Objectives The present study aimed to elucidate issues in maternal and child health in suburban areas by comparing the effects of increases in population, economic power, and amount of information on health behaviors among mothers such as pregnancy, childbirth, and child care in village A in the suburbs of Kathmandu between 2001 and 2006. Methods We conducted an interview survey on mothers of children aged 0-12month in village one in Lalitpur district in Nepal. Data from 2001 and 2006 were compared for the educated group, non-educated group, and all subjects. Results The number of mothers in ethnic minorities increased in 2006. The most commonly used facility for pregnancy examinations, delivery, and child illnesses was hospitals, and their use tended to increase from 2001 to 2006 for each type of visit. In addition, the cost of pregnancy examination and delivery increased approximately 7-and 2-fold, respectively. Kaup index increased by one point for the condition of child development. Prevalence of general infections among children decreased. Conclusion Subjects were polarized into the middle class, which included individuals who had increased income by working as migrants abroad, and an economically disadvantaged group which included individuals who had migrated from rural areas. The active use of health services at hospitals among pregnant women and children was attributed to recognition of the safety and comfort of hospitals as well as the consumer culture resulting from growth of the middle class. The economically disadvantaged group was considered to be at high risk with regard to maternal and child health, and was thus thought to require affordable and accessible support. Issues in child care appeared to be shifting from “nutritional improvement” and “infection control” to “nutritional balance”.
Preface We have been carrying out a project to improve epilepsy care in Mongolia since 2002, in collaboration with the global campaign of WHO, ILAE (International League Against Epilepsy) and IBE (International Bureau for Epilepsy). Epilepsy in Mongolia In Mongolia, the number of patients with epilepsy has been increasing. The current problems of epilepsy care in Mongolia are as follows: 1) There are few epilepsy specialists, including surgeon, resulting in insufficient management of epilepsy care. 2) Few diagnostic instruments such as EEG, CT, MRI, blood testing are available even in the capital city, Ulaanbaatar. In addition, these tests are very expensive. 3) Lack of drug supply and incomplete health insurance system prevent many patients from stable long-term treatment. 4) Difficulty in access to medical institution due to immature infrastructure of transportation hampers early diagnosis and appropriate treatment. Our activities We developed a program for improving epilepsy care. Three workshops were held in Ulaanbaatar where 50-150 physicians participated (2002, 2007 and 2008) for lectures and case discussions. We also accepted a neurologist for training of epileptology at our institute. We offered two analogue EEG machines along with necessary consumables. Future prospects Most important in Mongolia may be to bring up epileptologists and establish epilepsy network. Because of the chronic shortage of human and medical material resources, there should be a center of epilepsy treatment in Ulaanbaatar, where medicine and consumables can be steadily supplied and transported, and the information network be prepared. Recently, an educational program of the epilepsy for the general public, “Quality Of Life Program”, has been undertaken, which is of high significance in Mongolia to solve stigma and to prevent epilepsy.
Malaria is a parasitic disease of major health significance that arrests the development of the tropical countries, and the developmental education on malaria for the local residents has crucial effects for the successful control of malaria. In the present study, we tried to innovate an effective education program for a community primary school in a malaria endemic area of Solomon islands. The integrated program was consisted mainly with practical exercises of the surveillance of mosquito larvae that transmit malaria parasites, identification of the species of mosquito larvae and the mapping of the breeding sites and the localization of the residence of village people under the cooperation of the local residents and teachers. We successfully established a risk map showing the approximate localization of Anopheles larvae that transmits malaria. An impressive observation of mosquito larvae was performed with microscope equipped with LED light box in the dark classroom without electric power equipments. Though no students have ever observed the mosquito larvae and few students have some knowledge for malaria, all students replied that they learned about malaria with a deep interest by the educational program. Thus, this educational program is shown to be promising for the health education in the schools of malaria endemic area.
Background In recent years, inbound tourists to Japan are increasing. Although they rarely suffer diseases or injuries during travels, they may feel anxiety for medical services in foreign countries. This study was aimed to consider how inbound tourists visiting Japan feel about Japanese medical cares. Methods Inbound tourists who came to the Tokyo Sightseeing Information Center were investigated. The questionnaire composed of 12 items relating to Japanese medical cares and levels was made in three languages; English, Chinese and Korean. Results A total of 163 tourists including 98 English speakers, 39 Korean speakers and 26 Chinese speakers were enrolled in the study. (1) Native English speakers had a high anxiety about the communication with Japanese medical staffs (p<0.001). (2) Chinese and Korean speakers subjective estimated the Japanese medical level low (p <0.001). (3) Chinese and Korean speakers had a high anxiety for medical costs while traveling (p<0.001). (4) In a case of emergency, English speakers mostly “look for a drugstore and a hospital”, while Chinese and Korean speakers mostly “contact a travel agency and a tour conductor”. Conclusion Considering foreign tourists' needs vary with their nationality and culture, Medical staffs should support them to have desired medical care in Japan.
Introduction Developing countries have many urgent issues to cope with, such as infectious diseases, and therefore people with disabilities have not had enough opportunities to receive rehabilitation services. A mobile unit as an outreach approach seems to be valuable in countries or areas lacking in adequate health care facilities. In Thailand, there are about 56 thousand people with lower extremity amputations. There are very few workshops and technicians in health care facilities producing prostheses. We studied a working mobile unit to clarify its effectiveness. Method We conducted participatory observations of the mobile unit in Chiang Rai, Thailand in October, 2006 run by the Prostheses Foundation, and hearings from the staff and the amputees to collect the information such as outlines of the foundation and the unit, and the number of participants. We collected data on those amputees from the reception note, such as their occupations, causes of amputations, kinds of prostheses, and their experiences of using prostheses. Results The mobile unit was a huge scale activity including 75 staff members, who visited the field with all necessary equipments. Fifty-four technicians produced 204 prostheses for 177 amputees in 4 days. Eighty percent of those amputees were unstable in income, such as farmers and those unemployed. Landmines were the cause of amputation for 20 percent of those seen. Thirty percent experienced their prostheses initially, 20 percent of whom had waited for 6 years or more to receive them. Therefore, it was found to be an effective activity to provide prostheses for poor people with amputations in rural areas. Also, technicians in rural areas learnt skills regarding prostheses from specialists in cities. Conclusions A mobile unit seems to be effective in Thailand to provide amputees with prostheses, and Prosthetics and Orthotics technicians in rural areas with opportunities for education.