(a) Status of Mentally or Physically Disabled Children

215. In Japan, the number of in-home physically disabled children was 81,000 in 1991 and 81,600 in 1996, showing stable trends. The number of mentally disabled children was 100,000 in 1990 and was reduced to 85,600 in 1995. Hereinafter, mentally or physically disabled children are referred to as "disabled children."

Number of Disabled Children
(Unit: persons)

	Total	0-4 years old	5-9 years old	10-14 years old	15-17 years old
Physically disabled (as of 1996)	81,600	17,700	21,100	25,800	15,500
Mentally disabled (as of 1995)	85,600	7,800	27,700	30,000	19,900

Source: Survey by the Ministry of Health, Labor and Welfare

(b) Ensuring that a child can enjoy a full and decent life in conditions which ensure dignity.
(In-Home Welfare Services)

216. See Paragraph 170 of the Initial Report of Japan.

(In-Home Child-Care Service Programs (Home-Helper Program for Disabled Children/persons))

Trends in the Number of Home-Helpers
(Unit: persons)

FY1998	FY1999
1,533	2,058

Note: Home-Helpers who exclusively deal with disabled children/persons
Source: Survey by the Ministry of Health, Labor and Welfare

(Children's Day-Care Service Program (Schooling Program for Disabled Children))

Trends in the Number of the Disabled-Children Schooling Programs
(Unit: persons)

FY1998	FY1999
452	502

Source: Survey by the Ministry of Health, Labor and Welfare

(Institutional Welfare Services)

217. See Paragraph 171 of the Initial Report of Japan.

Current Status of Institutions for Disabled Children (As of October 1, 1999)

	Number of Institutions (facilities)	Capacity (persons)	Size of staff (persons)
Institutions for mentally disabled children	278	15,659	12,586
Institutions for autistic children	7	338	283
Schools for mentally disabled children	230	8,404	7,581
Institutions for physically disabled children	66	6,972	4,457
Schools for physically disabled children	83	3,400	2,614
Clinics for physically disabled children	7	400	264
Institutions for blind children	14	429	188
Institutions for children with auditory/speech disabilities	16	561	218
Schools for children with hearing difficulties	27	893	849
Institutions for severely handicapped children	88	8,887	8,629
National clinics for children suffering from myotonia (sickbed commission)	27	1,772	596
National clinics for persons with severe diseases (sickbed commission)	79	8,000	7,795
Rehabilitation centers for mentally disabled persons	1,250	84,083	83,027
(Commuting-style centers)	339	12,820	11,946
Maternity clinics for mentally disabled persons	226	14,200	13,927
(commuting-style centers)	839	31,670	30,827
Dormitories for mentally disabled workers	119	2,805	2,628
Welfare homes for mentally disabled persons	68	856	708

Source: Survey by the Ministry of Health, Labor and Welfare

(School Education)

218. It is important that students with disabilities receive careful, specific education with particular attention being given to the type and extent of their disabilities so that they are able to develop their capabilities to the fullest extent possible and cultivate the ability to participate independently in society. This education is carried out in various forms including special schools for the blind, schools for hearing impairments, schools for Intellectually disabilities, schools for Physically disabilities and Health impairments and special classes and "resource rooms." Lessons in these rooms aiming for the students with mild disabilities to improve and overcome their disabilities are incorporated in the curriculum of elementary and lower secondary schools, in these schools.
Only students of such elementary and lower secondary schools have been provided opportunities to have itinerant teaching, in which teachers of schools for students with disabilities teach at homes and medical institutions, in case that these students have difficulties in attending schools. In fiscal year 2000, the system has been expanded to upper secondary schools for such students.
Special schools and special classes promote programs of joint activities with elementary and lower secondary school children and the local community in order to improve the experience and ability to mingle with the community of the children. During some subjects and special activities, the children are given opportunities to get together with other children, and participate in events of the community. These serve as the ideal opportunities for fostering fellowship and considerateness, and depending the understanding of local residents towards children with disabilities and special education.
At schools for students with disabilities, curricula are specially designed for each disabilities, classes are kept small, textbooks are prepared with special consideration, teachers with expert experience and knowledge are employed, and particular attention is paid to making institutions and facilities. In consideration of equal educational opportunities and special conditions for attending such schools, and to reduce the economic burden on parents, and facilitate enrollment into schools for students with disabilities, the Government provides allowances to encourage special education which covers part or all of the expenses involved for studying at schools. This covers textbooks (upper secondary schools), school meals, transportation (for attending), living in dormitories, the school trip, and school supplies, depending on the parent's financial capability, under the Law Financial Assistance for Encouragement of School Attendance for Students with Disabilities.
The Final Report of the Advisor Group on Special Education, which was held in January 2001, advised that, in the future, special education should focus on (i) the development of united consultation and a support system from the earlier stage of the life, (ii) the improvement of guidance on attending school, (iii) the improvement of education to students with learning disabilities in regular school, and (iv) the furtherance of the expertise of teachers and staff members working in special education, to provide truly required support with the proper understanding of the special educational needs of each student, in consideration of changing situations surrounding special education, such as recent ever-progressing normalization.

Schools for students with visual, hearing or physical impairments

Classification	Number of schools	Number of students
School for the blind	71	1,184
School for the hearing impairments	107	3,512
School for students with other disabilities   Intellectually disabilities   Physically disabilities   Health impairments   Sub-total	523 196 95 814	29,517 11,971 3,008 44,496
Total	992	49,192

(As of May 1, 2000)

Elementary or lower secondary school

(Special Class) 73,000 students

Classification	Number of schools	Number of pupils and students
Intellectually disabilities	16,431	48,712
Physically disabilities	1,446	2,518
Health impairments	801	1,766
Visually impairments	123	174
Hearing impairments	512	1,050
Speech impairments	345	1,193
Emotionally disturbance	6,598	17,508
Total	26,256	72,921

(Resource Room) 28,000 students

Classification	Number of pupils and students
Speech impairments	23,290
Emotionally disturbance	2,660
Visually impairments	146
Hearing impairments	1,420
Physically disabilities	7
Health impairments	24
Total	27,547

(As of May 1, 2000)

* 140 children were exempted or temporary exempted from enrollment at school due to his/her impairments.
Total: 149,660 children (about 1.3%)

School enrollment of infants and children (as of May 1, 2000)

Total number of infants, children and students enrolled at school. (Kindergarten, elementary school, lower and upper school)	17,500,718	100.0%
Out of above infants or children, those who receive special education for his/her disabilities	190,572	1.09

(Employment promotion, Vocational training)

219. Under the Law for Employment Promotion, etc. of the Persons with Disability and the Human Resources Development Promotion Law, Public Employment Security Offices (Hello Works), Vocational Centers for the Persons with Disability, and Public Human Resources Development Institutions, etc. conduct vocational guidance, placement and vocational training, to all persons with disability (including children) who want to work.

(Measures to promote the exchange of relevant information on preventive health care in the spirit of international cooperation. Measures to widen Japan's experiences in these areas)

220. See Paragraphs 178 to 180 of the Initial Report of Japan.
The Japanese Government had contributed a total amount of 5.31 million dollars to "the United Nations Voluntary Fund on Disability" by 1999. It also provides financial aid to the projects implemented by the Economic and Social Commission for Asia and the Pacific (ESCAP), which amounted to roughly $450,000 in the fiscal year 2000.

(a) Measures to take for the following purposes under Articles 6 and 24)

(Medical examinations at school)

221. See Paragraph 187 of the Initial Report of Japan.

(Dealing with children's mental health problems)

222. In order to deal with children's mental health problems, the general curriculum guidelines, called the Courses of Study revised in 1998 have expanded contents by explicitly stating that health and physical education in lower secondary school add stress management as a new item to learn. Other measures have been taken, such as the preparation and distribution of reference materials for teachers, research and study on mental health and life habits, and training seminars for nurse-teachers. In fiscal year 2001, the Government has started to provide assistance for health counseling activities, including sending of specialized doctors to schools by the Boards of Education of prefectures and designated cities.

(Sex Education/AIDS Education)

223. As for sex and AIDS education at schools, the National Curriculum Standards revised in 1998 have expanded contents by clearly stating that guidance should be provided to children in third/fourth and higher grades through their health and physical education class (in the area of health education), and guidance about AIDS/sexually transmitted diseases (STDs) should be given in the health and physical education classes at lower secondary schools. Other measures have been taken, such as the preparation and distribution of educational materials for students, preparation and distribution of reference materials for teachers, training opportunities for teachers and school staffs, and practice and research in pilot schools. In 2001, reference materials about STDs for teachers will be prepared and distributed.

(Guidance about foods)

224. To deal with emerging food-related health problems, such as concerns over ever-increasing life-style related diseases, the National Curriculum Standards revised in 1998 expanded its guidance contents over all school education activities, including health, physical, home economics classes and extra-curricular activity, and promote the active use of school nutritionists who are professionals of diet, to provide guidance on food. The Government also has taken several other measures, such as the preparation and distribution of reference materials for teachers and staffs, symposiums, and practical research in pilot schools. In 2001, educational materials for students will be also prepared and distributed.

(Maternal and Child Health)

225. See Paragraph 181 of the Initial Report of Japan.

(b) Measures to review changes after the Initial Report. Impact on the life of children. Indicators used to evaluate progress and problems in implementing the said Article.

(Measures to diminish infant and child mortality)

226. Eighteen-month-old and three-year-old children are given medical examination services as opportunities to early detect diseases and abnormalities (secondary prevention).

(Distribution of general and basic public health care services in local and urban areas)

227. Maternal and child health services are provided according to the regional situations under the Maternal and Child Health Law. The government endeavors to promote establishing municipality Health Centers as bases to provide comprehensive health care services such as health education, health consultation and medical examination.

(Information on children qualified to receive medical support)

228. The Maternal and Child Health Handbook provides a list of major publicly funded medical services. Municipalities have been working on establishing Maternity Health Centers for Maternal and Child Health to provide various consultation and guidance services on maternal and child health.

(Measures to ensure Vaccination System)

229. To prevent the outbreaks or expansion of diseases suspected of infection, vaccination is given to infants under the Preventive Vaccination Law.

(Disease Prevention Measures)

230. The percentage of underweight infants (less than 2,500g) in Japan has been recently increasing partly due to the increased multiple childbirth caused by widely provided medical treatment for reproduction. The mortality rate of underweight infants has been declining thanks to the improvement of the medical treatment for pre-natal, natal and post-natal period.

Percentage of new born babies by weight (%)

	1975	1985	1990	1995	1998
Total Less than 2,500g Less than 1,500g Less than 1,000g	100.0 5.1 0.3 0.1	100.0 5.5 0.5 0.2	100.0 6.3 0.5 0.2	100.0 7.5 0.6 0.2	100.0 8.1 0.6 0.2

(Appropriate pre-natal and post-natal health care for mothers)

231. Since pregnancy/delivery is a big turning point for assisting women in health, the Ministry of Health, Labor and Welfare has been making efforts to ensure safety and comfort in this period. More specifically, pre-natal treatment networks have been improved to deal with premature babies who require emergency treatment in which a mother and her baby are transported from general clinics to advanced medical institutions to receive extensive care. The Ministry has been promoting the improvement of medical treatment for mothers before and after delivery, by improving medical institutions for children and for the pre-natal period so that they may provide highly advanced treatment from pregnancy to delivery, and/or to childhood.

(Campaigns to provide basic knowledge and information)

232. Prefectures disseminate and prove education for basic knowledge, information, for example, through seminars about infant accident prevention.

(Child health and nutrition and benefits of breast feeding)

233. In accordance with the resolution of "Infant nutrition and feeding with mothers' milk" by the WHO Assembly in 1974, the Japanese Government has been promoting feeding with mothers' milk as part of measures for maternal and child health since 1975, with the cooperation of local municipalities and relevant private organizations, considering not only that mothers' milk contains both the nutrients necessary for the healthy growth of babies in the best composition as well as disease-immune substances but also that it has significant meaning in terms of the mother-baby interaction that is beneficial for the psychological and emotional development of babies.

(Improvement of the education and training system for health-related staff)

234. It is necessary to further improve the quality of staff who are engaged in maternal and child health services. It is particularly important to properly deal with more diversified problems such as parenting anxiety and to enhance follow-up guidance after medical examinations. In order for such staff to acquire professional expertise and counseling techniques, seminars and training opportunities focusing on such issues have been further enhanced.

(Education about family planning)

235. As part of administrative measures for maternal and child health. Municipal Health Centers conduct measures to help women make independent decisions about contraception, for instance by implementing "Programs for Healthy Motherhood Development" to disseminate knowledge about sex and contraception and to provide consultation and guidance on the effects of artificial abortion to adolescents. They also and by providing guidance and information about sex education, contraception and the effects of artificial abortion to adolescents through public health nurses and/or midwives of Public Health Centers and consultants for planned parenthood.

(Measures to prevent young unwanted pregnancy)

236. Information and knowledge about sex and contraception is widely disseminated to young adolescents. Measures are also taken to help women make independent decisions about contraception by, for example, providing guidance and information about sex and contraception through public health nurses and/or midwives from Public Health Centers and consultants for planned parenthood.

(c) The situation of spread of HIV/AIDS and education on HIV/AIDS

(Programs and strategies for prevention)

237. Anti AIDS measures have fully expanded with the development of the "Basic Principles of a Comprehensive AIDS Strategy" at the Ministerial Conference on Combatting AIDS in 1987.
In December 1998, "The Law on the Prevention of Acquired Immune Deficiency Syndrome" (Law no.2 in 1998. Hereinafter referred to as "the AIDS Prevention Law") was enacted. It stipulates that the prevention of the spread of AIDS should be done with consideration for human rights.
Since fiscal year 1994, "the Seven-Year Plan to Stop AIDS" has started, under which the Government has taken measures such as the improvement of medical treatment, improvement of consultation/guidance and inspection systems, promotion of R&D and international cooperation, and education and dissemination of correct knowledge, declaring (i) the development of efficacious drugs and vaccine, (ii) the prevention of AIDS spread in Japan, and (iii) support for the prevention of AIDS spread in Asian regions and throughout the world.
In April 1999, "The Law on the Prevention of Infectious Diseases and Medical Treatment for Patients with Infectious Diseases" was established to promote comprehensive measures for preventing infectious diseases and the medical treatment for infectious disease patients, classifying AIDS as one of four major types of infectious diseases. With the enactment of this new Law, the AIDS Prevention Law was abolished, and in October of the same year, "Principles for the Prevention of Specified Infectious Diseases in Relation to AIDS" was established. The Guideline stipulates that the national government, local governments, medical communities and NGOs including patient organizations work together to carry out comprehensive measures for prevention and medical treatment with full consideration given to the human rights of patients. It also provides that effective countermeasures shall be taken for groups of individuals who are considered to have chance to be affected and need special consideration (juveniles, foreigners, homosexuals, sex business workers and users).

(Evaluation of outbreak)

238. Since 1984, the AIDS Monitoring Committee has been evaluating information about the case of AIDS detected in Japan with proper understanding of information about the spread of the Acquired Immune Deficiency Syndrome (hereinafter referred as to "AIDS") patients and HIV-positive persons in careful consideration of the protection of privacy. The Committee said that as of the end of December 2000, the accumulated number of patients in Japan, excluding patients and HIV-positive persons infected through blood products, was 1,923, and the accumulated number of the dead was 1,205. Recent characteristics include (i) a nationwide spread of patients, (ii) the increase of Japanese infected patients, and (iii) sexual contact between members of the opposite sex as major infectious sources.

(Treatment for child and parent)

239. Base hospitals for AIDS treatment have been established nationwide and have provided the latest treatment so that patients and infected persons can feel safe to seek treatment. Since April 1998, HIV-infected persons have been recognized as physically disabled, and are provided public aid, for example, by subsidizing medical costs and employing income tax deduction.
Furthermore, the Government has prepared "Manuals to Prevent Mother-to-Child Transmission" to prevent HIV infection between mother and baby, and promote their wide publication by distributing them to medical institutions, and through placing them on the web-site of AIDS Prevention Information Center (s).

(Campaigns to prevent discrimination against children with AIDS)

240. In 1988, the World Health Organization (WHO) defined December 1st as "World AIDS Day" and proposed educational activities on AIDS to prevent AIDS diffusion at the global level and to eliminate discrimination and prejudice against patients and infected persons. In 1996, the Joint United Nations Program on HIV/AIDS (UNA IDS) took over this program. Japan also has approved the objecting of UNA IDS and has carried out various educational activities on December 1 of every year. For example, campaigns were conducted at the Japan Professional Soccer League (J League) in fiscal year 1993, professional baseball games in fiscal year 1999, and the 79th National High School Soccer Championship in fiscal year 2000 and various events performed at school festivals and streets.
In fiscal year 1998, educational materials for AIDS prevention (e.g., DVS and educational boards) were produced, distributed to prefectures, and made available to schools and NGOs. In fiscal year 1999, the AIDS Prevention Information Center was established to widely disseminate AIDS information to all layers of the general public via the Internet.
By promoting the education and dissemination of correct AIDS information through all those programs, the Ministry has been making efforts to eliminate discrimination and prejudice against patients and infected persons.

(AIDS education at schools)

241. See Paragraph 233.

(e) Promoting international cooperation to achieve the rights specified in Article 24

242. See Paragraphs 37-39.

(Child Allowance, Child-rearing Allowance)

243. See Paragraph 36 of this report.

(Child care services for children whose parents work)

244. Under the "Project of After-school Measures for Healthy Growth of Children" mentioned in Article 6-2, Paragraph 7 of the Child Welfare Law, the Government promotes the healthy growth of children in the lower grades of elementary school whose parents or guardians are not present in the daytime because of work (after-school children) by using children's recreational facilities as proper places for play and life after school. There were 11,378 such facilities as of May 2000. This project is being allocated subsidies from the State, the Prefectures and the Municipalities, by one third each (subsidies for the Project of After-School Measures for Healthy Growth of Children).
If it is recognized that both parents can not take care of their child (ren) since, for instance, both of them regularly work in the daytime, and relatives living together or other persons can not take care either, municipalities are required to place and take care of the child (ren) in a day-care center. The number of Day-care centers was 22,200, and 1,788,302 children nationwide have used those centers as of April 2000. The costs for the Day-care Centers are borne half by the State, and one quarter each by the Prefectures and the Municipalities (Share of Management costs for the Day-care Centers).

(Progress and Problems)

245. See Paragraph 34 and 105.

(Living standard)

246. See Paragraphs 243-245 of this report.

(Livelihood Protection and Housing Aid under the Public Assistance Law)

247. The Public Assistance Law is a general law for individuals who are unable to maintain the minimum standard of living due to poverty, under which assistance is provided for each household up to the difference between its income and the demand calculated on the criteria set up by the Minister of Health, Labor and Welfare. Livelihood Aid is provided within the range necessary meet the needs for clothing, food and other articles essential to everyday life, and living Aid is provided within the range necessary for repairmen and other housing maintenance costs. Both aids are provided in cash basis or, it necessary, in kind.

(Follow up of "Declaration" of HABITAT II)

248. HABITAT II (Second United Nations Conference on Human Settlements) held in 1996 in Istanbul adopted "the Habitat Agenda" indicating the basic plan of action on human settlements.
Paragraph 13 of "Habitat Agenda" states that "Special attention must be paid to the shelter needs of vulnerable children." The Japanese Government also has been making efforts to promote child protection in view of the necessity of the above facilities. Since 1996, the number of Children's Home has been slightly increasing and the number of children placed there has also increased by 3000 persons since 1996. The number of children placed in Home for Infant has also increased, though slightly.