JNA News Release2015. October Vol.18

JNA News Release
Japanese Nursing Association
5-8-2 Jingu-mae, Shibuya-ku, Tokyo 150-0001, JAPAN

Tel: +81-3-5778-8559

Fax: +81-3-5778-8478

http://www.nurse.or.jp/jna/english/

The 11th ICM Asia Pacific Regional Conference was Held
JNA co-hosted the 11th ICM Asia Pacific Regional
Conference (ICM-APRC) in Yokohama, Japan, from July
20th to 22nd of 2015, with the Japanese Midwives
Association and the Japan Academy of Midwifery. The
conference theme was “Midwifery Care for Every Motherand Their Newborn.” This ICM-APRC was attended byapproximately 3,200 midwives and midwifery students
from 37 countries and regions mainly in Asia and thePacific and was featured with 212 oral and 440 poster
presentations.

Flag ceremony at the 11th ICM Asia Pacific Regional Conference

JNA President, Suga Sakamoto, who acted as Conference President for this 11th ICM-APRC, gave a
Conference President’s Lecture and stated the following points. “The current situations and issues inmaternal and child health around the world and in Japan signify the need for midwives to fully exert theirexpertise and to actively take roles they are supposed to play. In Japan, we are facing the quantity and quality
issues caused by circumstantial changes surrounding perinatal care, such as the uneven distribution ofworking midwives among healthcare facilities and the limited opportunities for midwives to acquire andaccumulate experiences in various types of midwifery practice. To address these issues, JNA has been
cooperating with other domestic midwifery organizations and undertaking various initiatives. Through thisICM-APRC, I wish all the participants to vigorously discuss and share your issues and initiatives in order tounitedly dedicate yourselves to our midwifery mission, ‘Midwifery Care for Every Mother and Their Newborn.’”
In regards to international meetings relating to ICM, the 31st ICM Triennial Congress will be held in Toronto,
Canada from June 18th to 22nd of 2017.

Baseline Survey on the Fundamentals of Public Health Nurse Activities was
conducted
JNA conducted the Baseline Survey on theFundamentals of(PHN)

environment. JNA has been conducting the survey

Activities from August to October 2014. The aim ofon PHNs since 2009, with this survey in 2014

the survey is to reveal problems surrounding PHNsi),(Number of responses = 23,502) being the third one.

who address the ever-changing health issues, and to

The findings from this survey are as follows.

reflect its findings in policy recommendations. Such

【In-service training structure】

problems

ones

in

PHNs’

operational

Approximately 70% of respondents had taken

structure, the current situation of their in-service

training for newly appointed PHNs. Approximately

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includePublic Health Nurse

education and training structure, and their activity

JNA News Release2015 Vol.18

30% of respondents, who are already in a position

PHNs (75.5%), and coordination and cooperation

that

or

outside their local government (66.3%). It has been

management-stage training, had not taken theirmore than one year since the “Notification of Public

respective training courses. The most common

Health Activities by PHNs”iii) in 2013 stated that it

reasonor

was desirable to assign “PHNs taking integrative

management-stage training was “such training is notroles.” These results revealed the current situation ofavailable.” Also, among the skills recognized by

PHNs-IC. It could be assumed that the job

respondents as necessary for their current duties,

description about a PHN-IC stated in the scope of

items ranked highest were “project planning”

duties led to a greater awareness of its roles in each(42.9%), “individual and family support” (42.0%), andlocal government and consequently contributed to“cooperation, coordination and social resource

PHNs-ICdevelopment” (38.0%). These results revealed thatcross-sectionally.

the current training structure for human resource【Maternity leave and childcare leave】

necessitates

for

not

takingtakingmiddle-careerthe

middle-careerdevelopment at different career stages is not

more

integrativeroles

The average number of times to take maternity or

satisfactory.

childcare leaves for respondents who already had【PHNs for Interdepartmental Coordination】

these leaves was 1.1 times, with the total average

PHNs

for

Interdepartmental

Coordination

length of 2.0 years. Also, among items as support(PHNs-IC)ii) are to be defined as PHNs taking

after returning to work, those with a larger gap

integrative roles and coordinating and facilitating

between “received”/“think needed” were “allocation

public health activities of PHNs cross-sectionally.

of persons to consult” (25.1% / 86.2%), “provision ofConsidering the above role and function to be theinformation on new systems, legal amendments,

only

training etc.” (36.3% / 90.0%), and “support in taking

respondents working in local governments, such as

training, lectures etc” (34.0% / 83.3%). These results

prefectural and municipal offices and public healthrevealed that all items as support after returning tocenters, were asked whether they were a PHN-IC.

work were “think needed” more than actually

6.1% answered yes and, among those answered“received,” even though several other items not

yes, 29.5% had a job description about a PHN-IC

mentioned above were also included in this survey.

stated in the scope of duties for their local

It is extremely important to build a support systemdefinitionofgovernment.

PHNs-IC

There

inrespondents, who answered they were a PHN-IC

professionalism and pursue career development

and had the job description, to practically take morewhile maintaining their work-life balance. This survey

integrative roles cross-sectionally, comparing todisclosed and identified needs of PHNs, including

those who did not have the job description. Also,

stating the job description about a PHN-IC clearly incommonthe scope of duties. JNA will take these needs into

performed

andasurvey,and environment that allow PHNs to retain their

roles

was

this

the

coordination

tendency forbycooperation

PHNs-IC

werecross-sectionallywithin their local government as a representative ofi)performing

consideration

andcontinues

to

make

policyrecommendations related to PHNs.

For information on PHNs in Japan, please refer to PHNs’ Activities and Their Activity Areas on Page 3.

ii), iii) For more information on PHNs-IC and “Notification of Public Health Activities by PHNs,” please refer toLearn More about Related Topics in Nursing on Page 5.

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JNA News Release2015 Vol.18
PHNs’ Activities and Their Activity Areas:

A "Public Health Nurse (PHN)" is a person under licensure from the Minister of Health, Labour and Welfare to use
the title of Public Health Nurse and provide health guidance as a profession (Article 2 Chapter 1, the Act on Public
Health Nurses, Midwives, and Nurses). After the enactment of the regulation for PHNsi) in 1941, PHNs became legal
qualifications.
PHNs’ activities have addressed health issues (see Table 1), being consistently and directly related to transitionalchanges in society’s needs and government policies. The scope of their activities has been increasingly expanding as
additional health issues emerging along with transitions in the times. Based on this fact, it could be said that PHNs’
activities in Japan have developed and advanced from the need to tackle and solve national health issues.
Activity site of PHNs (see Table 2) includes such as local government, welfare, industry, medical care, andeducation. Main duties of PHNs depend on which activity site each PHN belongs to.
Table 1：Overview Transitional Changes in Health Issues Addressed by PHNs 1)
2008～
1998～

Measures for suicide・Life-style related disease (NCDs) prevention

Long-term care insurance・Healthy Japan 21・Health risk management

1989～ Health and welfare measures for the elderly・Support for parenting
Publ
1985～ Network among public health, health care, and welfare・QOL activities
1975～
1965～
1955～
1945～

Health projects for the elderly・Health promotion activities

Home visits for people with mental disorders・Measures for life-style related diseases (NCDs)

Measures for tuberculosis・Maternal and child health activities

Activities to prevent communicable diseases・Home visits for people with tuberculosis
1945～

2008～

Table 2：Baseline Survey on the Fundamentals for PHN Activities
Statistics by Activity Site Percentage of PHNs in Each Area and their Main Duties 2)
Number of valid responses: 23,502
Activity Site
Local
Government

WelfareIndustry
Medical care

Education

Percentage (number of persons)・Main duties
75.9％ (17,836 persons)
At local governments, such as prefectural and municipal offices and public health centers, engage
mainly in duties related to maternal and child health, life-style related disease prevention, mental
health, public health and long-term care prevention for the elderly etc.
8.2％ (1,938 persons)At welfare facilities, engage mainly in duties such as long-term care prevention, lifestyle counseling,development of care plan etc.
6.4％ (1,501 persons)
At companies and offices, engage mainly in duties such as health checkup, measures for mental
health, health counseling etc.
4.9％ (1,145 persons)
At medical facilities with preventive services, engage mainly in duties such as health checkup, healthcounseling, lifestyle counseling etc.
2.0％ (475 persons)At educational and research institutions, engage mainly in duties such as education and research,
project planning and coordination, management etc.

Others

2.6％ (607 persons)Total

100％ (23,502 persons)i) At first, only women were legally eligible to qualify as a PHN and the former title of PHNs was a feminine form. In 1993, the law revision

allowed men to be qualified as a PHN and male PHNs were referred differently. In 2002, both female and male PHNs began to bereferred to as hokenshi, the standardized Japanese term for PHNs 3).

For more information on PHNs in Japan, please refer to JNA News Release Vol 6.
http://www.nurse.or.jp/jna/english/news/pdf/2011nr_6.pdf
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Reference:
1)
A Practical Handbook for Public Health Nurses third edition, Japanese Nursing Association Publishing Company;
2013. [in Japanese]
2)
Data obtained from Baseline Survey Report on the Fundamentals for Public Health Nurse Activities, JapaneseNursing Association; 2015. [in Japanese]
3)
A Guide：All about Public Health Nurses, Japan Association of Public Health Nurse Educational Institutions; 2012. [inJapanese]

JNA President Delivered a Presentation at the 2015 ICN Conference
During the ICN Conference, which was held in South

JNA, she explained the challenges related to the

Korea from June 19th to 23rd of 2015, JNA President,

working conditions of nursing professionals in Japan,

SugatitledJNA’s efforts against these challenges, the outcomes of“Keeping Healthcare Workers Healthy – Outcomes ofthese efforts, and future plans. The audience praised

JNA’s Efforts to Improve the Working Conditions of

the fact that JNA-initiated efforts, which initially focusedNursing Professionals” at a Socio-Economic Welfare

on nursing professionals, subsequently led to a

Network Meeting.

nationwide movement for the overall improvement of

Sakamoto, delivered apresentation

Drawing upon the results of surveys conducted byworking conditions for the entire healthcare profession.

The Presentation Contents：Outcomes of JNA’s Efforts to Improve the Working Conditions of Nursing Professionals
1) Challenges related to the working conditions of nursing professionals：
 Prolonged night shift of more than 15 hours (most of nursing professionals working in 2-shift systems)
 Short interval between working shifts
 Overtime work High turnover rates of nursing professionals, including newly graduated ones
 Increased number of nursing professionals not engaged in nursing practice2) JNA’s efforts against the above challenges：
 Development and dissemination of “Guidelines on Night Shift and Shift Work for Nurses”
 Promotion of Work-Life Balance for nursing professionals
 Achievement of effort obligation for “Clinical Training for Newly-graduated Nursing Personnel”

3) Outcomes of the above efforts：
 Effectively disseminated the guideline by JNA
 Lowered the turnover rates of nursing professionals
 Subsequently led to a nationwide movement for the entire healthcare profession
4) JNA future plans： Develop common indicators to evaluate nursing quality and labor

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JNA News Release2015 Vol.18

Lectures and Building Tour Organized by JNA
At the request of other organizations or groups, JNA provides
lectures on the challenges of nursing in Japan and JNA’s efforts
to visitors, such as officers from overseas health ministries,
nursing instructors, nurses and nursing students. Lecture topics
include working conditions of nurses, aging trends, and nurses
not engaged in nursing practice. These visitors come to the JNA
buildings with a well-advanced appointment during their trip toJapan for training at other institutions or facilities.
Most lectures are accompanied by a tour of the JNA
headquarters building. The headquarters building, impressivewith the glass cone as shown in the right picture, is located in
Omotesando, Tokyo, one of the country’s centers of commerce
and fashion culture. Construction of the building itself wascompleted in 2004. The JNA Plaza is located on the third floor of
the building and serves as a space for providing information anddisplaying exhibits about nursing. The JNA Plaza is accessible togeneral visitors as well.

The main entrance of JNA headquarters building

Learn More about Related Topics in Nursing
Q What is a PHN taking integrative roles (PHNs for Interdepartmental Coordination)?
PHNs for Interdepartmental Coordination (PHNs-IC) are to be defined as PHNs taking integrativeroles and cross-sectionally coordinating and facilitating public health activities of PHNs, who areassigned to various departments in each local government, such as prefectural and municipal offices
and public health centers. Such integrative roles include guidance and coordination in terms of thehuman resource development and the expertise of a PHN.
【Background of the need for PHNs-IC】
As shown in Table 1 describing the transitional changes in health issues addressed by PHNs on
Page 3, the health issues of community residents range widely and these issues have become
increasingly more diverse and complex. Generally, PHNs in local governments are assigned tovarious departments and scattered in each local government. Public health activities of the PHNs
divide individuals, families/households and communities into factors, such as system, age anddisease, and their activities have been further differentiated and specialized. With such a narrowframework, it is difficult and challenging to solve many of the health issues currently facing. Therefore,
it has become desirable to have PHNs-IC who can approach these issues cross-sectionally.
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JNA News Release2015 Vol.18【Nature of PHNs-IC】
Up until now, the roles and functions of PHNs-IC have not been clearly defined and remainedvague. Also, the ways PHNs-IC took roles and functioned in each local government were varied. For
this reason, there have been repeated discussions on the nature of PHNs-IC. Meanwhile, in the
Notification of Public Health Activities by PHNs, issued by the Director-General of Health Service
Bureau, the Ministry of Health, Labour and Welfare in 2013, it was stated that it was desirable toassign “PHNs taking integrative roles” who coordinate cross-sectionally with the expertise of a PHN,
particularly in local governments. The notification remained to use the expression of “PHNs taking
integrative roles,” not PHNs-IC. However, this represents a major step forward and set forth the natureof PHNs-IC. It is important to acknowledge and accept the significance of being mentioned in the
notification and to systematically develop human resources.
【JNA’s efforts】
JNA has been undertaking the “Human Resource Development Program for PHNs-IC,” in addition
to clarifying the definition, roles and functions of a PHN-IC. The aim of this program is to train
PHNs-IC who are capable of appropriately taking their roles and fulfilling their functions within each
local government. In the fiscal year 2014, the program, lasting approximately 7 months and including
prior self-learning and group sessions, was tentatively introduced to PHNs-IC in municipalities as thefirst time and was completed by 47 of these PHNs. The latest 2015 version of the program has been
implemented and the program itself will be further refined before the final version. In addition tohuman resource development, JNA will continue to work toward the promotion of the placement of
PHNs-IC as well.

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