Update: 5/25/2023

Welcome to Japan's Public Health Nursing Information Website!
In Japan, more than 70 years have passed since the Act on Public Health Nurses,
Midwives, and Nurses, which manages public health nurse (PHN) qualifications, came into
effect in 1948. We created this website to allow people from all over the world to learn more
about the basics of public health nursing practice in Japan. We hope this website will be usefulto all of you.
I. Public Health Nursing as defined by Japan Academy of Public Health Nursing
Since its founding in 2012, the council of Japan Academy of Public Health Nursing hasdeliberated on the definition of the terms "public health nursing practice", "public healthnursing science", and "public health nurses", occasionally soliciting public comments on theseterms. The final definition of these terms was approved by the council in April 2014. In
addition, the system of public health nursing science was examined and approved by the by
the council in 2017.
- Japan Academy of Public Health Nursing“ The Definition of Public health Nursing”
https://japhn.jp/wp/wp-content/uploads/2017/05/def_phn_en.pdf“The System pf Public Health Nursing Science#https://japhn.jp/wp/wp-content/uploads/2022/05/phn_system_en_220512.pdf
II. Public health-related policies and statistics
This section contains links to information regarding public health-related policies,
statistics, and other data.
- Ministry of Health, Labour and Welfare“Annual Health ,Labour and Welfare Report”
https://www.mhlw.go.jp/english/wp/index.html- Japan Public Health Association“Public health in Japan 2021”
http://www.jpha.or.jp/sub/pdf/PHJ2021.pdf- Japanese Nursing Association

Update: 5/25/2023“Nursing in JAPAN”
https://www.nurse.or.jp/english/assets/nursing/nursing-in-japan-en.pdf
III. Public health nursing in Japan•

Regulations on Public Health Nurses
The enactment of Regulations on Public Health Nurses in 1941 provided a regulatory

framework for certifying public health nurses (PHNs). Several years later, the Act on Public
Health Nurses, Midwives and Nurses (Act No. 203 of 1948) was passed and the PHN has
become one of the national qualifications that is awarded only to those individuals who havepassed a national examination. The purpose of the Act on Public Health Nurses, Midwives
and Nurses is to improve the quality of PHNs, midwives, and nurses, and to thereby expand
and improve medical care and public health. 1) According to this Act, the term "Public Health
Nurse" refers to a person who, under licensure from the Minister of Health, Labour andWelfare, uses the title "Public Health Nurse" and provides health guidance as part of his/herjob.
A person seeking to become a PHN must pass the National Public Health Nursing
Examination and the National Nursing Examination, and must receive licensure from the
Minister of Health, Labour and Welfare.1) In other words, only government-certified
individuals are permitted to use the title "Public Health Nurse".

2. Education and Training of PHN
This section provides links to information regarding the PHN training programs
available in Japan.
１）Education System of PHN- Japanese Nursing Association（Nursing in JAPAN）“Nursing Education in Japan”
https://www.nurse.or.jp/jna/english/nursing/education.html#basic- Japan Academy of Community Health Nursing（Newsletter No.10）
http://jachn.umin.jp/newsletter/10.NewsFromJACHN2010.pdf
The regulation on designation PHN was amended to increase the total number of credits from28 credits to 31 credits, effective April 1, 2021.

Update: 5/25/2023

２）New Nursing Staff Training Guidelines ~ Public health nurse edition ~ （In Japanese）- Ministry of Health, Labour and Welfare
https://www.mhlw.go.jp/bunya/iryou/oshirase/dl/130308-3.pdf

3. Number of certified public health nurses in Japan
This section provides figures and tables showing changes in the number of certified
PHNs in Japan.
According to the information provided on this webpage, there are currently 55,595
employed PHNs (Female: 53997, Male:1598), in Japan as of the end of 2020 whichcorresponds to a rate of 44.1 per 100,000 population. You can see the Changes in the Numberof Employed Public Health Nurses by Place of Work in table 1. Also, you can view the 2020
data on certified PHNs in Japan on the following webpage:- Public Health Administration Report 2020: "Number of Employed Public Health Nurses by
Place of Work", Ministry of Health, Labour and Welfare.
https://www.mhlw.go.jp/toukei/saikin/hw/eisei/20/dl/kekka1.pdf
Table 1. Changes in the Number of Employed Public Health Nurses by Place of Work
Year
Total

1996

1998

2000

2002

2004

2006

2008

2010

2012

2014

2016

2018

2020

31581

34468

36781

38366

39195

40191

43446

45028

47279

48452

51280

52 95555595

Public Health Centers

8887

7888

7630

7670

7635

7185

6927

7131

7457

7266

9204

9451

9952

Municipal Offices

15641

18336

20646

21645

22313

23455

24299

25502

26538

27234

28509

29666

30450

Hospitals

1615

1744

1770

1653

1858

1904

2770

2791

3019

3075

3271

3307

3559

Clinics

1362

1448

1388

1427

1193

1257

1392

1497

1661

1757

1930

2003

2301

Home-visit Nursing Stations

456

657

638

497

487

309

276

268

250

275

315

259

307

Long Term Cere Insuarance Facilities

70

54

52

629

542

571

533

447

379

460

1027

1336

1603

Social Welfare Facilities

448

542

627

472

471

337

390

417

409

490

412

421

519

Business Institutions

1475

1659

1672

1910

2415

2437

3524

3532

4119

4037

3079

3349

3789

Nursing School Training center
orResearchIinstitute
OthersNumber of public health nurses per
100,000 population

379

519

641

826

841

884

983

1075

1119

1210

1188

1148

1194

1248

1621

1717

1737

1440

1852

2352

2368

2328

2648

2342

2015

1921

27.3

29.0

30.1

30.7

31.5

34.0

35.2

37.1

38.1

40.4

41.9

44.1

Source: Public Health Administration Report by the Ministry of Health, Labour and Welfare,which, up until 1998, was referred to as Ministry of Health and Welfare Report. (The numberof PHNs employed at midwifery homes is included in the"Others" category).
4. Roles and responsibilities of public health nurses
Due to the social changes that have taken place in recent years, health issues in JapanUpdate: 5/25/2023

have become more diversified and complex than ever. Consequently, PHNs are increasingly
faced with the challenge of coping with serious problems, such as abuse, disaster,
communicable diseases and health crisis incidents. Public health nursing services are
therefore needed in various fields, and as a result, work settings of PHNs have diversified andbroadened a great deal. However, according to data reported by the Ministry of Health,Labour and Welfare, which shows the number of PHNs by place of work, the majority(approximately 70%) of PHNs work at public health centers, municipal offices, or othersimilar public institutions.
To help not only individuals at various stages of life and disability (and their family) but
also communities (including groups, organizations, and geographic regions) improve theirability to promote health, PHNs are taking comprehensive action to secure the availability of
the resources needed to achieve this goal.

Nursing School Training center Others
3%
orResearchIinstituteBusiness Institutions
2%
7%
Social Welfare and Long
Term Institution
4%

Medical Institution
11%

Public Institution
73%

Source: Public Health Administration Report 2020, Ministry of Health, Labour and Welfare.

Figure 1. Percentage of public health nurses' workplaces
1) Public institutions
Figure 2 shows changes in the number of full-time public health nurses working in theautonomous community.
https://www.mhlw.go.jp/toukei/saikin/hw/hoken/katsudou/09/dl/ryouikichousa_r04_1.pdf

Update: 5/25/2023*Cities or Special Districts Where a Public Health Centers is Established (2)Source: Ministry of Health, Labour and Welfare “Public health nurse activity area survey”
Figure2.Changed in the Number of Full-time Public Health Nurses Working in Each
Communities(1) Public health centers (established in prefectures or designated cities and special districts)
A public health center is an organization governed by the Community Health Act. It isestablished not only in each prefecture to provide health services to multiple municipalities
within the prefecture but also in each government-designated city or major urban area(including the special district of Tokyo) that is allowed to have a dedicated public healthcenter.
The PHNs working at public health centers collaborate with other healthcare
professionals and institutions to identify health care issues. They also engage in a wide rangeof professional activities to serve the community, including promoting measures to prevent
lifestyle-related diseases, suicides, domestic and child abuse, providing support to help people
suffering from incurable diseases, responding to infectious disease outbreaks and publichealth emergencies. Furthermore, they analyze the results of various surveys (including vitalstatistics surveys) conducted by public health centers to develop health programs and toestablish a comprehensive system for delivering effective health, medical, welfare, and nursing
services. PHNs contribute to community health promotion by strengthening collaboration
among the municipal authorities that are under the jurisdiction of specific public healthcenters, by providing professional advice and support to them, and by serving as coordinators
to facilitate communication among the relevant parties. PHNs also contribute to improving

Update: 5/25/2023

the quality of healthcare services available within the community by providing guidance tomedical facilities, by reviewing and making improvements to various health programs and by
assisting in human resources developmental efforts.
(2) Health centers (municipalities)
The Community Health Act mandates that a health center be established in each
community. PHNs working at health centers encourage community citizens to actively takepart in improving their own health by working alongside them, by making home visits oroffering health guidance when needed also by providing health seminars and health checkups,
and by engaging in community activities.
Their primary job responsibility is to identify the characteristics and health issues of thecommunity to provide personal services aimed at the primary prevention of diseases.
Specifically, health centers provide the following types of services: maternal and child healthservices (infant health checkups and parenting support programs), adult health services(lifestyle-related disease prevention programs, mental health care programs, welfare services
for persons with disabilities, and woman protection programs), and elderly health services(programs designed to prevent the elderly people from becoming dependent on long-termcare and to help them live a meaningful life). To eliminate health inequities and to promote
the efforts to improve community health, PHNs collaborate with community organizations,
volunteer groups, and other relevant institutions to not only create and effectively use social
capital but also ensure that the community has the necessary resources to cope with natural
disasters or other potential health crises.
2) Business establishments
PHNs working for a company or business institution are called "occupational healthnurses". Governed by the Industrial Safety and Health Act, occupational health nurses arecommitted to managing and improving the health and safety of both employers and employees
through collaboration with industrial physicians and health supervisors.
Their tasks can be largely categorized into the following five types: (1) health management(physical checkups, stress check, health guidance, etc.), (2) work environment management(removal of factors that are detrimental to health and creation of a pleasant working
environment), (3) work management (encouragement of a proper working posture,
management of working hours, etc.), (4) overall management (establishment of a corporate
system for ensuring occupational safety and health, promotion of measures for improving
occupational health, etc.), and (5) occupational health education (provision of education toUpdate: 5/25/2023

employees upon employment or upon assignment to either new or hazardous duties to ensurethat they understand not only their work but also what they should do to stay healthy).
Prevention of work-related injuries and accidents were the primary issues of concern during
the post-war period of rapid economic growth. However, greater emphasis has been recently
placed on preventing lifestyle-related diseases and mental health issues (such as depression)
through collaboration with human resources and labor divisions. Furthermore, globalization
has led to the need to deal with emerging infectious diseases and terrorist threats.
There are also public health nurses who work for medical insurers under the Health
Insurance Act. Public health nurses contribute to the health care of workers and their families
who join the medical insurer. For example, the public health nurses analyze healthexaminations and medical cost data and provide health guidance to prevent the aggravationof metabolic syndrome and diabetes.
3) Schools
At schools, certified nursing teachers take charge of all matters concerning the healthcare
and health education at school. Governed by the School Health and Safety Act, nursing
teachers are responsible for managing the health and safety of all students (including infants
and children) and school staff. In addition to offering education and guidance on healthrelated matters, nursing teachers provide physical checkups and health counseling to school
children and staff and are responsible for managing and preventing infectious diseases atschool. They also contribute to improving community health by using the school as a channel
for reaching out to and providing health education to the community residents throughcollaboration with the relevant institutions. PHNs working at a university or other educational
research institutions (i.e. faculty members who are also certified PHNs) take part in training
students in accordance with the educational principles set out by the institution and based on
the PHN/nurse education curriculums. They also engage in research activities concerning
public health nursing, thereby contributing to the development of public health nursing
science and improvement of nursing practice.
4) Social welfare facilities
There are mostly two types of social welfare facilities that PHNs work for, namely thosethat serve elderly people and those that serve children.
The former includes social welfare councils, elderly citizens' welfare centers, geriatrichealth services facilities, and so on. At these facilities, PHNs engage in activities to improvethe elderly's health, offer general counseling to them, and provide the necessary support toUpdate: 5/25/2023

their family.
Community General Support Center for elderly citizens is a facility established (2005)
under the supervision of the municipal government based on the Long-Term Care Insurance
Act. This facility, which is run either directly by the municipal government or by the social
welfare corporation designated by the municipal government, provides comprehensive
support to help elderly citizens live a better life. PHNs working for this facility offer caremanagement services to prevent elderly citizens from becoming dependent on long-term care,take part in the projects aimed at protecting the rights of the elderly and people withdisabilities, and play an important role of serving as mediators or coordinators to promote andstrengthen collaboration and communication among health institutions, medical institutions,and welfare institutions within the community.
Social welfare facilities serving children include day-care centers and long-term carefacilities for children in general as well as children (and other people) with disabilities. PHNs
working at these facilities collaborate with the nursery school teachers and other staff tomanage children's health and environment. In line with this, increasingly more PHNs havebeen recently assigned to work for child consultation centers, where they provide care tochildren with disabilities as well as to children suffering from post-traumatic stress disorder
as a result of abuse. These PHNs also provide information to, and facilitate communication
among, the relevant institutions to ensure that children get the necessary support.
5) Medical institutions (hospitals, clinics, etc.)
At medical institutions, such as hospitals and clinics, PHNs are assigned to divisions, suchas the collaborative community health care office, health guidance office, or discharge support
office.
PHNs assigned to the collaborative community health care office collaborate with other
health care professionals both inside and outside the hospital as well as with the relevant
institutions to review and make improvements to the patient support policy. They also provide
guidance and consultation to patients as well as their families. PHNs assigned to the healthguidance office regularly check patients for signs of lifestyle-related diseases or other illnesses,
provide health guidance and education to patients identified as having health problems, andhelp hospital staff maintain their health. PHNs assigned to the discharge support officecollaborate and coordinate with the local health and welfare divisions, home-visit nursing
stations, and other relevant institutions to secure the necessary support to both patients andtheir family so that patients discharged from the hospital can continue to convalesce at home.
They also provide consultation and support to patients and their family when necessary.

Update: 5/25/2023

References<Related to Public Health Center>
1.Yoshioka-Maeda K.Developing sustainable public health care systems for responding to
COVID-19 in Japan. Public Health Nurs.2021. doi: 10.1111/phn.12861.
2. Yoshioka-Maeda K, Shiomi M, Katayama T, Hosoya N. Impact of web-based learning for
health program planning competency, knowledge and skills among mid-level public healthnurses: A randomized controlled trial. Public Health Nurs. 36(6):836-846.2019<Related to Community General Support Center for elderly citizens>
1.Yamaguchi Y. Current status of operations in community general support centers and thecorrelation of personal traits, work environment and occupational stress. Sangyo Eiseigaku
Zasshi. 52(3):111-22.2010<Related to Occupational health>
1.Yoshikawa E, Sawai M, Kakemoto S. Education systems for occupational health nursing in
the basic education course for public health nurses in Japan. Sangyo Eiseigaku Zasshi.
25;61(1):16-23. 2019
2. Kubo Y, Hatono Y, Kubo T, Shimamoto S, Nakatani J, Burgel BJ. Exploring career anchors
among occupational health nurses in Japan: A qualitative study. Jpn J Nurs Sci.
14(1):61-75.2017
3. Ikeda T. The role and future task of the occupational health nurse. J UOEH.35 Suppl:5966.2013<Related to School health>1.Tomokawa S, Miyake K, Asakura T. Sustainable human resource training system forpromoting school health in Japan. Pediatr Int. 62(8):891-898. 2020.