The JICA KIDSMILE Project was launched in 2002, after the intimate review of many former projects in the Lao P.D.R. The overall objective of this project is to strengthen management systems for child health services. This project follows three main principles: 1) to respect not only vertical relationships but also horizontal networks (among departments, among ministries, and with donors), 2) to support existing Laotian activities, without introduction of new health service packages, 3) to improve the existing health systems which had been already implemented by Laotians before this project.
The history of JICA's cooperation with the health sector in Laos demonstrates many past successes, such as the eradication of poliomyelitis in 2000. However, only several years after the end of technical cooperations, these outcomes have almost disappeared, and we are facing similar health problems as before, such as low immunization coverage. Now, we recognize that any health system cannot be sustained without stronger Laotian initiative or ownership. In the KIDSMILE Project, we want the Laotian health workers and administrators to consider what they can do by themselves as the real core implementers of all activities, for the sustainability of their work even after the project is completed.

Introduction  Since the year 2003, National Center for Global health and Medicine (NCGM) has been implementing a JICA group training: ‘Continuum of Care for Quality Improvement of Maternal, Newborn, and Child Health in Francophone Africa’. During these ten years, we have recognized the difficulty for trainees to adopt their new knowledge and skills, into their own work because of social and cultural differences. To overcome this issue, we had introduced an approach: ‘laboratory method’ for experiential learning. In this method, participants work together in a group to learn through experiences-based analysis.  However, we have faced the gap between the ‘laboratory method’ and the whole contents of course. Trainees could not utilize ‘laboratory method’ as a useful tool to learn practical skills in the training. To solve this problem, in the year 2013, we added several new learning styles to make the ‘laboratory method’ more usable throughout the training period.Method and Results  We utilized the ‘inception reports’, which all trainees had submitted to JICA before they came to Japan, as an important tool for the ‘laboratory method’. Trainees extracted their common theme from all reports in their group work. Moreover, they used one common ‘matrix’ to analyze their common agenda. Trainees recorded their learning on the ‘matrix’ and revised them if necessary after discussions in regular review meetings. This work helped trainees understand how to put the ‘laboratory method’ into their practice. They also recognized their colleagues and themselves as important ‘resources’ for learning by sharing their own experiences.Conclusion  Participants in the group-training course could utilize the ‘laboratory method’ for their learning throughout the course by using a ‘matrix’ as a tool for analysis. The awareness that their colleagues and themselves could be valuable ‘resources’ could be a breakthrough for working after they went back to their countries.

PURPOSE: To examine the influence of ovariectomy (OVX) on bone turnover and trabecular bone mass at the 3 clinically important skeletal sites in mature cynomolgus monkeys. MATERIALS AND METHODS: Six female cynomolgus monkeys, aged 17-21 years, were randomized into 2 groups by the stratified weight: the OVX and sham-operation groups (n = 3 in each group). The experimental period was 16 months. Lumbar bone mineral density (BMD) in vivo and serum and urinary bone turnover markers were longitudinally measured, and peripheral quantitative computed tomographic and bone histomorphometric analyses were performed on trabecular bone of the lumbar vertebra, femoral neck, and distal radius at the end of the experiment. RESULTS: OVX induced in a reduction in lumbar BMD compared with the sham controls and the baseline, as a result of increased serum levels of bone-specific alkaline phosphatase and urinary levels of cross-lined N- and C-terminal telopeptides of type I collagen. Furthermore, OVX induced reductions in trabecular volumetric BMD and trabecular bone mass compared with the sham controls, with increased bone formation rate at the lumbar vertebra, femoral neck, and distal radius. CONCLUSION: The results indicated that OVX in mature cynomolgus monkeys (17-21 years of age) increased bone turnover and induced trabecular bone loss at the three skeletal sites compared with the sham controls. Thus, mature cynomolgus monkeys could be utilized for preclinical studies to examine the effects of interventions on bone turnover and trabecular bone mass at the 3 clinically important skeletal sites.
Alkaline Phosphatase/blood ; Animals ; *Bone Density ; Collagen Type I/urine ; Female ; Femur Neck/metabolism ; Lumbar Vertebrae/metabolism ; Macaca fascicularis/*physiology ; Ovariectomy/*adverse effects ; Radius/metabolism ; Random Allocation

  As global migration has been increasing rapidly, the Japan Association for International Health (JAIH) established the committee for migration and health in early 2021. This committee, which aims to challenge the health issues of migrants inside and outside Japan, held the first kick-off symposium in the 36th Congress of JAIH on 27 November 2021. Five symposiasts were invited and had presentations from the viewpoints of human rights and culture, which were recognized as the common keywords. This article was written by all symposiasts and chairpersons as the report of the kick-off symposium.