Making healthcare services more widely available is essential for people around the world to lead healthier lives. One of the missions of Japan’s National Center for Global Health and Medicine (NCGM) is to engage in international healthcare collaboration. How is it tackling this challenge?
Many people in the world still lack access to adequate healthcare services. Given this situation, the Japanese government has been promoting global health as a priority area for international cooperation, with the National Center for Global Health and Medicine (NCGM) at the core of this initiative. The NCGM conducts research and develops technology for infectious diseases and other illnesses, while also being involved in international healthcare collaboration through research and training for technical specialists.
Dr. OBARA Hiromi, an obstetrician-gynecologist at the NCGM’s Bureau of International Health Cooperation, is originally from Aomori Prefecture in northern Japan. Born and raised in a sparsely populated region with no large hospitals nearby, she recognized the disparity in medical care between urban and rural areas. When Obara joined an NGO with activities based in Cambodia during her fourth year of medical school, she learned that global disparities in healthcare are beyond comparison in terms of their severity, which eventually led to her decision to pursue a career in international health. At the time, the concept of sexual and reproductive health and rights was just beginning to attract the international medical community’s attention. With the prospect of being involved in issues related to women’s lifelong health, such as childbirth, Obara decided to major in obstetrics and gynecology.
From 2001 to 2003, she was involved in a project in Cambodia for maternal and child health run by the Japan International Cooperation Agency (JICA) as a long-term expert in obstetrics and gynecology. She assisted doctors and midwives working in rural areas of Cambodia, which had lost many such healthcare workers during its civil war. With Japanese grant aid, JICA established the National Maternal and Child Health Center (NMCHC) in Phnom Penh, Cambodia’s capital. During the course of the project, the medical staff at the NMCHC led training for workers in the same professions in rural areas. Obara and her JICA team helped design the training and midwifery support programs, which are tailored to the level of medical care and locally available resources in each area.
In 2005, she joined the International Medical Center of Japan, the NCGM’s predecessor, because she wanted to be fully involved in international healthcare cooperation. She spent 12 years in three countries, collaborating with medical professionals and health administrators in each country to improve maternal and child healthcare systems.
At a conference held in Tokyo by the WHO Western Pacific Regional Office under the co-sponsorship of the NCGM, the administrative officer of the Lao Ministry of Health presented a “Plan to Improve the Quantity and Quality of Newborn Care.” Dr. OBARA Hiromi is on the far right of the photo.
Leveraging her experience in several low- and middle-income countries, Obara has served on many committees to formulate the guidelines of the World Health Organization (WHO) on maternal and child healthcare. She believes her role is to be the voice for those working in medical settings in such countries. She said, “To ensure that guidelines will be implemented properly in each country, I try to provide technical information that will make these guidelines easy to understand and implement as well.”
The goal of the NCGM’s Bureau of International Health Cooperation is to achieve universal health coverage (UHC), which means all people having access to appropriate and affordable services that promote health and provide preventive care, medical treatment, and rehabilitation. Obara said, “There are people in the world who can’t receive healthcare because they can’t afford the medical bills or the cost of transportation to hospital, while others hesitate to seek care because they are unaware that they have access to their country’s health insurance system. In Laos, we made sure that the Maternal and Child Health Handbook indicates that giving birth is free.” She feels that in order to achieve UHC, steady action is required to ensure that the fundamentals of basic healthcare services are provided and are accessible to more people.
Left: Obara (right) with a WHO official at a meeting to modify and finalize the Maternal and Child Health Handbook in Laos.
Right: The Maternal and Child Health Handbook in Laos that Obara and others were involved in producing. The handbook includes such messages as the statement that giving birth is free, informing people of the availability of various systems related to maternal and child healthcare.
“We’re not doing anything extraordinary. I hold profound respect for the local people and their enthusiasm,” Obara said modestly. However, the work she and her colleagues have put in to build trust with communities is the cornerstone of the wider effort to bring healthcare services to people around the world.