Approximately 99% of the 360,000 pregnant women who die during pregnancy or childbirth and the 8.1 million children who die before reaching their fifth birthday every year live in developing countries. This fact indicates that the health and well-being of pregnant women and young children is one of the most serious issues facing the developing countries.
In fiscal 2011, JICA prepared a thematic guideline for maternal and child health and has been extending its cooperation for strengthening health systems that make a comprehensive "Continuum of Care for maternal and child health" more widespread and sustainable. Specific measures being taken under this framework include: developing administrative and management capacity of central and local health authorities; improving and upgrading health facilities; strengthening capabilities of midwives and other health service providers; improving community solidarity and systems; and strengthening the coordination among health centers, primary and referral health facilities.
In fiscal 2011, JICA started the Project for Cordillera-wide Strengthening of the Local Health System for Effective and Efficient Delivery of Material and Child Health Services in the Philippines and the Project for Improving Material and Child Health Care System in Khatron Oblast in Pakistan. Both projects are aimed at enhancing the implementation system for enabling safe deliveries for expectant mothers and providing adequate care for newborn babies. In Bangladesh, JICA conducted the Safe Motherhood Promotion Project (SMPP) under the government's health care program and the approach for improving health services for expectant mothers and newborn babies taken by this project was recognized by the Government of Bangladesh as a package worthy for replication. In order to incorporate the approach in health policies and strategies for maternal and child health in Bangladesh and to extend this approach to all areas of Bangladesh, JICA has been extending its cooperation through the Safe Motherhood Promotion Project (Phase 2), the dispatch of a policy adviser for the Ministry of Health and an ODA Loan for training people, supplying equipment and building facilities in order to improve maternal and child health care.
With three major infectious diseases, namely HIV/AIDS, tuberculosis and malaria, alone claiming the lives of over 4 million people each year, infectious diseases pose a direct threat to the people in developing countries and they are also a factor in hindering economic and social development. Infectious disease control is an issue that needs to be addressed not only by specific countries or regions, but also by the entire world, as those diseases spread on a global scale through economic activities and as a result of the development of transportation.
In the field of infectious disease control, JICA mainly provides support for the improvement of access to and the quality of testing, the collection and analysis of health information, and strengthening service providers' capacities to provide necessary treatment and care services. Moreover, JICA supports policy making at the national level, and enhancing service delivery at health facilities at the sub-regional level. In fiscal 2010, JICA launched a project entitled "Health Systems Strengthening for HIV and AIDS Services Project in Tanzania", which provides support to strengthen monitoring and evaluation systems with supervision in order to improve the quality of HIV and AIDS responses implemented at health and medical facilities. In addition, JICA is implementing various projects under the Science and Technology Research Partnership for Sustainable Development (SATREPS) in Asia and Africa, utilizing Japan's knowledge in the field of research and development on infectious diseases, and is also promoting joint research on tropical diseases.
"Health systems" refer to the frameworks that form bases for the provision of health care and medical services to people (improving governance, improving medical facilities, managing proper medical products, identifying and effectively utilizing accurate health information, and securing and managing financial resources) as well as to the fostering and managing human resources for health. While it is necessary to take a balanced approach to addressing the issues of specific diseases and strengthening of entire health systems a number of partnerships have been established by various organizations that specialize in strengthening key components of health systems. In light of this situation, JICA is expected to play a role in supporting developing countries, in harmony with international initiatives and these existing partnerships.
JICA actively contributes to the formulation of national health plans and budgets, and supports the smooth implementation of these plans. A preparatory survey was conducted concerning the provision of an ODA Loan to support the improvement of the health system in Iraq through the construction of core regional hospitals. In Kenya, JICA strengthens management capacity of local health administration and community-level strategies that support community activities to promote good health based on the policies of the Ministry of Health. In Tanzania and South Sudan, JICA provides support to establish databases for health service providers to support the management of these individuals and for increasing the use of these databases. In addition, to deal with issues throughout Africa, JICA implements programs to promote the creation and sharing of knowledge within Africa and to reinforce self-reliant health systems. One activity is a health system management personnel training program. This is a joint program with the Government of Kenya and the African Health Leadership and Management Network, which consists of African higher education institutions in the field of health care. JICA also provides cooperation for the management of human resources for health in French-speaking areas of Africa. Another program aims to utilize a Japanese management method called 5S-KAIZEN to improve the management of hospitals and other health facilities.