Use of In-Home Services of the Public Long-Term Care Insurance System by Elderly Foreign Residents in Osaka City: Care Managers’ Perception / 国際保健医療

Objectives  This study investigated the use of In-home services of the Public Long-Term Care (LTC) Insurance System by foreign residents in Osaka city to serve this population better.Methods  Using information from the WAMNET database, questionnaires were sent to 1,800 care managers (CMs) affiliated with 1,106 In-home Care Support Office and Community General Support Centers in Osaka city (1-4 CMs/site), and collected between February and early March 2011. The data collected were analyzed quantitatively, focusing on descriptive statistics. And fisher’s exact tests were used to evaluate the relationship between the Japanese communication skills and age, sex, and family structure.Results  We obtained answers from 460 CMs (collection rate 25.6%). The total number of foreign residents covered under the service by CMs was 590, and we analyzed the valid data of 312 foreign user’s information.   Home-Visit LTC and Day Care for LTC were most frequently used. 34.3% of CMs had difficulty communicating in Japanese, there was a higher proportion of people who had difficulty in communication with older age group (p<0.05), and noticed that nearly 60% faced economic hardship. Conclusion  Our results suggest that careful communication is required with older age groups. This indicates that there may be difficulties in communication and understanding the clients’ needs, which are necessary to create care plan and to ensure optimal utilization of the services. And it is possible to reduce the service required user charge due to the insufficient economic status. The support system should be strengthened to address communication and economic difficulties faced by foreign users of In-home services, from the standpoint of the service fairness.

Access to maternal and child care for undocumented migrants in Japan / 国際保健医療

It is well established that restrictive policies on immigration increase the risk of perinatal mortality and morbidity among migrant women. Undocumented pregnant women and their newborn babies are particularly at high risk of complications, due to multiple and interacting factors such as: (i) limited access to health care, (ii) social isolation, (iii) financial burdens, and (iv) trans-generational effects.<BR>In Japan, in response to the increase in foreign residents since the 1990s, laws and regulations on social protection are being readjusted. Accordingly, the ‘New Residency Management’ system will be introduced in July 2012 to better accommodate the needs of ‘legal’ foreign migrants. At the same time, undocumented migrants will face tougher restrictions. All the undocumented migrants will be denied registration in the new system unless they come forward to the Immigration Bureau. As a result, they could also be denied welfare services provided up to now by municipalities.<BR>In this article, we discuss the potential impact of the forthcoming New Residency Management system on the health of undocumented pregnant migrants and their children.<BR>More research is needed on this issue in the Japanese context, but we should not fail to guarantee minimal public assistance for undocumented migrant women, particularly at the time of childbirth.

A needs survey of medical service for foreign residents in Japan from the viewpoint of medical practitioners-Report of a survey for doctors in Gunma medical association and Gunma pediatric association- / 国際保健医療

<B>Introduction</B><BR>Recently, an increasing number of registered foreigners get married and bear children in Japan. At the same time, a variety of needs for maternal and child health (MCH) impose burden for medical practitioners. A questionnaire survey was conducted to clarify the situation of MCH service for foreign residents.<BR><B>Method</B><BR>Self-report questionnaires developed by “The study group for MCH in a multiethnic and multicultural society” were sent by mail to the pediatricians registered in the Gunma medical association or Gunma pediatric association. In total, target number was 299. The survey period was between 2003/10/6-11/3.<BR><B>Result</B><BR>The number of valid response was 167. Out of 167, 155 doctors replied to have experience of caring foreigners. 75% of them had the experience of trouble in communication. For the question of the need of translator, 76.8% of doctors answered “absolutely necessary” or “necessary if the quality of translation is high enough”. Desired competencies for translators were “Accurate translation of diagnosis, hands on of treatment strategy” or “To help taking detailed patient's history”.<BR>For the experience of using MCH handbook in foreign languages, 52.9% of doctors answered “Never used it”.<BR><B>Discussion</B><BR>We found that the majority of doctors had difficulty in communicating with foreigners.<BR>To meet the doctors' requirement for the competency of translator, two strategies should be considered. One is to develop professional medical translator through education of basic medical knowledge or Japan's health care system. The other is to train foreigners already engaging in translation.<BR>For communication tools development, user friendly concept should be reflected including 1) adscript of foreign and Japanese languages, 2) illustration usage and 3) eye-friendly materials for elderly. Contents should have explanations including 1) diagnosis and treatment policy for common disease, 2) ways of coping with common symptoms, and 3) the information of a variety of Japan's welfare services.

Research into the problems faced by and support given to non-Japanese speakers in need of perinatal care: From an analysis of the deliveries in one hospital over a 12-year period / 国際保健医療

This study aims to analyze the perinatal care provided to non-Japanese speakers in one hospital in Tokyo from 1990 to 2001. It attempts to identify critical issues in perinatal care services and to recommend measures which should be taken to improve them.<br>Two major problems were identified: firstly, communication difficulties between health-care providers and the women and, secondly, a severe lack of information available to the women regarding health, medical and welfare services in Japan.<br>In particular, communication difficulties were a big burden for health care providers in that they presented an obstacle to collecting medical histories, to finding out about symptoms, to establishing good rapport with the patients and to providing spiritual support. It also made it difficult to provide health care based on informed consent.<br>Systematic assistance from medical interpreters is urgently needed in order to provide foreign women with the same level of care as that provided to Japanese patients.

Foreign residents' health care in Japan / 国際保健医療

The purpose of clarifying a foreign resident's in Japan healthy problem and a health care subject was carried out, and foreigner demographic statistics and vitalstatistics were analyzed. The following things became clear.<br>From the second half of the 1980 th generation, foreign-resident-in-Japan population and international marriage were increased rapidly, and many race-nization in Japan was progressing.<br>The people population from Brazil was concentrated on 30 years-old cost from 20 years-old cost, and the population of the less than 15-year-old child born in Japan was increasing every year. Moreover, ”the sickness and wound and the external cause of death” which are occupied to the total number of death were high.<br>The Korean resident in Japan formed 80 percent of the 65 or older-year foreigner registration person. The three major causes of death of Korean are malignant neoplasms (cancer), heart diseases and cerebrovascular diseases. It was similar with the Japanese death trend. Suicide of a persons-of-middle-or-advanced-age male was increasing like the Japanese male.<br>A foreign resident's in Japan healthy subject is roughly classified into three. There is a geriatric health problem about a Korean resident in Japan. In recent years, about the foreigner who immigrated to Japan, there is a problem of mother-and-child health and labor health. And to all foreigners, there is a problem of the mental health resulting from migration, foreign culture, and the minority.<br>The health care corresponding to internationalization is called for also in Japan.