Abstract
The purpose of this study is to identify the changing role of public health nurses working for cities and towns, and their challenges after implementation of the Community Health Act. A questionnaire survey was conducted among chief public health nurses in 3, 189 cities and towns (excluding designated cities, kernel cities, and ordinance-designated cities), with replies from 2, 208 cities (response rate of 69.
2%). The results of the survey were as follows :
1) Restructuring was performed in 950 cities and towns (43%), including merger of public health and social welfare services, deployment of public health nurses in the social welfare department, and establishment of a care insurance section.
2) The core activities are planned to be health promotion, development and support of citizens' organizations, and home care services.
3) Requests for public health centers in supporting cities and towns include adjustment of services across broader geographical areas and support of difficult cases.
The future challenges are : 1) increased collaboration with social welfare and other services, 2) restructuring and efficiency improvement of current programs, taking care insurance and other municipal plans into consideration and 3) program evaluation and investigational research.
