農村における公衆衛生の推進

―母子保健を鍵にして途上国への応用可能性を考える―

抄録

Japan has showed a remarkable improvement of health status after the Second World War. Infant Mortality Rate (IMR) in Japan has constantly decreased to 3.2 per 1,000 live births in 2000, reaching the lowest in the world. The author focused on discussion on maternal and child health (MCH) in Japan. A joint Japanese and American research team investigated the reasons why IMR in Japan was low. The team reached five possible explanations for Japan's low IMR: narrow socio-economic distribution, national health insurance covering the whole population, MCH Handbook, population-based screening and health check-ups, high value placed on childbearing.

I showed three examples: MCH handbook, Aiiku activities of community participation and community development in Sawauchi Village. In 1948, Handbook for mothers and children ”Boshi Techo” was firstly distributed by the Ministry of Health and Welfare, Japan. The content consisted of registration, maternal care and deliveries, health checkup and growth of a child, and a ration for food. Now, MCH handbooks are distributed by municipalities, towns or villages. It consists of 72 pages as a national version, and the local governments can add local information by their own needs.

Japan's experience is very different from that of many developing countries, but I argue that a basic health care delivery system and community awareness are just as important to fight infectious diseases and reduce the mortality rate.