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As global migration has been increasing rapidly, the Japan Association for International Health (JAIH) established the committee for migration and health in early 2021. This committee, which aims to challenge the health issues of migrants inside and outside Japan, held the first kick-off symposium in the 36th Congress of JAIH on 27 November 2021. Five symposiasts were invited and had presentations from the viewpoints of human rights and culture, which were recognized as the common keywords. This article was written by all symposiasts and chairpersons as the report of the kick-off symposium.
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Introduction The Novel Coronavirus Disease 2019 (COVID-19) outbreak forced social events to be cancelled, and academic meetings were no exception. This has increased the need for online seminars (webinars), although, lack of knowledge or experience for hosting such events were prominent. We, “Kansai Global Health”, began preparing a series of webinars from March 2020 under the theme “COVID-19 and the Sustainable Development Goals (SDGs)”. We hereby report our experience and tips on what hosts should bearing in mind for academic webinars. Our Event Participants of Kansai Global Health were required to register prior to the webinar on Google Forms, where characteristics of the participants were subsequently obtained. Zoom software was used to create a YouTube livestreaming video for viewing. An online questionnaire was used to obtain feedback from the participants. Data analysis of the livestreaming was conducted with YouTube Analytics. The cumulative total of participants was 2083. Most were Japanese residents, but 69 participants registered from overseas such as Tunisia and Zambia. The majority of the participants were health professionals, with some non-health professionals and students. 85.7% of the participants rated the webinar satisfaction above four on a scale out of five. Comments from the participants were mostly positive, while some participants claimed some errors of the host members prior to and during the webinar. Lessons Learnt The satisfaction of webinars consisted not only of the contents but also of the quality of the hosts. These accidents could be avoided, or kept under control, with thorough preparations and rehearsals of the hosts discussing possible protocols under such circumstances and making good use of communication tools such as message applications. Adequate hosting techniques are essential for feasible discussions online. Global health webinars should improve hosting skills, as well as its contents, to create a future platform to conduct fruitful discussions.
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BACKGROUND@#Natural disasters have long-term negative impacts on the health and socioenvironmental conditions of a population, affecting the physical environment as well as the relationships within the community, including social networks. Mothers in post-disaster communities may have difficulty receiving social support not only from family members and relatives but also from members of their community, such as people in their neighborhoods. This study focused on mothers with infants and preschool-aged children in post-disaster communities. The associations of social support with sociodemographic characteristics and socioenvironmental conditions related to child-rearing among mothers in post-disaster communities were assessed.@*METHODS@#An anonymous self-administered questionnaire survey was conducted in October 2015 in 988 households in areas affected by the Great East Japan Earthquake and Tsunami. The data collected on sociodemographic and socioenvironmental characteristics included the presence of pre-disaster acquaintances in the neighborhood and social support for child-rearing. The associations of sociodemographic and socioenvironmental characteristics with social support were examined.@*RESULTS@#We analyzed 215 completed questionnaires from mothers living in different houses from those they lived in before the disaster to reflect continuous relationships with people from the pre-disaster communities. Social support was significantly associated with infant sex, extended family, support obtained from relatives not living together, pre-disaster acquaintances, use of child support resources, and no perceived difficulties in child-rearing. In addition, the presence of pre-disaster acquaintances was associated with categories of mental/physical place of comfort and child-rearing support, with adjusted odds ratios of 1.88 (95% CI 1.03-3.44) and 2.84 (95% CI 1.46-5.52) compared with mothers who did not have any pre-disaster acquaintances.@*CONCLUSIONS@#Factors associated with the obtainment of social support in child-rearing among mothers in post-disaster communities were attributed not only to mothers themselves and family members but also to socioenvironmental factors such as the presence of pre-disaster acquaintances. The presence of pre-disaster acquaintances promoted rich social support in child-rearing in post-disaster communities. When reconstructing a community following changes in residence location after a disaster, the pre-disaster relationships among the community dwellers should be considered from the viewpoint of child-rearing support.
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Child, Preschool , Female , Humans , Infant , Male , Child Rearing , Disasters , Earthquakes , Japan , Mothers , Psychology , Social Support , TsunamisABSTRACT
<b>Objectives</b><BR> The objective of the study was to analyze the effects of home-based records on pregnancy, delivery, and child health care in Indonesia.<BR><b>Methods </b><BR> The data were obtained from women who had children under 5 years old at the time of the collection of the 2002, 2007, and 2012 Indonesia Demographic and Health Surveys. The study divided women into two groups: those who used the Maternal and Child Health Handbook (MCHHB) or antenatal card (AC) as a home-based records group, and those who did not use MCHHB or AC as the control group. We calculated the adjusted odds ratios and expressed the effects using meta-analysis methods. <BR><b>Results</b><BR> The study revealed that, compared with the control group, the home-based records group had more knowledge and better practices during pregnancy, delivery, and child health care (e.g., immunization). The home-based records group knew how to solve the problems of complications during pregnancy and used skilled birth attendants for delivery. This study also found that husbands in the home-based records group were involved in discussing the delivery location, finding transportation, and identifying a blood donor. <BR><b>Conclusions</b><BR> This study showed that home-based records had strong associations with the knowledge and practices of women regarding pregnancy, delivery, and child health care.
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<b>Introduction</b><BR> Sales of prescription-only drugs are not well regulated in developing countries. Self-medication with antibiotics is a major concern in global public health from the perspective of increased drug resistance. In addition to common self-medication with prescription-only drugs, distribution of dangerous counterfeit drugs is a social problem in Indonesia. This study aims to examine the factors relevant to self-medication with antibiotics by clarifying customers’ behavior requesting antibiotics at pharmacies and pharmacists’ response in the capital region of Indonesia.<BR><b>Method</b><BR> Two hundreds customers who requested antibiotics were exit-interviewed at 6 community pharmacies in the Ciputat district of South Tangeran City. Structured questionnaire was used on general attribute including health insurance coverage and having/not-having prescription and instructions by pharmacists, etc. Eight informants of pharmacists and an owner from a pharmacy were interviewed by using semi-structured questionnaire. They were questioned on number of customers requesting antibiotics with/without prescriptions, pharmacists’ responses and experience of health damages. The investigation was conducted between late May and early July of 2012.<BR><b>Results</b><BR> Of the customers requesting antibiotics, 48.5% (97/200) had no prescriptions. Neither consultation with doctor nor self-medication is statistically associated with health insurance coverage. Among customers without prescriptions, 51.9% (54/104) purchased antibiotics by showing drug samples they did not take. This was significantly more frequent than those following advice by family/friends or pharmacists. Pharmacists are cautious of dispensing antibiotics without prescriptions. They assess patients, being mindful of allergy and drug resistance. Pharmacists recognize the importance of patient education and intervention in the community.<BR><b>Conclusion</b><BR> The results of exit-interview suggested that economic reason is not a dominant factor to promote self-medication. From the observations among self-medicated customers who are on over-confidence, purchase antibiotics using drug samples they left over, and having preference of advice by family/friends to advice by pharmacist, self-medication is considered based on heuristic selection as well as risk-management within their limited scope of options. The efficacy of antibiotics is manifested in a short duration so that it gives efficient feedback as well as successful experience to patients. The successful experience is considered to strengthen patients’ behavior of self-medication. Pharmacists are expected to challenge their new role to develop patient education to alter patient behaviors.
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Since it first accepted 138 participants in 1954, the Japan International Cooperation Agency (JICA) has accepted approximately 270,000 participants from developing countries for training in Japan during the past 57 years.<BR>In order to verify factors that contribute to the utilization of knowledge and techniques/skills after participants have returned to their countries, questionnaires were distributed through e-mail to 856 former participants, of whom 601 were Indonesian (total response rate: 24.4%), and 264 were Laotian (total response rate: 31.9%)<BR>Interviews were conducted with 28 Indonesian and 15 Laotian ex-participants through snowball sampling.<BR>In the questionnaire, most ex-participants stated that JICA training was valuable. The reasons they mentioned were that they could understand conditions in Japan through field trips/observation, gain up-to-date knowledge about Japan, and learn about the process of technological development in Japan.<BR>About the usefulness of knowledge and techniques/skills gained in Japan for their work, knowledge was considered to be slightly more useful than techniques/skills.<BR>On the other hand, the participants had some difficulties in utilizing knowledge and techniques/skills because of a lack of budget or facilities/equipment, and differences between conditions in Japan and their own countries’.<BR>In the interview survey, the majority of ex-participants provided examples of good practices in which they actively utilized skills/techniques and knowledge they gained in Japan after returning to their countries. The three factors contributing to this result were (1) their needs matched Japanese resources used in training. (2) Ex-participants developed awareness and learned new things spontaneously during the training. (3) Ex-participants and Japanese instructors maintained a long-term relationship after the training.<BR>This study suggests that in order to enable participants to apply knowledge and techniques/skills gained in Japan to their local circumstances, JICA needs to identify appropriate technology that developing countries wish to implement and to conduct follow-up related to adoption and diffusion in their countries through ongoing dialogue.
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<B>Objectives</B><BR>To analyze the professionalization process of medical interpreting in the United States. The findings are expected to provide suggestions for Japan, a nation primed to educate its future professional medical interpreters.<BR><B>Method</B><BR>Initial members of the world’s oldest medical interpreters association were interviewed. The transcripts were analyzed through thematic analysis.<BR><B>Results</B><BR>A group of staff interpreters met to share stories of difficult cases and dilemmas at work in the 1980s, later forming a professional organization in Boston, Massachusetts, in 1986. Later, they began to discuss common issues and developed some standards to clarify role definitions. They advocated for the profession with an aim to increase employment by collaborating with stakeholders to enact the first state law of medical interpreting. Out of eight participants, six worked as a professional interpreter and trainer simultaneously, thus educating newcomers to the profession. Conferences enabled professional medical interpreters and stakeholders to expand their network for local or joint initiatives to further develop the profession. The state government provided grants to medical interpreting education projects and issued guidance to hospitals for best practices.<BR><B>Conclusion</B><BR>To establish medical interpreting as a profession, organizational and advocacy activities were vital. Pioneering medical interpreters played an important role in the process of developing the profession by forming a professional organization, creating standards, approaching stakeholders, and becoming professional trainers to educate newcomers to be skillful enough. This network expanded through conferences enabling multiple stakeholders to take initiatives and accelerate the process. The participants pointed out the lack of training courses, difficulty in building relationships with physicians, and self-stress control. A survey conducted in Japan revealed that medical interpreters pointed out a lack of training courses, a lack of understanding by physicians and patients, and a lack of mental support. This study provides important lessons for burgeoning interpreters in Japan, with these commonalities in mind.
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In 2013, the fifth Tokyo International Conference on African Development (TICAD V) will be hosted by the Japanese government. TICAD, which has been held every five years, has played a catalytic role in African policy dialogue and a leading role in promoting the human security approach (HSA). We review the development of the HSA in the TICAD dialogue on health agendas and recommend TICAD’s role in the integration of the HSA beyond the 2015 agenda. While health was not the main agenda in TICAD I and II, the importance of primary health care, and the development of regional health systems was noted in TICAD III. In 2008, when Japan hosted both the G8 summit and TICAD IV, the Takemi Working Group developed strong momentum for health in Africa. Their policy dialogues on global health in Sub-Saharan Africa incubated several recommendations highlighting HSA and health system strengthening (HSS). HSA is relevant to HSS because it focuses on individuals and communities. It has two mutually reinforcing strategies, a top-down approach by central or local governments (protection) and a bottom-up approach by individuals and communities (empowerment). The “Yokohama Action Plan,” which promotes HSA was welcomed by the TICAD IV member countries. Universal health coverage (UHC) is a major candidate for the post-2015 agenda recommended by the World Health Organization. We expect UHC to provide a more balanced approach between specific disease focus and system-based solutions. Japan’s global health policy is coherent with HSA because human security can be the basis of UHC-compatible HSS.
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<B>Background:</B><BR>Maternal and child health handbook (MCHH) consists of records of pregnancy, delivery, child development and immunization, as well as child growth charts. MCHH has been utilized in Japan since 1947 and it is now introduced in more than 20 countries in the world.<BR><B>Objectives:</B><BR>The objectives of this study were to collect research documents and reports in the past studies of MCHH and to analysis the effect of MCHH on maternal and child health through systematic review.<BR><B>Methods:</B><BR>The systematic searches were conducted for the studies published between 1980 and October 2011. After the initial screening of titles and abstracts of the studies, we reviewed 57 documents which were studied for MCHH in maternal and child health (MCH) programs or activities. After the final selection, we identified only 5 documents with 43 question items in Indonesia (1999 and 2001), Bangladesh (2003), the Philippines (2009) and Cambodia (2010).<BR><B>Results:</B><BR>The relationship between MCHH and pregnancy care revealed that mothers who used MCHH during pregnancy had higher level of knowledge (OR 1.44, 95% CI: 1.22-1.70) than whose did not use MCHH during pregnancy. The strong significant effects of MCHH were observed in knowledge of antenatal care visit (OR 1.86, 95% CI: 1.59-2.18), and mother should consume more food during pregnancy (OR 1.97, 95% CI: 1.37-2.83). Mothers who got MCHH during pregnancy had safer practice by skilled birth attendants (OR 1.12, 95% CI: 0.95-1.32) and delivered in health facilities (OR 1.31, 95% CI: 1.12-1.53). MCHH showed the effect of knowledge of child health care (OR 1.22, 95% CI; 1.05-1.41).<BR><B>Discussion:</B><BR>This study utilizing meta-analyses showed MCHH had higher association with knowledge of mothers than practice in pregnancy and child health care, although the study has its limitation. The illumination of the relationship between knowledge and practice by the effect of MCHH needs more quantitative analysis in both community and hospital settings in many countries.
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<B>Introduction</B><BR>The questionnaire survey was conducted among medical interpreters to clarify the duties of medical interpreters and the contents of training programs, and to analyze the challenges in practice.<BR><B>Methods</B><BR>The self-reported questionnaires were distributed to NPOs of medical interpreters, local international exchange associations, and hospitals with medical interpreters. They were directly collected to authors and analyzed.<BR><B>Results</B><BR>The number of valid responses was 284 (response rate: 33.4%). 46.1% of the respondents had worked as medical interpreters for 5 years or more. There were a few fulltime workers and 76.4% worked as a part-time interpreters. The respondents could interpret 14 languages including sign language. Only 8.5% of them had worked more than 20 times per month, while 68.3% worked less than 4 times per month. 54.4% of the respondents have had training of medical interpreting for more than 20 hours. The respondents answered their difficulties as medical interpreters between medical providers and foreign patients.<BR><B>Discussions</B><BR>This study was targeted at medical interpreters and revealed that many medical interpreters were working at hospitals and other health facilities. The training programs to develop knowledge, skills and ethical conduct are urgently needed to establish the professionalism of medical interpreters. The coordinators are essential to advocate the roles of medical interpreters to medical providers and foreign patients, and to support medical interpreters.
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<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.
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<b>Objective</b><br>To assess the effects of the utilization of Maternal and Child Health Handbook (MCHH) in West Sumatra on the utilization of maternal health services.<br><b>Methods</b><br>A repeated cross sectional study design was used. Three consecutive surveys were conducted in two districts, in 1999, 2001 and 2003, involving respectively 611, 621, and 630 mothers (pregnant and/or with one or more children under age three) as respondents. Respondents for each survey were selected from the same sub-districts and villages, using a multistage random sampling method. Data were collected primarily by using a pre-tested structured questionnaire. Multiple logistic regression analyses were carried out to estimate the net effects of the MCHH on mother's use of maternal health services.<br><b>Results</b><br>After controlling for other influencing factors, utilization of MCHH was found to be associated with better maternal knowledge regarding antenatal care (ANC), tetanus toxoid (TT) immunization and skilled birth attendance. MCHH utilization was also associated with higher likelihood of mothers' utilizing ANC, TT immunization and family planning services, and of use or planned use of skilled birth attendance. Simply owning the handbook did not affect maternal knowledge and was only associated with higher utilization of skilled birth attendance.<br><b>Discussion</b><br>The MCHH needs some modification, taking into account the educational level of the targeted mothers. Appropriate health care provider training is needed to promote the use of the MCHH as a tool for encouraging and focusing communication between mothers and health care providers, as well as to ensure that health care providers are able to use the handbook.<br><b>Conclusion</b><br>Utilization of the MCHH has the potential both to improve maternal knowledge and to increase the utilization of maternal health services. For maximum benefits, the handbook should be actively used by both mothers and health care providers.
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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.
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A Maternal and Child Health(MCH)handbook was introduced in Indonesia in 1993 to improve the quality of MCH services. BolMong district in the North Sulawesi province, a pilot area for the Japan International Cooperation Agency, started a user-fee system for distributing the handbook. The purpose of this study was to describe the policy-making process, management system, implementation, and outcome of this system. In June 2000, the Local Government instituted a user-fee system; price was set at Rp. 3,500(40 yen). Through continuous efforts of district health officers, all the money collected was used only for reprinting. Midwives collected the money from mothers and turned it in to their health center on a monthly basis, who then sent it to the district office. District health officers monitored and supervised the distribution of the handbooks to maintain the integrity of the system. Payment rate was calculated by dividing the number of pregnant woman paying the book by the number of books distributed. Considering a non-payment rate of 31.8% and an increase in printing cost of 30%, only 47.7% of the initial order could be reprinted. The remaining cost was subsidized by local government. The following three factors were critical in sustaining a user-fee system: strong political commitment by local government, proper supervision of distribution and funds, and simple distribution and management methods.