The Ministry of Health, Labour and Welfare has proposed a policy in which medical support communities are chosen where infants with high medical dependence can live. As a result, the number of children undergoing home-visit nursing care is increasing year by year. The purpose of this study was to clarify the realities of home-visit nursing care for children in Oita Prefecture and was to consider the challenges. An inventory survey was performed for the managers of the home-visit nursing care stations that carry out home-visit nursing care for the children in Oita. Sixty-two children were using home-visit nursing care. The medical care, that was implemented, involved tubal feeding gastric fistula, which 64.5% of the children received, and endotracheal suction, which 58.1% of the children received.100% of the facilities managed general conditions. The proportion of respite care was 55.6%, and the proportion of consultation assistance was 27.8%, which was a low implementation rate. About 20% of the facility had conducted a home-visit nursing care for children in Oita Prefecture. Increasing the serviceable facilities and eliminating the regional differences in the service are required. Respite care support and consultation assistance are challenges for the future.

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This paper provides an overview of contemporary health care challenges that include changing population demographics, communicable and non-communicable diseases and disasters. Directions for sustainable and affordable health care systems that prioritise preventative approaches to health care are presented. The pivotal position of nurses supporting the achievement of goals and targets set by the World Health Organization, Governments and health care authorities globally are examined. Nurses' roles in promoting health and wellbeing of individuals, groups,communities and whole populations that facilitate equitable access to health care at all levels and prevent unnecessary hospitalization are portrayed. Finally, the preparedness for nurses to support the primary health care agenda is discussed and recommendations offered to strengthen their involvement.

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[in Japanese]

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