Chapter 3. Promotion Measures

Part 1. Promotion measures for Sukoyaka Family 21

The contents of the initiatives concerning the major agenda items of Sukoyaka Family 21, as discussed in Chapter 2, require the contribution of the various related parties and organizations, including healthcare, medical, welfare, education, and our services based on their respective positions, not to speak of the contributions of the people of Japan towards their attainment. Their simple inclusion in the budget as an auxiliary project or a contracted project by the Government or local public entities will not automatically produce results.

Promotion measures for executing the Sukoyaka Family 21 as a national campaign based on the fundamental concepts of health promotion will include the following three pillar items:

1) Clarification of the contents of the initiatives that can be taken by related parties and organizations;

2) Establishment of a Promotion Council for Parent and Child Health; and

3) Setting goals.

Part 2. Clarification of the contents of initiatives that can be taken by the respective organizations

The important basic standpoint is to place primary importance on the initiatives to be taken by the people in accordance with the fundamental concepts of health promotion. It is also important that the local public entities implement measures in accordance with the circumstances of their respective communities, and that related parties and organizations identify the initiatives to which they can contribute and incorporate them into their routine activities. Such initiatives must not be forced by the Government but taken voluntarily by the parties concerned.

It is important to enable the people to take initiatives towards the realization of a community, in which importance is attached to child health, appropriate support is provided for children during adolescence, thoughtful consideration is shown to parents and to couples faced with infertility, and support is provided for the development of children, whether they are healthy, disabled, or suffering from disease, and for their parents. In order to encourage such initiatives, we as the parties concerned have clarified the contents of the initiatives that can be taken by the people, local public entities, the Government, professional organizations, and civilian organizations, in this order. In doing so, we used the contents of "recognition of problems," "direction of initiatives," and "specific initiatives" for individual agenda items, which were discussed in Chapter 2.

1. The people (residents)

The people (residents) will actively participate in activities that will deepen their recognition of each agenda item, and improve the power (the power of living) of protecting one's health from the various health problems they face. The people will also regard such problems as community problems, and strive to solve them in cooperation with the related organizations.

2. Local public entities

Local public entities will need to provide active support to residents so that they can work on each agenda item as a community issue, while taking into consideration the uniqueness of the community. Different local public entities and related departments will be requested to cooperate in setting goals for each of the community's agenda items and making assessment of them, and to support seminars for the parties involved in the community as well as the activities of related organizations.

At the municipal level, which is closest to the residents, we will provide maternal and child health care services in response to the needs of the local residents. In the event of a future review of the maternal and child health plan, we will proceed with our cooperation with the organizations concerned with the participation of residents, while taking into account the objectives of "Sukoyaka Family 21."

At the prefectural level, we will need to clarify the contents of initiatives that are to be independently promoted by prefectures, and provide necessary support such as area wide liaison and information supply so as to facilitate the promotion of various initiatives at the municipal level. Public health centers play an important role in this aspect.

3. The Government

The government will strive to accumulate scientific knowledge by way of gathering necessary information and conducting surveys and research, developing health education and general education materials and holding seminars for the parties concerned. This will be intended to help the people (residents) to jointly tackle each agenda item as a community issue, and to help local public entities and the related organizations to provide active support for such activities. In addition, the government will present goals and direction, deal with public education/PR/information supply activities, as well as with the improvement of various systems and foundations, and encourage active participation of related organizations, so as to develop Sukoyaka Family 21 as a national campaign.

4. Professional organizations.

Professional organizations will actively participate in providing consultations and treatment, providing information, conducting surveys and research, educating, and developing human resources concerning the respective agenda items by using their expertise as leverage. They will also give active support to residents, and cooperate in measures taken by the Government or by local public entities.

Table 1 shows the examples of professional organizations that would be concerning the items of "Sukoyaka Family 21".

Table 1. Examples of professional organizations

5. Civilian organizations

Civilian organizations such as non-profit organizations ("NPO"s) that play a major role in lubricating communications between the people (residents), local public entities, the Government, and professional organizations through their systematic and public interests-oriented activities, will carry out their activities voluntarily and proactively.

Table 2 shows the examples of civilian organizations that would be concerning the items of "Sukoyaka Family 21"

Table 2. Examples of civilian organizations

Table 3 through Table 6 shows the initiatives that can be taken by each entity.

Table 3. Stepping up health care measures and promoting health care education for the adolescents

Table 4. Assuring safety and comfort during pregnancy and childbirth, and supporting for infertility

Table 5. Maintaining and improving the standards of child health care and medical service

Table 6. Promoting trouble-free mental development of children and alleviating anxiety about child rearing

Part 3. Establishment of a Promotion Council for Sukoyaka Family 21

In order to effectively adjust and promote the initiatives discussed in Part 2, a Promotion Council for Sukoyaka Family 21 will be established at the center of this project, which will amalgamate the action plans of the related parties, report on the progress, and supervise exchanges between the related parties. The council will provide information and gather opinions via the Internet, and conduct activities to pave the way for promotion of the national campaign through national rallies.

Part 4. Setting goals

1. Ideas concerning goal setting

In order to promote Sukoyaka Family 21 as a national campaign, it is considered important to clarify the period and specific objectives to be achieved. Accordingly, we have positioned goal setting as a major pillar of our promotion policy. We aim to have attained our goals by 2010.

In line with the basic concepts of health promotion, we devised indicators according to the three stages described below:

1)	Indicators concerning healthcare standards;
2)	Indicators concerning the voluntary activities of residents; and
3)	Indicators concerning the initiatives of the Government and related organizations.

"Indicators concerning healthcare standards" reflect the healthcare standards of residents, including the level of QOL to be attained. They also indicate the direction that the residents and related organizations should be targeting.

"Indicators concerning residents' voluntary activities" reflect the tasks to be taken up by individual residents in attaining the respective agenda items. They include indicators regarding the healthcare activities and lifestyles of parents and families and those involved with learning such as knowledge and techniques. If initiatives are to be taken by the community based on these indicators, sufficient attention should be paid so that they will not become a Government mandate to residents.

"Indicators concerning the initiatives of the Government and related organizations" reflect the initiatives that can be taken by them for the purpose of improving resources and the environment in such areas as project implementation, offering and facility improvement.

In principle, we have selected these three-staged indicators in consideration of the co-relation between themselves. In other words, "indicators concerning residents' voluntary activities" were established as a means of achieving one of the "Indicators concerning healthcare standards." Likewise, "indicators concerning the initiatives of the Government and related organizations" were established as a means of realizing the activities of residents.

Therefore, "indicators concerning healthcare standards" can be considered as the ultimate indicators that can be attained as a result of the initiatives as a whole. On the other hand, "indicators concerning the initiatives of the Government and related organizations are obligatory in nature because they are assigned as tasks to be fulfilled, and "indicators concerning residents' voluntary activities" are used to monitor the results of the initiatives taken by the Government and related organizations. Although the existence of evidence concerning the causal relationship between these interrelated indicators is usually required, the indicators we have established include those that were selected from broader perspectives, and others that are qualitative in nature and are used to determine whether or not a particular measure has been taken. The committee considers that by including them as indicators we will be able to gather a large volume of data, which may render it possible to gather evidence for the causal relationship between the indicators in the future. With regard to those whose baseline data is not available because they are still in the planning stage, we plan to carry out necessary surveys by Welfare and scientific research (General research on children and families, etc.) after the plan has been devised in order to obtain the figures that are closest to the status in 2000.

In choosing the respective indicators, we first listed up those that are related to the descriptions of the major agenda items in Chapter 2, and then strictly selected those according to the criteria such as acuteness as an indicator, clarity of interpretation, data accessibility, and elimination of redundancy in order to limit the number of indicators to the minimum. Accordingly, it should be noted that many of the subjects referred to under the major agenda items were not included as indicators. It should also be noted that the indicators were established to target the country as a whole, and therefore individual communities should set their own indicators according to their situations.

2. Process of establishing the indicators

With regard to the maternal and child healthcare plans that were prepared by and collected from 2,362 municipalities as part of the maternal and child health plans drawn up by municipalities nationwide prior to 1996, we extracted indicators which were included in the maternal and child healthcare plans of 212 municipalities where 1) the indicators concerning healthcare standards and 2) the indicators concerning the voluntary activities of residents, had already been established. At the same time, we also extracted items to be taken up as indicators based on past discussions at the committee, prioritized them according to the above standpoint, studied them at the committee, and established them as indicators for the initiatives of respective agenda items as shown in the attached table.

Attached Table: Target of the initiatives for each agenda item (until 2010)