April 7, 2014
April 7 is the World Health Day, created to mark the establishment of the World Health Organization in 1948. In commemoration of this event, we would like to touch on JICA's assistance in the health sector.
Measles vaccine inoculation (Strengthening Infectious Disease Prevention, Control and Response in Amhara Region project, Ethiopia)
Health cooperation aims to protect the health of people in developing countries and save lives. This aim matches JICA's emphasis on "human security." JICA has expanded its various health cooperation initiatives to help achieve the Millennium Development Goals (MDGs) (*1) relating to maternal and child health and infectious diseases.
The international community has worked together in the health sector for the past several decades. As a result, for example, world child mortality has been cut in half from 12.6 million (1990) to 6.6 million (2012), which is a remarkable improvement. On the other hand, disparities in health status and accessibility to health services remain striking among and within countries. And there is an endless number of cases of people falling into poverty after being forced to use high-priced health services.
Under such circumstances, the concept of universal health coverage (UHC) has been gaining attention in recent years. With UHC, all people can enjoy health and medical services at an affordable cost. Japan has focused on UHC and is proactively working toward its promotion in collaboration with the World Health Organization (WHO), the World Bank and other development entities.
A role-playing activity in Cambodia encourages participants to think about what constitutes good midwifery in one of JICA's human resource development projects, the Project for Improving Maternal and Newborn Care through Midwifery Capacity Development.
To strengthen cooperation aimed at making progress toward UHC, JICA is incorporating the viewpoint of correcting disparities into its activities of human resource development and improving the quality of health care services such as by helping extend health services to remote and impoverished areas and ensuring that reliable services reach women and children. Furthermore, JICA has also begun to work in the field of health financing, including support for the development and operation of social insurance systems so impoverished people can receive health and medical services at a price they can afford.
For example, in Ethiopia, to help with the provision of appropriate health services, a project is being carried out to establish a surveillance system (*2). The system will help collect reliable disease information at the community level and help authorities take such necessary actions as implementation of vaccination campaigns based on that information.
Also, in Cambodia, in response to the problem of a shortage of maternal and child health workers after recovery from civil war, and in order to make it possible to offer reliable services to women and children, JICA is carrying out activities including the development of human resources to strengthen maternal and child health services in conjunction with improving health systems and facilities.
In its Training to Strengthen Social Insurance Systems (October 2013), which targeted the Asia region, JICA gave a presentation on the background and momentum behind the achievement of Japan’s universal health coverage through the establishment of social health insurance systems. What's more, in response to a request from the Thai government, which is beginning to introduce on a trial basis a payment system for health/medical services, JICA carried out training relating to Japan's fee schedule for Thailand's National Health Security Office (October-November 2013).
Also, in Kenya, JICA is formulating a cooperation program that would contain the mix of technical and financial assistance to tackle vital issues in improving basic health services, making birth care free of charge, expanding public health insurance to the poor and strengthening health administration management by regional governments. The program aims to support the Kenyan government in preparing for its future achievement of UHC as it undergoes a decentralization of power.
Assisting with training based on joint research with the World Bank
On the international stage, at the fifth Tokyo International Conference on African Development (TICAD V) held in Yokohama in June of last year, JICA invited Awa Marie Coll-Seck, Senegalese minister of Health and Social Action; Margaret Chan, WHO director-general; Babatunde Osotimehin, United Nations Population Fund executive director; Keizo Takemi, member of the House of Councilors; and Yuko Obuchi, then senior vice minister of Finance, and organized a high-level event relating to UHC where Japan's experiences in UHC and issues facing countries in the African region were discussed.
Moreover, JICA participated in a cabinet-level meeting (held in December 2013 in Tokyo) on health policies relating to UHC. At the meeting, the results of joint research by the Japanese government and the World Bank were announced. The research included UHC country analysis and potential applications of UHC to policies. Also, JICA supported the execution of World Bank Institute Flagship Course training targeting developing country policymakers, which was planned based on the results of the joint research.
Because initiatives to achieve UHC, such as systemic reforms to improve administrative services and the redistribution of income from high earners to low earners that accompanies the introduction of an insurance system, are deeply intertwined with their respective countries' governance and political problems and no uniform prescription exists, they are not easy. Therefore, JICA will continue to carry out assistance that makes use of various modalities such as technical cooperation and financial assistance, taking into account health situation, development stage, administrative capacity, political will and other factors unique to each country, while making maximum use of Japan's experiences and lessons and the trust Japan has built with various developing countries around the world.
1: Made up of eight goals related to poverty reduction, education, gender equality, maternal and child health, infectious diseases, the environment and global partnerships. Initiatives are being carried out by various countries, international agencies and NGOs aiming to achieve the goals by 2015.
2: A system for establishing countermeasures with an understanding of the outbreak symptoms and status of infectious diseases and the like.