菅コミットメントと日本の教育・保健分野における取組（現状と課題）
DC開発フォーラムBBL
2011.3.3

JICA 人間開発部
萱島信子・亀井温子・菊地太郎

ＪＩＣＡの教育/保健協力の最近のトピックス① 教育/保健分野の協力政策/方針• ODAのあり方検討 (2010.06)
開かれた国益の増進
MDGｓ重視• 日本政府の協力政策 （2010.09 MDG10首脳会合）

菅コミットメント： 2011～2015の5年間に次の支援を行う。
保健分野50億ドル（GFへの8億ドル拠出含）
教育分野35億ドル
教育協力政策2011-2015 ~School for All～
国際保健政策2011-2015 ~EMBRACE~• JICAの協力方針 （2010.09）
教育協力ポジションペーパー
保健協力ポジションペーパー

ＪＩＣＡの教育/保健協力の最近のトピックス② 全般的な傾向

ODAのあり方検討（2010.06）→国益、MDGｓ
 新成長戦略（2010.06）→ex.パッケージ型インフラ海外展開
 ODA予算の漸減（2010年度△7.9％、2011年度△7.4％）
アジア：有償資金、インフラ重視→高等教育支援に追い風 アフリカ：技協･無償資金、MDGｓ→依然として、基礎教育/基礎保健重視ＪＩＣＡの教育/保健協力の最近のトピックス③ 教育/保健分野の円借款拡大を模索

2008年にJICAとJBIC円借款部門の統合
 教育/保健分野の円借款実績はわずか（累計実績におけるシェア2％&0.4％）


社会セクターで円借款の拡大を模索
 財政支援と技術協力のシナジーを実現したい 世銀やADBとの協調融資も是非
教育協力ポジションペーパー
なぜ教育協力を行うのか

基本的人権としての教育
2. 社会・経済開発への貢献
3. 多文化共生社会を実現するための相互理解の促進
1.

→教育はすべての開発の礎

教育協力ポジションペーパー
取り組みの重点：基礎教育
質の高い教育の普及を目指す

1.
①
②
③

2.
3.

質の向上（理数科を中心とした教師教育改善）
アクセス改善（現地業者を活用した学校建設）
マネジメント改善（住民参加型の学校運営

地域的にはサブサハラアフリカを最重点
ポストコンフリクト国への支援重視

教育協力ポジションペーパー
取り組みの重点：高等教育
1.

2.

3.

各地域/国の拠点となる中核的な大学を主な支援対象とし、教員の能力向上や研究体制の整備、マネジメントの強化などの活動を重点
組織活動強化の観点から、日本の大学も含めたネットワーク構築も重視
特にわが国の知見が豊富な工学分野での支援に重点教育協力ポジションペーパー
アプローチ
1.

2.

3.
4.

現場重視の取り組みと教育政策への反映
被援助国の教育開発計画に沿った中長期的協力の推進
ネットワーク型協力・交流の推進
成果重視の事業設計・実施・評価

基礎教育の取り組み「みんなの学校」
ミニマムパッケージ

成果(1) 民主選挙によるCOGES委員の選出

教育の機会及び質の向上(2) 学校活動計画の策定と実施(3) 行政とCOGES
連合によるモニタリン
グ

機能するCOGES（住民組織）

地域社会と学校の関係改善
住民参加の促進
地域社会の活性化（教育分野以外の活動など）

教育におけるプロセスの重要性
学校も、投入・プロセス・アウトプットから成り立っている。投入の質と量を増やすだけではなく、その投入をより有効に活かす（プロセス）ことが必要。
インプット学
習者の特性

プロセス・教師・授業・教材・学校運営・施設・カリキュラム

アウトプットアウトカム

・識字/計算能力・所得向上

・ライフスキル・価値観
・修了率/進学率

・貧困削減
・生産性
・健康

・市民社会

コンテクスト(外部要因）
コミュニティや親の教育に対する意識、社会経済状況、教育行政、文化・風習等（図：「教育の質」～JICAの基礎教育協力の改善に向けて～、2007年、JICA教育課題TF）

学校活動の例

バンコによる机と椅子
就学促進劇

夜間学習

日干しレンガ（バンコ）の教室

トイレ改善

「みんなの学校」成果と今後

 現場から政策へ
 ニジェールから周辺国への拡大 インパクト評価の導入（ブルキナファソ、セネガル） 世銀JSDF連携経験

高等教育の取り組み SEED-Net
ASEAN University Network/Southeast Asia Engineering Education
Development Network Project（AUN/SEED-Net）Top
engineering
universities
in ASEAN

University of Yangon
Yangon Technological University
King Mongkut's Institute of Technology
Ladkrabang
Burapha University
Chulalongkorn University[ASEAN 10 Countries]
19 MemberUniversities[Japan]11 Supporting Universities
Consortium (JSUC)

Hokkaido University
Keio University
Kyoto University
Kyushu University
National Graduate Institutefor Policy Studies
Shibaura Institute of Technology
Tokai University
Tokyo Institute of Technology
Toyohashi University of Technology
University of Tokyo
Waseda University
National University of Laos

Institute of Technology of Cambodia

Hanoi University of Technology
Ho Chi Minh City University ofTechnology

Universiti Sains Malaysia
University of Malaya

University of the Philippines – Diliman
De La Salle University

National University of Singapore
Nanyang Technological University

Institut Teknologi BruneiUniversiti Brunei Darussalam
Institute Teknologi Bandung
Gadjah Mada University

SEED-Netの成果
 ASEAN域内及び日本への留学による若手教員900名の学位取得（修士・博士）
 メンバー大学の大学院プログラムの改善・国際化
 700件の共同研究実施
 域内アカデミック会議の開催、1300人の教員相互派
遣等の取り組みネットワーク型協力・交流の推進の強み
 域内共通課題に対する取り組みの強化
 教育・研究の質の向上へ貢献

JICA’s Support for Achieving MDGs: Health Sector
Position Paper

Launched in September 2010

Available online at:
http://www.jica.go.jp/english/operations/thematic_issu
es/health/pdf/position_paper.pdf

Outlining JICA’s health sector cooperation for
2011-2015, to assist countries to achieve
health-related MDGsWhy [objectives]
What [priorities]
How [guiding principles]

In line with JICA’s four principles
Addressing the global agenda
 Reducing poverty through equitable growth Improving governance Achieving human security
Health Sector Position PaperWhy?

Saving Lives,Protecting Health

Building Human Resources
For Economic andSocial Development

Responding to Infectious
Diseases that Have
Impacts Beyond Borders

Priorities in Health Cooperation: Two Sub-Sectors in HealthMaternal andChild Health
WhatCross-cutting issues in health cooperation/ Challenges to the Strengthening of Health Systems

Strengthening
Capacity ofPublic
Administrationfor HealthHow

Infectious Diseases
ControlStrengthening the Capacityof Referral Health Facilities
and Coordination to Improve
the Quality of Health CareServices

Focus onCapacity Development

Evidence-based Operation
For Quality Assistance

Addressing the Shortageof Human Resources
for Health

Coordination and Alignment
To National Health PlanJICA’s Health Sector Cooperation: Why,What, How?
Why [objectives]: Saving lives, protecting health

Building human resources for economic/socialdevelopment
 Responding to infectious diseases that have impacts
beyond bordersWhat [priorities]: Achieving MDGs 4, 5 and 6
Maternaland Child
HealthInfectious
DiseasesControl

To be achieved via health system strengthening:Strengthening capacity of public administration for health Improving health facilities, strengthening referral system andcoordination to improve the quality of health care services
 Addressing the shortage of human resources for healthJICA’s Health Sector Cooperation: Why, What,How? (Cont’d) How [guiding principles]

Focus on capacity development
 Ensuring sustainability, informed byexperiences from the field Evidence-based operation for assuring
quality of assistance Coordination and alignment tonational health plans Partnering with key stakeholders,
participating in harmonization
mechanisms


NB: JICA’s position paper is also in line with theJapan’s Global Health Policy 2011-2015 (MoFA,September 2010), which aims to deliver results
effectively and efficiently by addressing
bottlenecks impeding progress on the healthMDGs.

Evidence-based operation
 Use of empirical evidence

Design, planning and implementation ofhealth sector cooperation
 Monitoring and evaluation based on
quantifiable indicators to measure theeffectiveness of capacity development inimproving health indicators
 Measuring impacts

Impact evaluation (experimental and quasiexperimental studies) & operational research To ensure quality and external accountability

Proportion of of institutional deliveries

Impact evaluation of PBF (Performance Based-Financing)

60.0
55.6

49.7

50.0

7.3 % increase
due to PBF

40.0
36.3

34.9

30.0
Baseline (2006)

Control facilities

Follow up (2008)

Treatment (PBF facilities)
20

Examples of JICA Health Programme

The Programme for the improvement of health status of people living in Upper West Region, Ghana （2005-2009）
Health status of people living in Upper West Region is improved.

PurposeProgress to date in Indicators in Upper West Region （Source：Ghana Demographic and Health Survey 03, 08）

MDG４： Infant Mortality Rate
Under-five Mortality Rate
MDG５： Births attended by skilled health professionals
MDG６： DPT（third time） Immunization Rate
Polio（third time） Immunization Rate
Measles Immunization Rate

Strategy

1. Improvement of access to andquality of health and medical services- Expansion of functioning CHPS (Community
Based Health Planning and Services) services- Improvement of referral systems- Improvement of medical services at hospitals
and health centers

Outcomes＜In 2008＞
97 / 1,000
142 / 1,000
46.2 %
94.8 %
94.8 %
96.7 %

2. Health promotion activities atcommunity level

3. Contribution to the policymaking with programme outputs- Sanitation improvement of local people- Nutrition improvement of local people- Empowerment of local communities- Reflection in the policy of the central
government- Cooperation with other donors

Grant Aid

Technical Cooperation- “The Project for Improvementof Fundamental Medical
Equipment in Upper WestRegion”（2006）- ”Scaling up of Community
Based Health Planning andServices (CHPS)
Implementation in the Upper
West Region”（2006-2010）

An activity ofa Community Health Officer＜In 2003＞
105 / 1,000
208 / 1,000
33.3 %
75.5 %
74.1 %
79.5 %

Dispatchment ofVolunteers：

JICA Ghana Office

Audio-visual education, Publichealth, Clinical / Public Healthnurse, and midwife

Meeting of local people
for health improvement- Extension Workshops- Study Tours

Polio Immunization
by a Community Health Officer

The Programme for Health System Strengthening inTambacounda and Kedougou regions, Senegal
Key Programme Objective
Contributing to the achievement of healthrelated MDGs in Tambacounda and Kedougou！
Year 2007

Year 2011

MDG4：Under-5 mortality
Rate200/1,000120 (40%reduction)

MDG5：Maternal Mortality
Ratio

800/100,000

Reduce

MDG5：% of births
attended by skilled healthpersonnel

27%

35% (30%increase)

MDG6：HIV prevalence

Partnership and Collaboration

Partnership withUNICEF, UNFPAJICA’s Programmes inWater/Sanitation andRoad construction

Policy advice bya JICA expert

Health Facilities at Regional level(Regional Hospital, etc)

Health Facilities at District level

0.4%

Ministry ofHealth andPrevention

Inputs from Japaneseside for the Programme

Maintain(Healthat lessCentres / Health Posts)
than 1.0%

Communities
Referral ofcomplicatedcases

Community sensitization onantenatal care by Japan Oversea
Cooperation Volunteers

Improvementof access tomaternal,
newborn andchild healthcare services

Implementation of the model of"evidence based maternal andnewborn health care“ by JICA project
Construction of Health Centres and
Health Posts through Grant Aid

Capacity development in healthadministration by a JICA expert
Renovation of the Regional hospitaland Health Human Resource
Centre through Grant Aid

Bangladesh: Health, Nutrition, and Population Sector Program(HNPSP), MDGs Status and Japan’s Contribution
Objectives of Health MDGs Indicators
199020072015

MDG4：Under-5
Mortality Rate

146

6048(On track)

MDG5：Maternal
Mortality Ratio

574

351

144(Off track)

MDG5：deliveries
attended by skilled
health personnel

5%

18%

50％(Off track)

0.005%

0.3%

On track

MDG6：HIVprevalence in pregnant
women in 15-24

Contribution
Verification of effectiveness andapplication as NARSINGDI model for thebetter health in other districts

Improvement of health of mothers,
pregnant women and newborn babies

Community

Safe MotherhoodPromotion Project (SMPP)
starts in 2006 for thehealth of mothers andpregnant womenCommunity support system formothers and pregnant women

Local
Gov.

Hospital

Safe delivery service withemergency obstetric care

JICA’s Health Cooperation in Africa• Started in 1960s• Contributing to the achievement of MDGs
4/5/6 in Africa
JICA’s DAH inAfrica, 2009-2010
Morocco:
MNCH• 26 countries with Technical Cooperation

Tunisia:
MNCH(additional 5 countries receiving grants only)
Egypt:
HSS

Senegal:
MNCH,HSS
Guinea:MNCH

Burkina Niger:
ATMFaso:HSSNigeria:
C d’I:
MNCH,
EPI
EPI

Chad:
EPI

• JICA’s DAH in Africa in FY2009: 4.87 bill
JPY (approx. USD 54 million)

Sudan:
Eritorea:
MNCH,
EPI, HSS
ATM,EPI,
Ethiopia:
HSS
MNCH• Combining various types of support:
TC Projects, technical advisors, trainings,
equipment/infrastructures, etc.
• Capacity development as a corner stone of thecooperation, supporting implementation of thenational health strategies in partnership withother development partners.

Sierra Leone:
HSS
DRC:
Benin:
Uganda:Liberia:
Kenya:
MNCH,
HSS
AT
M,
MNCH,
ATM, HSS
EPI, HSS
Ghana: HSS
HSSTanzania:
Burundi:MNCH,ATM, HSS Comoros:
MNCH
HSS
Angola:EPI (Grants)
EPI,Malawi:
HSS
HSS
Zambia:Mozambique:
Botswana:
MNCH, ATM,ATM, HSS
ATMHSS
Madagascar:
Namibia,
MNCH,
Lesotho,South Africa:
ATM, HSS
Swaziland:ATM, HSS Zimbabwe:
ATM
EPI

Ref: TICAD IV (2008-13) Targets forHealth JPY 43 bil. (approx. USD 477 mil.) of
technical cooperation and grand aids for Africa
includes; Improvement of 1,000 hospitals and healthcentres
 Training of 100,000 health workers

Partnering with key stakeholders,
participating in harmonization
mechanisms

Donor Congestion in Kenya
Constructed and produced by Steve Kinzett, RHSC/PATH - please communicate
any inaccuracies to skinzett@path.org or telephone +32 (0) 2 210 0221

Supplies Logistics System in Kenya (as of January 2007)

CommodityType(colour coded)

Contraceptives andRH
equipment

Condomsfor STI/
HIV/AIDS
prevention

STI
Drugs

US
A
I
DKf
W

EUU
NF
P
AW
HOUS
A
I
DKf
W

EURO
PAUNFPA

VaccinesandVitamin A

Essential
DrugsBlood
SafetyReagents(inc. HIVtests)

TB/
Leprosy

Malaria

AntiRetro
Virals(ARVs)

MOH
Equipment

Laboratory
supplies

Organization Key
Government
World Bank Loan
Bilateral Donor
Multilateral Donor
Private/NGO

Source offunds forcommodities

Procurement
Agent/Body

Point of firstwarehousing

Organization
responsiblefor delivery todistrict levels

27

Organization
responsible fordelivery to subdistrict levels

KEMSA
Regional
DepotsNLTP(TB/
Leprosy
drugs

DF
I
D

Crown
Agents

GOKW
HO

KE
M
SA

IPP
F

JICA

CI
DA

Governmentof Kenya

GA
VI

UNICEFJapanese
PrivateCompany

KEMSA Central Warehouse

KEMSA and KEMSA Regional Depots(Logistics Managagement Unit and customer service)

GDFKN
CVSIDA

DA
NIDA

GTZ
UNICEF

MEDS(procurementimplementationunit)

KEPI ColdStore

Private Drug
SourceUSGov

GOK, WB/IDA

C
DC

NPHLS
store

KEPI
(vaccinesandvitamin A)

Mainly District level staff: DPHO, DPHN, DTLP, DASCO, DPHO, etc or staff from the Health Centres,
Dispensaries come up and collect from the District level

GlobalFund for
AIDS, TB
andMalaria

MSF

PSCMC
(CrownAgents,GTZ, JSIand KEMSA)

MSF

MEDS

Provincialand District
Hospital
Laboratory
Staff

Other
NGO
Stores(e.g. MSI,FPAK)MEDS(to Missionfacilities)

Mission
Hospitals/Health Centres

NGO
clinics/centres

Development assistance for health (DAH) from 1990 to 2007

NGO and others
Bill & Melinda Gates
Foundation

GFATM、GAVI
WHO,UNICEF,UN
FPA,UNAIDS

WB/IDA,DFI

Bilateral
Agencies【Share of Japan】
3.2％($0.7bn. 2007)
Source: Development assistance for health (DAH) from 1990 to 2007 by channel of assistance retrieved fromhttp://www.thelancet.com
Vol 373 June 20, 200928

Source；IHP updateJICA’s Participation into HHA
UNFPA
AfDB
DFID

HHAUNAIDS(Harmonization for Health in Africa)

USAID

The Bank

UNICEF

Pharm.

CoP(Communities of Practice)

Governance

JICA
Infrastructure
HRH
Financeon Governance, HRH and EBPB (Evidence
based Planning and Budgeting)Regional networks in Africa

Interactive
relationshipeg. AHLMN (Africa Health
Leadership and Management Network)

Regional partners

ありがとうございました