ABSTRACT
In 2013, the Government of Japan issued “Japan Revitalization Strategy”, in which facilitation of overseas expansion of Japanese drugs, medical equipment, health services, and health system through Public Private Partnership (PPP) is included. In alignment with this strategy, ministries and agencies have initiated on various health project, one of which is “Project for global growth of medical technologies, systems and services through human resource development”funded by the Japan Ministry of Health, Labour, and Welfare from 2015. As an administrative organization of this project, National Center for Global Health and Medicine (NCGM) has organized 119 project for 4 years from 2015 to 2018. This report summarizes the experiences and the results of evaluation in terms of program management, expansion of introduced health technologies and the health impact. As the results, the overall project management was satisfactory from the viewpoints of varieties of project, the execution rates. Then, health technologies were adopted in the national guidelines or policies and 17 introduced medical products were purchased by local governments. When it comes to health impacts, 19646 health staffs were trained through this program for 4 years and 912334 persons were estimated as beneficiaries by 29 project in 2017. Based on data shown as above, the overall achievement of this program should be considered satisfactory. Since this program is unique among other PPP program in Japan as well as other countries as the program scheme to promote expansion of medical products through human resource development, the experiences should provide some insights about the ways to facilitate PPP in health sector. In order to extract the Tips of good practices for future activities, further analysis on each project is necessary.
ABSTRACT
The way of Public Private Partnerships in development including Global Health has been changing dramatically. Japan is also making efforts to promote Public-Private Partnership to promote the Japanese medical technology and services globally. Since the program schemes are varied, we collect the information mainly through WEB at July 2017 to compare the features of each program and policy. We made a list of programs conducted by Ministries and responsible organizations. The programs are categorized in two directions, inbound which means inviting foreign patients to Japan for treatment, and outbound which means exporting Japanese medical devices, medicines, system, and services. Those are also categorized in two groups by objective and content, support for establishing foundation/core facilities, and support for the system and human-resource development. We created the correlation diagram based on these categorizations to show the relationship between each scheme/program. Programs undertaken by different agencies such as the Cabinet Secretariat, Ministry of Economy, Trade and Industry, Ministry of Health, Labor and Welfare, Ministry of Foreign Affairs, Japan International Cooperation Agency seems comprehensive and exhaustive. Therefore, we can expect a bigger impact if the appropriate support through those programs were provided in right time, especially for the outbound support. There is a need for developing overarching strategy among each program to the target country based on the needs assessment, local adaptability of the technology and services. From the fact that it has become clear that issues related to developing private funds for development by public funds as priming water such as the motivation for investment behavior and the different results are different in the public and private sectors, it is necessary to clarify the guidelines in Japan in order to strengthen such Public-Private Partnership.
ABSTRACT
<b>Introduction</b><br> Even though many oversea training programs end in developing an action plan from what they learned during the course, follow-up opportunities are quite limited. Group training program on maternal and child health for Francophone African countries are conducted in Japan since 2003, organized by National Center for Global Health and Medicine and funded by Japan International Cooperation Agency. Follow-up activities in Senegal and Benin are reported with lessons learned.<br><b>Methods</b><br> Training organizer team made a semi-structured interview with 11 trainees, 6 superintendents and 4 Japanese advisors, asking “Do trainees implement what they planned at the end of the training course in Japan? If not, what are the difficulties implementing their plans?”Organizer team also provided some interventions to solve the problems they faced.<br><b>Results</b><br> In Senegal, actions were not implemented yet, because plans were shared neither with their superintendents nor with Japanese advisors working with trainees as project counterparts. Organizer team set up a meeting with all stakeholders to clarify the objectives and outcomes of the training course within the concept of the project. This process made the superintendents understand and support the action plans, and facilitated to start implementing them. In Benin, trainees started activities by themselves based on their action plan under a small financial support from a Japanese advisor. It was rather easy, because they were decision makers of a hospital, but they faced difficulties to manage the staff to continue the activities. Organizer team encouraged them to continue the activities during the meeting in the hospital.<br><b>Conclusions</b><br> Appropriate participants can be selected and training could be effective, when cooperation project are well defined and the role of advisors is clear in the follow-up. Involvement of decision makers or superintendents for the selection and follow-up process can be a contributing factor to improve the effectiveness of the training.
ABSTRACT
<b>Purpose</b><br> Every year, a lot of training programs by Japan International Cooperation Agency (JICA) are conducted in Japan. However, the method of monitoring and evaluation of those trainings are not always conducted other than simple questionnaire survey. The purpose of this research is to demonstrate the significance of daily recording and analysis of the trainee’s voice as a way of the improvement of the quality of training.<br> Bureau of International Cooperation in National Center for Global Health and Medicine (NCGM) conducted detailed monitoring and evaluation for “JICA training for Maternal and Child Health in French speaking African countries in 2009” which NCGM itself had planned training curriculum and implemented the training. The key word of this training was “Continuum of care”. At the end of the 5 weeks training, NCGM expected the trainees to obtain comprehensive understanding of continuum of care, especially two different perspectives, which were “the health system” and “the dignity of individual client”.<br><b>Method</b><br> NCGM training team kept recording the trainee’s voice, then analyzed them every day during five weeks’ training. At the end of the training course, the team divided trainee’s voice into several categories, and then analyzed their time-dependent change.<br><b>Results</b><br> The everyday recording and analysis of the trainee’s voice made NCGM training team possible to differentiate the trainee’s fundamental interest and understanding from simple guesses or curiosity. Based on the result of daily analysis, the training team could introduce unscheduled discussion or fine-tuned the contents of lectures for better understanding of trainees. The trainees’ interpretation about “continuum of care” showed obvious change before and after the training. The active learning program by using Laboratory method gave deeper impact on trainees than the expectation of training team. At the end of training course, the trainees formulated concrete and detailed action plans. The purpose of their action plans was to establish the continuum of care from aspects of both “the health system” and “the dignity of individual client” by analyzing the existing stakeholders and institutions, and ensuring a collaborative linkage among them, which were exactly the expected outcome.<br><b>Conclusion</b><br> Daily recording and analysis of the trainee’s voice was effective and useful to monitor the training. The comprehensive analysis at the end of training course revealed the short impact of the training on trainees, which could be used as a self evaluation tool for the training team.<br> NCGM plans to visit the trainees’ workplace in their home countries for middle and long term monitoring and evaluation. The results will be feed backed into the training curriculum of next year.
ABSTRACT
A questionnaire study was carried out from September through December 1998 to clarify the sex distribution of professorships at Japanese medical schools. Sixty-four (1.7%) professors in 32 medical schools were women. Thirty-five female professors had graduated from national and prefectural medical schools, and 29 had graduated from private medical schools. Twenty professors had careers in basic medical research, 8 in public health, and 36 in clinical medicine. Forty-seven (73.4%) of 64 female professors responded to the mailed questionnaires, and 18 had been promoted in the last 5 years. Although more than half of the female professors faced disadvantages because of their gender, many were fully supported by their supervisors or their families or both. The number of female professors reflects the status of female medical doctors.