2021年09月20日

The Global Health Education Program (G-HEP) held its eighth and final lecture of the Global Health Academy on September 8th.  The lecture on Quantitative and Qualitative Research was presented by Don-Eliseo Lucero-Prisno III, BSc MD MSc MPH PhD FHEA.

Dr. Lucero-Prisno has over twenty years’ experience in the field of global health as an academic and researcher. His areas of research include but are not limited to infectious disease, social science, health policy and health economics. He holds many academic posts at a number of institutions throughout the world, including University of the Philippines, London School of Hygiene and Tropical Medicine and Harvard Medical School, Harvard University.

In his presentation, Dr. Lucero-Prisno gave a comprehensive introduction to the basic principles of research design and the methods of quantitative and qualitative research. Dr. Lucero-Prisno also shared his insight from the perspective as an editor of a scientific journal as to what type of research editors look for when it comes to publication. Showing real examples of published literature, he explained how to stand out from hundreds of papers that are submitted by looking for a topic that is unique.

One key takeaway from the lecture that Dr. Lucero-Prisno mentioned was to take advantage of every moment and publish what you learn and start early on.  This lecture was the perfect segue to the research component of the program. Participants having learned in previous lectures about the various aspects of global health including health systems, migrant issues, and policy, now have the knowledge and motivation for their upcoming research.

■ Program Lectures
1) Thailand’s Health System and COVID-19 (complete)
2) Japan’s Health System and COVID-19 (complete)
3) Community Health (complete)
4) Health Technology (complete)
5) Global Health (complete)
6) Migrant Health (complete)
7) Policy Recommendations and Advocacy (complete)
8) Quantitative and Qualitative Research (complete)

The Global Health Education Program (G-HEP) is a joint program organized by the Health and Global Policy Institute and Mahidol University, Faculty of Public Health in Thailand.


■About Mahidol University
Mahidol University is the number one university in Thailand for medical education and the first public health academic institution in Thailand.

Vision:
 Be a leader in promoting population health through being a health literate faculty in ASEAN countries by 2021.
Mission:
 1. To offer an outcome based public health education through being a health literate faculty.
 2. To be visible as a leader in public health education, integrative and innovative research, professional academic services on the basis of good governance to promote health and longevity and the betterment of mankind.

2021年09月09日

Antimicrobial resistance (AMR) occurs when the microorganisms that cause infectious disease grow resistant over time to the antimicrobials used to treat them. If not enough is done to combat this problem, it is estimated that AMR will cause more deaths than cancer by 2050. Urgent action is needed. In celebration of the 72nd session of the WHO Regional Committee for the Western Pacific to be held in Himeji in October, this symposium will share the current state of AMR-related issues within Japan and overseas, and discuss future countermeasures.

This event is organized by AMR Alliance Japan (Secretariat: Health and Global Policy Institute).


“AMR A Global Health Crisis –What We Can Do for the Fight Against the Silent Pandemic of AMR: Learning from COVID-19-“

[Overview]

■Date and Time: Saturday, September 25, 2021, from 16:00-18:00 JST
■Language: Japanese and English (Simultaneous Interpretation will be available)
■Venue and Capacity:
 – Online Participation (Zoom Webinar): 400 * On a first-come-first-served basis
 – Himeji Venue: 90
■Participation fee: Free
■Organizers: AMR Alliance Japan, Himeji City, Himeji Medical Association, Himeji Dental Association
■Supported by: Ministry of Health, Labour and Welfare (TBD), Himeji Pharmacist Association, Hyogo Nursing Association Seiban Branch
■Sponsor: Japan Pharmaceutical Manufacturers Association
■Symposium Secretariat: Oscar Japan Co., Ltd International Department
E-mail: amr2021@oscar-japan.com


[Program]
 (Titles Omitted)
For more information, please refer to the PDF at the bottom of this page.

15:50-15:55 Greetings (For Himeji Venue Only)
Etsuji Ishibashi (Chairman, Himeji Medical Association)

16:00-16:05 Opening Remarks and Introduction
Ryoji Noritake (CEO, Boad Member, Health and Global Policy Institute)

16:05-16:25 Message
Ken Kasai (Regional Director for the Western Pacific, World Health Organization (WHO) )
Yasuhisa Shiozaki (Member of the House of Representatives; Former Minister of Health, Labour and Welfare; Member, Global Leaders Group on Antimicrobial Resistance; Chairman, Special Mission Committee on Data Health Advancement, Liberal Democratic Party of Japan(LDP))
Shigeru Omi (President, Japan Community Health care Organization (JCHO); Chairperson, Committee for the Promotion of Pandemic Influenza and New Infectious Disease Preparedness and Response)

16:25-16:40 Lecture 1 “AMR as a Global Health Crisis: A message from the United Kingdom”
Dame Sally Davies (UK Special Envoy on Antimicrobial Resistance)

16:40-16:55 Lecture 2 “AMR in Japan and Expectations toward Future”
Norio Ohmagari (Disease Control and Prevention Center, National Center for Global Health
and Medicine (NCGM); Director, AMR Clinical Reference Center, NCGM)

16:55-17:55 Panel Discussion: Antimicrobial Stewardship
Panelists:
Socorro Escalante (Regional Coordinator for the programme on Essential Medicines and Health Technologies (EMT) and antimicrobial resistance (AMR), Western Pacific Regional Office, WHO)
Norio Ohmagari (Same as above)
Testuji Kawamura (Director, NHO Himeji Medical Center)
Kyoko Ama (Representative, Children and Healthcare Project; Fellow, Health and Global Policy Institute)
Takeshi Enami (Director, Tuberculosis and Infectious Diseases Control Division, Health Service Bureau, Ministry of Health, Labour and Welfare)
Hajime Inoue (Assistant Minister for Global Health and Welfare, Ministry of Health, Labour and Welfare)
Tetsuya Ito (Chair, International Affairs Committee, Japan Pharmaceutical Manufacturers Association)

Moderator:
Ryoji Noritake (Same as above)

17:55 -18:00 Closing Remarks
Hideyasu Kiyomoto (Mayor of Himeji City)

*The program and speakers are subject to change.

For registration, please visit here
https://jigyou.com/amr2021/touroku.html

If you have any inquiries for the registration, don’t hesitate to contact the symposium secretariat (E-mail: amr2021@oscar-japan.com) as shown above.

We look forward to your participation.

2021年09月09日

Dr. Kiyoshi Kurokawa (Chairman, HGPI) and Mr. Ryoji Noritake (CEO and Board Member, HGPI) will participate in the International Forum on the Super Aging Challenge (Day1: The 3rd Nikkei Super Active Ageing Society Conference).

In order to help solve the issue of “super aging,” this forum will invite global experts from industry, academia and government to discuss how to achieve a more active aging society. HGPI has been associated with this forum in cooperation.

[Overview]
Day1: The 3rd Nikkei Super Active Ageing Society Conference
Date and time: Monday, November 15, 2021, from 9:00 – 18:00 JST (Tentative)
Venue: Iino Hall
Admission Fee: Free
Language: Simultaneous interpretations in English and Japanese
Organized by: Nikkei Inc. / Ministry of Economy, Trade and Industry (METI)
Sponsors: Amgen K.K. / Mitsubishi UFJ Trust and Banking Corporation / MTG Co.,Ltd.
Supporters: Ministry of Health, Labour and Welfare (MHLW) / Financial Services Agency (FSA) / WHO Regional Office for the Western Pacific (WPRO) / Association of Pacific Rim Universities (APRU) / Economic Research Institute for ASEAN and East Asia (ERIA)
Media partner: Financial Times
In association with: Health and Global Policy Institute
How to attend: You can choose to watch this event remotely or onsite. * Pre-registration required.

[Session Schedule]
Dr. Kurokawa: “Day1 Summary Session” Panelist
Mr. Noritake: “Panel Session③ “Social participation” Moderator

For further information, click NIKKEI event & seminar Website.

2021年09月09日

Health and Global Policy Institute (HGPI) Manager Mr. Shunichiro Kurita gave a lecture entitled “Citizen-Centered Efforts to Create Dementia-Inclusive Communities Through Local Regulations.” In view of the situation surrounding Coronavirus Disease 2019 (COVID-19), the lecture was given online.

While sharing examples from past comparative studies on local regulations for dementia, Mr. Kurita talked about the importance of developing communities for building a dementia-inclusive society as well as how local regulations can best serve as a tool for citizen-centered community development. Various opinions were shared during the question-and-answer session following the lecture.

2021年09月06日

Health and Global Policy Institute (HGPI) held the first meeting of its task force on Redefining Longterm Careto Create a Longterm Care System for the Era of Healthy Longevity.In accordance with Coronavirus Disease 2019 (COVID19) control measures, the meeting was held entirely online and was not open to the public.

This project aims to reexamine the ideal structure of the longterm care system, an indispensable social system in the era of healthy longevity. In Step 1, we redefined “longterm care” based on existing studies and surveys on the nature of the longterm care system as well as on changes in society since the longterm care insurance system was first established. In Step 2,we will discuss the ideal form of the longterm care system that will be required by society in the future based on task force and expert meetings and draft a “New Vision for LongTerm Care” (tentative title) that incorporates multiple, crossdisciplinary perspectives. Step 3 will begin from FY2022 and will involve efforts to achieve the longterm care system portrayed by that vision. Based on discussions among multistakeholders from industry, Government, academia, and civil society, we will crystallize issues in the current longterm care system, formulate policy proposals, and engage in advocacy.

At the first meeting of the task force, we discussed the changing needs of individuals, families, and society with regards to longterm care. The discussion spanned the initial establishment of the longterm care insurance system, the present day, and the future. We also discussed how to best define longterm carefor the era of healthy longevity.

FY2021 Task Force (In alphabetical order; titles omitted)
Motoi Fujisaki
(Chief Risk Officer, Representative Managing Officer, Sompo Care Inc.)
Satoko Hotta (Professor, Graduate School of Health Management, Keio University; Representative, Designing for Dementia Hub; Board Member, HGPI)
Takashi Iguchi (Associate Professor, Social and Cultural Studies Division, Graduate School of Humanities and Sociology, The University of Tokyo)
Shinya Ishii (Speciallyappointed Professor, Symbiotic Social Medicine Course, Graduate School of Medicine, Hiroshima University; Research Fellow, HGPI)
Shu Kinoshita (Assistant Professor, Faculty of Letters, Keio University)
Mie Morikawa (Professor, Department of Policy Studies, Tsuda University)
Yumi Shindo (Researcher, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology)
Masayuki Takahashi (Associate Professor, Graduate School of Humanities and Social Sciences, Saitama University)
Kiyoyuki Tomita (Manager, Value Unit, Integrated Dimension Strategy Department, Eisai Co., Ltd.)
Junichiro Toya (Director, Sakura Shinmachi Urban Clinic, Platanus Medical Corporation)

2021年09月06日

AMR Alliance Japan (Secretariat: Health and Global Policy Institute (HGPI)) has begun a project to publish case studies showing actual cases in which antimicrobials were and were not used as examples of antimicrobial stewardship.

In this first case study, Dr. Keiji Okinaka (Director of Infection Control and Prevention Section, National Cancer Center Hospital East / Department of General Internal Medicine, National Cancer Center Hospital East /Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital) reports on a case of “A disseminated filamentous fungal infection that broke through echinocandin antifungal treatment.”

For further information, please see the case study below.

2021年09月01日

Health and Global Policy Institute (HGPI) Manager Shunichiro Kurita participated as a panelist at the 35th Annual Conference of the Japan Association of Local Government Policy Studies during sectional meeting seven, entitled “Steps Toward Regulations for Dementia That Achieve Citizen-Centered Dementia Policy.”

During his speech, Mr. Kurita explained the significance of regulations for dementia and key points in the enactment process. His speech was based on the interim report and policy proposal “Steps Toward Regulations for Dementia That Achieve Citizen-Centered Dementia Policy” presented in March 2021 by the Comparative Research Group on Local Regulations for Dementia, which was jointly established by HGPI and Designing for Dementia.

The speakers of the sectional meeting were as follows.
Satoshi Saito (Member, Urayasu City Council)
Soichi Kosuga (Photojournalist)
Shunichiro Kurita (Steering Committee Member, Designing for Dementia; Manager, HGPI)
Takashi Mihara (Senior Researcher, Insurance Research Department, NLI Research Institute)

2021年09月01日

Health and Global Policy Institute (HGPI) and Designing for Dementia co-hosted the tenth meeting of the Comparative Research Group on Local Regulations for Dementia. The group was formed with the goal of achieving better coexistence with dementia in the future by comparing existing local regulations related to dementia, to examine the content of those regulations, and to consider the ideal procedures for formulating regulations related to dementia.

On March 21, 2021, the group published its interim report and policy recommendations in a document entitled, “Steps Toward Regulations for Dementia That Achieve Citizen-Centered Dementia Policy.”

At the Research Group’s tenth meeting, each member shared updates on their activities since the release of the interim report. There was also a report on a presentation based on the study group’s activities that was given at an academic conference. Finally, attendees compared items outlined in the interim report with the “Kawachinagano City Regulation for Building a Dementia-Friendly City,” a local regulation for dementia which came into effect in Kawachinagano City, Osaka Prefecture on July 1, 2021.

■ Overview
Date and time: Tuesday, August 17, 2021; 15:00-16:30
Venue: Online (Zoom)

■ Research group members (Titles omitted; in alphabetical order)
Masaaki Hirai (Representative, Mahoroba Club)
Soichi Kosuga (Photojournalist)
Shunichiro Kurita (Steering Committee Member, Designing for Dementia; Manager, HGPI)
Takashi Mihara (Senior Researcher, Insurance Research Department, NLI Research Institute)
Shinpei Saruwatari (Steering Committee Member, Designing for Dementia; Promoter for Consultation Support Integration, Omuta City Hall; Director, Shirakawa Hospital Comprehensive Community Health Office)
Takehito Tokuda (Steering Committee Member, Designing for Dementia; Board member, NPO Dementia Friendship Club)

*HGPI also serves as the secretariat for this research group.

■Observers
Yoko Ushio (Member, Higashihiroshima City Council)
Tetsu Saito (Member, Urayasu City Council)
Steering Committee, Designing for Dementia

 

■Comparative Research Group on Local Regulations for Dementia

The First Meeting: Wednesday, September 30, 2020
The Second Meeting: Wednesday, October 28, 2020
The Third Meeting: Tuesday, November 24, 2020
The Fourth Meeting: Friday, November 27, 2020
The Fifth Meeting: Thursday, December 3, 2020 Hearing at Kusatsu City, Shiga Prefecture

The Sixth Meeting: Wednesday, December 9, 2020 Hearing at Setagaya Ward, Tokyo
The Seventh Meeting: Friday, December 18, 2020 Hearing at Gobo City, Wakayama Prefecture
The Eighth Meeting: Tuesday, December 22, 2020 Hearing at Hamada City, Shimane Prefecture
The Ninth Meeting: Tuesday, January 26, 2021

2021年08月30日

Key Points

– The experiences and opinions of people with dementia can serve to trigger changes in our behaviors and attitudes.

– Progress in awareness-building initiatives such as the Dementia Supporter Training Program has improved understanding toward dementia, so now is the time for us to build a next version of our society based on the narratives of people with dementia.

– Gathering individuals’ experiences and opinions and arranging them into universal, objective information is likely to help us advance to a new stage in the effort to build a more dementia-inclusive society.


On a weekend in early August, 2021, I had the opportunity to participate in a symposium hosted by a certain advocacy organization for people with mental disorders. In addition to the Health and Global Policy Institute (HGPI) Dementia Policy Project, I also serve as manager of HGPI’s Mental Health Policy Project. (Although many organizations address these two topics together, at HGPI, dementia has a separate project from other topics in mental health. The Mental Health Policy Project began in FY2019.) HGPI’s mission is to achieve “citizen-centered, evidence-based healthcare policy,” and in each project, we maintain close communications with the people most affected by each issue and with the advocacy organizations representing them. We also try to participate in symposiums and other such events hosted by advocacy organizations whenever possible. Since the start of the Coronavirus Disease 2019 (COVID-19) pandemic, many of these symposiums and meetings were made remote, including those hosted by HGPI. Therefore, it had truly been a long time since I had participated in an event in person.

At the symposium, lectures, panel discussions, and other discussions were held on the topic of long-term hospitalizations. This has been a central topic in the field of psychiatric medicine in Japan for many years. People with mental disorders told stories about their experiences and shared their thoughts and opinions on policy reform. I was particularly impressed by a play about life in a psychiatric hospital that had been written by a working psychiatrist. I think many people have not been able to see it yet and I have not received special permission to share details, so I will refrain from sharing too many details here. It was set in a private psychiatric hospital and depicted the relationships and conflicts among people undergoing long-term hospitalizations, physicians, and other healthcare professionals. It also portrayed the issues in society that led to these conflicts. Its overall message (at least, in my interpretation) was “the importance of sweeping away the roles in which society places us, of understanding our own thoughts and feelings, and of speaking up to share those thoughts ourselves.” This was by no means only meant for the patients; to me, it also seemed to tell physicians that they must not be trapped in their roles and speak out about their own thoughts. The phrase “take back your name” appeared many times throughout the play. I feel that these words were an attempt to raise the alarm that we must not allow ourselves to lose the ability to express our true thoughts that can be filtered out by our positions. It was the first time in a while that I had attended an event in person, and along with gasps of the audience and the tension in the air, I strongly felt the importance of people expressing their experiences and thoughts in their own words, of accepting those words, and of the ability of storytelling to touch people’s hearts.


How should we respond to the narratives of people with dementia?

As you may already be aware, the voices of the parties most affected in the field of dementia (specifically, people with dementia) are growing more prominent every day, both in Japan and around the world. Recently, many books have been written by people with dementia and many interviews featuring people with dementia have been published online. Compared to a decade ago, we now have far more opportunities to hear the stories of people with dementia. HGPI has had many people with dementia speak at our symposiums, where they have issued statements based on their own experiences and opinions.

In addition, one of the five pillars of the National Framework for Promotion of Dementia Policies, formulated by the Government in 2019, is to “Promote public awareness and support efforts made by people with dementia to disseminate their stories and opinions.” Specific measures within this pillar include the appointment of dementia ambassadors (also called “Ambassadors of Hope”) and Caravan Mate Ambassadors; the creation of the “Guide for Living a Better Life with Dementia from a Firsthand Perspective,” which contains advice on living with dementia after diagnosis; and holding meetings for people with dementia in each region.

However, as the voices of people with dementia grow more prominent, we must not only accept their experiences and opinions but also consider the position of their voices in society. Cultural anthropologist Junko Kitanaka has pointed out that as people’s narratives and movements gain momentum and political significance, they face the issue of determining which parties are the most “legitimate” ones that those narratives and movements represent.1 People who represent the parties most affected by an issue then “face a conflict in which they must step beyond the uniqueness of their own experiences to serve as representatives, even though those experiences form the basis of their authority,.”2

Based on these points, I think we should recognize the narratives of people with dementia that we encounter at various symposiums or in books as their experiences and opinions, and that we should not unilaterally treat those narratives as universal or representative. Deriving universal principles from the experiences and opinions of people with dementia is not the goal. Rather, the goal is to allow their sincere narratives to resonate in hearts and minds, where they will serve as triggers for each individual to take action and change their attitudes toward dementia.


From narratives to collective wisdom

As previously mentioned, the National Framework for Promotion of Dementia Policies aims to implement measures to deepen understanding toward dementia throughout society by “Promoting public awareness and supporting efforts made by people with dementia to disseminate their stories and opinions.” One such measure is the Dementia Supporter Training Program. Through that program, which began in 2005, more than 12 million people have been trained as dementia supporters. Its instructors, called Caravan Mates, are people with certain expertise or roles and who have completed an instructor training course. In addition to serving as program instructors, Caravan Mates also serve as leaders in joint efforts with local governments to promote understanding toward dementia in communities. In recent years, there has been growing momentum for efforts to train dementia supporters in the corporate and professional sectors. When the National Framework for Promotion of Dementia Policies was presented in 2019, it included a training target of 4 million dementia supporters at companies and workplaces. The Dementia Supporter Training Program has received international attention, as well. For example, a version of it called Dementia Friends was started in the United Kingdom in 2012.

In April 2021, HGPI held a symposium titled “Considering the Best Dissemination and Awareness-Building Measures for Building a Dementia-Inclusive Society.” Based on that symposium, we have presented the following policy recommendations in “The Next Fifteen Years in Raising Awareness for Dementia.” (Click here for details.)

  • Instead of perceiving dementia as a societal issue, a shift should be made so that it is perceived as an issue of building a society of coexistence for all. This should be done while conversing with people with dementia and those close to them.
  • While referring to findings from other fields of disease, methods for evaluating dissemination and awareness-raising measures and initiatives should be reviewed.
  • Every stakeholder in industry, Government, academia, and civil society should be an active participant and work to advance collaboration.

As the number of narratives from people with dementia increases, I hope they will be heard as individual stories as well as perceived as widely relevant, objective information that can be used as the basis to formulate national and local Government policies or to create products and services including those from private companies. As Kitanaka points out, we must “not only position narratives as individual and subjective stories, but also attempt to transform them into scientific evidence through collection and comparison.”3

This is being reflected in efforts at the Ministry of Economy, Trade and Industry (METI), particularly by the Dementia Public-Private Council’s Dementia Innovation Working Group, where efforts for participation from people with dementia in the development of products and services are advancing. We look forward to further progress in this area moving forward. I also think the Dementia Supporter Training Program is an excellent initiative because it can be used to provide standardized information nationwide with a shared curriculum and textbook and supervision from specialists. There have been recent advances in understanding of dementia, so if that program can be reinforced with evidence generated from narratives of people with dementia, it will evolve and become even more effective.

Building a better society will not only require narratives of people with dementia to serve as triggers for change. Future initiatives to raise awareness toward dementia will require information based on the opinions and experiences of people with dementia that is transmitted as collective wisdom. For example, right now, the main source of objective information used in the Dementia Supporter Training Program is medical information. However, as the narratives of people with dementia are gathered and converted into evidence, it will be possible to include objective information from new perspectives. While efforts being made under the National Framework for Promotion of Dementia Policies are currently at the stage of supporting people with dementia in sharing their stories, by gathering the narratives of people with dementia into collective wisdom and converting that into evidence, it is likely to promote Evidence Based Policy Making (EBPM) in dementia policy as a whole.

 

Works referenced
1 Kitanaka, J. 2016. “Narrative-based Science: The Dawn of the Advocate-Scientist.” Gendai Shiso, Vol. 44-17.
2 Same as above, pages 191-192.
3 Same as above, page 192.


About the author

Shunichiro Kurita (HGPI Manager; Steering Committee Member, Designing for Dementia Hub)


HGPI Policy Column (No.23) -from the Child Health Team- >

2021年08月25日

Key points

– The Act on Support for Children Requiring Continuous Medical Care and their Families (tentative translation; official title TBD) is planned to come into effect on September 18, 2021.

– The number of children requiring continuous medical care has increased as medical technology has advanced, making the creation of an environment in which these children can access adequate support an important issue. This led to the enactment of the Act on Support for Children Requiring Continuous Medical Care and their Families.

– When this act comes into effect, expectations are high for its foundational concepts to state the need for all of society to support the daily lives of children requiring continuous medical care and the need to ensure such children can receive adequate and equal support regardless of where they reside. Expectations are also high for the support it will provide to their families.


On June 11, 2021, the Act on Support for Children Requiring Continuous Medical Care and their Families was passed by a plenary session of the House of Councillors. *1 In this column, we would like to introduce the background of this act, the purpose of its legislation, and our future expectations.


Defining “medical care” and “children requiring continuous medical care”

Here, “medical care” refers to “acts of daily living support that are of a medical nature and are necessary for everyday life.” These acts include respiratory management with ventilators or sputum suctioning, and are distinguished from medical activities performed by certified medical personnel. “Children requiring continuous medical care” are those with serious disabilities who require this form of care in a continuous manner for everyday living at home or in society (Figure 1). In this context, “children” are defined as people below age 18 or people age 18 or above and enrolled in a secondary school. According to a report from the Subcommittee for People with Disabilities of the Ministry of Health, Labour and Welfare (MHLW) Social Security Council, there were approximately 20,000 of these children in Japan as of 2020, and their numbers have been increasing rapidly, particularly in recent years (Figure 2). *2 *3

Figure 1 (Reference: MHLW Working Group on Community Inclusion for Children with Intractable Diseases and Specified Chronic Diseases, October 1, 2019. Document 2-1: Measures for Children Requiring Continuous Medical Care.)


Figure 2 (Reference: 112th Meeting of the MHLW Social Security Council Subcommittee for People with Disabilities, June 21, 2021. Document 7: The Act on Support for Children Requiring Continuous Medical Care and Their Families.)


Background to the enactment of the Act on Support for Children Requiring Continuous Medical Care and Their Families

Alongside recent progress in medical science and technology, more lives being saved in neonatal intensive care units (NICU) and other facilities, even infants that are very premature, and the number of children who require continuous medical care has increased from an estimated 9,987 in 2005 to 20,155 in 2019. More and more children are living in communities while receiving continuous in-home care with devices like ventilators and feeding tubes, so there is a growing need to resolve the various issues accompanying this trend. For children receiving continuous medical care to be able to live in their communities with peace of mind, it will be essential to provide them with pediatric medical care and in-home care as well as with aid from disability welfare services. However, in the past, healthcare services have been the main source of care for these children. This means development on systems and collaborative practices involving the fields of welfare, healthcare, childcare, and education is behind. In that context, during a review of the Services and Supports for Persons with Disabilities Act in 2016, the Act on the Comprehensive Support for the Daily and Social Life of Persons with Disabilities and the Act on the Partial Amendment of the Child Welfare Act were enacted, a legal definition of “children requiring continuous medical care” was created, and prefectural and municipal governments were obligated to make efforts to establish systems for communication and coordination with support organizations in medicine, welfare, health, childcare, and education. This was a major turning point for efforts to reinforce support for children who require continuous medical care. [4]

However, according to the MLHW FY2019 Project for the Promotion of Comprehensive Welfare for Persons with Disabilities “Survey on Living Conditions of Children Requiring Continuous Medical Care and Their Families” Report,[1] *5 providing continuous care has been the source of problems in everyday life for these children and their families. In addition to “I cannot secure a spot in a nursery school” and “There is nowhere I can take my child to be looked after,” these issues also included the need to be accompanied by a guardian to go to school.

Against this backdrop, the “Act on Support for Children Requiring Continuous Medical Care and their Families,” which was drafted by a bipartisan group, was passed by a plenary session of the House of Councillors on June 11, 2021.


Expectations for the enactment of the Act on Support for Children Requiring Continuous Medical Care and their Families

The Act on Support for Children Requiring Continuous Medical Care and their Families comes into effect on September 18, 2021. Its basic concepts are to provide support for the daily and social living of children requiring continuous medical care from all of society and to ensure they receive equal and appropriate support regardless of where they live. It will obligate the national Government and local governments to provide this support. Operators of day care centers and schools will also be obligated to take measures to provide support through measures including the placement of nurses or nursery teachers who can operate medical devices such as for sputum suctioning in day-care centers, or the placement of nurses or other healthcare professionals in schools. It also mentions expanding the education system and implementing necessary measures to ensure children requiring continuous medical care can receive appropriate medical care and other support without having their guardians present. Furthermore, each prefecture will be obligated to establish Support Centers for Children Requiring Continuous Care to expand the consultation and support system for children requiring continuous care and their families. Their role will be to provide these children and their families with consultation, information, advice, and other forms of support. These centers will also provide information and training to relevant organizations in medical care, health, welfare, education, and labor.

In the past, there have been reports of cases in which children were required to be accompanied by a guardian at all times or when commuting to and from school, regardless of the severity of their condition. We have high expectations for the Act on Support for Children Requiring Continuous Medical Care and their Families to reduce the burden on families. We also hope that providing expanded social support for children requiring continuous medical care will improve our systems for building more inclusive communities throughout society.

 

[1] Conducted by Mitsubishi UFJ Research and Consulting Co., Ltd.

Works referenced

*1: Ministry of Health, Labour and Welfare. Official Gazette No. 138. June 18, 2021.
*2: Ministry of Health, Labour and Welfare. Concerning the Promulgation of the Act on Support for Children Requiring Continuous Medical Care and Their Families, Announcement No. 742, 3 MEXT Announcement No. 499, Health Policy Bureau Announcement No. 0618-1, Child and Family Policy Bureau Announcement No. 0618-1, Department of Health and Welfare for Persons with Disabilities Announcement No. 0618-1. June 18, 2021.
*3: Ministry of Health, Labour and Welfare, 112th Meeting of the Social Security Council, Committee on Persons with Disabilities, Document 7, Concerning “The Act on Support for Children Requiring Continuous Medical Care and Their Families.” June 21, 2021.
*4: Ministry of Health, Labour and Welfare. FY2009 Joint Meeting of Parties Responsible for Building Community Support Systems for Children Requiring Continuous Medical Care, etc.: Steps for Enhancing Support for Children with Disabilities Requiring Continuous Medical Care.
*5: Mitsubishi UFJ Research and Consulting Co., Ltd., FY2019 Ministry of Health, Labour and Welfare Project for the Promotion of Comprehensive Welfare for Persons with Disabilities. Survey on Living Conditions of Children Requiring Continuous Medical Care and Their Families” March 2020 Report.

 

About the author
Motoki Tamura (Program Specialist, HGPI / Doctoral Student, Community Health & Preventive Medicine Department, Hamamatsu University School of Medicine)


HGPI Policy Column (No.22) -from the Dementia Policy Team- >

2021年08月24日

******** The full report was published on August 24, 2021.
For more information, please refer to the PDF.


On May 22, 2021, Health and Global Policy Institute (HGPI) held Health Policy Summit 2021 using a hybrid format in which guests participated both in-person at the venue in Tokyo and online.

The event included four sessions, which were entitled “Examining the Ideal Future Structure of the Healthcare Provision System and Addressing Issues Highlighted by COVID-19,” “Health Policy and Economic Dynamics of the COVID-19 Pandemic,” “The Future of Healthcare DX,” and “Global Panel on the Roles of Science and Politics During National Emergencies.” Participants deepened discussions on each subject by sharing their perspectives on potential solutions to issues as well as their hopes and expectations.


Welcome Remarks

Norihisa Tamura (Minister of Health, Labour and Welfare)



Explanatory introduction

Ryoji Noritake (Board Member and CEO, HGPI)



Session 1: Examining the Ideal Future Structure of the Healthcare Provision System and Addressing Issues Highlighted by COVID-19

Although Japan’s National Health Insurance system is well established, the pressure being placed on healthcare services by COVID-19 has made more people than ever before aware of the fact that medical resources are finite. The pandemic has also brought to the fore the challenges facing Japan’s healthcare delivery system. There is an ongoing debate on how to strike a balance between the sudden but temporary increase in demand for healthcare services during pandemics and disasters, and the increase in demand for healthcare and nursing care due to ageing. There are also discussions over the roles healthcare entities, professionals, and the government should play. In Session 1, each leader shared opinions from their own position and deepened the discussion on the ideal healthcare provision system for meeting future needs based on experiences from the COVID-19 pandemic.

Panelists
Ryozo Nagai (Board Member, HGPI; President, Jichi Medical University)
Toshio Nakagawa (President, Japan Medical Association)
Masami Sakoi (Director, Health Policy Bureau, MHLW)
Hiroe Takahashi (President, Osaka Nursing Association; District Director, Japanese Nursing Association)

Moderator
Kohei Onozaki (Board Member, HGPI; Professor, Health Policy and Management, Graduate School of Public Health, St. Luke’s International University)


Lunch session: Health Policy and Economic Dynamics of the COVID-19 Pandemic

Professor Yusuke Tsugawa shared insights on the situation surrounding the COVID-19 pandemic in Japan and around the world based on a vast amount of scientific evidence and data.

Speaker
Yusuke Tsugawa (Assistant Professor, Faculty of Medicine (Internal Medicine) and Graduate School of Public Health (Medical Policy), University of California, Los Angeles (UCLA); Board Member, HGPI)


Session 2: The Future of Healthcare DX

COVID-19 also showed that Japan has much progress left to make in digitalization. Managing data on infected people at public health centers, issuing economic stimulus payments, and other such initiatives require an enormous amount of information processing. However, systems for each data gathering, data management, and policy implementation process were not completely compatible with existing guidelines. This increased workloads and made it difficult for everyone involved to operate quickly and efficiently. The digital transformation (DX) of Japanese society promoted by a digital agency is likely to ensure future innovation in Japan by building a user-friendly digital social infrastructure and overcome various issues regarding personal information protection (a topic of great interest among those who handle Personal Health Records (PHR) and Electronic Health Records (EHR) which has been discussed in the medical field for many years), data sharing, and the use of real-world data. At Session 2, we discussed the potential of healthcare DX from various fields and examined the best way forward.

Panelists
Kazuto Ataka (Professor, Faculty of Environment and Information Studies, Keio University; CSO, Yahoo Japan Corporation)
Takuya Hirai (Minister for Digital Transformation; Minister in charge of Information Technology Policy; Minister of State for the Social Security and Tax Number System, Cabinet Office)
Tomohiro Kuroda (CIO, Kyoto University Hospital; Professor, Medical Informatics in Graduate School of Medicine and Graduate School of Informatics, Kyoto University)
Satoko Shisai (Vice President, Head of Digital & IT Supervisory Division, Chugai Pharmaceutical Co., Ltd.)

Moderator
Seigo Hara (CEO, MICIN, Inc.; Fellow, HGPI)

 


Session 3: Global Panel on the Roles of Science and Politics During National Emergencies

Political leadership is an essential element for overcoming national crises such as the spread of emerging infectious diseases. This year is also marked ten years since the Great East Japan Earthquake and the accident at the Fukushima Dai-ichi Nuclear Power Station. The role of the Government is expanded in the face of disasters, accidents, and the unchecked spread of emerging infectious diseases, but what roles should we really expect of politics and science? Furthermore, are we really making the most out of the lessons history has taught us? COVID-19 drew attention to leadership in each country. However, even countries that have successfully separated politics and science in the past are now facing criticism for not ensuring the independence of decision-making processes in the face of the COVID-19 pandemic. Meanwhile, people around the world are still attempting to overcome the uncertain circumstances facing us through trial and error. In Session 3, we asked what roles politicians and scientists should fulfill, what their responsibilities are for providing explanations, and how they should engage in transparent communication with the public when Governments make policy decisions during unprecedented crises like the COVID-19 pandemic. We also asked what kinds of preparations and verification systems will enable politicians and scientists to have mutual respect and involvement. These issues were examined from a global field of view and include perspectives from abroad.

Panelist
Kiyoshi Kurokawa (Chairman, HGPI)
Norio Ohmagari (Director, Department of Infectious Diseases, National Center for Global Health and Medicine)
Shigeru Omi (President, Japan Community Health care Organization (JCHO); Chairperson, Committee for the Promotion of Pandemic Influenza and New Infectious Diseases Preparedness and Response)
Peter Piot (Senior Fellow, HGPI; Director and Professor of Global Health, London School of Hygiene and Tropical Medicine)

Moderator
Ryoji Noritake (Board Member and CEO, HGPI)

  


Closing Remarks
Kiyoshi Kurokawa (Chairman, HGPI)

HGPI Chairman Kiyoshi Kurokawa expressed his gratitude to participants and shared his thoughts on the coming era.


Hosted by: Health and Global Policy Institute
Co-hosted by:
 National Graduate Institute for Policy Studies (GRIPS) Global Health Innovation Policy Program
Sponsored by: CHUGAI PHARMACEUTICAL CO., LTD
Supported by: Ministry of Health, Labour and Welfare (MHLW), Ministry of Education, Culture, Sports, Science and Technology (MEXT)

(Photographed by: Kazunori Izawa)

2021年08月24日

The Global Health Education Program (G-HEP) held its seventh lecture of the Global Health Academy on August 11th, welcoming Ryoji Noritake (CEO & Board Member) and Joji Sugawara (Manager) from the Health and Global Policy Institute (HGPI). The lecture focused on the theme Policy Recommendations and Advocacy.

The session began with a presentation from Mr. Sugawara who reviewed key public health concepts such as health promotion, social determinants of health, and health equity. Based on those concepts, he explained what advocacy means and shared some practical methods that can be applied to advocate for public health issues. Mr. Sugawara then introduced the history of HIV/AIDS advocacy and the Médecins Sans Frontières (MSF) campaign to lower drug prices. He finished his talk by stressing how individuals can engage in and lead advocacy campaigns. Spending time in one’s community to learn about local issues, reaching out to local and national politicians, and speaking up are three simple ways to start advocating for change.

Mr. Noritake spoke during the latter half of the session and introduced examples of HGPI’s past advocacy work. The first case study, Cancer Control Policy (2005-), highlighted the importance of collecting quantitative data, creating key messaging, connecting stakeholders, and involving policy makers and the press. The Stroke and Cardiovascular Control Policy (2009-) case study demonstrated the value of learning from other diseases and countries, while the Noncommunicable Diseases (NCDs) (2011-) project was introduced as a way of supporting the development of policy advocates by gathering the voices of patients and other stakeholders.

The next lecture on Quantitative and Qualitative Research will take place on September 8th.

■ Program Lectures
1) Thailand’s Health System and COVID-19 (complete)
2) Japan’s Health System and COVID-19 (complete)
3) Community Health (complete)
4) Health Technology (complete)
5) Global Health (complete)
6) Migrant Health (complete)
7) Policy Recommendations and Advocacy (complete)
8) Quantitative and Qualitative Research

The Global Health Education Program (G-HEP) is a joint program organized by the Health and Global Policy Institute and Mahidol University, Faculty of Public Health in Thailand.


■About Mahidol University
Mahidol University is the number one university in Thailand for medical education and the first public health academic institution in Thailand.

Vision:
 Be a leader in promoting population health through being a health literate faculty in ASEAN countries by 2021.
Mission:
 1. To offer an outcome based public health education through being a health literate faculty.
 2. To be visible as a leader in public health education, integrative and innovative research, professional academic services on the basis of good governance to promote health and longevity and the betterment of mankind.

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