The ecosystem approach to health is a promising strategy in international development: lessons from Japan and Laos

Background: An ecological perspective was prominently present in the health promotion movement in the 1980s, but this seems to have faded. The burden of disease the developing world is facing cannot be addressed solely by reductionist approaches. Holistic approaches are called for that recognize the fundamentally interdependent nature of health and other societal, developmental, and ecosystem related factors in human communities. An ecosystem approach to human health (ecohealth) provides a good starting point to explore these interdependencies. Discussion: Development assistance is often based on the assumption that developed countries can serve as models for developing ones. Japan has provided lavish assistance to Laos for example, much of it going to the development of transport networks. However, there is little sign that there is an awareness of the potentially negative environmental and health impacts of this assistance. We argue that the health consequences of environmental degradation are not always understood, and that developing countries need to consider these issues. The ecohealth approach is useful when exploring this issue. Summary: This article presents a brief case study of Japan\u27s development assistance to Laos, and its environmental and health implications, as an illustration of the ecohealth approach. We highlight three implications of the ecohealth perspective

ラオス中南部の農村地域における児童のタイ肝吸虫感染に関わる要因の検討

広島大学(Hiroshima University)博士(保健学)Hygienedoctora

Personal characteristics associated with handwashing behaviour among Japanese university students studying abroad: Prospective observational studies

Background: Hand hygiene is recommended to travellers to prevent common travel-related illnesses such as diarrhoea and respiratory infection. For effective hygiene promotion interventions, we aimed to identify the personal characteristics associated with handwashing behaviour. Methods: Prospective observational studies consisting of pre- and post-travel surveys were conducted among Japanese university students studying abroad between 2016 and 2018 (n = 825; 6–38 travel days). Associations of age, sex, study major, and overseas travel experience with handwashing behaviour (5-point scale) were evaluated using ordinal logistic regression models, with adjustment for destination, travel duration, and psychological factors (risk perception of diarrhoea and concern about hygiene). Results: Among the participants in our analysis (n = 629), 28.0 % washed their hands before every meal while abroad. The male sex and no overseas travel experience were associated with decreased frequency of infrequent handwashing, even after adjusting for all potential confounding factors, whereas the study major was not associated. The adjusted odds ratios (95 % confidence intervals) were 0.74 (0.56–0.99) for men vs. women and 0.69 (0.52–0.93) for no overseas travel experience vs. overseas travel experience but not to the current destination. Conclusions: The lack of overseas travel experience correlated with handwashing frequency in both men and women. In addition to the travel destination, the male sex and no overseas travel experience should be highlighted in pretravel hand hygiene interventions

Present conditions and problems of health education in Republic of Niger : The Importance of Health Education in Primary Schools in a developing country <Reports>

Recently, "school health" is drawing attention as an efficient approach in order to improve child health in the developing countries. Since 1980's, the assistance for the school health has been advancing in the world. However, there is very little information and research reports on the details of health related knowledge and behavior in primary school in developing countries. Therefore, this article aims to clarify problems of school health from a standpoint of educational cooperation. In particular, this report focused on the present conditions of health education and sanitation in primary schools of Republic of Niger of West Africa, i.e., about sanitary facilities, especially toilets and water supply system. As a result, it became clear that most of the diseases affecting Niger children on a daily basis are caused by the environment and lifestyle of the children. Meanwhile, sanitary facilities in schools, i.e. lavatories and water service were not fully utilized on a day-to-day basis. The reason was that the children haven't acquired knowledge and habit of disease prevention. At the same time, most of the teachers did not have enough time for teaching, teaching contents, nor teaching skill and experiences. As a conclusion, this article suggests that we should take health education more seriously with preventive action oriented approach aiming at the change of behaviors. Furthermore, the assistance should also be focused on improving the capacity with teaching methods at primary schools in order to address the child health problem from the educational point of view in Niger

Inclusive Education in Association of Southeast Asian Nations (ASEAN): Literature Review from 1995–2015

ArticleSchool Health. (13):20-29(2017)journal articl

School-based interventions to promote adolescent health: A systematic review in low- and middle-income countries of WHO Western Pacific Region.

BACKGROUND:In the World Health Organization Western Pacific Region (WHO WPRO), most adolescents enroll in secondary school. Safe, healthy and nurturing school environments are critical for adolescent health and development. Yet, there were no systematic reviews found on the efficacy of school-based interventions among adolescents living in low and middle income countries (LMIC) in the Region. There is an urgent need to identify effective school-based interventions and facilitating factors for successful implementation in adolescent health in WPRO. METHODS:For this systematic review, we used five electronic databases to search for school-based interventions to promote adolescent health published from January 1995 to March 2019. We searched RCT and non-RCT studies among adolescents between 10 to 19 years old, done in LMIC of WHO WPRO, and targeted health and behaviour, school environment and academic outcomes. Quality of studies, risk of bias and treatment effects were analyzed. Effective interventions and implementation approaches were summarized for consideration in scale-up. RESULTS:Despite a broad key term search strategy, we identified only eight publications (with 18,774 participants). Most of the studies used knowledge, attitudes and behaviours as outcome measures. A few also included changes in the school policy and physical environment as outcome measures while only one used BMI, waist circumference and quality of life as their outcome measures. The topics in these studies included: AIDS, sexual and reproductive health, de-worming, nutrition, obesity, tobacco use, and suicide. Some interventions were reported to be successful in improving knowledge, attitudes and behaviours, but their impact and scale were limited. The interventions used by the different studies varied from those that addressed a single action area (e.g. developing personal skills) or a combination of action areas in health promotion, e.g. developing a health policy, creating a supportive environment and developing personal skills. No intervention study was found on other important issues such as screening, counseling and developing safe and nurturing school environments. CONCLUSIONS:Only eight school-based health interventions were conducted in the Region. This study found that school-based interventions were effective in changing knowledge, attitudes, behaviors, healthy policies and environment. Moreover, it was clarified that policy support, involving multiple stakeholders, incorporating existing curriculum, student participation as crucial factors for successful implementation

School Health: an essential strategy in promoting community resilience and preparedness for natural disasters

Background: The Third UN World Conference on Disaster Risk Reduction recommended the implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030, which aims to achieve substantial risk reduction and to avoid various disaster-associated losses, including human lives and livelihoods, based on the lessons from the implementation of the Hyogo framework. However, the recommendations did not lay enough stress on the school and the Safe School Concept, which are the core components of a disaster response. Objective: To raise the issue of the importance of schools in disaster response. Results: For human capacity building to avoid the damage caused by natural disasters, we should focus on the function of schools in the community and on school health framework. Schools perform a range of functions, which include being a landmark place for evacuation, acting as a participatory education hub among communities (students are usually from the surrounding communities), and being a sustainable source of current disaster-related information. In 2007, the Bangkok Action Agenda (BAA) on school education and disaster risk reduction (DRR) recommended the integration of DRR into education policy development, the enhancement of participatory mechanisms to improve DRR education, and the extension of DRR education from schools to communities. Based on our discussion and the recommendations of the BAA, we suggest that our existing challenges are to construct a repository of disaster-related lessons, develop training materials based on current information drawn from previous disasters, and disseminate the training to schools and communities. Conclusions: Schools linked with school health can provide good opportunities for DRR with a focus on development of school health policy and a community-oriented participatory approach

Surveying factors related to primary school children's Opisthorchis viverrini infection in rural central-southern Laos : Relationship between children's and their guardian's habit of eating raw fish and children's Opisthorchis viverrini infection

本報告は, ラオス中南部の農村地域において, 児童のタイ肝吸虫(Opisthorchis viverrini : O. viverrini)感染に関わる要因を検討するために, 対象児童とその家族の日常的な魚の摂取習慣(リスクフィッシュおよび生魚の摂取習慣)と児童のタイ肝吸虫感染の状況との関係を明らかにした. 59組の児童(タイ肝吸虫感染が認められた子どもと認められなかった子ども)の養育者(親)に対して面接調査を実施し, 家族が頻繁に食べる魚, 家族が生で頻繁に食べる魚, 対象児童が魚の生摂取を開始した年齢について回答を得た. その結果, 対象地域では, リスクフィッシュが頻繁に摂取されていた. 家族が頻繁に摂取しているリスクフィッシュ, 生で頻繁に摂取している魚の種類は, 感染群と非感染群の間で有意な差は認められず, 家族の魚の摂取習慣が子どものO.viverrini感染に与える影響は十分に確認できなかった. 一方, 感染群は非感染群に比べて生魚の摂取経験を持っている児童が有意に多く, 児童が幼児期や学童期から生魚の摂取を開始することが, 児童のタイ肝吸虫感染と関連する一因となっていることが示唆された.To identify risk factors related to children's O. viverrini infection in the central-southern rural area of Laos, we clarified relationships between children's O.viverrini infection and children's and their guardian's habit of eating fish( risk fish and raw fish) in their daily life. To address the present aim, we conducted face to face interviews with 59 paired children's guardians, who were composed of case (children with O.viverrini infection) and control (children without O.viverrini infection) groups. Concretely, we asked what kinds of fish they ate frequently and ate raw frequently in their daily life. In addition, we asked about their children's experience and their starting age for eating raw fish. Based on these results, it was found that the risk fish was frequently eaten. However, we could not clear identify a relationship between children's O.viverrini infection and their frequent eating of risk fish and eating them raw in the family. On the other hand, the children in the case group had more experience of eating raw fish than those in the control group. Therefore, it was suggested that eating raw fish from early childhood might be one of the risk factors for children's O.viverrini infection in this area