Japan's Official Development Assistance White Paper 2005

Main Text > Part II ODA DISBURSEMENTS IN FISCAL YEAR 2004 > Chapter 2 Details and New Policies about Japan's ODA:Striving for Further ODA Reforms > Section 2. Measures for Each of the Priority Issues > 1. Poverty Reduction > (2) Health and Welfare

(2) Health and Welfare

In many developing countries, a large number of people suffer from lack of basic health services that are usually available in developed countries. Three goals of MDGs relate to the area of health: reducing child mortality, improving maternal health, and combating HIV/AIDS, malaria, and other diseases. The focus is placed on these goals, as they are also concerned with poverty reduction. Japan has been providing assistance to address health-related priority issues, which are the promotion of maternal and child health, measures against infectious diseases, and the development of health systems. It also offers assistance in other areas of health, as well as cross-sectoral actions such as promotion of gender equality, education-related efforts, safe water supply, and infrastructure development. Through these efforts, Japan has been playing a leading role in providing cooperation in the health sector.

In cooperation with the Asian Development Bank ( ADB ), the World Bank, and the World Health Organization ( WHO ), the Japanese government hosted the "High-Level Forum on the Health MDGs in Asia and the Pacific" in June 2005. The forum was held with high level participants, including 11 ministers, from ministries in charge of health, finance, and development of 24 countries in the Asia-Pacific region, as well as from donor countries, international agencies, and NGOs to discuss the current status and issues faced in meeting health-related MDGs. Furthermore, at the forum the Japanese government announced the Health and Development Initiative, which focuses on the achievement of the health MDGs. (See 2 (3) of Section 1 for details on the High Level Forum, and Box 5 for the Health and Development Initiative.)

This section outlines Japan's efforts regarding assistance for strengthening health systems, assistance for maternal and child health, and international cooperation. (See 3 (2) of this Section for information on measures to prevent infectious diseases.)

A. Assistance for Strengthening Health Systems

Globally, attention tends to be focused on direct countermeasures against diseases, such as the fight against HIV/AIDS through provision of anti-retrovirus medication to patients. Meanwhile, Japan recognizes that along with direct disease countermeasures, the establishment of public health in developing countries plays a vital role in preventing diseases. Therefore, Japan has been providing assistance in enhancing regional health care and prevention activities based on the viewpoint of "primary health care", that provides basic health care services equally to a larger number of people. It also promotes capacity development of health-related personnel and infrastructure development in order to develop and reform nationwide health systems in line with the situation of each developing country. For instance, Japan has been implementing the "Project for Development of Human Resources in Health," which has been aiming to quantitatively and qualitatively improve the education of health-related personnel in Senegal since FY2001.

Column 3 "Hospital de los japoneses" (Japanese hospital) in the Dominican Republic

B. Assistance for Maternal and Child Health

Issues surrounding maternal and child health encompass a wide range of aspects from health care services, health care systems, and public health to the social environment that surrounds women who are to carry and nurture children. In developing countries, especially least developed countries (LDCs), urgent attention is needed to improve the health of pregnant and nursing women, reduce infant mortality and illnesses, and promote measures against HIV/AIDS and other sexually transmitted diseases.

To improve the health of pregnant and nursing mothers, Japan launched the Maternal and Child Health Handbook Project in Indonesia based on experiences of using maternal and child handbooks within Japan. It also provided assistance in training personnel engaged in maternal and child health care services such as midwives and nurses, developing emergency obstetrical care systems, and securing physical and social access to emergency obstetrical care facilities (e.g., infrastructure development, gender equality, and women's empowerment). (See 3 of Part I, Chapter 2, Section 3 for further information on the above projects.) In addition, assistance is given to reduce unwanted pregnancies by providing education and information on family planning, improving access to birth control methods and contraceptives, and promoting the education of adolescents.

To reduce infant mortality and illnesses, Japan assists in providing vaccination against illnesses that could lead to deaths of infants such as polio, measles, and tetanus. Since many of such diseases are preventable through relatively inexpensive intervention, assistance is provided to spread the use of vaccination. Efforts are also made in developing primary health care services, such as promoting universal usage of ORS (Oral Rehydration Salt) to combat diarrhea in children.

Regarding measures against HIV/AIDS and other sexually transmitted diseases, efforts must be promoted from the prevention perspective, as well as the treatment and care sides. Taking into account the access to health care services and information, assistance is given with consideration from various perspectives and a comprehensive approach. For example, Voluntary Counseling and Testing ( VCT ) has been introduced as part of reproductive health services. 13

A man wearing a pregnancy simulator and learning about reproductive health including family planning at a health center (Photo: Japanese Organization for International Cooperation in Family Planning [JOICFP])
A man wearing a pregnancy simulator and learning about reproductive health including family planning at a health center (Photo: Japanese Organization for International Cooperation in Family Planning [JOICFP])

Japan has been cooperating in UNICEF-led efforts for developing emergency obstetrics medical services, and offering assistance through collaboration with United Nations Population Fund ( UNFPA ) and International Planned Parenthood Federation ( IPPF ), which is an international NGO, as well as other channels. In FY2004 Japan provided assistance in such projects as the Project for the Improvement of Obstetrical Service, which aims to promote safe childbirth and improve infant survival rates in Armenia, and the Project for Improving Maternal and Child Health Care in the Democratic Republic of Timor-Leste, which supports UNICEF in addressing the issues of infant illnesses and providing support before and after childbirth within Timor-Leste's medical institutions.

C. International Cooperation

Japan collaborates with various partners in providing health sector assistance through policy dialogue, project planning, implementation, and monitoring and evaluation. Regarding NGOs, the Ministry of Foreign Affairs holds dialogue meetings with relevant Japanese NGOs on a regular basis to exchange opinions and information, and it also commissions NGOs to do various studies that contribute to the implementation of assistance. With UNICEF, Japan has been continuing cooperation to eradicate polio since the beginning of the 1990s. In recent years, the cooperation has expanded to vaccination against infectious diseases such as measles and tetanus, distribution of curative drugs for malaria and mosquito nets, and safe water supply. With the United States, Japan announced the USAID-Japan Partnership for Global Health 14 in June 2002. The United States Agency for International Development ( USAID ) and Japan together are cooperating to improve the standard of health care in developing countries. Specifically, they are collaborating in projects in Africa, Asia, and Central and South America, including VCT activities 15 in Kenya and HIV prevention activities in border areas of Tanzania. Personnel exchanges between JICA and USAID are also carried out.

Furthermore, with regard to ASEAN, Japan held "ASEAN and Japan High Level Officials Meeting on Caring Societies" in November 2003 in Tokyo with the cooperation of ASEAN Secretariat and WHO. The aim of the meeting was to develop human resources in the area of health and welfare in Asian countries. High-level officials in charge of welfare policies and health and medical care policies from 10 ASEAN countries were invited to attend the meeting. They discussed the role of human resource development in the area of health and welfare services in each country and agreed to continue dialogues on a regular basis in the future. Moreover, in August 2004 Japan held the "2nd ASEAN and Japan High Level Officials Meeting on Caring Societies" in Yokohama. Discussions were focused on the issues of aging society, which is a common social issue anticipated to grow in the near future in the Asian region, and on the development of health and welfare-related human resources that would support the aging society. Proposals were made to establish frameworks necessary for developing health and welfare-related human resources that would support the aging society, to discuss actions that need to be taken into consideration by policy makers, and to deal with the issue of health and welfare of disabled persons as well as maternal and child health and welfare at the third meeting.

As mentioned before, Japan has been actively contributing to cooperation for achievement of the MDGs. At the "Harmonized Action on the Health, Nutrition, and Population MDGs Meeting" in May 2003, which was co-sponsored by the World Bank, Canada, and the United Kingdom, Japan argued that a framework should be formulated for concerted action based on the following four points: (1) that further importance be given to the ownership and leadership of the government of developing countries themselves; (2) that action be based on a country-by-country approach, given the necessity of building health care systems and reforming health administration, etc.; (3) that it is important to promote a regional approach and South-South cooperation because infectious diseases is an issue which crosses national borders; and (4) that the utilization of diverse modalities of aid tailored to the actual conditions in each country and region is important.

Furthermore, at the High-level Forum on the Health MDGs held in Geneva in January 2004, Japan emphasized the importance of improving the capacities of recipient countries in order to effectively utilize assistance funds, and in particular, the importance of promoting human resource development in the health sector based on a long-term plan of at least ten years' duration. At the 2nd High-level Forum on the Health MDGs, which was held in December 2004 in Abuja, Nigeria, Japan stressed the importance of South-South cooperation in the area of health care.

At the High-Level Forum on Health MDGs in Asia and the Pacific held in June 2005, Japan was received with high regard and appreciation for its cooperation in the health sector, and at the same time strong expectations were expressed toward further strengthening and enhancing support to achieve the health MDGs under the Health and Development Initiative.