Challenge for real initiative and ownership / 国際保健医療

ABSTRACT

The JICA KIDSMILE Project was launched in 2002, after the intimate review of many former projects in the Lao P.D.R. The overall objective of this project is to strengthen management systems for child health services. This project follows three main principles 1) to respect not only vertical relationships but also horizontal networks (among departments, among ministries, and with donors), 2) to support existing Laotian activities, without introduction of new health service packages, 3) to improve the existing health systems which had been already implemented by Laotians before this project.<br>The history of JICA's cooperation with the health sector in Laos demonstrates many past successes, such as the eradication of poliomyelitis in 2000. However, only several years after the end of technical cooperations, these outcomes have almost disappeared, and we are facing similar health problems as before, such as low immunization coverage. Now, we recognize that any health system cannot be sustained without stronger Laotian initiative or ownership. In the KIDSMILE Project, we want the Laotian health workers and administrators to consider what they can do by themselves as the real core implementers of all activities, for the sustainability of their work even after the project is completed.