4.Public health and “koshu-eisei”
Medical Education 2012;43(3):147-150
“Public health” was translated to “Koshu–eisei” in Japanese. These two terms have been believed to imply the same meaning and contents. But “Koshu–eisei” was established in the Japanese specific history and social environment. It would be instead used as “shakai–igaku (social medicine)” in the context of the Japanese medical education. The social medicine is identified as a part of medical discipline, as well as clinical medicine. The education of “Koshu–eiseigaku” of public health in the original sense would be developed as an interdisciplinary area at School of Public Health. Actually the Schools have been already opened in some Japanese universities for the students with wider background and specialties. The Japanese medical education is changing its boundaries and sharing the purposes with public health.
5.Influence of world politics and economics on global health: Analysis of five major cases
Journal of International Health 2011;26(1):1-9
Until recently, many global health policies and programs were developed and transformed under the influence of world politics and economics. One example is the primary health care strategy established in a political and social context to enhance the sovereignty and human rights of developing countries. However, the initial ideal had to be abandoned after implementation of the structural adjustment policy derived from the context of growing neoclassical economics. The Integrated Management of Childhood Illness (IMCI) policy was developed entirely based on economical reviews the World Bank initiated. Childhood malnutrition in developing countries remains unresolved due to the politically unequal distribution of food and the strategic selling pressures of multinational food companies. The universal access policy of anti-retrovirus drugs for HIV infection has been impeded by the economical battle for intellectual property rights for the manufacturing and purchasing of these drugs. The World Health Organization's Framework Convention on Tobacco Control was enacted against the marketing strategies of multinational tobacco companies. This paper aims to measure the effects of the intentions of international financing organizations and multinational businesses on the development of global health policies and to discuss the challenges for global health under them.
6.Recent world activities for health system strengthening
Motoyuki YUASA ; Chiaki MIYOSHI ; Eiji MARUI
Journal of International Health 2009;24(4):309-315
Background
In recent global health developments, attention has focused on health system strengthening (HSS). Behind this move is the realization that HSS is essential for the development of sustainable and effective health care activities required to meet UN Millennium Development Goals and eradicate poverty. Since the publication of the World Health Report (WHR) 2000, the World Health Organization (WHO) has made intensive efforts to promote HSS.
Progress
This paper descibes recent global activities for HSS, based on official WHO documents and related issues, along with the following three phases: publication of the WHR 2000, follow up of feedback on the WHR 2000, and global trends for HSS after publication of the WHR 2003. In particular, we shall clarify progress made after the year 2003 with regards to policy, implementation, and scientific methodology. For policy, the principle of Primary Health Care has been introduced to HSS, and the participation of international agencies has been promoted. With regards to practice, training a health care workforce and financial assistance from global funds are addressed. Finally, for scientific methodology, we refer to instances such as the development of the WHO framework for health systems, the promotion of evidence-based health research, and strengthening of health information systems.
Conclusion
To make vertical health care programmes for acute care, infectious diseases and chronic illnesse etc. more effective, HSS as the lateral foundation is an urgent global health care issue. It is surely necessary that Japan's basic strategy for supporting HSS is clarified as well as attempts to introduce concrete components for HSS into bilateral cooperation and NGO programmes.
7.Global health in the context of world politics/economics and development
Motoyuki YUASA ; Marika NOMURA ; Eiji MARUI
Journal of International Health 2010;25(1):1-10
Global health policies and strategies are influenced by world politics/economics and development. Thus, a clear and accurate understanding of global health requires proper knowledge of the history of world politics and economics. Since the end of World War II, world politics and economics have dramatically changed through the cold war era to the multipolar age. Meanwhile, the direction in which developing countries have progressed has been determined by select international financial organizations such as the International Monetary Fund and the World Bank in accordance with the policy of the USA Presidency.
This paper reviews the history of global health policies and strategies in the context of world politics and economics as well as world development.
8.Comparison of turnover issues among female physicians by generation
Yuka YAMAZAKI ; Itsuko HORIGUCHI ; Eiji MARUI
Medical Education 2010;41(6):411-416
1) Physicians who graduated from medical school less than 5 years earlier hoped that they could be satisfied with both their work and private life. They considered the choosing of a specialty suited to their lifestyle to be a strategy for continuing to work.Previous studies have suggested that this idea is specific to this generation.
2) Physicians who had graduated more than 31 years earlier had entered a medical university at a time when female students were rare; they continued to work with the belief that they must work hard so that female physicians could be seen to be actively employed. However, some of them had regrets about working continuously or child rearing.
3) The problems that female physicians faced concerning gender discrimination, child birth, and child rearing were common among both age groups.
9.The effects of marriage and child–bearing on career satisfaction among female physicians
Kyoko Nomura ; Yuka Yamazaki ; Shinobu Tsurugano ; Eiji Marui ; Eiji Yano
Medical Education 2011;42(4):209-215
The number of female physicians is increasing. In Japan, marriage and child–bearing have been considered barriers preventing female physicians from working continuously. This study investigated the effects of marriage and child–bearing on career satisfaction among female physicians.
1)We surveyed the alumni of two private medical schools (University A: n=646; University B: n=316). The response rate was 38% for University A and 71% for University B.
2)When the subjects were asked if they were satisfied that they had chosen a career as a physician, 85%(n=400) answered that they were satisfied.
3)In total, 348 female physicians (74%) were married, and of them, 280 (80%) had experienced childbirth, and 259 (77%) were married to physicians.
4)Factors that significantly and positively affected career satisfaction were marriage for all female physicians and child–bearing for married female physicians.
5)The results of this study suggest that marriage and child–bearing, rather than being obstacles to career development, have positive effects on the career satisfaction of female physicians.
10.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.