11.Article 12

11.Article 12

(1)

Supporting the health of women throughout life

In order to help women to be in good health throughout their life, the Government promotes integrated health services from adolescence to pregnancy and childbirth. For middle-aged or older women, it conducts health education with emphasis placed on lessening menopausal disorders and prevention of obesity, offers health consultation, and promotes the establishment of healthy eating habits and proper exercise and regular checkups for breast cancer and osteoporosis.

Public health offices, women's centers and medical institutions have implemented since FY 1996 "Projects to support the Health of Women throughout their Life" consisting of "health education" to be in good health throughout life, "general consultation" to cope with health problems peculiar to women, and "consultation on sterility" to provide proper consultation and guidance to married couples distressed by sterility.

(2)

Services concerning pregnancy and childbirth

Activities to maintain the health of mothers and children are systematized in order to provide integrated, overall services most appropriate at each stage of life from the pre-marriage period on to pregnancy, childbirth and until the period when the newborn infant reaches infancy.

As a result of the revision of the Mother and Child Health Law since April 1997, municipalities began to offer basic health services from the time when a notice of pregnancy is filed until the time when the child reaches the school age. This has enabled local government offices to establish lifelong health care services by combining together the school and work hygiene programs and the health care programs for the aged that are already been in place.

(3)

Improvement of perinatal medical care

The number of maternal death was 72 and the maternal mortality rate in the same year was 6.0 per 100,000 births in 1996, with both figures remaining almost unchanged for the last several years. The infant mortality rate was 3.8 and the neonatal mortality rate, which accounted for 53.6% of the infant death, was 2.0 per 1,000 births, while the perinatal mortality rate (the number of fetal death at 22 weeks and over a gestation plus the number of early neonatal death which are divided by the number of births plus the number of fetal death at 22 weeks and over a gestation multiplied by 1,000) was 6.7. All these figures are on the decline year by year.

The number of babies a woman gives birth is on the decline, while the number of women becoming pregnant at the age of 35 or older and the number of premature babies weighing less than 1,500 grams are on the increase. Against this background, the Government is promoting improvement of perinatal intensive care unit (PICU) and neonatal intensive care unit (NICU) across the country to provide advanced health care services for pregnancy, childbirth and infancy in order to create an environment where women can give birth to babies and bring them up in peace. In 1966, the Government began promoting establishment of a medical system for pregnant women and newborn infants in every prefecture.

(4)

Family planning

The birth rate in Japan has declined sharply since 1975 and the total fertility rate (the average number of children that would be born to each woman in her lifetime in accordance with the fertility rate of a given period: the sum of the age-specific fertility rates for women aged 15 to 49) was 1.43 in 1996. Japan's population is forecast to decline in the years ahead and various measures are being taken to cope with a decreasing number of children. In the circumstances, the concept of family planning and how to make use of it is being taught as part of studies on sex at school and home training classes, and local health offices are providing technical advice and guidance. According to a survey conducted in 1996, 56.3% of married women practice birth control. The figure rises to 77.8% if those who once practiced birth control are included. Birth control is also prevalent among unmarried women, with 42.2% of such women responding that they prevent conception and 90.7% of unmarried women who had sexual intercourse saying they do the same.

Under the Maternal Protection Law, abortion is allowed only when being pregnant or delivering a baby is likely to cause a considerable harm to the woman for physical or economic reasons, or when a woman became pregnant due to rape under duress or adultery, and in both cases only on the consent of the woman in question and her spouse and in less than 22 weeks of pregnancy. The number of abortions declined to less than 600,000 in 1980 and to about 338,000 in 1996 after hitting a peak at 1.17 million in 1955. The number of abortions by women aged 19 or younger was 28,256 (8.3%) in 1996, showing an increase over the preceding year in both number and ratio. The number of abortions per 1,000 women had remained roughly at the same level since 1980. The number of babies born to women aged 19 or younger has been on the decrease and came to 15,621 (1.29% of the total births) in 1996. This shows that more than 60% of pregnant women aged 19 or younger had abortions.

(5)

HIV/AIDS

The Government implemented a "Seven-Year Stop AIDS Campaign" in FY 1994 and has promoted various measures since then 1) to develop specific remedy and vaccines, 2) to prevent the spread of AIDS in Japan, and 3) to help prevent the spread of AIDS in the Asian region. Specific steps are as follows.

1) Seven-year Stop AIDS Campaign

(i)	Enhancement of medical setup
	In line with a rise in the number of cases of acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV), the Government is promoting the establishment of a medical setup where persons infected with HIV can receive medical treatment in peace. It has established a base hospital for treatment of AIDS in each prefecture and a block base hospital in eight blocks nation-wide. It also promotes study and training at the AIDS treatment/R&D center set up in the International Medical Center of Japan.
(ii)	Consultation/guidance setup and test setup
	In addition to providing counseling on AIDS, the Government trains counselors and volunteer leaders to improve counseling at medical institutions and NGOs. It also administers HIV tests at local health offices free of charge with the names of the persons withheld, and offers counseling prior to and after such tests.
(iii)	Promotion of research and international cooperation
	It promotes research of AIDS treatment and development of AIDS medicines at domestic universities and research institutes, and is promoting cooperation with those abroad.
	It also supports global efforts to combat AIDS through contributions to the Joint United Nations Programme on HIV/AIDS Program and participation in international conferences on AIDS.
(iv)	Awareness-raising on correct information on AIDS
	In addition to activities to raise awareness and disseminate correct information on AIDS through the distribution of posters and leaflets and to eradicate prejudices against AIDS, it promotes AIDS prevention measures by carrying out street demonstrations to mark the "World AIDS Day" on Dec. 1.
(v)	Promotion of countermeasures against AIDS by prefectural governments
	In order to implement detailed measures appropriate to each region, the Government provides subsidies to prefectural governments to set up a council to combat AIDS, to promote on-sight training of persons engaged in medical treatment and various publicity activities, and to offer tests and consultation.

2) Education at school and in society

In view of the importance of education in deepening correct understanding of HIV/AIDS and eradicating prejudices and discrimination against cases of AIDS and HIV positives, the Government 1) prepared and began distributing textbooks on AIDS to elementary, junior and senior high schools in FY 1992, 2) prepared and began distributing teaching materials for teachers in FY 1992, 3) began training of teaching staff in FY 1993, and 4) began practical researches in areas designated as AIDS education promotion areas in FY 1993. It also inaugurated a project to establish an AIDS education information network in FY 1995 to disseminate AIDS education information nation-wide. As social education, it promotes learning opportunities on HIV/AIDS in the community and disseminates of correct information and conducts awareness-raising activities on HIV/AIDS.

(6)

Preventive measures against diseases peculiar to women

Checkups for osteoporosis, breast cancer and uterine cancer are conducted by municipalities as part of medical examinations for the aged and costs are born out equally 1/3 each by the Government, prefectural governments and municipalities.

1) Checkup for osteoporosis

Osteoporosis is the basic disease of bone fracture and the number of people suffering from the disease is expected to increase as Japan rapidly enters an era of aging population. Early finding of persons with decreased bone quantity is needed to prevent osteoporosis.

In 1995, the Government instituted a checkup of women in their 40s and 50s, or those shortly before or after menopause, for osteoporosis as part of an overall health examinations covered by the Health and Medical Service Law for the Aged to facilitate early detection of the disease. A total of 10,624 women had a checkup for osteoporosis in FY 1996.

2) Checkup for breast cancer

The number of women's death caused by malignant breast tumors was 7,900 in 1996. The number of death caused by malignant breast tumors accounted for 7.4% of the total women's death caused by malignant tumors. The age-adjusted death rate has been on the increase since mid-60s.

Breast cancer checkups were added to the cancer examinations covered by the Health and Medical Service Law for the Aged in 1987. Women aged 30 years and above are eligible for the once-a-year checkup. In FY 1996, a total of 3,187,084 women had a checkup for breast cancer across the country. Of them, 134,244 women had a close examination and breast cancer was detected from 2,921 of them.

3) Checkup for uterine cancer

The number of women's death caused by malignant uterine tumors was 4,963 in 1996. The age-adjusted death rate has been on the decrease and the figure for 1996 was one-fourth that for 1955. The number of death caused by malignant uterine tumors accounted for 4.7% of the total women's death caused by malignant tumors in 1996, sharply down from 26.3% in 1950.

Cervical cancer checkups and uterus cancer checkups were added to the cancer examinations covered by the Health and Medical Service Law for the Aged in 1983 and 1982, respectively. Women aged 30 years and above are eligible for a cervical cancer checkup and those who the doctor found fall under a certain category after asking questions have a uterus cancer checkup.

In 1996, a total of 3,847,779 women had a checkup for cervical cancer and 38,012 of them had a close examination and cervical cancer was detected from 2,538 of them. The number of women who had a checkup for uterus cancer was 247,264 and 4,476 of them had a close examination and uterus cancer was detected from 259 of them.

12.Article 13(a)

(1)	Exemption of unemployment insurance premium payment during child care leave
	Previously, employees, taking child care leave, had to pay unemployment insurance premiums based on their standard pay. However, a 1994 revision has exempted women from such payment during child care leave to create an environment conducive to childbearing.
	The amount of insurance benefits to be paid to such employees will be calculated as if they had kept paying premiums.
(2)	Provision of child rearing allowance
	Child rearing allowance provided to unmarried mothers, divorced fatherless families ect. is also provided to unmarried mothers after a child is recognized since August 1998.

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