[Event Report] The 88th HGPI Seminar: Dr. Masaki Sonoda – Considering How to Structure Healthcare in Terms of How It Will Affect Children in the Future (October 9, 2020)
At this HGPI Seminar, we hosted Dr. Masaki Sonoda (CEO, CI, Inc.) and Dr. Naoya Hashimoto (CEO, Kids Public). In addition to their activities aiming to solve healthcare issues involving children using the newest technologies at the frontlines of healthcare, both doctors are members of the committee for the Child Rearing Healthcare Committee established at the Ministry of Health, Labour and Welfare according to the Basic Law for Child and Maternal Health and Child Development. Dr. Sonoda and Dr. Hashimoto spoke about the current situation surrounding policy related to children’s healthcare and shared their outlook on the future.
As a countermeasure against the spread of Coronavirus Disease 2019 (COVID-19), this seminar was held online.
Key Points of Dr. Masaki Sonoda’s Lecture
- Physicians only have limited time to intervene in their patients’ lives, so a sociology-based approach which focuses on efforts to prevent diseases or the worsening of symptoms is important.
- Sick child care is a form of child rearing support which combines medical care and childcare. Currently, sick child care is not being adequately provided to people raising children who require support.
- The effective use of ICT and cooperation between industry, government, and academia are indispensable to disseminate sick child care and other forms of child rearing support.
The perspective from sick child care, a form of child rearing support
■ Dr. Sonoda’s initial awareness towards issues in sick child care and the background of his activities supporting sick child care
Dr. Sonoda possesses a background as a Doctor of Obstetrics and Gynecology and is currently engaged in activities related to sick child care. His past clinical experiences made him acutely aware of the fact that doctors cannot intervene in patients’ lives until patients undergo medical examinations and, even then, they only have limited time to do so. Therefore, in addition to approaches based on internal medicine (using pharmaceuticals and other medical products) and surgery, he began to feel that it is important to adopt a sociology-based approach to create frameworks for preventing diseases or the worsening of symptoms.
During his time in graduate school, Dr. Sonoda’s research focused on issues related to single-parent child rearing and postpartum depression, particularly among women facing unplanned teen pregnancies, economic hardship, and social isolation who are identified as “social high-risk pregnancies.” During those efforts, Dr. Sonoda met mothers who had to quit their jobs because their child suddenly became ill and it was difficult for them to alter their work schedules. When women continuously take time off work because their child is sick, it can be difficult for their superiors to entrust them with important work tasks, even when superiors are sympathetic. This can cause lower productivity among working mothers and may result in them facing increased pressure to quit their jobs.
When the “2017 Survey on Women’s Employment and Child rearing” conducted by the District Economics Research Institute of Kumamoto Area asked working mothers which problem caused them the most trouble, the most frequent response was adjusting their work schedules when their children suddenly became ill. Dr. Sonoda began to recognize this as an issue and started his activities for sick child care in response.
Sick child care is a form of child rearing support in which sick children are cared for at facilities established at day cares and healthcare institutions when it is difficult for them to attend other day care services.
Every year, over 100 new sick child care facilities are being established. As of 2019, there were approximately 1,800 such facilities nationwide. In 2018, sick child care facilities were used by 690,000 people. However, according to a study conducted under the FY2013 Health and Labour Sciences Research Grants entitled “Study on Sick Child Care and Post-sickness Child Care Facility Use and Facility Improvement Methods,” sick child care facilities had low usage rates of approximately 30%. One of the reasons for that is because these facilities are difficult to use. For example, over 90% of sick child care facilities only take reservations over the phone. This means that when children suddenly get sick, guardians have to call sick child care facilities during the busiest time of day, the morning, to ask if there are any vacancies. Also, approximately 30-70% of reservations end in same-day cancellations for reasons such as the child’s fever has gone down. When sick child care facilities receive these cancellation calls in the morning, their staff must rush to phone parents and other guardians on the waiting list. In other words, their day-to-day operations can become extremely hectic.
■Eliminating the hurdles to using sick child care facilities with the power of technology and design
To solve issues related to the difficulty of using sick child care facilities, Dr. Sonoda helped develop an online sick child care reservation service which emphasizes technology and design called “Azukaruko-chan.” Azukaruko-chan allows parents and guardians to check vacancy status and make reservations at each facility online. Furthermore, in the future, they plan to implement a communication system that will allow facilities to share information on incoming reservations involving diseases that require immediate responses, such as chickenpox and influenza.
There are many groups that existing sick child care services do not reach, including people do not know such services exist. In other words, it is a field in which there are many users who have given up on finding solutions. In a CI, Inc. survey of 300 working women with children in the age group eligible for sick child care, only 12% of respondents said they have used a sick child care facility in the past. Also, when CI, Inc. checked how many respondents were aware of sick child care services, among the 88% of respondents who answered “I have not used sick child care facilities,” 75% said, “I did not know of them at all,” or, “I only know them by name.” Through Azukaruko-chan, Dr. Sonoda hopes to put more parents and guardians in touch with sick child care facilities in the future.
■ The importance of partnerships between industry, government, and academia and discussions at the Child Rearing Healthcare Committee on Healthy Parents and Children 21
Cooperation between industry, government, and academia is extremely important for child rearing support. CI, Inc. is currently conducting a joint project with academia to build evidence for sick child care. There are also many ongoing initiatives run by municipal governments in the field of child rearing support. Cooperation with the Government is essential to improve and expand these types of services. To that end, it is also necessary for companies with employees who are of child rearing ages to be understanding. In the future, Dr. Sonoda would like to build a platform for sharing information with sick child care facilities nationwide that will spread knowledge among companies and communities and further advance partnerships between industry, government, and academia. Dr. Sonoda wants to someday expand that platform to include daycares in addition to sick child care facilities to build connections between daycares, healthcare institutions, and sick child care facilities and to create frameworks and an environment which enable parents and guardians to continue working even when their children get sick during the day.
To conclude, Dr. Sonoda spoke about discussions at the Child Rearing Healthcare Committee, where he serves as a committee member.
The Basic Law for Child and Maternal Health and Child Development was enacted in December 2019. Based on that law, the MHLW established the Child Rearing Healthcare Committee in FY2020, which has advanced discussions on the future of child health and development.
Child-centered cooperation between healthcare, welfare, daycare, and education is essential to provide all pregnant women and children seamless healthcare, welfare, and other services and support from pregnancy to the child rearing period for mothers, and throughout the entire growth process from birth to adulthood for children. Furthermore, there are legislative issues caused by the vertical split in Government that cannot be overcome by efforts from the MHLW alone. These require cooperation across Ministries and include cooperation from the Ministry of Education, Culture, Sports, Science and Technology (MEXT) on aspects related to education; cooperation from the Ministry of Economy, Trade and Industry (METI) on gathering support from industry; and cooperation from the Ministry of Internal Affairs and Communications (MIC) to ensure the effective use of ICT and other tools.
Dr. Sonoda has focused his efforts at the Child Rearing Healthcare Committee on Healthy Parents and Children 21, a program which aims to build a society in which all children can grow up in good health. Currently, work is advancing on the creation of a database of initiatives run by municipal organizations, companies, organizations, universities, and other organizations for the second phase of Healthy Parents and Children 21 (which is in effect FY2015 to FY2024). However, compared to municipal governments and other such public organizations, involvement from private companies and organizations is still lacking. In the future, they plan to emphasize involvement from the general public in their activities and wholeheartedly welcome participation from everyone in industry.
 Specifically, “Tokutei ninpu,” a term which refers to expectant mothers who have been identified as requiring extra support after birth due to unstable income, mental disorders, or other issues.
 “Azukaruko-chan” is a name that combines “azukaru” or “to place in the care of” with the suffix “chan,” which is attached to the names of people one finds endearing.
Dr. Masaki Sonoda (CEO, CI Inc.)
Dr. Sonoda was born in Itoigawa City, Niigata Prefecture and graduated from Saga University Faculty of Medicine. During his studies in obstetrics and gynecology, he first encountered pregnant women facing high risk of postpartum depression and abuse, and while studying public health at the University of Tokyo’s Graduate School of Medicine, his interests shifted from the treatment of disease to methods of changing people’s everyday lives. He developed a desire to contribute to improving society through efforts to implement the results of research into society rather than contributing through research. This led him to taking a leave of absence from graduate school and establishing Connected Industries Inc. in 2017. The organization name reflects his vision for connecting various professionals through organic connections to change the world. To take on a more active role in building those connections, Dr. Sonoda enrolled at the Digital Hollywood University Graduate School after founding CI Inc. They launched an online service for reserving day care services for sick children in April 2020 called Azukaruko-chan (https://azkl.jp/).
Dr. Sonoda’s main positions include: Doctor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of Tokyo; Student, Digital Hollywood University Graduate School; CEO, Head of the Information and Communications Technology (ICT) Adoption for Infant Care and Networking Project (https://www.ci-inc.co.jp), CI Inc.; Member, Council for Child Health and Development; Secretary, Healthy Parents and Children 21; Member, Japan Child Health Association Homepage and Public Relations Committee; and Member, Japan Child Health Association Board of Education.