particularly heavy emphasis. b) Research methodology, Domestic affair and women & courtney was included under the category of empirics in the college curricula, nursing and vocational school do not offer this at all. c) Courses classified under aesthetics were physical education, drill, music, recreation and fine arts. Most college curricula had 4 credits in these areas, nursing school provided for 2 credits, and most vocational schools offered 10 units. d) Synoptic included leadership, interpersonal relationship, and communications, Most schools did not offer courses of this nature. e) The category of ethics included citizenship. 2 credits are provided in college curricula, while vocational schools require 4 units. Nursing schools do not offer these courses. f) Courses included under synoptic were Korean history, cultural history, philosophy, Logics, and religion. Most college curricular 5 credits in these areas, nursing schools 4 credits. and vocational schools 2 units. g) Only physical education was given every Year in college curricula and only English was given in nursing schools and vocational schools in every of the curriculum. Most of the other courses were given during the first year of the curriculum. Ⅱ. Supporting science courses are fundamental to the practice and application of nursing theory. a) Physical science course include physics, chemistry and natural science. most colleges and nursing schools provided for 2 credits of physical science courses in their curricula, while most vocational schools did not offer t me. b) Courses included under biological science were anatomy, physiologic, biology and biochemistry. Most college curricula provided for 15 credits of biological science, nursing schools for the most part provided for 11 credits, and most vocational schools provided for 8 units. c) Courses included under social science were sociology and anthropology. Most colleges provided for 1 credit in courses of this category, which most nursing schools provided for 2 creates Most vocational school did not provide courses of this type. d) Courses included under behavioral science were general and clinical psychology, developmental psychology. mental hygiene and guidance. Most schools did not provide for these courses. e) Courses included under health science included pharmacy and pharmacology, microbiology, pathology, nutrition and dietetics, parasitology, and Chinese medicine. Most college curricula provided for 11 credits, while most nursing schools provide for 12 credits, most part provided 20 units of medical courses. f) Courses included under education included educational psychology, principles of education, philosophy of education, history of education, social education, educational evaluation, educational curricula, class management, guidance techniques and school & community. Host college softer 3 credits in courses in this category, while nursing schools provide 8 credits and vocational schools provide for 6 units, 50% of the colleges prepare these students to qualify as regular teachers of the second level, while 91% of the nursing schools and 60% of the vocational schools prepare their of the vocational schools prepare their students to qualify as school nurse. g) The majority of colleges start supporting science courses in the first year and complete them by the second year. Nursing schools and vocational schools usually complete them in the first year. Ⅲ. Professional Education courses are designed to develop professional nursing knowledge, attitudes and skills in the students. a) Basic courses include social nursing, nursing ethics, history of nursing professional control, nursing administration, social medicine, social welfare, introductory nursing, advanced nursing, medical regulations, efficient nursing, nursing english and basic nursing, College curricula devoted 13 credits to these subjects, nursing schools 14 credits, and vocational schools 26 units indicating a severe difference in the scope of education provided. b) There was noticeable tendency for the colleges to take a unified approach to the branches of nursing. 60% of the schools had courses in public health nursing, 80% in pediatric nursing, 60% in obstetric nursing, 90% in psychiatric nursing and 80% in medical-surgical nursing. The greatest number of schools provided 48 crudites in all of these fields combined. in most of the nursing schools, 52 credits were provided for courses divided according to disease. in the vocational schools, unified courses are provided in public health nursing, child nursing, maternal nursing, psychiatric nursing and adult nursing. In addition, one unit is provided for one hour a week of practice. The total number of units provided in the greatest number of vocational schools is thus Ⅲ units double the number provided in nursing schools and colleges. c) In th leges, the second year is devoted mainly to basic nursing courses, while the third and fourth years are used for advanced nursing courses. In nursing schools and vocational schools, the first year deals primarily with basic nursing and the second and third years are used to cover advanced nursing courses. The study yielded the following conclusions. 1. Instructional goals should be established for each courses in line with the idea of nursing, and curriculum improvements should be made accordingly. 2. Course that fall under the synthetics category should be strengthened and ways should be sought to develop the ability to cooperate with those who work for human welfare and health. 3. The ability to solve problems on the basis of scientific principles and knowledge and understanding of man society should be fostered through a strengthening of courses dealing with physical sciences, social sciences and behavioral sciences and redistribution of courses emphasizing biological and health sciences. 4. There should be more balanced curricula with less emphasis on courses in the major There is a need to establish courses necessary for the individual nurse by doing away with courses centered around specific diseases and combining them in unified courses. In addition it is possible to develop skill in dealing with people by using the social setting in comprehensive training. The most efficient ratio of the study experience should be studied to provide more effective, interesting education Elective course should be initiated to insure a man flexible, responsive educational program. 5. The curriculum stipulated in the education law should be examined.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.165-203
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• 1987

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