Japan Health Policy NOW | Niigata Prefecture – Health Center Activities: Case Study 2

Tohkamachi Health Center and Maternal & Child Health Unit/Health Promotion Division at the Municipal Citizen Welfare Department

Background

This activity started from stakeholder gatherings at Tohkamachi Health Center, in response to focused HIV/AIDS interventions by the national Government and the official launch of “Healthy Parents and Child 21.” It has been operational for more than 10 years.

Overview of activities

■ Regular meetings for high school nurse-teachers

When	Implemented every February as a part of a regular meeting for nurse-teachers from prefectural high schools, in partnerships with the Health Center and the Tohkamachi City
Participant	Nurse-teachers from 6 high schools in the areas covered by the Tohkamachi Health Center
Overview	Share problems seen in each school Discuss lecture content for the following year

■ Deployment of lecturers to offer sexual health education

Target	All students from 6 prefectural high schools, special needs schools, and six-year secondary schools in the area Elementary and junior high schools (excluding the aforementioned secondary schools) organize their own separate programs
Lecturer	Lecturers are assigned according to requests indicated in plans submitted by schools. Negotiations with lecturers are done by each school Lecturers include local obstetricians, midwives from midwives’ associations, nursing school teachers, retired nurse-teachers, and so on
Budget	Four schools are funded by the prefecture and 2 schools are funded by the municipal health department
Frequency	Once a year
Overview	AIDS/STD prevention, bodily mechanisms, unwanted pregnancy prevention mechanisms, and information on where to consult when assistance is needed For high schools: unwanted pregnancies, LGBT issues, suitable ages for pregnancy, and cervical cancer. For junior high schools (first through third year students), menstruation symptoms (PMS) and control measures, messages to encourage students to have positive self-images, and so on Subjects covered mainly include body mechanisms, how to prevent unwanted pregnancies, the prevention of STDs, and information on where to consult when assistance is needed Some schools collect requests from students prior to lectures, and compare changes in the levels of knowledge before and after lectures The health center also monitors chronological changes in the levels of knowledge about STDs and contraception
Special Features of the Program	Utilize materials to help understanding and stimulate interest among students according to their ages, including the use of community data and pictures/movies

Strengths of the Initiative

Collaboration among different professionals
- Conducted as a joint project of the Health Center and the city Government.
- School nurse-teachers and lecturers (doctors/midwives) cooperate with each other to solve problems in the community.
Providing supportive environment for students
- Students can feel comfortable with the topic and that it is easier to seek advice since the lecturers are local healthcare providers.

Current Issues of the Initiative

Ensuring quality of the lecture
- Need training sessions for lecturers (obstetricians, midwives, public health nurses) to enable them to offer quality education catered to the needs of schools and students. (comment from the Health Center)
Support to individual cases
- Although the deployment of lecturers is effective in improving overall knowledge levels, efforts are needed to strengthen support for individual issues. (comment from the city Government)

Direction for Future Development

Ensuring quality of the lecturers
- There is a need to provide lecturers with opportunities to learn from each other, such as use of open lectures for the lecturers themselves. (comment from the Health Center)
Close partnerships with nurse-teachers
- A system should be set up to provide personal counseling and support to students, in coordination with school nurse-teachers, using the access the city Government has to local information on pregnancy and delivery situation. (comment from the city Government)
- Since elementary schools, middle schools, and high schools conduct a consistent sexual education program, there is a need for OBGYN institutions, school nurses, and the local government to coordinate and discuss issues and measures.

Expectations for other stakeholders

Government
- It is hoped that the national Government will provide places for students where they can access correct information, advice and support. (comment from the Health Center)
Schools
- It is would be desirable for schools to use a unified set of educational materials. (comment from the city Government)

Interviewees

Health Center
- Community Health Division, Health and Welfare Department, Tohkamachi Regional Promotion Bureau, Niigata Prefecture
City Government
- Health Promotion Division, Tohkamachi Municipal Citizen Welfare Department

Interview date: December 2017

Health Center Activities

Niigata Prefecture

Providing sexual and reproductive health education (AIDS/STD Prevention) through a community- and needs-based approach led by health centers