4.Lessons from the Field Count more than Ever: The New Era of Global Health
Kenzo Takahashi ; Jun Kobayashi
Tropical Medicine and Health 2015;advpub(0):-
For many years, Japan has been silent on theachievements of Japan's Overseas Development Assistance program including thehealth improvement of foreign countries. Japan’s contribution to global healthcommunities through G8 process including Hashimoto Initiative is steadfast. Onthe other hand, in the field activity level, experts involved in ODA have not disclosedtheir achievements. However, the article by Wada et al.,which describes the contents of TEN MR (Minimum Requirement), shed light onJapan’s silent ODA community by disclosing Japan’s achievements in globalhealth by drawing lessons that may be applicable to othercountries. Our future challenge in the global health will be how to synthesizeactions that reflect the lessons learnt from the field and which show scientificevidence using established methods.
5.Lessons from the Field Count more than Ever: The New Era of Global Health
Kenzo Takahashi ; Jun Kobayashi
Tropical Medicine and Health 2015;43(4):243-245
For many years, Japan has been silent on the achievements of Japan’s Overseas Development Assistance program including the health improvement of foreign countries. Japan’s contribution to global health communities through G8 process including Hashimoto Initiative is steadfast. On the other hand, in the field activity level, experts involved in ODA have not disclosed their achievements. However, the article by Wada et al., which describes the contents of TEN MR (Minimum Requirement), shed light on Japan’s silent ODA community by disclosing Japan’s achievements in global health by drawing lessons that may be applicable to other countries. Our future challenge in the global health will be how to synthesize actions that reflect the lessons learnt from the field and which show scientific evidence using established methods.
6.Food Taboo and ‘Yu fai’ Tradition in Perinatal Period in Northeast Thailand
Marika NOMURA ; Kenzo TAKAHASHI ; Waraporn CHEDDABUTT ; Eiji MARUI
Journal of International Health 2007;22(1):27-34
Introduction
Women in northeast Asian countries follow special practices during prenatal and postnatal periods. The traditional ‘Yu fai’ custom in Thailand includes a food taboo known as kalum.This paper intends to describe the unknown details of parturient women's traditional taboos in northeast Thailand.
Methods
Ethnographic semistructured interviews in the Thai language were conducted in February 2006 with 10 women in northeast Thailand who had babies ranging in age from newborn to 6 years.
Results
The purpose of Yu fai is to enable a mother who has recently undergone parturition to recover her pregestation physical and mental conditions following childbirth. Some new mothers will complain of bad health if they fail to apply Yu fai. Certain food taboos and recommendations are part of the Yu fai practice, and each has a specific context based on traditional beliefs.
Conclusions
The three objectives of Yu fai are identified as follows: to recover the mother's body to its usual pregestation condition; to enable sufficient breast milk or the capability for future pregnancies; to endure a long and healthy life. Applying Yu fai will influence a mother's lifetime health conditions after childbirth. Each of the prohibited or recommended food items is the result of specific contexts based on traditional beliefs. However, Yu fai is now changing, along with urbanization and improved communications, even in the rural areas of northeast Thailand.
7.Continuous Support for Community-based Activities Activity System Model as a Conceptual Framework: Qualitative Research
Aki SHIBATA ; Masumi TAKEI ; Asuka SUZUKI ; Kenzo TAKAHASHI
An Official Journal of the Japan Primary Care Association 2024;47(1):3-11
Introduction: This study aimed to identify issues and concerns involved in a community-based activity and to identify requirements for supporting its continuation. Methods: Between September and November 2021, interviews were conducted with 12 volunteer residents who manage a community-based activity. Deductive content analysis was used to analyze the data. Yrjö Engeström's activity system model was used as the analytical framework. Results: Within the components of the activity system, the following "contradictions" were identified: supporters were anxious to continue their activities, the number of new participants in the community-based activity was not increasing, and human relationship difficulties constituted a regional characteristic. Among the components, the following "contradictions" were identified: many older adults were unable to participate in the community-based activity because of age- or health-related reasons, many older adults worked, and there were various other activities that did not result in subsequent participation in the community-based activity. Conclusion: The model also identified the need to consider visualization of the benefits of the community-based activity, comprehensive publicity activities involving residents, creating a system that allows people of all health levels to participate, and ongoing support for health promotion for the younger generation with anticipation of old age.
8.Effect of nutritional status on transdermal fentanyl absorption in cancer patients
Tomohiko Tairabune ; Hiroaki Takahashi ; Takeshi Chiba ; Atsuko Sugawara ; Yusuke Kimura ; Kenzo Kudo ; Go Wakabayashi ; Katsuo Takahashi
Palliative Care Research 2012;7(2):395-402
Objective: This study aimed to investigate the effect of nutritional status on estimated fentanyl absorption in cancer patients being treated with a fentanyl transdermal patch (FP), by measuring the residual fentanyl content in used patches. Methods: 24 adult Japanese inpatients receiving FP treatment for chronic cancer-related pain were enrolled. During FP application, the nutritional risk of the patients was measured using the Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002), both of which are nutrition screening tools used widely in Japan. We then classified the patients into low-, medium-, and high-risk groups according to the nutritional risk measured by MUST, and compared the transdermal fentanyl delivery efficiency (FE) between that groups. Results: The FE, which is estimated by the residual fentanyl content in used FPs collected from the patients, was found to be decreased in the high-risk group. According to NRS 2002, the mean transdermal fentanyl delivery efficiency in the high-risk group was significantly lower than that in the low-risk group. Conclusion: These results showed that changes in nutritional status affect FE, and that poor nutritional status might decrease transdermal fentanyl absorption in cancer patients.
9.Can Japan Contribute to the Post Millennium Development Goals? Making Human Security Mainstream through the TICAD Process
Kenzo Takahashi ; Jun Kobayashi ; Marika Nomura-Baba ; Kazuhiro Kakimoto ; Yasuhide Nakamura
Tropical Medicine and Health 2013;41(3):135-142
In 2013, the fifth Tokyo International Conference on African Development (TICAD V) will be hosted by the Japanese government. TICAD, which has been held every five years, has played a catalytic role in African policy dialogue and a leading role in promoting the human security approach (HSA). We review the development of the HSA in the TICAD dialogue on health agendas and recommend TICAD’s role in the integration of the HSA beyond the 2015 agenda. While health was not the main agenda in TICAD I and II, the importance of primary health care, and the development of regional health systems was noted in TICAD III. In 2008, when Japan hosted both the G8 summit and TICAD IV, the Takemi Working Group developed strong momentum for health in Africa. Their policy dialogues on global health in Sub-Saharan Africa incubated several recommendations highlighting HSA and health system strengthening (HSS). HSA is relevant to HSS because it focuses on individuals and communities. It has two mutually reinforcing strategies, a top-down approach by central or local governments (protection) and a bottom-up approach by individuals and communities (empowerment). The “Yokohama Action Plan,” which promotes HSA was welcomed by the TICAD IV member countries. Universal health coverage (UHC) is a major candidate for the post-2015 agenda recommended by the World Health Organization. We expect UHC to provide a more balanced approach between specific disease focus and system-based solutions. Japan’s global health policy is coherent with HSA because human security can be the basis of UHC-compatible HSS.
10.Overweight/Obesity among Kindergarten Children and Its Risk Factors in the Central Region of Ho Chi Minh City:
Marika NOMURA ; Pham Thi Ngan HA ; Tran Thi Minh HANH ; Kenzo TAKAHASHI ; Naoko SAKAMOTO ; Le Thi Kim QUI ; Eiji MARUI
Journal of International Health 2007;22(1):1-10
Introduction and Purpose
Overweight and obesity have recently emerged as major problems of malnutrition among children in developing countries. However, risk factors for childhood obesity in Asian countries remain largely unknown. Identification of target populations for its prevention and intervention is urgently needed. This survey was conducted to assess the prevalence of overweight and obesity and identify possible risk factors among kindergarten children in Ho Chi Minh City, Vietnam.
Methods
In this cross-sectional study conducted in March, 2005, 780 children in their third and fourth years in kindergarten and their mothers were randomly selected from eight local kindergartens. Height and weight of mother-child pairs were measured, and an interview was conducted by trained staff using a questionnaire in Vietnamese. Overweight/obesity was defined as a weight-for-height > 2 SD above the National Center for Health Statistics median reference value. Risk factors for overweight/obesity were analyzed using logistic regression.
Results
There were 741 respondents (377 boys and 364 girls); the response rate was 95.0%. Average age of children was 61.8 ± 6.8 months; the average age of mothers was 35.0 ± 5.2 years. The average height and weight were 110 ± 5.7cm and 21.2 ± 4.0kg respectively. Of the 741 children, 27.8% were identified as being overweight/obesity. Four possible variables selected were: 1) child's sex, 2) mother's awareness of her child's current body type, 3) mother's expectation for her child's body type in the future, 4) mother's awareness of her own current body type .
Conclusion
Our findings point to the importance of addressing appropriate body images in the management of children's nutritional health. Providing sufficient amounts of information on appropriate body type in addition to feeding practice to mothers should be a priority at the Ho Chi Minh City Nutrition Center to prevent child overweight and obesity.