In this study, we summarized trends in the global monitoring framework by conducting secondary analysis on relevant materials published from 2015 to 2017, including the transition period from the United Nations Millennium Development Goals (MDGs) to the Sustainable Development Goals (SDGs). Since SDGs also cover developed countries, we analyzed the SDGs monitoring system in Japan. The secondary materials used were official documents on SDGs, issued by international organizations, such as the United Nations or WHO, and domestic public organizations. For SDG analysis, we focused on three goals, Goals "Hunger," Goal 3 "Health and well-being," and Goal 6 "Water and sanitation." In addition, we analyzed the "specific measures to achieve SDGs" presented by the SDGs Promotion Headquarters at the Prime Minister's Office in December 2016.
Universal Health Coverage (UHC) is a key target of Sustainable Development Goal (SDG) 3. UHC is a comprehensive approach to improving access to health without financial burden, which is a fundamental human right and provides the basis for economic and social development, as well as social stability. Three key components of UHC, namely population coverage, service coverage, and financial protection, are inextricably associated with health financing. In the SDGs, one of two indicators for monitoring UHC progress is financial protection, which helps individuals decrease the risk of catastrophic expenditure in health. Although further discussion is possible on the threshold of catastrophic payment, this is an important, imperative step towards UHC achievement. This paper presents an overview of trends in strengthening health financing and monitors its progress in the context of UHC. Universal Health Coverage (UHC) is a key target of Sustainable Development Goal (SDG) 3. UHC is a comprehensive approach to improving access to health without financial burden, which is a fundamental human right and provides the basis for economic and social development, as well as social stability. Three key components of UHC, namely population coverage, service coverage, and financial protection, are inextricably associated with health financing. In the SDGs, one of two indicators for monitoring UHC progress is financial protection, which helps individuals decrease the risk of catastrophic expenditure in health. Although further discussion is possible on the threshold of catastrophic payment, this is an important, imperative step towards UHC achievement. This paper presents an overview of trends in strengthening health financing and monitors its progress in the context of UHC.
Japan positioned health as cornerstone of its diplomacy, drove forward UHC (Universal Health Coverage), and declared its expected contribution to resolving universal agendas using the experience of Japanese achievements in health and longevity. Therefore, sharing the Japanese UHC experience will become more popular. This article introduced JICA ’s (Japan International Cooperation Agency) technical cooperation projects in Myanmar for strengthening the health system administration and development of human resource, both essential towards the UHC movement. Health policy in Myanmar had been lowpriority under its long-term military government. More recently, Myanmar has prioritized financially its health policy. In this respect, the Ministry of Health and Sports in Myanmar (MoHS) revised the National Health Plan (NHP) and guided townships to plan a "Basic Essential Package of Health Service" (EPHS ), which is the basic component of NHP and comprises health services for these township. As MoHS emphasizes the consolidating function of the central and regional governments in planning, the Health System Strengthening Project has provided a review of the smooth consolidation at central and region levels. The project also launched the Medical Record Technician training, which aims to improve the quality of data for monitoring and evaluating NHP, and the rapid confirmation of statistic data using computerization. Myanmar is now confronted with the lack of teaching staff and the necessity to improve teaching skill in medical education. As such, the Project for Enhancement of Medical Education has offered support for training programs in Japan for teaching staff. Staff from general medicine draw up an education plan and share their experience obtained through a PhD course. Specifically, training courses for clinical educational staff are first drafted in Myanmar, with discussions between Myanmar and Japan based on absolute needs in teaching to follow. The clinician trainees then draft teaching materials to be used in Myanmar during their short-term training in Japan. As such, they share their training experience through a seminar in Myanmar. Since the end of World War II, although Japan has rapidly achieved UHC through planning and an implementation system, it needs to shape its health system to keep up with the low birth rate and society longevity, thus requiring a self-review system to incorporate overseas challenges.
The United Nations started to mobilize efforts to achieve the Sustainable Development Goals (SDGs) by 2030. Among the 17 SDGs, SDG 3 is to ensure healthy lives and promote well-being for all and at all ages. Under this goal, there are nine targets, the most significant being target 3.8: to achieve universal health coverage (UHC). UHC is the "linchpin" of the other health-related SDGs, since it is the foundation to achieve the others. UHC is not only about financial protection, but it is also critical to ensuring the quality of healthcare services, which requires the effective coordination of various service providers from the perspectives of their service users, being identical to the integrated people-centred health services (IPCHS) suggested by WHO . Those global issues are relevant to the concerns in Japan, such as "community-based integrated care."
Combating communicable diseases remains a challenge for the global health community, despite the relative reduction of weight on communicable diseases in the Sustainable Development Goals (SDGs) compared to the previous Millennium Development Goals (MDGs). The efforts on core capacity development under International Health Regulations (IHR) (2005) represent an important global policy agenda to strengthening security for health threats, including communicable diseases (health security). However, its global progress was slow under monitoring through self-evaluation. The World Health Organization introduced an external assessment process, called "joint external evaluation" (JEE)" in 2016 and developed a new "monitoring and evaluation framework" to foster core capacity development. This transparent and collaborative process is expected to engage multiple sectors into mid- to long-term policy planning and development towards future health security.
In 2015, the sustainable development goals (SDGs) were ratified as the new global agenda for the Millennium Development Goals (MDGs). In this article, we review the progress in maternal and child health achieved during the MDG period and the remaining challenges for the SDG era, and stipulate the policy direction of global maternal and child health by referring to Japan’s past experiences in maternal and child health improvement. During the MDG era, a series of systematic review in the academic journal, Lancet, and the results of randomized controlled trials (RCT) conducted in India established evidence-based intervention in the MCH field. Through the SDGs discussions, maternal and child health, which showed delayed progress compared with infectious diseases in the MDG era, drew attention as "unfinished agenda" at the UN level. Reflecting this attention, the "Global strategy for women's, Strategies for children's and adolescents health (2016–2030)" was published. In the strategy, three aims were presented for maternal and child health: survive, thrive, transform. On the other hand, in the SDGs agenda, the universal health coverage (UHC), which simultaneously secures financial resources and an improvement in the quality of services, was proposed and its contribution to maternal and child health expected. However, considering the past experience of Japan in establishing the world’s first universal health insurance, the improvement of maternal and child health indicators, including infant mortality rate reduction, started before the introduction of universal insurance coverage achievement. Moreover, we surmise that such activities contributed as outreach and community empowerment by the health workforce including the public health nurses, practicing midwives, and volunteers. As for UHC, it contributed primarily to financial resources for employing human resources such as public health nurses. Consequently, for the improvement of maternal and child health, an evidence based approach including systematic reviews and RCTs is needed. Additionally, reflecting Japan's experience, we should revisit not only UHC promotion, but also community-level activities such as primary healthcare with volunteer workers.
The International Conference on Population and Development (ICPD), held in Cairo in 1994, proposed to secure adolescents' access to sexual/reproductive health programs and services, later becoming widely recognized worldwide. Under the UN Millennium Development Goals (MDGs), since 2000, adolescents' sexual/reproductive health has been monitored under the aim of improving maternal health and reducing the spread of HIV/AIDS. Globally, the "birth rate of 15 to 19 year olds" decreased, and the "HIV prevalence rate of 15 to 24 year olds" also declined, awhile the ratio of "HIV/AIDS knowledge of 15 to 24 year olds" increased. However, it cannot be said that a big step forward was achieved due to geographical and economic disparities between countries. Under the UN Sustainable Development Goals (SDGs), since 2016, indicators such as sexual violence, child and forced marriages, and female genital mutilation were newly added. These are indicators of sexual health related human rights, and go beyond the perspective of reproductive health. Hitherto, adolescent's sexual/reproductive health has been assumed from the perspective of a risk approach. For example, it focused on how to prevent risk behaviors and negative outcomes such as unsafe sex, sexual transmitted diseases and unwanted pregnancy. More recently, research on adolescent's sexual/reproductive health with a positive approach, focusing on self-esteem and taking pride in their own figures, is increasing. Currently, Comprehensive Sexual Education based on human rights and gender, and including not only knowledge of narrow sexual/reproductive health, but also the skill of communication and making decision related to sexuality is recommended globally as sexual education for adolescents. Japan is not a country to provide advanced sexual education. However, we need to objectively evaluate what was done and is being done to improve adolescent sexual/reproductive health in Japan by comparison with global trends and disseminate to the world. This could be Japan's contribution to the development of adolescent sexual/reproductive health in the world.
Objectives: In promoting measures against non-communicable diseases (NCD) in the Sustainable Development Goals (SDGs), it is important to identify the efforts to preventing NCD in the National Health Plan (NHP), which shows health strategies for each country. Some NHPs were analyzed in this study, and their descriptions regarding NCD prevention measures were examined. Typical NCD-related indicators were analyzed as per the level of national income, and comparisons between NCD risk factors and national income level were performed. Methods: The study materials were the NHPs of 47 countries listed in MiNDbank, a database managed by WHO. Moreover, we examined the relationship between certain NCD risk factors (smoking, obesity, alcohol intake, physical inactive, etc.) and national income levels in 47 countries using one-way analysis of variance. Results: Significant differences were found between national income levels for the NCD-related indicators. However, there was no significant difference between the smoking rates among males and national income level. Although descriptions on NCD prevention were found for 57.4% in the NHPs of the target countries, there was no significant relationship between the national income level and the ratio of NCD prevention descriptions. Additionally, only 34.0% of countries set numerical targets. Regarding NCD prevention, smoking was most frequently described, followed by exercise and obesity. Smoking targets were set in most countries, regardless of the national income level. On the other hand, vegetable intake targets were only set for high-income countries. Conclusion: Although NHP describes measures regarding NCD prevention, sufficient descriptions were not provided. Consequently, it will be necessary to promote NCD measures, especially in the NHPs of middle-income countries.
Current problems with global-level nutrition involve insufficient nutrition, which remains unresolved, and nutrition transition. Japan has previously experienced such a transition and, although public health nutrition activities have addressed these issues for over 70 years, few reports have hitherto covered it. This study chronologically reviews and analyzes public health nutrition policies and community-based activities undertaken since the end of WW II. The public health nutrition activities in Japan can be classified into 1) community-based nutrition activities, 2) constructing a system for the formation and training of dietitians, and 3) National Health and Nutrition Surveys that monitor and evaluate the health of the Japanese populace. Moreover, communitybased nutrition activities include three main periods, that is, 1945–1965: health promotion and diet improvement; 1966–1999: health promotion policies based on national government policy; and 2000 and beyond: responding to nutrition problems through multi-disciplinary collaboration during the era of the aging-society. Despite the health and nutrition transition after WWII, a continuous rising average life expectancy among the Japanese populace points to the presence of both a health policy-based PDCA(plan, do, check, act) cycle for public health nutrition activities and a national-level monitoring and evaluation system. Therefore, the experience of Japan in improving nutrition as to achieve the Sustainable Development Goals (SDGs ) involves the two crucial processes of promotion of sustainable efforts at regional and national levels, and the monitoring and evaluation of population health on a global scale.
The achievement of the UN Millennium Development Goals (MDGs) on water, sanitation, and hygiene (WASH) was reviewed, and the surrounding situation of the indicators of the Sustainable Development Goals (SDGs) on the 2030 agenda was summarized. The status of WASH related indicators (i.e., dependency of improved drinking water, piped water on premises, surface drinking water sources, improved sanitation facilities, and open defecation) of each country or regions were visualized using Geographical Information System (GIS). Furthermore, the relationships between these indicators and WASH-related health indexes (i.e. disability-adjusted life years (DALY) caused by diarrhea) was analyzed by regression curves. As a result, the relationship between "piped water on premises quot; and DALY was proven by a regression curve with a relatively high correlation.
In the international society, "Agenda 2030: the Sustainable Development Goals" was adopted at the United Nations Summit in September 2015. The "Sustainable Development Goals (SDGs)" consisting of 17 goals and 169 targets, are established with the aim "no one is left behind."
"Homicide" and "Conflicts" is one of the targets of Goal 16 (Peace and Governance) as new areas of health-related targets.
These targets are to: “Significantly reduce all forms of violence and related death rates everywhere".
In this paper, the current patterns of violence, such as homicide and conflicts, are briefly described, and the trends of these patterns are summarized from demographic viewpoints, regional differentials, and types of perpetrators, touching upon peace studies. These trends suggest important directions for future investigation as to prevent violence through a public health approach.
Particularly, a public health approach that emphasizes collaboration with other sectors is expected to contribute to the reducing violence-related mortality and preventing violence-related deaths even in low-and middle-income countries.
In order to grasp and resolve the magnitude of this task, strengthening health information systems capable of gathering accurate and timely internationally comparable data, such as the number of deaths by sex, age, regional, and cause of deaths, is also necessary.
Public health provides a useful framework for both continuing to investigate and understanding the causes and consequences of violence, and preventing violence from occurring through primary prevention programs, policy interventions, and advocacy.
Objectives: This study clarifies the role of the Public Health and Welfare Office (PHWO) in providing public support (PS) to pediatric patients with chronic intractable diseases (PPCID). Methods: A questionnaire survey of PPCID families was conducted in Gunma Prefecture (response rate = 97.7 %; n = 807). We examined the rate or content of PS by group, which were created according to the presence or absence of anxiety/problems/hope in four areas, being divided by regional characteristics. Predictive factors related to PS were studied using multivariate analysis. Results: (1) The hope rate was relatively low. (2) The rate for anxiety and lack of disease awareness were different among the four areas. (3) The major hopes were for consulting/exchange/information meetings and support for registering for or attending school. The contents were different among the four areas, and PPCID families with lower child age had hopes of nursing or education support. (4) The presence of anxiety/problems/hope was related to daily life restrictions, seriousness of the disease, and lower age of the child. Conclusions: PPCID families may lack understanding of the PS provided by PHWO. Moreover, the regional differences may be related to area characteristics. The anxiety/problem/hope rate may be related to worries about future nursing and child education. PHWO must provide information regarding their role in PS and hold consulting/exchange/information meetings with PPCID families, based on regional area features to educate families about PS for child care.
Objectives: This paper considers the importance of interdisciplinary collaboration between medicine and engineering in the construction of sidewalks based on recent literature from Japan and overseas. Methods: First, it considers the effects of promoting the use of sidewalks, which is the prerequisite for their construction, from a medical (public health) perspective. Second, we present a chronological overview of sidewalks based on universal design followed by an explanation on the resolution of medical issues in the construction of sidewalks in the future by using engineering technologies from a professional and the users' perspective. Finally, this paper raises medical (neuroscience) issues beyond users' perspective and proposes solutions based on engineering technology for the future "deepening of universal design in sidewalk construction." Citing coincidence anticipation timing (CAT) performance for example, this paper provides a medical (neuroscientific) explanation for the need to prevent falls users are unaware of, thus proposing solutions using specific engineering technologies.
Conclusions: In the future, there is a need to further enhance this type of universal design suitable for a super-aged society.