Success of Japan In Infant Mortality
Japan had done an excellent job in the maternal and child health. A sharp reduction of infant mortality was observed in 1975. Now, Japan is one of the lowest among the developed countries.
What had the Public Health policies that were implemented to achieve such significant result?
Public Health Practice
Excellent Maternal Care & Follow Up of Infants
It was claimed to be the success of MHC (Municipal Health Center). Pregnant mothers were given free health guidance and preventive medical activities as well as a health record for the child through the course of pregnancy and after birth. Health guidance and consultation by public health nurses may continue after birth especially when the new born babies are weighed 2500mg or less, in which case parents are required to report to the local public health centers to prompt them for quick action.
Mass Screening for Diseases
All newborn babies are entitled for public funded mass screening to detect congenital metabolic diseases such as phenylketonuria, and for the babies born to HB positive mothers, immunoglobulin and vaccination will be provided as part of health insurance benefit.
To detect preventable causes of intellectual impairments such as phenylketouria, cretinism, neuroblastoma etc. mass screening program for neonates has been conducted since 1977.
Insurance
For very low birth weight babies who require intensive care after birth, health insurance coverage starts on the first day of their births as dependent family status of their parent's health insurance. The usually required 20-30% co-payment will be waived by public funding for the babies whose birth weight below 2000g. All babies are entitled to free well-baby check ups twice at the age of 1.5 years and 3 years, all of which are provided by municipal governments.
Efforts of Public Health v.s. Declination of Birth Rate
Looking into these measurements that the government had taken, we could see the weight of attention in the newborns, or with the younger generations of tomorrow. But then, ironically inspite of all these excellent facilities, the birth rate in Japan is continue in decline. The alarming birth rate figure had left Japan into a futureless tomorrow within the next 50 years, accompany with huge aging unproductive problems. What is happening in Japan? If maternal and infant care is not the setback for having a baby, then what is the reason for not having babies?
Values
Risks and Perceptions
Could it be a medical issue? Could it be a moral issue? Or could it be a perception issue? Or could it be the finance burdens in raising up a child? Comparing the baby blooms immediate after WW2 and 1970s, it clearly depicts a change of value in the lives of the Japanese. Could we tell what is happening in the society?
My interest is about is there some kind of "risks" for the Japanese women to have babies? And if yes, what are their concerns?
Another interesting finding is, although there were massive screenings for congenital metabolic diseases for the babies, but in a somewhat odd contrast, intrauterine diagnoses of Down syndrome and other detectable anomalies are not actively performed. Why? Is this a cost problem? Or is this something to deal with the perceptions?
May God help us in understanding.
References: 1. Public Health Japan, 2005
