Research on Issues Preventing Japanese Global Health Personnel from Working at International Organizations / 国際保健医療

Objective  There is a growing need to develop human resources with diverse experience, expertise, and a global perspective who can contribute to global rule-making in health. One of the government’s goals is to increase the number of Japanese personnel working for international organizations, but it has not reached the desired level. This study identified the barriers that medical and non-medical professionals have when applying for or working at international organizations, as well as the support measures they expect from the government, to highlight issues and examine employment support measures.Methods  A qualitative and descriptive research was conducted based on semi-structured interviews with 20 physicians, nursing professionals, graduates of public health graduate schools, non-medical professionals, students, etc., who were (1) seeking employment with international organizations, (2) currently employed, and (3) previously employed but left.Results  The following seven themes were highlighted as barriers to applying for or working at an international organization: 〈issues specific to Japanese society and people〉, 〈concerns about a career in global health〉, 〈discrepancy between a career as a healthcare professional and a career in global health〉, 〈need to strengthen skills〉, 〈preparation for competitive examinations〉, 〈importance of WLB〉, 〈issues inherent in international organizations〉. Conclusion  Possible support measures include individual career counseling, seminars on how to survive in international organizations, and seminars for female applicants of child-rearing age, based on the knowledge and experience of current/former employees of international organizations. As for the issues that hinder the dispatch of medical personnel overseas, the first step would be to compare and verify the positive effects that strengthening the overseas dispatch would have on their skills, the workplace environment, and the acceptance of foreign patients. The development and introduction of systems, such as sabbatical and long-term leave, and reinstatement of employment is especially required of global companies and international hospitals.

Preference of Japanese Global Health Personnel—Lessons Learned from a Qualitative Study / 国際保健医療

Objectives  The need to develop and produce human resources for global health is increasing. The objective of this study was to reveal through qualitative research as a first step of Discrete Choice Experiment, which job ‘attributes’ are considered important by Japanese medical and non-medical personnel in considering employment at health-related international organizations. We then sought to identify appropriate support measures that match the chosen attributes for those who wish to work for international organizations. Methods  We requested a total of 20 subjects from 3 groups of Japanese medical and non-medical personnel; 1. those who wish to work for health-related international organizations (applicant group), 2. those who are currently working (working group) and, 3. those who resigned (resigned group).   Subjects were asked to choose and rank in order of importance, 11 pre-defined attributes when considering employment at international organizations, followed by semi-structured interviews.Results  All three groups chose job content, opportunity for self-realization and opportunity for capacity development as top three attributes. This was followed by duty station as second place tie for working group and fourth place for applicant and resigned groups.   However, for applicant and working groups, emphasis on employee’s entitlements such as work-life-balance, salary, welfare, job security/long-term contract ranked mid- to lower-level between fifth to eighth places. Guaranteed job where one can return to when one leaves the current post, ranked ninth place and opportunity for children’s education and opportunity for spouse’s job ranked tenth equally.   For the resigned group, work-life-balance and job security/long-term contract ranked fifth place equally but other attributes were not chosen.Conclusion  The study findings suggested that Japanese medical and non-medical personnel who aim for employment at health-related international organizations have tendencies to opt for utilization of their experiences and expertise, and search for capacity development and self-realization, rather than better employee entitlements or working/living conditions.   According to the attributes ranking, we consider implementation of career development seminars on expected job satisfaction at international organizations as the primary support measure to encourage and dispatch more personnel. However, publicity highlighting employee entitlements such as work-life-balance, working environment for women and welfare alongside salary may also provide better incentive.   Insecure contract terms, a lack of national organizations and hospitals that value the experience gained in international organizations present a challenge. There is a need to work with these organizations in the mid- to long-term to inform them on the benefits of accepting those staff wishing to return after a period working within international organizations.

Report on Mini Symposium “Vertical to horizontal: How to use the available resources - the experience and its application for UHC” / 国際保健医療

<p>  The vertical program to control tuberculosis in the 1950’s through 1960’s helped the development of the horizontal program of Universal Health Coverage launched in 1961 in Japan. Vertical and horizontal intervention do not compete each other but collaborate with each other. The same should be true for the present day context of global health, namely vertical intervention for tuberculosis, HIV/AIDS and malaria control and the horizontal UHC intervention.</p>

Sector Wide Approach (SWAp) in the Health Sector of the Government of Tanzania:The Present and the Future / 国際保健医療

The Government of Tanzania has gropingly urged an enterprise of development partnership between the host government and funding donor agencies by promoting structural reformation and reinforcement of the government administrative functions. While Poverty Reduction Strategy Paper was accepted and implemented since November, 2000, the Government of Tanzania has spearheaded a challenge of uniformity of development modalities through sector reformations, funding integration and good governance by leading other neighboring countries. Hence, issue prioritization, budgetary integration, executive standardization were intensively discussed by the Government of Tanzania and stakeholders throughout an innovative process of development partnership. <br>Simultaneously, Tanzania has released consecutive development plans such as "Tanzania Development Vision 2025", "Tanzania Assistance Strategy", "Poverty Reduction Strategy Paper" accompanied by the financial arrangement of "Public Expenditure Review" and Mid-term Expenditure Framework". These strategic development dispositions created an attractive environment for development partners to promote integrated financial assistant scheme.<br>According to the Health Sector Reform in the Government of Tanzania since 1994, a practical application of development partnership has been initiated and implemented by the induction of "Health Sector Basket Fund", which was introduced by the accord of several donor partners and international agencies. This pooling fund mechanism aims to integrate current scattered budgetary systems and to promote transparency, accountability and ownership of the finance in the Health Sector. Indeed, the sector-specific Basket Fund forwarded the decentralization process of the Health Sector Reform in light of evidence-oriented health interventions at the district and community levels. <br>In this paper, the present condition of the development partnership in the Health Sector of the Government of Tanzania is examined according to the background, adaptation, application, current considerations and future orientation of the development partnership.

Preface / 国際保健医療

Japan Overseas Cooperation Volunteers (JOCV) are really acting as independent pioneers rather than individual volunteers in their mundane lives in developing countries. Their passionate crusades spearhead an innovative betterment of the health and the society. Their natural practices and challenges reflect us how the international health development should be. In this feature section, we will face the gap between the reality and the hope in the genuine experiences of JOCV and will learn how the authors sprouted out their efforts under the mutual friendship.