Kokusai Hoken Iryo (Journal of International Health)
Print ISSN : 0917-6543
Volume 24 , Issue 2
Showing 1-7 articles out of 7 articles from the selected issue
Feature Articles
  • Sirikul ISARANURUG
    2009 Volume 24 Issue 2 Pages 61-66
    Published: 2009
    Released: July 31, 2009
    JOURNALS FREE ACCESS
     The maternal and child health service in Thailand was originally established in 1918, and the first official maternal and child heath handbook was published in 1985. Since then, the handbook has been a major feature of the Thai MCH service and an important instrument for improving the health of pregnant women and children in Thailand. It has been periodically reviewed, revised and updated to maintain currency and to meet the ever changing and evolving health care needs of Thai women and children. This paper outlines the origins and history of this handbook. It comments briefly on its utilization which is still less widespread than expected, especially among clients of private health services. Future challenges are to promote use of the handbook through all types of health facilities throughout Thailand, so as to increase its utilization and further improve the quality of maternal and child health services.
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  • Dinh Thi Phuong HOA, Akemi BANDO
    2009 Volume 24 Issue 2 Pages 67-71
    Published: 2009
    Released: July 31, 2009
    JOURNALS FREE ACCESS
     In Vietnam, health care is of great concern to society, and special attention is given to maternal and child health (MCH) care. Many difficulties and challenges stand in the way of further improving the country's MCH, particularly for minority peoples living in mountainous areas. Especially in those areas, difficult access to medical care and in some cases low quality of obstetric and newborn care contribute to high rates of neonatal mortality, which now accounts for about 70 per cent of infant mortality and more than 50 per cent of under-five mortality.
     Many mothers and health care providers are confused by the many kinds of cards and the thin handbooks used to record MCH information, which also vary among areas and projects. Families, especially those with low levels of education, sometimes lose their cards and thin handbooks. Vietnam's Ministry of Health (MoH) is working to overcome those problems.
     A comprehensive MCH Handbook was first introduced in Vietnam in 1998, in the Mekong delta province of Ben Tre, by a Japanese NGO, The Support of Vietnam Children Association (SVCA). By 2004, all the communes in that province were using the MCH Handbook. In the 5th International Symposium on MCH Handbook, organized in that province in 2006, many Vietnamese people participated and discussed that progress and related issues and opportunities with international guests. MoH representatives and other Vietnamese participants in the symposium, after learning of the successful MCH Handbook experiences in that province and in several other countries, were very interested in possible nationwide use of a MCH Handbook in Vietnam.
     In 2008, the MoH developed plans to use the MCH Handbook nationwide, and in 2009 it is preparing projects for nationwide implementation. The MoH expects that several international organizations will collaborate in those efforts, especially since the MCH Handbook is a tool expected to help achieve Millennium Development Goals (MDG) 4 and 5 in Vietnam.
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  • Shafi Ullah BHUIYAN
    2009 Volume 24 Issue 2 Pages 73-76
    Published: 2009
    Released: July 31, 2009
    JOURNALS FREE ACCESS
     In many countries, maternal and child health (MCH) handbooks help ensure the quality and continuity of health care for mothers and children. In Bangladesh the main health communication tools currently in use, such as treatment cards, immunization cards, and antenatal and postnatal cards, support only one-way communication. There is no evidence that mothers in Bangladesh are convinced of the cards' merits. A pilot MCH handbook project was carried out in Bangladesh in 2002 by the author, as a PhD student in the International Collaboration Division of Japan's Osaka University. The study showed that the MCH handbook had strong positive impacts on mothers' MCH knowledge, practices, record keeping, and service utilization and on the quality of MCH services. Since 2006 the Government of Bangladesh has approved project-based utilization of MCH handbooks, and some NGOs are now implementing projects using MCH handbooks. Building on the findings of the earlier pilot study, and with 2007-2009 support from the Japan Society for Promotion of Sciences (JSPS), researchers have been conducting a community-based study of the use of the MCH handbook, in preparation in for potential nationwide expansion of MCH handbook use in Bangladesh.
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Original Article
  • Tsutomu SHIODA, Nanako TAMIYA, Kouichiro TABUCHI, Osamu YOSHIDA, Hidek ...
    2009 Volume 24 Issue 2 Pages 77-86
    Published: 2009
    Released: July 31, 2009
    JOURNALS FREE ACCESS
    Objective
     To examine the effects of the educational status of mothers and outreach services on childhood mortality in a Zambian village
    Methods
     The study design was a cross-sectional descriptive study. A survey was carried out in a village of Zambia in 2007. Five Japanese medical and nursing students interviewed mothers who had children under five years old. A structured questionnaire was used to collect information on social and educational factors and their experience of child deaths. In total, 73 mothers were interviewed, but three subjects were excluded because their records were inadequate. Information on the remaining 70 subjects was analyzed. The relationship between the dependent variable (child death rate per household) and independent variables (mother's characteristics, community circumstances) was examined. In this study, we used “the numbers of babies or young children who had died without defining age by care takers in a household” (child death rate per household) as a measure of child mortality.
    Results
     Of the 70 mothers, 30 were literate (42.9%). 33 mothers received health information from an outreach program and 22 from community health workers (CHWs).
     The mother's education and the availability of health information from the outreach program were significantly related to lower child death rate per household (p=0.015 and p=0.019 respectively). The relationship between the mother's literacy and child death rate per household also showed an inverse tendency. Mothers with some education who received health information from the outreach program had reduced child death rate per household.
     After stratification by maternal age (younger or older than 30 years), greater education, literacy and outreach program of the younger mothers were more strongly associated with decreased child death rate per household.
    Conclusions
     Education and community learning are important for the health of children. Maternal educational level and a community-based approach have strong impacts on child survival.
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Information
  • Machiko HIGUCHI
    2009 Volume 24 Issue 2 Pages 87-95
    Published: 2009
    Released: July 31, 2009
    JOURNALS FREE ACCESS
    Introduction and Purpose
     Ratio of elderly people has rapidly increased not only in developed countries but also in developing countries. Especially, the number of elderly people over 60 years old will be three times more than at present in the next 45 years in Asian countries. The 9th five year plan in Thailand focused on strengthening health promotion activities in remote areas. Especially, Thai traditional and alternative medicine has been promoted to develop the quality of elderly people's lives. This study was conducted to compare the traditional health behavior of elderly people in a suburban area and a remote area in northeast Thailand.
    Methods
     Forty three elderly people were interviewed in two villages and semi-structured questionnaires were used to collect data from the year 2006 to the year 2007.
     Participatory observation was also conducted to obtain information on village atmosphere and national & social environment.
    Results
     People in the remote area practiced traditional health behavior i.e. growing herbs in their home gardens, believing in the concept of 'heat food' and 'cold food' more than the suburban areas. Meanwhile, people in the suburban used herbal soup more than people in the remote area. People in the remote area consumed many kinds of food and believed certain foods as harmful for health more than people in the suburban area did. Approximately 50% of people in the remote area used to get Thai traditional massage compared to only 30% of people in the suburban area.
    Conclusion
     There was a variety of disparities in the consumption of herbs and foods between remote and suburban areas even though they existed only 20 km's apart.
     People who practiced more traditional health activities suffered from less chronic illnesses than people who did not.
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  • Kazuhiro KAKIMOTO
    2009 Volume 24 Issue 2 Pages 97-105
    Published: 2009
    Released: July 31, 2009
    JOURNALS FREE ACCESS
    Introduction
     Since it is not easy to learn about health situation of Indonesia in Japan, this paper is expected to share the information collected through activities of the author in Indonesia.
    General findings
     The economic crisis in 1997 and the rapid shift to the decentralization policy in 2001 affected health issues.
    Health situations
     The health budget realization rate was more than 80% in 2007, however only 20% was disbursed in the first half year. The Public Health Security Fund started in 2008 enables the poor to receive free medical services.
     Life expectancy was 70.5 years old in 2007 and maternal and child health (MCH) indicators have improved recently, however are still worse than the surrounding countries. In addition, HIV and avian influenza cases have been increasing.
     The Health Strategic Plan 2005-2009 is the master plan, through which the minister prioritizes community mobilization by Desa Siaga (Alert Village) programme.
    Conclusions
     Planning capacity of local authorities and community based health facilities need to be improved. In addition, MCH and communicable diseases control are major health issues.
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Field Report
  • - The Effects by the Superfluous Shift to a Cash Crop -
    Tsutomu KOBAYASHI, Hideki YAMAMOTO
    2009 Volume 24 Issue 2 Pages 107-113
    Published: 2009
    Released: July 31, 2009
    JOURNALS FREE ACCESS
    Introduction
     Currently Cambodia depends on imported foods from Viet Nam and Thailand. To address this situation, the Asian Sustainable Village Network OKAYAMA that the author belongs to, has been cooperating with Cambodian Federal Farmers Organization, a local NGO to undertake a farming project. The importance of agricultural promotion mainly in vegetable farming sector was examined and it is hoped that this project will reduce malnutrition in Cambodia, particularly among the rural poor who suffer with malnutrition, disease and disorder related conditions and will make Cambodia a sustainable society.
    Method
     In order to determine agricultural conditions, we investigated market places in Phnom Penh and examined utilizing farmland in Kampong Cham. In addition, we visited market places in rural districts and farmers' homes to gain more information about eating habits of the population. To find out farming production we referred to statistical data from Cambodian Ministry of Agriculture. A PubMed review was undertaken to determine aspects of malnutrition.
    Results
     Phnom Penh is a very busy place for the daily sale of perishable vegetables which are predominantly transported from Viet Nam. Cambodia, despite of its little irrigation system, and another technical problems is sufficient in its production due to its large farming area. Recently, cassava cultivation has increased in Cambodia in order to meet increasing demands in bio-fuel. We came to know that Cambodians do not have a favorable opinion about vegetables imported from Viet Nam. One of the dissatisfaction voted by the people in Cambodia is that the vegetables from Viet Nam have excessive chemical contamination and they lack in freshness. Restaurants and supermarkets in Phnom Penh preferred local products if they were available. In farming areas the production and consumption of vegetables are limited. For many, vegetables are a luxury. Meals predominantly consist of rice, small dried salted fish and some herbs. This situation is considered a leading factor of malnutrition.
    Conclusion
     As a result of the limited production and supply of vegetables in Cambodia, vegetable consumption is limited and viewed as a luxury. This situation has led to a mal-balanced diet and requires considerable effort to uplift vegetable production in Cambodia to reverse the imbalance of nutritional intake. Thus it can be very well said that agricultural promotion in Cambodia, particularly in vegetable sector is deemed extremely important for the future development of Cambodia.
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