Objectives
 Vietnam, where leprosy used to be highly endemic, through governmental implementation of MDT in 1983 and nationwide disease control efforts, has achieved WHO's leprosy elimination goal at a national level since 1995.
 However, a number of patients who suffered from leprosy prior to the governmental control programme remain institutionalised. Although these patients have severe physical disabilities, social services provided to improve their quality of life appear inadequate.
 The purpose of this study is to report the findings of an investigation of the current state of leprosy and to clarify the problems of leprosy control in Vietnam.
Methods
 402 leprosy patients from two leprosy hospitals and four leprosy resettlement villages in Vietnam were investigated their disabilities on upper limb, inferior limb, and facial appearance. And their disabilities classified according to the WHO classification scheme for disabilities in leprosy patients.
Results
 The group “Visible deformity or damage present” (G2) made up 70.1% of the study participants; the group “Anaesthesia present, but no visible deformity or damage” (G1) made up 18.9%; the group “No anaesthesia, no visible deformity or damage” (G0) made up 10.9%. More than half of those with visible physical disabilities were in their 60s or 70s. The level of disability of pre-MDT leprosy sufferers was significantly more severe than that of the post-MDT group.
Conclusions
 The effect of MDT for prevention of occurrences of physical disability was reaffirmed, but for many patients who contracted the disease prior to the implementation of MDT in Vietnam, the after-effects of leprosy are ongoing and they are forced to live in resettlement villages due to their disability. Vietnam has reduced the prevalence rate, but there are still a number of former patients who are not receiving adequate help. Providing help that is needed to raise their quality of life is the next step.

Background:
Maternal and child health handbook (MCHH) consists of records of pregnancy, delivery, child development and immunization, as well as child growth charts. MCHH has been utilized in Japan since 1947 and it is now introduced in more than 20 countries in the world.
Objectives:
The objectives of this study were to collect research documents and reports in the past studies of MCHH and to analysis the effect of MCHH on maternal and child health through systematic review.
Methods:
The systematic searches were conducted for the studies published between 1980 and October 2011. After the initial screening of titles and abstracts of the studies, we reviewed 57 documents which were studied for MCHH in maternal and child health (MCH) programs or activities. After the final selection, we identified only 5 documents with 43 question items in Indonesia (1999 and 2001), Bangladesh (2003), the Philippines (2009) and Cambodia (2010).
Results:
The relationship between MCHH and pregnancy care revealed that mothers who used MCHH during pregnancy had higher level of knowledge (OR 1.44, 95% CI: 1.22-1.70) than whose did not use MCHH during pregnancy. The strong significant effects of MCHH were observed in knowledge of antenatal care visit (OR 1.86, 95% CI: 1.59-2.18), and mother should consume more food during pregnancy (OR 1.97, 95% CI: 1.37-2.83). Mothers who got MCHH during pregnancy had safer practice by skilled birth attendants (OR 1.12, 95% CI: 0.95-1.32) and delivered in health facilities (OR 1.31, 95% CI: 1.12-1.53). MCHH showed the effect of knowledge of child health care (OR 1.22, 95% CI; 1.05-1.41).
Discussion:
This study utilizing meta-analyses showed MCHH had higher association with knowledge of mothers than practice in pregnancy and child health care, although the study has its limitation. The illumination of the relationship between knowledge and practice by the effect of MCHH needs more quantitative analysis in both community and hospital settings in many countries.

Objective
The purpose of this article is to investigate the extent of depressive symptoms among international students and the characteristics of those at risk.
Methods
Evidence is derived from self-administered questionnaire interviews of 480 international students enrolled in a university in northern Japan. Depressive symptoms are measured using the Center for Epidemiologic Studies Depression scale. The associations of socio-demographic characteristics with depressive symptoms are examined using multiple logistic regression analysis.
Results
Of the 480 respondents, 197 (41%) have depressive symptoms. The results indicate that gender, course category, and residential arrangement are significantly associated with the risk of having depressive symptoms.
Discussion
Depressive symptoms are relatively prevalent, but these are not a generalized condition since these tend to occur among specific sub-groups of international students. There is a need to further investigate the mental illness so that those with elevated risks are identified and given support.

It is well established that restrictive policies on immigration increase the risk of perinatal mortality and morbidity among migrant women. Undocumented pregnant women and their newborn babies are particularly at high risk of complications, due to multiple and interacting factors such as: (i) limited access to health care, (ii) social isolation, (iii) financial burdens, and (iv) trans-generational effects.
In Japan, in response to the increase in foreign residents since the 1990s, laws and regulations on social protection are being readjusted. Accordingly, the ‘New Residency Management’ system will be introduced in July 2012 to better accommodate the needs of ‘legal’ foreign migrants. At the same time, undocumented migrants will face tougher restrictions. All the undocumented migrants will be denied registration in the new system unless they come forward to the Immigration Bureau. As a result, they could also be denied welfare services provided up to now by municipalities.
In this article, we discuss the potential impact of the forthcoming New Residency Management system on the health of undocumented pregnant migrants and their children.
More research is needed on this issue in the Japanese context, but we should not fail to guarantee minimal public assistance for undocumented migrant women, particularly at the time of childbirth.

Objective
Despite the steady high prevalence of infectious diseases, Sri Lanka has an increasing awareness of lifestyle-related health diseases. To lower their risks in the future, making better lifestyle choices and establishing patterns of healthy behavior during young adulthood are essential. The purpose of this qualitative study was to explore current issues of university students' health behaviors and their environments.
Methods
The study was conducted in a university of the Central Province, Sri Lanka. Four graduate students in the Faculty of Medicine and three senior students in the Faculty of the Arts were interviewed in a focus group. Interviews were tape-recorded, transcribed, and analyzed inductively.
Results
The results yielded three core categories: little interests in health, unhealthy lifestyles, and lower usage of the Student Health Center. In addition, three major health problems were observed among the participants: eating habits, substance use, and mental health. Students had little paid attention to their health. It also showed passive participation on a health check-up. Additionally students' hidden risky behaviors were observed: alcohol intake and smoking. Mental health problem is one of the great health concerns among the students. Although the School Health Center was available, the gaps between its provisions of services and students' needs are an important issue.
Discussion and Conclusion
Students need to pay more attention on their health conditions and the importance of preventive health. Furthermore, to improve the current university health services, accessibility, usability, and students' needs should be carefully reviewed in the context of advocacy of preventive health behaviors.

Objectives
High adolescent fertility rates still persist in many developing countries. Adolescent childbearing often leads to negative outcomes including physical and mental disorders of mothers, a high incidence of infant death and household poverty. Obviously, it is important to explore the determinants of adolescent reproduction and its related behaviour to ensure its prevention. This study assesses the impact of the level of female autonomy and status of the community on adolescent childbearing, age of sexual debut and age of marriage.
Methods
This paper uses the pooled micro data from the Demographic and Health Survey Nicaragua 1998 and 2001. A logistic model is used to estimate the impact of the level of female autonomy and status of the community on adolescent childbearing, age of sexual debut and age of marriage. These variables are aggregated for each municipality using data on women aged over 20. Four female community autonomy variables are used. They are the percentage of women who have the final say on: own healthcare, making large household purchases, visit to family or relatives, and what food is to be cooked each day. Three variables of female status in the community are mean age at first marriage, mean age differences between spouses, and the percentage of those enrolled in secondary level education.
Results
Analysis proved that the level of autonomy and status of women in the community influence adolescent childbearing, age of sexual debut, and age of marriage. Particularly, the probability of younger sexual debut and younger marriage decreases when a community has a higher level of female autonomy and status.
Conclusion
The results indicate the importance of community intervention to strengthen female autonomy and promote female status in order to prevent adolescent childbearing.

Background
Mortality statistics are key inputs for evidence based health policy at national level. However mortality statistics alone does not provide necessary information for further identification of improvement opportunities which could be manageable in local health systems in the place where vital registration system is not established.
This study intends to disclose the profile of death events among the urban poor, with aim to identify improvement opportunities from the view of quality management of local health system.
Methods
Eleven communities in Ancol, Jakarta, were selected for the survey, and the information of death events were collected from community leaders of rukun warga (RW), village office, health centers, hospitals, and public cemeteries. The families or co-habitants of the deceased cases under 55 years old were interviewed.
Results
Two hundred and twenty four of death events were identified. The number reported in the demography statistics was 114 in 24 months during the same period, while 67 cases less than 55 years old were investigated by interview regarding history prior to death. . Thirty-eight percent died at healthcare facilities while 59% died at home. Private services were consulted as frequently as public services. Case studies based on history review revealed “improvement opportunities” in local health systems, and some of those critically contributed to eventual deaths which would be prevented by improvement in quality management of local health systems.
Conclusion
Community death events were good tracer for assessment of actual performance of local health systems as well as for identifying improvement opportunities.

  Colombia faces difficulties in providing assistance to landmine victims as a result of long-drawn-out armed conflict against guerrilla groups and narco-traffickers. The present article describes recent trends and future challenges for landmine victim assistance in Colombia.
  Governmental, non-governmental, and international organizations as well as landmine victims’ groups are important actors for assisting landmine victims: Governmental organization modify laws, non-governmental organizations provide proper medical care, international organizations contribute financial and technical cooperation, and landmine victims’ groups build networks among landmine victims.
  　However, various challenges remain. First, because most explosions occur in mountainous areas, victim access to medical care is difficult. Transferring landmine victims to a medical institution takes a lot of time. Second, as many people cannot go back to their landmine-polluted hometown, this internal displacement has led to problems regarding the resettlement of victims in landmine-free areas. It is not easy for them to participate in the new society. Finally, although many landmine victims suffer from psychological problems such as post-traumatic stress disorder, psychological care is often inadequate.
  The increase in the number of landmine victims in Colombia requires the establishment of an efficient landmine victim assistance system.