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KMID : 0379319870120010036
Korean Journal of Rural Medicine
1987 Volume.12 No. 1 p.36 ~ p.53
A Study on Perfomances and Achievement of Village Health Workers in Rural Primary Health Care Program




Abstract
It is utmost important to establish the efficient fixable way of peoples active participation in primary health care especially in the areas where the public or governmental service input for the basic health care is insufficient like as in rural areas of Korea. In light of above reason, this study focused mainly on the evaluation of roles and activities of village health workers (VHWs) who were selected from grass-root level of village people in order to derive further motivation for active participation. This is believed to be a sort of feedback mechanisms. Actually, the authors collected -the activity reports of VHWs who had been devoting themselves in the primary health care services of Jeomdong Area, of Yeoju Gun one of Korea University Community Health Action Programs and survey record on the VHWs activity from correspondent people. Those data were analyzed through computer programmed package. The activities performed by VHWs were limited to the performance in 1985 for convenience.
The summarized results were as follows ;
1) General characteristics of VHWs
Among a total of 28 VHWs in the area, about 39.3% of them have been replaced up to the date since the implementation in 1983, because of moving out, occupational employment and of others.
The age of majority (75.0/) lied between the range of 30-50, and educational background of 67.9% belonged to category of primary school graduation, about 50% of them experienced to be or were also ensiled "chief of women club of corresponding villages.
2) Work-load of VHWs.
Each VHW was assigned for tasks of health care for average 55 households of 248 persons. They shared approximately 6 days a month for the activity in average and it covered 17 cases of basic health care in a month. A half of the VHWs performed home visits irregularly without solidified schedule.
3) Work performance analysis.
Information¡¯s collected through VHWs were compared with data from official vital registration at local administration center " Myon Office" in 1985. VHWs collected 1008 of new born, 1162 of death, 58.3 of move in and 748 of move out in comparison with 100.0 of official registration each.
Pregnant women of 79.8% of mothers among the total pregnancy of 94 which were confirmed as normally delivered or aborted cases by all means afterwards had been detected by VHWs as being pregnant and all of them received some of antenatal cares by VHWs. Ail(100%) of delivered women were detected by VHWs through home visits and they were cared postnatally. Whereas, according to the records of birth registration, the places of delivery were clinic in 33.7%, and mother¢¥s home in 66.3%, VHWs reported them to be clinic in 48.9%, midwifery in 20.2%. It was cleared that most of misinformation was caused by uncautious filling of birth registration at notification. Among the total of 717 eligible women under age 44 years, family planning status of 92.6% was reported by VHWs confirming practice of control to be 70.8% of reported fertile women.
4) Attitude of VHW on the roles and functions
Although 92.0% of VHWs expressed VHWs to be worthwhile, only 52.0% of them had dignity and satisfaction in their activity and 440% of them had passive attitude of working saying they followed direction regardless. Concerning difficulties in performance as a VHW, 60.7% of them pointed out lacking of medical and health related knowledge by themselves.
Still, 64.0% of them thought visiting unfamiliar house to be awful and 40.0% complained the recording forms of activity to be difficult and hard . It was also revealed that 56.6% confessed lack of interest on community health service itself. Most of VHWs needed more educational training especially on clinical fields such as cares of gynecological diseases, hypertension, diabetes, and other chronic disease of the aged. Regular on-the-job basic training¡¯s were said to be needed twice a year.
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