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    037653
    Peer Reviewed

    Primary health care and health education in Japan.

    Yamamoto M

    Social Science and Medicine. 1983; 17(19):1419-31.

    The Japanese level of health is one of the highest in the world, although the level is not uniform throughtout Japan. Preventive health care services are not integrated with medical care services. While efforts are being made in the health education subsystem of the primary health care services, organization is weak and funding and training of personnel are inadequate. Health specialists have failed to grasp the real meaning of primary health care, which includes the integration of services. Medical specialists also do not fully understand the idea of comprehensive primary health care. According to the Alma Ata Declaration, a conference sponsored by WHO and UNICEF in 1978, primary health care is to be responsive to sociocultural and political conditions and intimately tied to the development of other sectors of society. The recommendations of the Conference, to be achieved by 2000 are: 1) Primary health care must be linked with all other sectors of development; 2) Maldistribution of health services facilities and personnel must be overcome, so that care is truly accessible to all people; with the help of the community, disparities in health indices can be corrected; 3) Training and education is needed to develop a full understanding of primary health care among the politicians, the administrators, the opinion leaders and the public in general; 4) Training in health education should be a part of the basic training of health policy decision makers. Health education for the public should emphasize planning and organizational skills as well as more basic health education; 5) Training and education is needed to develop among medical specialists a respect for the work of allied health professionals, an awareness of the necessity of team work in primary health care, and a willingness to participate in team efforts; 6) Medical practitioners must help foster awareness of components of healthy living and encourage lay people to assume greater responsibility to the medical practitioners; 7) Paramount is the need for integration of medical care services and health care services at all levels. The Ministry of Health and Welfare has recently proposed special legislation which would integrate health activities and medical care for the aged. Tables and charts provide statistical summaries of mortality, causes of death, age structure projections, urban-rural residence, life expectancy, medical expenditures, clinical load for physicians, number of hospital beds, and staffing of health centers for Japan and selected comparisons to other Western Countries.
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