1.Review of current situation and future strategies on prevention and control of Noncommunicable diseases (NCDs) in the Pacific Island States
Marika Nomura ; Hiroko Miura ; Midori Ishikawa
Journal of International Health 2016;31(4):309-321
In the Pacific island states, in addition to the traditional health issues common in developing countries, such as maternal and child health and communicable diseases, the increase in noncommunicable diseases (NCDs), e.g., obesity and diabetes, has become a serious problem. NCDs account for 80% of all deaths in this region, and the increase in early deaths of people younger than 70 years old is of particular concern. It has also been pointed out that the cost of countermeasures against NCDs are constricting government finances, and enhancing a health system that supports such countermeasures is also an urgent challenge. However, with respect to international health cooperation in Japan, the present status of NCDs and the associated statistical data in the Pacific island states are not likely to be addressed. Therefore, in this report, we comprehensively explain the present status of and approaches to NCDs around the world based on the World Health Organization (WHO), including those in the Pacific island states. By taking advantage of health indicators, we confirm the disease structure present in the 10 Pacific island states that cooperate bilaterally with Japan and then discuss the approaches in these states. As a result, although countermeasures against NCDs have been actively implemented in the Pacific island states in accordance with the WHO strategies, no tendency for the prevalence of NCDs to improve has been seen. To promote countermeasures against NCDs in the Pacific island states in the future, it will be necessary to engage in analysis and discussion of the present situation, to develop human resources, taking into consideration the region-specific characteristics of the islands, and to accumulate sufficient numbers of successful local stories consistent with the local strategies.
2.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.
3.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.
4.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.
5.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.