There are serious midwife shortages in isolated islands in Kagoshima. Many pregnant women in Tanegashima Island, for instance, who want to deliver their babies, are badly in need of the help of midwives. However, the safety of delivery cannot be made light of, even under such circumstances. In order to protect pregnant women and their children, it is necessary to increase the number of midwives. In Tanegashima, the number of births is about 200 a year. So the island community has to secure 6 or 8 midwives at least.
  In April 2011, one hospital started dispatching midwives to Tanegashima. Now a number of midwives are working by day and night shifts.
  We think it is too difficult to increase midwives in Tanegashima in the future. There is no way to secure midwives without dispatching them from Kagoshima city.There are limitations to the number of midwives that can be dispatched from two hospitals. Therefore, many maternity hospitals and obstetrical departments of medical institutions in Kagoshima should unite their efforts to improve this situation.
  We hope that the midwives in Kagoshima will extend their services from their own hospital to isolated islands in the future.

  Although the nurse certification system was established by the Japanese Nursing Association in 1994, there are currently no educational institutions in Kagoshima Prefecture for certified nurse specialists (CNS) and certified nurses (CN). The aim of this study was to sound out generalist nurses working in hospitals in Kagoshima Prefecture on CNS and CN educational needs in order to determine methods of supporting those aspirational nurses in the development of their careers. A (self-administered) questionnaire survey was conducted on 1,800 nurses working at 40 hospitals in Kagoshima Prefecture in September 2008. Responses came from 1,258 (69.9%) nurses, of which 999 (79.4%) were valid. Of the respondents, 40.9% indicated they would like to obtain a CNS license, while 56.5% indicated they would like to obtain a CN license. Regarding the CNS license, most respondents wanted to obtain CNS qualification in cancer nursing, followed by acute/critical care nursing. Regarding the CN license, CN qualification in emergency nursing came to the top followed by palliative care nursing. As Kagoshima Prefecture is comprised of remote islands and remote rural areas, it is a disadvatage for many nurses geographically to staisfy their education needs. These results suggest that in order to support nurses' career development, it is necessary to establish an individual consultation system for career development and develop a flexible educational curriculum.