Kokusai Hoken Iryo (Journal of International Health)
Print ISSN : 0917-6543
Volume 25 , Issue 1
Showing 1-6 articles out of 6 articles from the selected issue
Review Article
  • Motoyuki YUASA, Marika NOMURA, Eiji MARUI
    2010 Volume 25 Issue 1 Pages 1-10
    Published: 2010
    Released: May 28, 2010
     Global health policies and strategies are influenced by world politics/economics and development. Thus, a clear and accurate understanding of global health requires proper knowledge of the history of world politics and economics. Since the end of World War II, world politics and economics have dramatically changed through the cold war era to the multipolar age. Meanwhile, the direction in which developing countries have progressed has been determined by select international financial organizations such as the International Monetary Fund and the World Bank in accordance with the policy of the USA Presidency.
     This paper reviews the history of global health policies and strategies in the context of world politics and economics as well as world development.
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Original Article
  • Koji KANDA, Yoshihide OBAYASHI, Ananda JAYASINGHE, K. Tudor SILVA, Rom ...
    2010 Volume 25 Issue 1 Pages 11-19
    Published: 2010
    Released: May 28, 2010
     Recent strategic plans for HIV/AIDS control in Sri Lanka have stressed the need to focus prevention interventions on most-at-risk populations and similarly laid out the importance of improving HIV/AIDS awareness among the general population. Programmatic attention has to be strengthened to effectively change AIDS-related poor knowledge, low risk perceptions and risky sexual practices at the individual level, and avert an epidemic. While current data on at-risk populations are available to inform interventions, there is paucity of latest evidence for the general population programs.
     In April-May 2009, a cross-sectional study involving 1,239 population-based and randomly selected respondents aged 15-49 was completed in Kandy, Sri Lanka (response rate=87.2%). The study collected data on HIV/AIDS knowledge, perceptions and sexual practices among the general population to supply current information for the intervention. Data were analyzed using univariate, bivariate and multivariate approaches.
     While almost all respondents were aware of HIV/AIDS, sizeable proportions (44.7-76.2%) knew little about the types of sexually transmitted infections, and about the transmission modes and prevention methods of HIV/AIDS. Although 80% of respondents had low risk perceptions and were mostly at low risk behaviorally, their knowledge of HIV/AIDS was inadequate. They assessed their risks and practiced unsafer sex without the benefit of having evidence-based knowledge. The knowledge, perceptions and practices were significantly associated with gender, marital status, education, religion, and/or residence.
     The gaps in substantive knowledge on HIV/AIDS suggest that no effective information and other related types of support have been provided to the general population in Sri Lanka. In the context of the need to contribute to sustaining the low prevalence of HIV in the country, a base of scientific knowledge and wider advocacy programs should be developed.
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  • Chiharu NONAKA, Machiko HIGUCHI
    2010 Volume 25 Issue 1 Pages 21-32
    Published: 2010
    Released: May 28, 2010
     The purpose of this inductive study was to clarify the process of building relationships between foreign patients, who are residents in Japan, with diverse cultural backgrounds and nurses who have cared for hospitalized foreign patients within the past year. Data collection was conducted through semi-structured interviews of eleven Japanese nurses. Analysis of data used the grounded theory methodology.
     The results of the analysis revealed the following core components of the relationship building process: [Intention to provide appropriate nursing care for foreign patients], [Intention to understand foreign patients’ diverse backgrounds from the perspective of one’s own culture], [Indecision regarding relationships with foreign patients], and [Compromises between nurses and foreign patients]. Furthermore, 25 categories and 110 subcategories of these components were identified.
     The most important feature of the process of building relationships between foreign patients and nurses was that nurses requested that foreign patients have the same role as Japanese patients
     Subsequently, the nurses became aware of the differences between their own culture and foreign patients’ diverse cultural backgrounds. Consequently, the nurses had made progress in increasing their awareness of cultural differences.
     The present results suggest the importance of facilitating Japanese nurses’ recognition of the existence of cultural difference, and improving the process of compromising with accepted cultural difference.
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  • Tsutomu KOBAYASHI, Hang'ombe B.MUDENDA, Hideki YAMAMOTO
    2010 Volume 25 Issue 1 Pages 33-39
    Published: 2010
    Released: May 28, 2010
    Preface and Objectives
     Cholera has recently become more serious in African countries. In southern Africa, a serious cholera outbreak was reported in 2008. Here we investigate Vibrio cholerae in aquatic environments, rivers, tube well waters, fish tissues, and aquatic plants in Zambia.
     The sampling was conducted on Kafue and Zambezi rivers as well as at public wells. The samples included river water, mud, fish, floating grass, and well water. All samples were enriched in alkaline peptone water (APW) and streaked on thiosulfate citrate bilesalts saccharos (TCBS) Vibrio agar. Some types of colonies were isolated using polymyxin mannose tellurite (PMT) agar. All water samples were analyzed for enterobacteria as well as vibrio contamination. River and shallow tube well water samples were analyzed for E. coli.
     Samples, including fish tissues, river, and tube well waters, except for the fish intestines, were found to be contaminated with vibrios when cultured on TCBS Vibrio agar.
     Deep tube well water was not contaminated with vibrios or E. coli. V. cholerae El Tor was not detected through sampling and culturing on PMT agar. E. coli was detected in river and shallow tube well water samples.
     Vibrios were detected in Zambia’s aquatic environments. Cholera outbreak may occur. Vibrio contaminations in fish have been reported from Bangladesh, Laos, Kenya, and India. Fish is a good source of protein to improve person’s nutritional status. However, it must be treated properly so that any contamination of residential areas is avoided. Therefore, people must pay attention to fish.
     Here several types of V. cholerae were isolated from different aquatic environments. Fish is a nutritious diet, but contaminated Vibrios fish must be treated so that it will not contaminate residential areas. We must investigate the gateway of cholera outbreaks in Zambia.
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Field Report
  • A case report of the field trial and problems
    Makoto OWHASHI, Masato KAWABATA, Akira ISHII, George TALEO
    2010 Volume 25 Issue 1 Pages 41-45
    Published: 2010
    Released: May 28, 2010
     Malaria is a parasitic disease of major health significance that arrests the development of the tropical countries. We assembled an innovated LED light box for diagnosis of malaria, and examined for availability of the LED light box in the clinics of malaria endemic area in Solomon islands in the previous study. In the present study, we tried to use the LED light box for the practical use in the clinics with diagnostic service of malaria in Vanuatu (next country of Solomon Islands) for 1 year, and verified the availability and problems of the continual use of the LED light box. We identified the advantage of the use of LED light box in the diagnosis of malaria using microscopy. On the other hand, additional training of basic electricity is needed for microscopists who have little experience for electronics in the course of training of mictroscopists for the practical use of the LED light box.
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  • -Monitoring and evaluation based on daily trainee’s voice
    Mari NAGAI, Miho GOTO, Yasuyo MATSUMOTO, Noriko FUJITA, Yoichi HORIKOS ...
    2010 Volume 25 Issue 1 Pages 47-57
    Published: 2010
    Released: May 28, 2010
     Every year, a lot of training programs by Japan International Cooperation Agency (JICA) are conducted in Japan. However, the method of monitoring and evaluation of those trainings are not always conducted other than simple questionnaire survey. The purpose of this research is to demonstrate the significance of daily recording and analysis of the trainee’s voice as a way of the improvement of the quality of training.
     Bureau of International Cooperation in National Center for Global Health and Medicine (NCGM) conducted detailed monitoring and evaluation for “JICA training for Maternal and Child Health in French speaking African countries in 2009” which NCGM itself had planned training curriculum and implemented the training. The key word of this training was “Continuum of care”. At the end of the 5 weeks training, NCGM expected the trainees to obtain comprehensive understanding of continuum of care, especially two different perspectives, which were “the health system” and “the dignity of individual client”.
     NCGM training team kept recording the trainee’s voice, then analyzed them every day during five weeks’ training. At the end of the training course, the team divided trainee’s voice into several categories, and then analyzed their time-dependent change.
     The everyday recording and analysis of the trainee’s voice made NCGM training team possible to differentiate the trainee’s fundamental interest and understanding from simple guesses or curiosity. Based on the result of daily analysis, the training team could introduce unscheduled discussion or fine-tuned the contents of lectures for better understanding of trainees. The trainees’ interpretation about “continuum of care” showed obvious change before and after the training. The active learning program by using Laboratory method gave deeper impact on trainees than the expectation of training team. At the end of training course, the trainees formulated concrete and detailed action plans. The purpose of their action plans was to establish the continuum of care from aspects of both “the health system” and “the dignity of individual client” by analyzing the existing stakeholders and institutions, and ensuring a collaborative linkage among them, which were exactly the expected outcome.
     Daily recording and analysis of the trainee’s voice was effective and useful to monitor the training. The comprehensive analysis at the end of training course revealed the short impact of the training on trainees, which could be used as a self evaluation tool for the training team.
     NCGM plans to visit the trainees’ workplace in their home countries for middle and long term monitoring and evaluation. The results will be feed backed into the training curriculum of next year.
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