Topical and Sectoral Studies

Study on Okinawa's Development Experience in Public Health and Medical Sector (December 2000)

Institute for International Cooperation
Japan International Cooperation Agency (JICA)

CONTENTS (PDF/646KB)

1. Japan's Response to Health and Medical Care Challenges in Developing Countries

1-1 Current Status of Health and Medical Care in Developing Countries
- 1-1-1 Disparity in Health between Developed and Developing Countries
- 1-1-2 Major Infectious Diseases in Developing Countries (Tuberculosis, HIV/AIDS, Malaria)
- 1-1-3 Children's Health in Developing Countries
- 1-1-4 Women's Health/Reproductive Health
- 1-1-5 The Population Problem and Public Health and Welfare
- 1-1-6 Health and Medical Care Policies in Developing Countries
1-2 Development Assistance Challenges in the Health and Medical Care Sector
- 1-2-1 Changes in Development Challenges
- 1-2-2 The Concept of Primary Health Care (PHC)and its Development
- 1-2-3 Reproductive Health and Rights (Health and Human Rights regarding Sex and Reproduction)
- 1-2-4 Children's Health Policies
- 1-2-5 Measures against Infectious Diseases
- 1-2-6 Measures against Malnutrition
- 1-2-7 Application of the Sector Program
- 1-2-8 The Health and Population Sector and Other Challenges
1-3 Japan's Development Cooperation in the Health and Population Sector
1-3-1 Current Status of Japan's Health and Population Development Cooperation
- (1) Current Status of Japan's ODA
- (2) Current Status of Japan's Health and Population Projects
1-3-2 Japan's Challenges in Health and Population Development Cooperation
- (1) Strengthening of the Country-Specific Sector Approach
- (2) Establishment of an Assistance Scheme from the Perspectives of Poverty Reduction and Living Environment Improvement
- (3) Systematization of Project Experience by Sector and Information Disclosure for the Promotion of Appropriate Technical Development
- (4) Fostering and Securing Human Resources for Health and Population Development Cooperation
- (5) Establishment of Development Cooperation as an Applied Science

2. Current Conditions in Regional Health and Medical Care in Okinawa

2-1 Basic Information on Okinawa
- 2-1-1 Natural and Geographical Features
- 2-1-2 Historical and Cultural Characteristics
2-2 Current Conditions in Health and Medical Care in Okinawa
- 2-2-1 Basic Information
  - (1) Changes in Population
  - (2) Changes in Production Activities
- 2-2-2 Health Indices of Prefectural People
  - (1) Population Movement and Composition of Disease
  - (2) Medical Expenses in Okinawa Prefecture
- 2-2-3 Current Conditions with Respect to Health and Medical Care Institutions and Facilities
- 2-2-4 Overview of Administration of Health and Medical Care and Sanitation
  - (1) Administrative Entities
  - (2) Health and Medical Care Plans
2-3 Current Conditions with Respect to Medical Practitioners
- 2-3-1 Doctors
  - (1) Current Situation and Ongoing Changes
  - (2) Trends in Training
- 2-3-2 Nurses, Public Health Nurses, and Midwives
  - (1) Current Situation and Ongoing Changes
  - (2) Trends in Training
- 2-3-3 Physical Therapists and Occupational Therapists
  - (1) Current Situation and Ongoing Changes
  - (2) Trends in Training
- 2-3-4 Diagnostic X-ray Technicians and Medical Technologists
  - (1) Current Situation and Ongoing Changes
  - (2) Trends in Training
- Appendix 2-1 Nursing Staff Training Institutions in Okinawa Prefecture
- Appendix 2-2 Okinawa Prefecture Nursing Staff Training Results
- Appendix 2-3 Overview of Okinawa Prefectural College of Nursing

3. Distinctive Local Health Care Activities in Okinawa

3-1 Impact of U.S. Sovereignty on Local Health Care
- 3-1-1 Health Care During U.S. Sovereignty
- 3-1-2 Health and Medical Care Administration During U.S. Sovereignty
  - (1) Government-Administered Medical Care
  - (2) Medical Servicemen
  - (3) Scholarship Program
  - (4) Establishment of Health Centers
  - (5) Training for Public Health Nurses
  - (6) Training of Medical Technologists
3-2 Medical Servicemen and Local Health Care Activities
- 3-2-1 Background and History
- 3-2-2 Description of Program
- 3-2-3 Medical Serviceman Trends
3-3 Activities of Health Nurses
- 3-3-1 Health Nurse Training
  - (1) Introduction
  - (2) Health Nurse Training: Courses Adjusted to Social Conditions
  - (3) Integration of Training at the Public Health Nursing School and the Health Centers
  - (4) Standardizing of In-Service Training and Continuing Education Services
- 3-3-2 Stationing of Public Health Nurses
  - (1) Stationing of Public Health Nurses in Local Communities
  - (2) Organization and Assignment
  - (3) Work Management and Supervision
3-4 Mother and Child Health Measures
- (1) Administrative Progress
- (2) Progress of Maternal and Child Health Activities
3-5 Development of Emergency Transportation System
- 3-5-1 Medical Support Information Network for Outlying Islands
  - (1) History of Medical Support Network
  - (2) Current System
- 3-5-2 Emergency Patient Transportation
  - (1) Emergency Medicine
  - (2) Emergency Operations
3-6 Infectious Diseases
- 3-6-1 Gastrointestinal Infectious Diseases
  - (1) Introduction
  - (2) Factors in Mass Outbreaks of Dysentery
  - (3) Improvements in Mass Outbreaks of Dysentery by Treating Sources and Paths of Infection
  - (4) Summary
- 3-6-2 Vaccinations
  - (1) Outline of Vaccination Programs
  - (2) Vaccinations
- 3-6-3 Tuberculosis Programs
  - (1) Tuberculosis in the Postwar Period
  - (2) Outline of Tuberculosis Programs
  - (3) Lessons from Postwar Tuberculosis Programs
- 3-6-4 Hansen's Disease Programs
  - (1) Introduction
  - (2) Hansen's Disease Programs Immediately Following World War II
  - (3) The "Hansen's Disease Prevention Law"
  - (4) Coordination between the Okinawa Leprosy Prevention Association,the Government of Japan and the Ryukyu Government
  - (5) Summary
- 3-6-5 Parasite Programs
  - (1) Epidemic Parasite Infections
  - (2) Zero Parasites Campaign
  - (3) Lessons from the "Zero Parasites Campaign"
- 3-6-6 Anti-Malaria Measures
  - (1) Situation before Postwar Anti-Malaria Campaign
  - (2) Development and Performance of Anti-Malaria Measures
  - (3) Reasons for the Success of Anti-Malaria Measures and Lessons to be drawn
- 3-6-7 Anti-Filaria Measures
  - (1) Situation before Postwar Anti-Filaria Campaign
  - (2) Development and Performance of Anti-Filaria Measures
  - (3) Reasons for the Success of Countermeasures and Lessons to be drawn
- 3-6-8 Measures against Leptospira
  - (1) Leptospira in Okinawa
  - (2) Overview of Leptospira
- 3-6-9 Measures to Combat Adult Diseases in Okinawa
  - (1) Adult Diseases in Postwar Okinawa
  - (2) Measures to Prevent Venereal Disease
  - (3) Effect of Venereal Disease Countermeasures
- 3-6-10 Environmental Hygiene Measures
  - (1) Measures to Secure a Safe Water Supply
  - (2) Transformation of Sewage Processing
3-7 Measures to deal with Harmful Pests
- 3-7-1 History of Pest Eradication in Okinawa
  - (1) Introduction
  - (2) Eradication by Regional Hygiene Divisions directed by the U.S. Military (1945-1951)
  - (3) Eradication by Health Centers (1951-1952)
  - (4) Eradication by Towns and Villages (1972-1998)
- Supplement: History of Vector of Okinawa Islands, 1945-1998
- 3-7-2 Measures Against Habu Pit Vipers
  - (1) Countermeasures for Victims (Humans)
  - (2) Countermeasures for Aggressors (Snakes)
  - (3) Environmental Countermeasures
3-8 Food Hygiene Measures
- 3-8-1 Food Hygiene Measures
  - (1) Introduction
  - (2) General Situation Before and After the Introduction of Food Hygiene Measures
  - (3) Food Hygiene Measures
  - (4) Conclusion
- 3-8-2 Meat and Dairy Hygiene Measures
  - (1) Introduction
  - (2) General Situation Before and After the Introduction of Meat and Dairy Hygiene Measures
  - (3) Background to Introduction, and Specific Measures
  - (4) Conclusion
3-9 Welfare Measures for Disabled Persons
- 3-9-1 Welfare of Physically Disabled Persons and Physically Disabled Children
  - (1) General Conditions with Respect to Physically Disabled Persons
  - (2) Support for the Physically Disabled
  - (3) Physically Disabled Children's Welfare
- 3-9-2 Mentally Disabled Persons' (and Children's)Welfare
  - (1) General Conditions with Respect to Mentally Disabled Persons (and Children)
  - (2) Welfare Measures for Mentally Disabled Persons (and Children)

4. Overview and Achievements of Institutions in Okinawa Capable of International Health and Medical Care Cooperation

4-1 Public Institutions in Okinawa
- 4-1-1 Okinawa Prefecture
  - (1) Organizational Overview
  - (2) Achievements in International Cooperation
- 4-1-2 Prefectural Hospitals
  - (1) Organizational Overview
  - (2) Achievements in International Cooperation
- 4-1-3 Health Centers
  - (1) Organizational Overview
  - (2) Achievements in International Cooperation
- 4-1-4 Okinawa Prefectural Institute of Health and Environment
  - (1) Organizational Overview
  - (2) Achievements in International Cooperation
4-2 University of the Ryukyus
- (1) Organizational Overview
- (2) Achievements in International Cooperation
4-3 Private Sector Institutions
- 4-3-1 Okinawa Nursing Association
  - (1) Organizational Overview
  - (2) Achievements in International Cooperation
- 4-3-2 Association of Medical Technologists
  - (1) Organizational Overview
  - (2) Achievements in International Cooperation
4-4 NGOs (Non-governmental Organizations)
- (1) Overview of NGOs in Okinawa Prefecture
- (2) International Cooperation Activities
- Appendix 4-1 ODA-Related International Cooperation

5. Conclusion

5-1 Preconditions for Formulating the Proposal
5-2 Okinawa's Distinctive Features and Potential Fields from the Perspective of International Health and Medical Care Cooperation
- 5-2-1 Okinawa's Distinctive Features
- 5-2-2 Potential Fields for Cooperation
- 5-2-3 Specific Fields for Cooperation
  - (1) Projects for Improving Regional Public Health and Medical Care Systems at the Provincial Level
  - (2) PHC-Oriented Regional Public Health Projects with Residents' Participation
  - (3) Education and Training Programs for Medical Care Workers
  - (4) Measures against Infectious Diseases
5-3 Toward the Expansion of Health and Medical Care Assistance Projects in Okinawa
- (1) Regional Promotion through Development Assistance Activities
- (2) Establishing Bases for Information, Research, and Training concerning International Public Health
- (3) Countermeasures against Infectious Diseases supported by Enhanced Research Functions
- (4) Using Okinawa as a Venue for Health and Medical Service Development Assistance
- (5) Support for NGOs in Okinawa and Citizens' Participation in International Cooperation
5-4 Conclusion: Learning from Okinawa's Experience

APPENDIX: THE PUBLIC HEALTH NURSE MANUAL

1. Assessing the Status of Public Health Nursing Activities in the Region
- (1) Determination of the Situation in the Region where the Nurse is Assigned
- (2) Formulation of Public Health Nurse Action Plan
- (3) Main Public Health Operations at Local Offices
- (4) Care of Emergency Patients (see Reference Document 2:"Treatment Guidelines for Public Health Nurses")
- (5) Health Promotion and Fostering of Regional Organizations-Health Promotion Activities involving Local Residents
- (6) Coordination and Cooperation with Related Organizations
- (7) Public Health Nurse Activities involving Residents
- (8) Administrative Procedures
2. Maternal and Child Health Activities
- 2-1 Health Management for Expectant and Nursing Mothers
  - (1) Maternal and Child Health Record Books
  - (2) Prenatal Checkups and Health Counseling
  - (3) Classes for Mothers and Parents
  - (4) Home Visits
  - (5) Preparations for Birth
  - (6) Delivery
  - (7) Health Guidance for Women Resting after Childbirth
  - (8) Family Planning
- 2-2 Infant Health Management
  - (1) Methods of Determining the Infant Health Situation
  - (2) Children's Nutrition
  - (3) Home Visits
  - (4) Infant Health Counseling
  - (5) Health Education
  - (6) Disease Prevention
  - (7) Assistance for Handicapped Children
  - (8) Sex Education at Puberty
  - (9) Activities of Members of Maternal and Child Health Promotion Groups

PAGE TOP