영유아 양육 및 보건의료 통합지원 체계 구축

Abstract

As the birth rate in South Korea has seriously declined, it is necessary to integrate child rearing services and healthcare services for infants and young children in order to improve accessibility and availability to the laws related to pregnancy, childbirth, and child rearing. The current study examined the methods for supporting cooperation and integration of child rearing and healthcare services in order to create a healthy and happy atmosphere for pregnancy, childbirth and child rearing in South Korea.

The research methods included statistical data by organizations in South Korea, policies, prior research, review of related literature (e.g. laws), surveys for 1,000 mothers of infants and young children, FGI for relevant persons in charge, case studies in other countries (Japan, the Netherlands, the UK, France), policy discussion, advisory councils, practice councils for policy research, and other interdisciplinary collaborations.

The results of research are as follows.

First, South Korea has carried out the first health project for Seoul babies, established branch offices of the community health center for mothers and children, and dispatched nurses to educational and nursery institutions, in order to support child rearing and promote health of mothers, newborns, and young children in child care institutions. These projects has strengthened functions of each service and cooperated them in order to provide better support for child rearing and healthcare for infants and young children. They have also played a role in “human resources support”.

Second, as a result of surveys for 1,000 parents of infants and young children which examined stress factors and support subjects in each life cycle, ‘economic burden of childbirth and child rearing’ was a largest stressor during pregnancy, and ‘fear of child rearing’ was the largest during the first childbirth. While rearing child, ‘economic burden of child rearing’ was a biggest stress factor. However, the main support subject was acquaintance, which means parents hardly received public support. In terms of public services for child rearing, the majority of parents answered that they did not know such services because of insufficient promotion. In the form of collaboration between child rearing and medical services, ‘branch offices of the child-care health center for mothers and children (tentative name) where people can receive both child-care counseling and medical consultation’ were the highest response rates.

Third, among foreign cases (Japan, the Netherlands, the UK, France), Japan, a country which has a medical system similar to South Korea, focuses on cases that comprehensively adjust health services for mother and children and support services for child rearing. The Netherlands supervise the quality of medical services through competitions between private companies although the government leads maternal and child health and healthcare for infants and young children. Moreover, it is characteristic that continuity from childbirth to child rearing is secured. France and the United Kingdom have established a national-led medical system, and not separately managed projects for maternal and child health but in terms of public health in existing healthcare systems.

In the basic direction of policy proposal, it is suggested that “continuity of care” should be considered so that services and human resources in each life cycle are linked to ensure a healthy start for infants and young children. First and foremost, we propose “cooperation among local organizations of delivery systems” and the need to design “consumer-centered and integrated support” in order to improve convenience for users.

For these reasons, it is presented that a project for “Center of Integrated Support for Child-rearing and Health” should be started and that the centers should be divided into three types to coordinate integrated support: child-rearing center, health center, and medical center. It is applicable to installation of new centers and enhancement of existing institutions. We also propose amendments to the Mother and Child Health Act and the Infant Care Act for functions of support centers, organization of human resources, and basis of establishment. Furthermore, we suggest expansion of the visiting nurse system for integrated health care and child-rearing support for mothers and newborns as well as the direction for revision of the Acts and the methods for placement of personnel in order to designate and operate healthcare kindergartens and daycare centers.