1.The Difficulty with the Social Safety Net Health Sector Program in Indonesia: Case Study of Health Card Program
Aiko SHONO ; Hiroshi OHMAE ; Misa MASUDA
Journal of International Health 2007;22(2):79-87
Introduction
Republic of Indonesia was badly affected by the economic crisis that began in Thailand in mid 1997. The crisis increased the incidence of poverty in Indonesia, and now it is time to grapple with this chronic poverty from various angles. The objective of this paper was to assess the impacts of the Social Safety Net (SSN) program on the health sector, which aimed to mitigate the effects of economic crisis. We focused on one of the SSN's health sector programs, the health card program, which provided free medical service for poor families.
We examined the usefulness and limitations of this program from an administration perspective.
Methods
Based on the ‘wealth ranking’ which is used in the field of development assistance, we chose 26 and 34 households that were classed as ‘relatively poor families’ from two villages in a rural area of Central Java, and interviewed households to understand how the health card program was delivered to them.
Results
The results indicated that 30 % (8/26) and 56 % (19/34) of the ‘relatively poor families’ have a health card, although half of these households had never used their cards, and half of them couldn't find their cards. Lack of awareness and indifference of medical staffs to the health card are considered to be possible reasons hindering people from using the card. Another reason was that some households felt ashamed to use the health card.
Conclusions
We suggest two methods to promote the increased usage of the SSN's health card as follows; first, choose the target household objectively, and secondly, enhance the management of the health sector program by taking advantage of midwives and teachers, as they have experience and can view the situation from a broader perspective. In addition, like any kind of public service, accessibility is an important factor to promote the usage of this health card.
2.Experience of the “Anti-Tobacco, Alcohol and Drug Abuse Education” in Primary School
Kaori Kawamura ; Shota Nakano ; Aiko Shono ; Manabu Akazawa
Japanese Journal of Social Pharmacy 2015;34(2):128-131
Introduction: A new role for community pharmacists is to perform educational activities related to tobacco, alcohol, and drug abuse. It is important to consider schoolchildren and provide classes targeted to this age group. However, it is difficult for community pharmacists to provide these classes for students because they have few chances to gauge what students understand. Therefore, we explored a better way for community pharmacists to deliver their classes. Methods: We provided a “drug safety” class, which encouraged 9-12-year-old students at primary school to resist tobacco, alcohol, and drug abuse. To prepare for the class, we held several discussions with the primary school teachers. We incorporated their advice and comments into our slides and skit for the class. Their points and our process of preparation for the class are shown. Results: Three important points were identified in our discussions with the teachers. I. We should consider delivering an interactive class for the children, so they could participate in a skit and quizzes, instead of a one-sided talk from the teacher. II. We should use pictures and examples that are visually simple for children. III. We should take parents who smoke and drink into consideration. Discussion: There is an increase in opportunities for community pharmacists to contribute to classes about tobacco, alcohol, and drug abuse at schools because of the importance of encouraging children to resist tobacco, alcohol, and drug abuse. It is important for pharmacists to consult with teachers to recognize the needs of students in their classes. The community pharmacists could then ensure their classes met the school and schoolteachers’ needs by using their experience in educational activities.
3.The Relation between a Class on Preventing Drug Abuse and Students’ Conversations after the Class
Azusa IWABUCHI ; Aiko SHONO ; Manabu AKAZAWA
Japanese Journal of Social Pharmacy 2017;36(2):88-92
Introduction: Education for preventing drug abuse for younger generations is important in both local schools and families. However, owing to their sensitive nature, drug abuse issues are difficult to discuss outside school. This study explored the association between a class that provided guest lectures on preventing drug abuse and students’ conversations on drug abuse issues with their family and/or friends on that topic. Methods: We held a 30-minute class as visiting lecturers, speaking with students in grades 4-6 at an elementary school in Tokyo. We also conducted a cross-sectional questionnaire before and after the class. The questionnaire focused on whether the students spoke with anyone on the topic, with whom they spoke, and what were the topics of such discussions. Results: Answers were obtained from 127 students. Before the class, 30 students (24%) reported having engaged in some form of conversation on the topic. After the class within five days, 56 students (44%) reported having such conversations (P<0.05). The greatest number of students spoke with their mothers after the class, and mainly about the class itself. Discussion: The class therefore may have encouraged their conversations outside school on drug issues. Conducting education in elementary schools on preventing drug abuse is likely to create communication opportunities with family members on this topic.