Kokusai Hoken Iryo (Journal of International Health)
Print ISSN : 0917-6543
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Dr. Tetsu Nakamura Memorial
Original Article
  • Aurora G. Querri, Akihiro Ohkado, Lisa Kawatsu, Jesse Bermejo, Armie V ...
    2020 Volume 35 Issue 1 Pages 15-25
    Published: March 20, 2020
    Released: April 02, 2020
    JOURNALS FREE ACCESS

    Introduction

      The Philippines adopted the primary health care (PHC) strategy in 1978 to deliver essential health services in the community related to prevention and control of prevalent health problems. The barangay health workers (BHWs) are expected to play a key role in profiling the health of the community by maintaining and updating a comprehensive dataset of the community, called the “thirteen folders”, through conducting routine house visits (Appendix A). This study aimed to determine the utilization and challenges in updating the 13-folders and its usefulness in conducting community activities of BHWs at the primary care level.

    Methods

      This study utilized a mixed- method of descriptive epidemiology and qualitative analysis, whereby data was collected from various resources as well as structured interview with 20 nurses and 31 BHWs in Districts I and VI, of Manila City. Questions related to activities of BHWs in identifying and profiling communities through house visits, utilization of feedback report and the challenges encountered were asked.

    Results

      None of the health centers met the BHW to community ratio of 1: 20 residents. Only one out of 31 BHWs conducted community visits as required or four times a week. In fact, irregular visits resulted to failure in conducting community profiling and in delays in updating the 13-folder with missing information noted in some folders. The BHWs’ role is perceived by both nurses and BHWs as assisting in objective-specific activities and as health educators. Delays in honorarium and duplicating tasks in updating the 13-folders were revealed as potential issues that could hamper their performance.

    Conclusion

      The BHWs are crucial in assisting health staff towards provision of responsive health services; however, lack of human resource should be addressed to reduce additional workload among BHWs. The 13-Folder is an imperative tool to identify the needs of the community other than health concerns but careful assessment is required to reduce repetitive tasks and to determine its value in improving community health outcomes. The delayed provision of honorarium should be dealt with to avoid further demotivation among BHWs. Finally, a refresher training should be considered to optimized the role of BHWs at the PHC level.

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Research Note
  • Chika Kambayashi, Akiko Kondo, Mami Koizumi, Akane Futami
    2020 Volume 35 Issue 1 Pages 27-38
    Published: March 20, 2020
    Released: April 02, 2020
    JOURNALS FREE ACCESS

    Objectives

      The objective of this study was to investigate the needs and motivation of nurses regarding training on how to take care of foreign patients at hospitals and to explore related demographic factors.

    Methods

      A questionnaire was distributed to all nurses working at two hospitals in Tokyo, one university and one general, using Google form. The needs and contents of training they would like to participate were summarized using descriptive statistics. Fisher’s exact test, t test, Mann-Whitney U test and Spearman’s correlation coefficients were used to analyze related factors.

    Results

      Responses of 138 nurses were analyzed (98 university and 40 general) with a response rate of 11.3%. More nurses in the university hospital held a bachelor’s degree and higher subjective English ability than the general hospital. In both hospitals, 59.7% answered that they “strongly feel” or “feel” stress/anxiety in dealing with foreign patients and 77.5% answered that training is necessary.

      “Language training” was felt most necessary, followed by training regarding “different cultures and religions.” In regard to language training, “daily conversation” was most necessary, followed by “technical terms”; English being most necessary, followed by Chinese. Approximately one-fourth of participants (24.6%) answered in the affirmative for attending such training by adjusting their private schedules and 59.4% answered they only wanted to attend if it fits into their schedule.

      Nurses who answered, “unable to speak English”, had a higher desire to improve their ability to take care of foreign patients; also, those who had higher stress/anxiety felt it was necessary to attend the training. Participants who had been studying a foreign language showed higher motivation.

    Conclusion

      Daily conversation in English was felt most necessary regarding training to care for foreign patients. Training during work hours rather than on private time was preferred.

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Field Report
  • Sayaka Fujita, Chihori Tatebe, Kohei Morita, Kaoru Nakamizu
    2020 Volume 35 Issue 1 Pages 39-47
    Published: March 20, 2020
    Released: April 02, 2020
    JOURNALS FREE ACCESS

    Introduction

      In December 2017, a workshop was held for foreign and Japanese residents to learn about the prevention of health problems in the time of disaster.

      This paper presents the results of a questionnaire survey conducted at the workshop, focusing on a disaster-preparedness education and support for foreigners living in Japan.

    Methods

      The workshop participants were asked about their knowledge of health problems in the time of disasters and their experiences with health counseling.

    Results

      Data were obtained from 25 of the 48 workshop participants. Almost half of the respondents indicated that they understood the potential mental and physical health problems in the time of disaster. Foreign participants were able to grasp the medical system at the evacuation shelters in Japan, and were able to learn about diseases, especially with regards to being aware of their own health condition. Regarding health maintenance at evacuation shelters, participants indicated their need for physical and mental health support, as well as more information and sharing.

    Conclusions

      Foreign participants emphasized their need for support regarding physical and mental aspects. This was informed by their experiences of living in an evacuation shelter and the workshop lecture, which facilitated a greater understanding of how everyday life would be affected after the disaster. The participants described challenges related to their own health, as well as language challenges in their experiences of health counseling. Since foreigners tend to hesitate when consulting others about language concerns, it is necessary to clarify the workings of support and medical care systems at evacuation shelters. In addition, frequently used medical terms and health guidance contents need to be presented in more than one language to lessen foreign residents’ anxiety during-the disaster.

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Information
  • Hitoshi Murakami, Miwa Kanda, Hisa Nakajima, Takahiro Sawayanagi, Kent ...
    2020 Volume 35 Issue 1 Pages 49-64
    Published: March 20, 2020
    Released: April 02, 2020
    JOURNALS FREE ACCESS

    Introduction

      The objective of this study was to identify measures Japan should take to achieve health (goal 3) and gender (goal 5) goals of the Sustainable Development Goals (SDGs) in synergy by comparing the status of health and gender in Japan and the United Kingdom based on gender analysis.

    Methods

      In-depth interviews were conducted with 8 gender experts and 2 obstetrician/gynecologists in Japan and 9 informants in government, civil society and academia in the UK. The status of sexual and reproductive health and rights (SRHR) and measures against gender-based violence were elaborated. Qualitative content analysis was conducted on the transcripts of the interview audio-records.

    Results

      We have compared contraception and abortion, control of sexually transmitted infections, sexuality education, measures against breast and cervical cancers and measures against gender-based violence in Japan and the UK. Significant differences were noted in contraception and abortion, sexuality education and measures against gender-based violence. There were four areas where the UK applied gender-transformative measures (measures that address not only the condition of women but also the gender relations between men and women and social status of women) whereas Japan has not yet applied such measures: 1) Ensuring selection of a wide range of contraceptive methods with low price, 2) Enabling abortion solely based on the decision by women, 3)Comprehensive sexuality education that includes gender and human relationship, and 4) Setting an integrated strategy against gender-based violence.

    Conclusion

      Japan can strive for both health and gender goals of the SDGs by addressing above four aspects. Promotion of civil society participation in policy decision and increased proportion of female parliamentarians will help address these aspects.

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