Conclusion

Organized by 31 members, the Committee on Sukoyaka Family 21 has extensively studied the vision of maternal and child healthcare in the 21^st century. Including the inauguration meeting on February 3, 2000, we have held nine meetings to discuss four major agenda items.

At each meeting, we held free and in-depth discussions on the four major agenda items without any restrictions. In proceeding with the committee, the Secretariat prepared discussions based on opinions and materials presented by the members in advance and corrections were made at the committee. Such opinions and materials were separately compiled as a collection of materials, which comprises six separate reports totaling approximately 3,000 pages in total.

In compiling these reports, we tried to avoid abstract expressions as far as possible, with the aim of producing specific output based on the standpoint of maternal and child healthcare. However, as our study focused on four major agenda items, in some cases we had to exclude some of the valuable opinions expressed by the members concerning maternal and child healthcare. We also extensively included, as objectives, specific initiatives, which may not be implemented in the short term. Such initiatives are requested to be attained over a ten-year period from the viewpoint of improving the resources and environment of maternal and child healthcare.

The committee was open to the public. The minutes are available on the website of the Ministry of Health, Labour and Welfare for your reference along with these reports.

That there be healthy and happy parents and children is not only the hope of individual families but the hope of society as a whole. We hope that these reports will be used as the basis of a national campaign aimed at realizing communities in which priority is given to child healthcare, appropriate support is provided for children during adolescence, thoughtful consideration is given to parents as well as couples facing infertility, and appropriate support is provided to child development whether the children are healthy, disabled, or suffering from disease, and to their parents. Your understanding and cooperation in the future is highly appreciated.

In promoting the national campaign of Sukoyaka Family 21, it is also important to clarify the concept of health promotion, namely the core concepts for this campaign, and to adopt effective methods in actual implementation. Specific methods studied and proposed by the Committee include the PRECEDE-PROCEED model (or MIDORI model in Japanese), community enhancement-oriented healthcare activities, and social marketing.

While the concept of health promotion forms the basis for the promotion of Sukoyaka Family 21, the related parties should select appropriate implementation methods to suit their own circumstances

1. The PRECEDE-PROCEED model

The PRECEDE-PROCEED model is a development model for the implementation of health promotion that was developed by L. W. Green as a specific measure in line with the concept of health promotion. It has mainly been applied in Western countries. This model comprises two parts: the PRECEDE part, which covers the process from pre-assessment (or simply assessment) through planning, and the PROCEED part, which covers implementation through post-assessment (See Figure 1). These two parts are symmetrical, with the implementation stage at their center. The indicators used for the pre-assessment, which extends from the first stage through the fifth stage, are also used as assessment indicators for the processes that are the target of the post-assessment.

2. Community enhancement-oriented healthcare

"Community enhancement-oriented healthcare activities" is a model developed through the course of the daily activities of public health centers and municipalities in Japan based on the fundamental concepts of health promotion and by introducing breakthrough thinking as advocated by Nadler and others.

In this model, related parties, including residents, administrative officers, and specialists discuss plans aimed at the realization of the healthy future of their own community, execute activities based on the plans prepared, and assess and review the activities in order to move on to the next stage of development. This model extends over four periods, including a preparation period, study period for activity direction, development period, and assessment and review period. (See Figure 2) In the study period for activity direction, a participation-style objective description method is introduced. In this method, workshops are held, and participants discuss conditions for the realization of a healthy community and prepare a plan.

3. Social marketing

Social marketing is an applied science regarding merchandise development and sales and consumer relationship building, which was originally created and developed in the field of economics. Since 1970, however, it has been introduced into the social field by non-profit organizations such as government agencies. (See Figure 3)

This method has recently been introduced into the service sector including the fields of education, medical services, and public hygiene. In particular, it was adopted in the area of development of services and improvement to better respond to the needs of users. This method is useful in developing services for residents and users by regarding them as consumers. Possible applications would be the development and improvement of pediatric medical services and maternal and child healthcare services at the community level.

Sessions of the Committee for the "Sukoyaka Family 21"

List of the members of the Committee for the "Sukoyaka Family 21"

(31 members)