Objectives
  The objective of the study was to analyze the effects of home-based records on pregnancy, delivery, and child health care in Indonesia.
Methods
  The data were obtained from women who had children under 5 years old at the time of the collection of the 2002, 2007, and 2012 Indonesia Demographic and Health Surveys. The study divided women into two groups: those who used the Maternal and Child Health Handbook (MCHHB) or antenatal card (AC) as a home-based records group, and those who did not use MCHHB or AC as the control group. We calculated the adjusted odds ratios and expressed the effects using meta-analysis methods.
Results
  The study revealed that, compared with the control group, the home-based records group had more knowledge and better practices during pregnancy, delivery, and child health care (e.g., immunization). The home-based records group knew how to solve the problems of complications during pregnancy and used skilled birth attendants for delivery. This study also found that husbands in the home-based records group were involved in discussing the delivery location, finding transportation, and identifying a blood donor.
Conclusions
  This study showed that home-based records had strong associations with the knowledge and practices of women regarding pregnancy, delivery, and child health care.

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Objectives
  This study aimed to compare accessibility to the health services in Brazilian CSHCN (children with special health care needs) with non-CSHCN living in Japan and the parenting stresses of the parents of both groups of children, as well as to examine if the children’s being CSHCN is a factor of increasing the parenting stresses of their mothers.
Methods
  A questionnaire was administered to 130 Brazilian mothers in Japan of children between 3-6 years of age living in Aichi Prefecture, and analyzed the valid answers of 73. The questionnaire was constructed with background information, CSHCN Screener^©, children’s health care service needs, and PSI/SF (Parenting Stress Index Short Form). We evaluated the differences between CSHCN and non-CSHCN, and conducted a multiple linear regression analysis on the parenting stress scores.
Results
  Nine out of 73 children were identified as CSHCN including four with asthma, three with autism, one with chronic bronchitis, and one with cardiac hypertrophy. Although all CSHCN had family doctors, their mothers had unmet needs for specific health care services, especially dental care, rehabilitation and consultation of specialists. There were three mothers of non-CSHCN who had delayed or forgone care.
  The average score of PSI in all mothers was: TS (Total Stress)＝60.2, PD(Parental Distress)＝22.0, P-CDI(Parent-Child Dysfunctional Interaction)＝16.9, DC(Difficult Child)＝21.7. DC score was significantly higher in CSHCN than in non-CSHCN. Three determinants of elevated TS score were having CSHCN or children with chronic diseases, experiencing severe economic difficulties, and having a husband who did not speak Japanese.
Conclusions
  The study revealed that Brazilian mothers with CSHCN in Japan were not disadvantaged in terms of access to health services, but had unmet needs in some specific areas. Although the mothers of CSHCN showed relatively low levels of total parenting stress, they had significantly higher levels of stress on the difficult child characteristics. Attention for the stress of the mothers of CSHCN is required.

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Objectives
  This study aimed at describing primary healthcare (PHC) providers’ opinions and attitudes about non-communicable disease (NCD) prevention in Sri Lanka and to suggest methods to increase their competence in preventing NCDs.
Methods
  Using purposive sampling, in-depth interviews were conducted among 25 PHC providers: 7 public health nursing sisters (PHNSs), 7 public health inspectors (PHIs), and 11 public health midwives (PHMs) in the western province of Sri Lanka. The interviews were transcribed verbatim and the data were thematically coded.
Results
  Three major areas regarding PHC providers’ perceptions of NCD prevention and control were identified: insufficient knowledge and training regarding NCD prevention, integrating NCD prevention into MCH activities, and insufficient resources and facilities for NCD prevention. All respondents expressed interest in implementing NCD prevention measures as part of their daily routine. However, insufficient knowledge of NCDs prevented them from playing an active role in NCD prevention and control. PHMs described that they could integrate health education about NCD prevention with their existing duties if they were knowledgeable on strategies to handle it in the field. They recognized that unmet PHNS and PHM quotas caused to hinder their delivery of appropriate services and that they could prevent NCD more effectively by delivering better services if they were provided basic data on NCD of the areas they were in charge of.
Conclusion
  The PHC providers recognized that they had insufficient knowledge and numbers of PHC providers to deliver services to control and prevent NCDs in the communities. Our findings suggest that it is important to provide sufficient training to PHC providers. In addition, there is a need to increase the numbers of PHC providers and improve facilities of medical officer of health (MOH) office. Moreover, the accessibility of basic NCD data from every administrative division is needed to achieve effective practices regarding NCD prevention and control in Sri Lanka.

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Objective
  In West African countries where the maternal mortality rate is high compared to the rest of the world, international assistance is conducted actively to improve the birth rate with the presence of Skilled Birth Attendant (SBA). However, few documents describe which workforces are considered as SBA and which work in delivery care actually on site. This paper summarizes the workforce engaged in delivery care and clarifies which are the occupations considered as SBA in West African French-speaking countries.
Method
  Literature review was conducted based on information from official documents related to health workforce in 7 West African French-speaking countries: Benin, Burkina Faso, Ivory Coast, Mali, Niger, Senegal and Togo, and the respective governmental websites. To determine the professional categories as SBA in each country, Demographic and Health Survey (DHS) was referred.
Result
  This research reveals that the workforces which engage in delivery care in the target countries are nurse, midwife, auxiliary nurse, auxiliary midwife, paramedical personnel, obstetric nurse, primary medical staff, matron, community health worker and traditional birth attendants. Titles and definitions of health workforce however vary in official documents issued by the government even of one country. In DHS Report, nurse and midwife are considered as SBA in all countries, but other professional categories vary in each country. In many countries, professional nurse and midwife categorized by WHO are included in SBA, while community health worker is not. Matron, which is a kind of community health worker, is considered as SBA exceptionally in Burkina Faso and Mali.
Conclusion
  None of the countries clearly define which professional categories are considered as SBA in official documents. Urgent definition of SBA is required and simultaneously the management system of health workforce and its uniformity for description in documents are needed. It is also suggested that various SBA-related policy assistance for the reduction of the maternal mortality are conducted without clear definition of SBA in each country. Thus it is reaffirmed that the policy assistance must be planned with adequate understanding in health workforce, based on appropriate selections of workers and well considered methods of intervention in the concerned field.

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  In this article, the author presents experience of JICA’s project, “The Project for Enhancement of Nursing Competency through In-Service Training” (hereinafter referred to as “the Project”) that is under implementation with the Ministry of Health, Republic of Indonesia, five universities and nine hospitals in Indonesia (hereinafter referred to as “counterparts”) based on the author’s experience as an expert for the Project from December 2012 to December 2015. In the Project, Indonesian counterparts improved their Nursing Career Ladder (hereinafter referred to as “the Ladder”) and modified/developed several training curricula in line with the Ladder.
  As a result, through improvement/development of the Ladder and several curricula in the Project, several results were found such as utilization of the Ladder for curriculum development; training planning and management; allocation of nursing authorities to nurses; effective allocation of human resources. It was also found that the Ladder could be utilized as the internal control in line with the Ladder of the Project and literature study.
  Presently, the Ladder is utilized for human resource development and human resource allocation and defined as a tool for nursing human resource development and career management, however the author concluded that the Ladder can be utilized for nursing management in consistent manner; communication between hospital (management) and nurse; fair evaluation; designated training contents and effective training planning; communication between hospital and stakeholders; allocation of authority; internal control by discussing the Ladder based on literature study, project activities and project results that were reported in the reports such as the Project’s mind-term review reports, experts reports to JICA and Indonesian counterparts and so on.

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