Global Health

Global Health.

Global Health

Japan healthcare is the best in the world with the lowest infant mortality rate and highest life expectancy. Japan is among the few industrialized Nation that has achieved universal health care to its citizen for more than five decades. The government and the private institutions are the major providers of impartial health care in Japan. In addition, the Japanese government provides fundamental health care services to all irrespective of their geographical location, age, terminal diseases, or precondition of risk factors (Kondo & Shigeoka, 2013). The ministry of health, labor and welfare is mandated with formulating health policies, establishing a national health care plan, and overseeing health care formulation countrywide. Also, the health ministry revises national health strategy every five years depending on the health situation, medical reports, and the need for immediate intervention. Moreover, municipal governments are responsible for supervising the public health services and home based care. Medical care plan ensures people gets quality and suitable health care and enhance division of duties among all health practitioners.

The government of Japan through its legislature passed laws and regulations to promote the health care provided to its citizen. For instance, the Health Insurances Act of 1922 and 1938, aimed to achieve universal insurance cover to all people by 1961. In addition, the Medical Care Act of 1948 also meant at improving health care delivery to Japanese while the Community Health Care Act of 1997 was enacted to promote extensive local and regional health services. Lastly, the Heath Promotion Act of 2002 intended to curb the spread of communicable disease, nutritionally related disorder, lifestyle diseases, and terminal illness (Blank & Burau, 2013). In Japan, global health policy of 2016-2020 addresses three key things, which are; reduce maternal and infant mortality, improve child health, and support worldwide health emergencies such as the outbreak of pandemic diseases. Thus, Japan promises to work with other stakeholders, donors, international organization, and partnership to achieve this strategy.

Many non-profitable organizations in Japan assist in providing basic health care to Japanese. The most prominent organizations deliver services such as HIV/AIDS intervention, drug and substance abuse rehabilitation, palliative care, and medical training and seminars. Community-based organizations also contribute in health care system in the country. They raise money to purchase various facilities and equipment needed in hospitals. In fact, the health care delivery system in Japan has three major pillars that support universal health care to all people. The pillars are; universal health insurance cover provided by the government, the health care delivery system under medical care act, and public health services. Moreover, the Japan government also provides health insurance facilities to most of it citizens, which cater for 70% of the hospital bills. In addition, the government subsidizes patient’s hospital bills to all poor residents who cannot afford their medical expenses (Hayashi, Ozawa, Kawabata & Takemi, 2016). Both private and public hospital provides medical services at the same cost. Of important, medical practitioners have the freedom of working either in private or public health institutions. Additionally, the health care reforms of 2006 require the health practitioners in Japan to focus on cancers, diabetes, cardiac diseases, and stroke, which are the leading deadly ailments in the country (Koezuka, 2016).

Health institutions in Japan focus on providing five major services, which include pediatric care, perinatal care, rural health care, emergency care, and disaster management care. Indeed, the major role of public health in Japan is to prevent and control the population from diseases. Further, public health also focuses on the promotion of general health of the population through community health education, nutritional management, and disaster awareness. Currently, the nursing personnel in Japan are divided into four major categories; midwives, outpatient nurses, inpatient nurses and public health nurses. Perennially, the role of nurses in Japan has significantly changed since 1948, which has created a serious shortage of nurses in most of the health facilities. For this reason, most of the nurses in Japan work for long hours due to a high number of patients. According to Tsugawa, Ikegami, Miake & Reich (2014), the Ministry of Health, Labor, and Welfare (MHLW) collaborates with the Ministry of Education to increase the number of nurses trained in higher education institution to improve the nursing system in the country.

Japan is a group of countries with the highest number of older adults in the world. This high number of the aged in Japan has caused Japan to spend a lot of money in its effort to attain universal health care. The expenditure on the health escalates with a very higher margin on an annual basis. Currently, Japan spends over three hundred and thirty-three billion dollars to meet for health expenses. This value increases with an average of $ 8.3 billion on an annual basis since the year 2011 (Campbell, 2014). Compared to other G7 countries Japan tops the other countries on retaining the in-patient for the longest time in hospitals. The health’s facilities in Japan ensure the patient fully recover before discharge, unlike the other countries, which have outpatient care for further treatments. Holding the patients for a long time in hospital increases the charges and burden to the government since it is the one that caters for a big percentage of the treatment. The ratio of doctors to patients is insufficient; the latest ratio indicates that there are 1.6 doctors for every 1000 persons (Tsugawa, Ikegami, Miake & Reich, 2014). In 2016 -2020 medical plan strategy, Japan plans to improve the information technology to curb the issue of physicians’ shortages in its hospitals. Japan also aims to not only increase the life expectancy of the aged by investing heavily on medical expenses but also make them lead a healthy lifestyle.

Japan has a population of one hundred and twenty-seven million people with a fertility rate of 1.41% (Tokudome, Hashimoto & Igata, 2016). The country is the 11th most populated nation in the world and among the countries with the least population growth rate. Currently, the population of Japan has a negative growth rate of 0.19, which make it, be position 177 worldwide. The death rate in Japan is higher that the birth rate since the death rate is 9.6 per 1000 persons and birth rate is 7.8 per 1000 persons. The life expectancy rate for males is 80.5 years and for females is 86.8years and average life expectancy is eighty-three years. The healthy life expectancy is 74.9 years which make it best country in the world with highest life expectancy. The majority of the Japanese population is between 15 and 64 years, which accounts for 56.9% of the Japanese population. 26.7% of the population is persons above the age of 65 years, which make it second in the world with a population of this age (Tokudome, Hashimoto & Igata, 2016). The life expectancy in Japan is high because of the universal health system and modern technology. The government of Japan invests heavily in preventing the communicable and influenza diseases as efforts to curb mortality rate. The leading cause of death is the stroke and respiratory infection, ministry of health has come up with strategies to reduce these diseases. Japan has the strategies of raising the life expectancy since it integrates ICT with health delivery system to improve the general lifestyle of all its citizens (Koezuka, 2016).

Long term insurance faces a myriad of problems, especially in home-based care. The citizens of Japan have the right to choose any care that they fill comfortable with, and the insurance cover caters for a bigger percentage of the medical expense. According to Blank & Burau (2013), the Municipal government cannot provide home-based care to all those who are in need, it, in turn, give the contract to profitable organizations to provide those services. The municipal government gives those organizations credentials to provide home-based care so long as they meet the minimum standards. Most of the contract-based organization they are controlled and governed by managers who have little skills and knowledge in health. The seniors and the manager of those organization they develop the care plan and most of them do not have basics of health. They provide low-quality services, and they charge a lot of money to long-term insurers. Institutionalization of home-based care currently is the major issue that affects universal health care in Japan.

Traditional Chinese medicine is the major cultural factor that Japanese embraces up to date. The government of Japan gives traditional herbalist permit to provide their herbal medicine to the Japanese. Most of the elderly Japanese they believe on herbalist more than trained doctors. Believing in them increases their vulnerability to succumb from terminal diseases such as cancers, stroke, and HIV/AID, which require specialized care. Suicide is the 10th chief cause of demise in Japan; it accounts for about 3.2% of the death in Japan annually. In the year 2015, more than thirty thousand people committed suicide (Inoue et al., 2016). Japan is among the countries with the highest rate of suicide in the world. The reason why Japanese commits suicide is that they believe in the ancient Samurai principles of Honorable suicide. This ideology just increases their vulnerability to depression and death in the sense of being a hero. Japanese like the culture of alcohol drinking and smoking. This increases their vulnerability to diseases such as stroke, cancer, obesity, cardiac diseases among others.

Nurses provide support to all people irrespective of their social and economic background. Nurses are the group health practitioners who work in all setting and environment. In most cases, they work in a real-world environment where they can integrate with the society freely and identify the problems and immediate health risks. The public health nurse cares the large group of people and eventually the entire community in a specific locality. The common responsibilities of nurses are to educate the society members on the current trends of health. They should enlighten the society on a variety of topics like diseases prevention and control, first aid, disaster management, early disease diagnosis and treatment, healthy lifestyle, nutrition and risk factors. Nurses can involve in community campaigns to create awareness on ways to prevent diseases such as vaccination campaigns and HIV and STI prevention. Nurses should communicate with the patient and advise them the best way to prevent the spread of their infection in their body or infect others According to (Hayashi, Ozawa, Kawabata & Takemi, 2016). Nurses also offer counseling to individuals and patients to prevent them from suffering from lifestyle diseases such as obesity or depression.




Blank, R. H., & Burau, V. (2013). Comparative health policy. Palgrave Macmillan.

Campbell, J. C. (2014). How policies change: The Japanese government and the aging society. Princeton University Press.

Hayashi, F., Ozawa, K., Kawabata, T., & Takemi, Y. (2016). Use of focus group interviews with public health nurses to identify the efforts of and challenges faced by branches of the Japan Health Insurance Association to achieve good performance of the Specific Health Guidance initiatives. Japanese Journal of Public Health, 63(10), 606.

Inoue, K., et al. (2016). A long‐term study of the association between the relative poverty rate and suicide rate in Japan. Journal of Forensic Sciences, 61(S1).

Koezuka, H. (2016, October). Utilization of IoT in the long-term care field in Japan. In 2nd International Conference on Cloud Computing and Internet of Things (CCIOT), Dalian, pp. 166-169.

Kondo, A., & Shigeoka, H. (2013). Effects of universal health insurance on health care utilization, and supply-side responses: Evidence from Japan. Journal of Public Economics, 99, 1-23.

Tokudome, S., Hashimoto, S., & Igata, A. (2016). Life expectancy and healthy life expectancy of Japan: the fastest graying society in the world. BMC Research Notes, 9(1), 482.

Tsugawa, Y., Ikegami, N., Miake, N., & Reich, M. R. (2014). Improving population health through public health centers in Japan. In A. maeda et al., Universal Health Coverage for Inclusive and Sustainable Development. New York: World Bank Publications.


Global Health