Kokusai Hoken Iryo (Journal of International Health)
Print ISSN : 0917-6543
Volume 26 , Issue 4
Showing 1-10 articles out of 10 articles from the selected issue
Review Article
  • Koji Kanda, Bilkisu Ibrahim-Jibrin, Lillian M. Mnisi, Mohammed M. Iyul ...
    2011 Volume 26 Issue 4 Pages 253-262
    Published: December 20, 2011
    Released: February 04, 2012
    JOURNALS FREE ACCESS
    Introduction
    Whereas the numbers of new HIV infections and deaths due to AIDS have been reduced or stabilized, they remain high in sub-Saharan Africa. To further control the generalized epidemics and their consequences, countries have continued strengthening their programs to prevent new infections and deaths: however, program outcomes and impact at the national level are not well understood. The purpose of the review was to describe the country-level outcomes and impact of HIV/AIDS programs in eight sub-Saharan African countries in order to highlight future action agenda to meet universal access and policies related to Millennium Development Goals (MDGs).
    Methods
    The review used 16 of the 25 program outcome and impact indicators prescribed by the United Nations General Assembly Special Session (UNGASS). The review reported on the percentages accomplished by each country in their programs, categorized these figures into high (80% and higher), moderate (50-79%) and low (below 50%), and highlighted the domains in which outcomes and impact were high.
    Results
    Across countries, with the exception of Tanzania, programs had achieved nearly universal or universal outcomes and impact, but their coverage was limited to 2-5 program domains. Moreover, in domains with multiple target groups, such as in the provision of antiretroviral therapy and in the promotion and distribution of condom use, the programs were unable to produce high-end results for the affected populations. To further reduce their infections and deaths and to advance towards universal access and MDGs, countries must make their program outcomes and impact comprehensive and equitable.
    Conclusion
    Almost all national programs have high level accomplishments, but they must broaden their domain and audience coverage to further control the generalized epidemics and deaths in the eight countries. National responses must collect and analyze all the UNGASS data systematically and regularly in order to determine current HIV/AIDS knowledge and behaviors, ascertain program effects, and inform future actions.
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  • Yoshimi Suzuki, Rie Sayama
    2011 Volume 26 Issue 4 Pages 263-272
    Published: December 20, 2011
    Released: February 04, 2012
    JOURNALS FREE ACCESS
    Objectives
    In recent years, the importance of ethics in the nursing has been increasing, and ethical practices the nursing professionals are being demanded. In global nursing, for instance when Japanese nurses work in a developing country, they face different socioeconomic status and cultures. These characteristics may affect the ethical aspect. However, no literature review of Global Nursing Ethics (GNE) has been conducted until now. The purpose of the integrative literature review is to investigate the literature concerning GNE from the viewpoint of the kind of literature, the countries where the primary authors live, and the major topics related to ethics. We then will generalize on the present condition of GNE.
    Methods
    Our review was based on the methodology of Cooper's integrative review. We searched the literature of the last ten years using the Pubmed database, CHINAL, and Japana Centra Revuo Medicina. 86 literatures that met our criteria were analyzed.
    Results
    1. 53 out of the 86 literatures contained “Information”.
    2. Regarding where the primary authors live, 42 live in the United States, 11 in the United Kingdom, and seven in Canada.
    3. The numbers of major topics reviewed were: 1) nursing ethics between each country, (a) 21 ethical issues related to immigration of nurses, (b) ten related to global nursing cooperation, (c) seven regarding comparison of nursing ethics between countries; 2) nursing ethics on a global scale, (a) 12 related to interpretation and use of global code of ethics for nurses, (b) 11 related to ethical consideration in global nursing research.
    Conclusions
    1. Most literatures contained “Information”, and this indicates that the knowledge of GNE has been spreading. Although the importance of GNE has been recognized, future research may be required.
    2. The top three authors are from English speaking countries indicating that geographical bias exists in the countries that deal with GNE.
    3. GNE depends on the context, so, it is necessary to pay attention to where and how they are used.
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Original Article
  • Mami Maeno, Mika Sakuyama, Satoru Motoyama, Hiroya Matsuo
    2011 Volume 26 Issue 4 Pages 273-280
    Published: December 20, 2011
    Released: February 04, 2012
    JOURNALS FREE ACCESS
    Objectives: To examine perceptions of nursing care for foreign patients in the ward and operating room (OR) and to clarify incidents and difficulties in nursing care.
    Methods: Fifty-five obstetric and gynecological ward nurses and 13 OR nurses were contacted in writing and asked to participate in a self-administered questionnaire to clarify their perceptions of nursing care for foreign patients.
    Results: The response rates for ward nurses and OR nurses were 65% (n=36) and 77% (n=10) respectively. One hundred percent of nurses with experience of foreign patient care stated that they had difficulties with language, cultural differences, the medical system, and financial problems. Incidents resulting from the nursing care included: not following instructions not to take food/drink, walking too soon, and missing their clinical follow-up appointment after discharge.
    Conclusions: This research showed major difficulties with perioperative nursing care for foreign patients. These difficulties may have occurred as a result of issues such as language, differences in culture and the health care system. Difficulty with nursing care for foreign patients sometimes causes incidents. It is recommended that the barriers between non-Japanese patients and the medical staff are rectified in the perioperative period, when mutual understanding is important.
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  • Hidemi Hashimoto, Kaoru Ito, Yumiko Yamaji, Yuka Sasaki, Seiko Murashi ...
    2011 Volume 26 Issue 4 Pages 281-293
    Published: December 20, 2011
    Released: February 04, 2012
    JOURNALS FREE ACCESS
    Objectives
    The study aims to clarify the difficulties of pregnancy, delivery, and child raising for immigrant women in Japan and their strategies for overcoming them.
    Methods
    The semi-structured interviews were conducted with 18 immigrant women who have experience of delivery or child raising in Japan. The participants were asked about their experiences and difficulties faced during pregnancy, delivery, and child raising, and how they overcame them. The data were analyzed in a qualitative and descriptive manner.
    Results
    Seven core categories of difficulties were extracted:«anxiety about child raising»,«problems with relationships with others»,«socio-economic problems»,«anxiety about pregnancy, delivery, and diseases»,«problems caused by illiteracy»,«lack of understanding about Japanese health system»,«choice of the delivery country». Women's«making efforts to manage»is supported by family members and it leads to«use of the Japanese health system». Getting support from friends and neighbors, and the use of an interpreter also leads to this. Some women try to overcome the difficulties by«using a non- Japanese health system»or«doing nothing».
    Conclusions
    When foreigners access health services, not only literacy but also health literacy, such as understanding medical terms or health systems are necessary. Many immigrant women got support from family and friends to overcome the difficulties. However, some women could not get such support and it is necessary for them to make a support network. Foreign women who take negative strategies and use non-Japanese health systems may be in the process of adjusting to Japanese society. Health providers should not deny such strategies, but understand them as a way of decreasing anxiety.
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Short Report
  • Sumiyo Shintani
    2011 Volume 26 Issue 4 Pages 295-304
    Published: December 20, 2011
    Released: February 04, 2012
    JOURNALS FREE ACCESS
    Introduction
    Attempts have been made to spread awareness of prenatal consultation in Morocco. However, the rates of consultation in rural regions have failed to increase. The purpose of this study was to determine the factors that affect prenatal consultation of women who live in a rural region in this country.
    Methods
    In this study, data were collected by interviewing a focus group that comprised three groups of 19 women (6-7 women per group) who lived in a rural region in Morocco. Moreover, data were collected by individual interviews, and data on health statistics were collected to complement the data obtained via the group interviews. These data were analyzed for quality by Grounded Theory.
    Results
    Six components were identified as factors that affect prenatal consultation in this region. Women had “traditional thinking about pregnancy”. They believed that pregnancy was a natural phenomenon, and that the beginning of fetal movements was important. Modern health care was introduced in this region in 2002. This health care instilled a “positive feeling about consultation” in women and improved their “trust towards modern medical workers”. However, this health care was discontinued in 2008. This discontinuation brought “economic problems” and “attendant necessities” for women. Moreover, the consultation was controlled by “thinking about consultation of hasband”, because in this region, men had power for decision-marking.
    Conclusions
    It is indispensable to improve health care system for spreading the use of prenatal consultation in this region. But, temporary introduction of modern health care instilled a positive feeling about consultation in women. I think that this positive feeling persists in the future.
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Field Report
  • Sachiko Yano, Noriko Ikeda, Yuko Kawai, Masaharu Nakade, Miho Sekizuka ...
    2011 Volume 26 Issue 4 Pages 305-313
    Published: December 20, 2011
    Released: February 04, 2012
    JOURNALS FREE ACCESS
    In the aftermath of disasters in areas where populations live in close proximity and where sanitation and water supplies are compromised, an environment is created which is conducive to epidemics of vaccine-preventable diseases.
    A strong earthquake occurred in Haiti in January 2010, severely affecting Port au Prince, the capital of the country, and the Government was functionally damaged. Over 220,000 people lost their lives and over 300,000 were injured.
    Around 1.3 million people are living in temporary shelters in the Port-au-Prince metropolitan area and over 500,000 people have left the disaster areas to seek refuge in the rest of the country.
    In Haiti, one of the world's most impoverished countries, the weak routine vaccination coverage was noted and the vaccination campaign was concerned as one of the first priorities.
    The Japanese Red Cross (JRC) sent a medical team, called an ERU (Emergency Response Unit) right after the earthquake and provided medical services such as clinics in affected areas.
    At the same time, we were involved in the vaccination campaign as one of the key players in the International Federation of the Red Cross and Red Crescent Societies (IFRC) in responding to the mass vaccination campaign by the Ministry of Health supported by WHO (World Health Organization) and UNICEF.
    More than 150,000 people were vaccinated in 1 month by all Red Cross members. 35,217 of them were by JRC and the coverage was 75.5% according to the random survey. Including all the activities, it took more than 3 months and 62% of initially estimated population was vaccinated until the end.
    After disasters, people typically move to other places seeking a better environment so mass vaccination campaign has to be carried out immediately, once it is decided upon. The selection of target populations, vaccines and good cooperation with other organizations is the key to success.
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  • Hiroshi Kobayashi, Motoyuki Yuasa, Tetsuya Mizoue, Diyanath Samarasing ...
    2011 Volume 26 Issue 4 Pages 315-321
    Published: December 20, 2011
    Released: February 04, 2012
    JOURNALS FREE ACCESS
    Introduction
    Recently, the increasing prevalence of chronic and lifestyle-related diseases has become the most crucial global health issue, even in low- and middle-income countries. However, current health systems are often unable to address the large burden of such diseases because of their poor capacity. In Sri Lanka, a country facing such issues, we implemented a school initiative project, the effect of which expanded beyond the school to the student's family as well as the local community. The project was aimed at prevention of chronic and lifestyle-related diseases among adults through school children's activities.
    Activities
    Major interventions such as workshops and regular publication of newsletters including the results of the workshops were implemented at four selected primary and secondary schools in the Southern Province of Sri Lanka. The newsletters the children brought home facilitated their communication with the parents regarding health issues. All the schools conducted health camps, which children planned and managed themselves, and incentive funds were offered to support the children's activities.
    Results
    Through discussion and learning at the workshops, children's self-confidence and self-reliance might be enhanced, particularly in regard to developing their health literacy. The health camps and incentive funds helped promote children's autonomy and capability. The attendance rate of the students at the four schools has increased since the inception of the project, while a questionnaire survey showed that the proportion of parents who smoked has decreased.
    Conclusion
    The trial suggested that school children have the potential not only to improve their own health but also to help their parents and the broader community adopt a healthier lifestyle. Application of the child-to-child strategy may be useful to deal with chronic and lifestyle-related diseases of adulthood as it expands to the child-to-parents and the child-to-community approach.
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  • Yoko Tsurugi, Khun Kim Eam, Mao Tan Eang, Ritei Uehara, Yosikazu Nakam ...
    2011 Volume 26 Issue 4 Pages 323-330
    Published: December 20, 2011
    Released: February 04, 2012
    JOURNALS FREE ACCESS
    Background
    The national tuberculosis (TB) control program established Phnom Penh as a pilot area for TB and human immunodeficiency virus (HIV) infection collaborative activities because of the high prevalence of HIV among patients with TB.
    Process
    In 2005, we provided transportation fees so that patients could travel to an operational district referral hospital for HIV counseling and testing by dispatched counselors. However, only around 10.3 patients with TB (range 0-21) per month in all 4 operational districts made use of this service. In 2006, we modified the program by providing HIV counseling and testing by four trained TB/HIV coordinators in TB wards. Thereafter, in-depth, individual, semi-structured interviews were conducted with the TB staff (not the coordinators) of 18 health facilities from April through November 2006 to identify problems in the current TB/HIV collaborative activities in Phnom Penh and to investigate ways for further improving the program.
    Results
    TB staff members encouraged their patients to undergo an HIV test under directly observed treatment, short course. Some TB staff lacked confidence to discuss HIV issues because they lacked sufficient HIV/ acquired immunodeficiency disease syndrome (AIDS) knowledge. Furthermore, there was no formal referral structure between TB and HIV services or sharing of information on the treatment of patients co-infected with TB/HIV with the antiretroviral treatment clinic.
    Conclusions
    We started the program to enable TB patients to receive HIV counseling and testing at the same venue as they received TB treatment. However, problems such as low confidence among TB staff in discussing HIV/AIDS and weak collaboration between TB and HIV services were identified. We found that training of TB staff, development of Information, Education and Communication (IEC) materials, regular meetings among stakeholders, and encouragement for the TB/HIV coordinators to supervise all TB/HIV activities in their operational districts were needed to improve the program.
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Information
  • Tomohiro Nakata, Nozomi Fujisawa, Takako Yamada, Koichi Tanaka
    2011 Volume 26 Issue 4 Pages 331-340
    Published: December 20, 2011
    Released: February 04, 2012
    JOURNALS FREE ACCESS
    OBJECTIVE:
    This study aims to examine the awareness and ability of health care providers to cope with language barriers at medical facilities in Hyogo Prefecture, Japan, and to clarify the issues concerning health care for foreigners.
    METHODS:
    In total, 2100 copies of self-report questionnaires on issues of health care for foreigners were mailed to health care providers of 352 hospitals in Hyogo. The survey was conducted from February to March 2010.
    RESULTS:
    The response rate of medical facilities was 21.6% (76/352), whereas that of the health care providers was 15.2% (320/2100). Approximately 10% hospitals handled foreign patients at least once per month, and they dealt with patients using several languages, including English, Chinese, Korean, and others. The providers' main issue was communication with their foreign patients. The documents and booklets for guidance regarding some health care procedures at the hospitals were also poorly prepared. It is therefore exceedingly necessary for hospitals to provide common documents in different languages; moreover, the government or local authorities should arrange for public medical interpretation services.
    DISCUSSION:
    Medical facilities in Hyogo have been struggling to improve their linguistic capabilities, and it is difficult to indicate whether public organizations concerned with medical interpretation are being recognized. Efforts on the part of medical facilities and local and national governments, as well as cooperation of nonprofit organizations, are immensely essential to resolve the issue of multilingual health care. This survey suggests that to help people with diverse languages, the health care system in Japan should be improved rapidly, particularly with regard to the establishment of licensed professional medical interpreters.
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  • Toyomitsu Tamura, Seiko Kobayashi, Mayumi Shimizu, Yasuyo Matsumoto
    2011 Volume 26 Issue 4 Pages 341-348
    Published: December 20, 2011
    Released: February 04, 2012
    JOURNALS FREE ACCESS
    The Republic of Senegal (hereinafter referred to as “Senegal”) became independent from its former colonial master, the Republic of France in 1960 and formed a democracy. Operations of nursing schools that had been established under the colonial rule were taken over by the Senegal government after the independence. Though having been influenced strongly by French nursing education system, they has developed uniquely and now grown to leading nursing schools of francophone West African countries.
    The objective of this manuscript is to focus on nurses that account to the largest number of healthcare workers in Senegal and to trace the historical transition of Senegal's nursing education. The research methods are collection of reference materials, classification of contents, and interviews. As a result, we found that a visiting nursing school established in 1922 is the oldest public nursing school and a total of eight public schools had been established before the independence. The Senegal government laid down National Economic and Society Development Planning and set forth measures for healthcare problems as a priority issue, and has concentrated on nursing education since the independence in 1960. In 1992, the former Ministry of Social Health Activity established the National School of Health and Social Development by integrating 14 public schools related to health welfare. In 2003, it started a practical nurse training program aimed at increasing of the number of nurse graduates and decentralizing nursing education. In 2010, the nursing education standard was revised to improve the quality of nursing education and it will be applied to all nursing schools hereafter.
    The need for strengthening management of human resource development and ensuring the quality of that by using the estimates of nurse supply and demand and the like can be suggested as future tasks for the nursing education in Senegal.
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