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KMID : 0358119840100020109
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Journal of the Korean Public Health Association
1984 Volume.10 No. 2 p.109 ~ p.130
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AN EXPERIMENTAL STUDY ON MODEL PRIMARY HEALTH CARE PROGRAM IN KOREAN RURAL COMMUNITIES UTILIZING VILLAGE LEVEL SELF-CARE SUBSTRUCTURE
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洪麗信/Hong, Yeo Shin
李恩玉/李善子/朴柾熹/Lee, Eun Ok/Rhee, Seon Ja/Park, Jung Hee
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Abstract
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This action research addresses itself to the problem of community organization of primary health care services. It is designed to test the feasibility and effectiveness of an experimental primary health care program in remote Korean rural communities incorporating existing nonhealth community organizations as substructures for primary health care services provided by Community Health Practitioners who-had been specially trained and deployed by ´´, the Ministry of Health, Korea.
A quasi-experimental research with two experimental groups and one control group is designed to analyze the effect of the experimental input on 1) the effectiveness of the program on the basis of the selected indices of health and health services: 2) the productivity of the Community Health Practitioner program in terms of the quantity of the services produced; and 3) the efficiency in terms of cost incurred and population reached-or coverage extended.
The problems identified from the baseline surveys fall largely into three categories; 1) Problems related to health care service needs; 2) Problems related to health service systems needs; and 3) Problems related to leadership capacities.
Problems related to hetlth care service needs have been identified through analysis of data from household survey.
The results are summarized as follows:
1. The demographic data show a marked decrease in proportion of age group 20-44 years and an increase in age group 45 years and above in study area. This phenomenon of emigration of young generation has implications of health care problems. Among those are; 1) more dependent population to care for; 2) more chronic illness problems among aged and women population from hard labor 3) comparatively less educated thus relatively more ignorant of health related matters; and 4) the problem of isolation among aged´´, ill people.
2. Morbidity rate for 15-day period shows 111.4 episodes of illnesses per 1, 006 population on the average with the range of 102.2 to 121. 5 illnesses events. Among´, those episodes of illnesses about 88.0% received treatment, however, the further analysis´ of service contact shows that people use drug store medicine on self diagnosis by 34.3% of the time on the whole, the second to CHP post services in frequency.
3. Among deliveries 45.4°,0 on the average occurred at home with family or neighbor assistance alone, and the rate of antenatal and postnatal care received were relatively lower in considering the fact that among antenatal care recipients, the frequency of care received were in the range of I to 3 times in whole trimester period.
The percentage of children immunized among 0.3-year age group ranges from 61.5% to 69.71 on average in each category of vaccination, about 30% short of total coverage.
The problems of inducing family planning practice among eligible women were also indicated. As hindrance factors, lower educational attainment, inappropriate family planning concept and unavailability of proper advisement for this group of women can be´´ identified.
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