At a conference held in Tokyo by the WHO
Western Pacific Regional Office under the cosponsorship of the NCGM, the administrative
officer of the Lao Ministry of Health presented a“Plan to Improve the Quantity and Quality ofNewborn Care.” Dr. OBARA Hiromi is on thefar right of the photo.

STEADY PROGRESS TOWARD

ELIMINATINGGLOBAL HEALTHCAREDISPARITIESMaking 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 ininternational healthcare collaboration. How is it tackling this challenge?
Many people in the world stilllack access to adequate healthcare
services. Given this situation,
the Japanese government has
been promoting global health asa priority area for international
cooperation, with the National
Center for Global Health andMedicine (NCGM) at the coreof this initiative. The NCGM

conducts research and develops
technology for infectious diseases
and other illnesses, while also
being involved in international
healthcare collaboration throughresearch and training for technicalspecialists.
Dr. OBARA Hiromi, anobstetrician-gynecologist at theNCGM’s Bureau of InternationalHealth Cooperation, is originallyfrom Aomori Prefecture in
northern Japan. Born and raised
in a sparsely populated region
with no large hospitals nearby,
she recognized the disparity inmedical care between urban andrural areas. When Obara joined
an NGO with activities based in
Cambodia during her fourth yearof medical school, she learned that
global disparities in healthcare arebeyond comparison in terms of
their severity, which eventually
led to her decision to pursue acareer in international health.
At the time, the concept ofsexual and reproductive healthand rights was just beginning to

attract the international medicalcommunity’s attention. With
the prospect of being involved inissues related to women’s lifelong
health, such as childbirth, Obara
decided to major in obstetrics andgynecology.
From 2001 to 2003, she wasinvolved in a project in Cambodia
for maternal and child healthrun by the Japan International
Cooperation Agency ( JICA) as along-term expert in obstetrics andgynecology. 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 theNational 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 thesame professions in rural areas.
Obara and her JICA team helped
design the training and midwifery
support programs, which are
tailored to the level of medicalcare and locally available resourcesin each area.
In 2005, she joined theInternational Medical Center ofJapan, the NCGM’s predecessor,
because she wanted to be

fully involved in international
healthcare cooperation. Shespent 12 years in three countries,
collaborating
withmedical
professionals
andhealthadministrators in each country
to improve maternal and childhealthcare systems.
Leveraging her experience inseveral 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 thevoice for those working in medical
settings in such countries. She
said, “To ensure that guidelines
will be implemented properlyin each country, I try to provide
technical information that will
make these guidelines easy tounderstand and implement aswell.”
The goal of the NCGM’s
Bureau of International Health
Cooperation is to achieve
universal
healthcoverage(UHC), which means all people
having access to appropriate andaffordable services that promotehealth and provide preventive
care, medical treatment, andrehabilitation. Obara said, “Thereare people in the world who can’t
receive healthcare because they
can’t afford the medical bills or thecost of transportation to hospital,
while others hesitate to seek carebecause they are unaware thatthey have access to their country’s
health insurance system. In Laos,
we made sure that the Maternaland 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 areprovided and are accessible tomore people.
“We’re not doing anything
extraordinary. I hold profoundrespect for the local people andtheir enthusiasm,” Obara saidmodestly. However, the work she
and her colleagues have put into build trust with communities
is the cornerstone of the wider
effort to bring healthcare services
to people around the world.

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.