Building Partnership and Citizen Participation in Japan

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Building Partnership and Citizen Participation in
Japan

• Tomoyuki Matsuno
• Okinawa Prefectural Miyako Public Health
  Welfare Center

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Three basic strategies and Areas for priority
action

• Build healthy public policy
• Create supportive environments
• Strengthen community actions
• Develop personal skills
• Reorient health services
• Moving into the future

Local Communities Municipalities Nation

• Strategies ??
• Advocate(??)
• Mediate(??)
• Enable(????)

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Two Tools for Well-Being(John McKnight)
Health Administration
Community
Self-help groupsLocal community
groupsNPOPartnershipCitizen Participation
Vision?Desire?Value
RuleLawPower
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Community Building to Policy Making
Making Policy
Building Network Community
Health Policy
Mediating, EnablingBuilding PartnershipCitizen
ParticipationCommunity Empowerment
AdvocacyVoice of peopleCommunity Vision, Value
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Building Partnership and Citizen Participation in
Japan

• Through Planning Process (Healthy Japan 21
  Planning)
• SOJO Model (System Oriented Joyful Operation)
• PCM (Project Cycle Management)
• PRECEED-PROCEDE Model
• Community Meeting
• Through Annual Event (Event-driven health
  promotion)
• Miyako Island Triathlon

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Okinawa Prefecture and Miyako Island
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SOJO Model
Through Planning Process

• Developed by Dr. Iwanaga in 1990s.
• Focus on QOL in community
• Share the desired outcome among participants
• Discuss the means to accomplish the outcome
• Through these process, empower the participants
  and communities

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Procedure of SOJO Model

• Step 1 Discuss desired outcome in the
  community
• Step 2 Discuss cause-effect relationship to
  accomplish each desired outcome
• Step 3 Evaluate the present situation
• Step 4 Clarify the gap between the desired
  outcome and the present situation
• Step 5 Discuss possible activities to cover
  identified gap
• Step 6 Implement proposed activities
• Step 7 Evaluate implemented activities

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Workshop (MCH ????)at ??? City
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Desired Outcome in Community
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Tree to accomplish each desired outcome
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What can we do?
MCH Volunteer Group
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Presentation of each workshop
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Project Cycle Management(PCM)
Through Planning Process

• Developed by FASID (Foundation for Advanced
  Studies on International Development) in 1990s.
• Comprised of three phases of planning,
  implementation, and evaluation by logical
  Framework Approach
• Consist, Participatory, Logical ? Accountable
  and Transparent
• Problem-oriented

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Procedure of PCM Model
Analysis Stage
Stakeholder Analysis
Problem Analysis
Object Analysis
Project Selection
Planning Stage
Implementation Monitoring Evaluation
Making PDM (Project Design Matrix)
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Example of PCM
Problem Analysis
Objective Analysis
Weightcontrol
Obesity
High caloriediet
Poor physicalactivities
Alcohol
Reduce high calorie diet
Increase physicalactivities
Lessalcohol
High Fatdiet
Many Snackin a field
Reduce highFat diet
Less Snackin a field
Project Selection
Making PDM
Weightcontrol
Reduce high calorie diet
Increase physicalactivities
Lessalcohol
Reduce highFat diet
Less Snackin a field
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Workshop
MiyakoIsland
?????????????
????????????
Hirara City
????
5km
???
???
???
Healthy Miyako Healthy Hirara City
???????????
????????????
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Example ofPDM(Healthy Diet ???)
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?????????
What healthy diet promoting group can do?
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Who?
When?
?2 ???????
To promote healthy diet, what each organization
will do?
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Promoting Healthy Diet

• Empower Healthy Diet Promoting Group
• 156 Volunteers since 1996
• Volunteers promote healthy diet
• Activities
• Introducing Healthy Menus in Public Information
• Cooking Practice at School
• Exchange with Nishi-Aizu Town

Healthy Diet Promoting Group
Exchange with Nishi-Aizu Town
Cooking Practice at School
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Develop Historical Walking Map and Volunteer Guide

• Purpose
• Protection of historical places
• Promoting tourism
• Promoting health of residents
• Training Volunteer Guide
• About 20 volunteers each year
• Outcome
• Guide by residents
• Supportive environment to promote health
• Good attitude toward protection of historical
  places among residetns

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Major Problem of Planning Method
Passion Fluctuation in Healthy Hirara Planning
Working together.making TV commercialmaking
drinking rulesmaking walking map
Passion
Discuss what each organization can do
Problem AnalysisObject AnalysisProject Selection
Submit Plan to mayor
Working together in trial areas
Many DiscussionNo Action
Time
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Not Serial Plan-Do-SeeBut Parallel Plan-Do-See!
Time
Series
Plan
Do
See
Parallel
Plan
Do
See
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Building Partnership Citizen Participation
through Annual Community Event
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Bike 150km
Swim 3km
Countries 8 Japan, USA, Canada, Korea, China,
Taiwan, Germany, Australia
More than 20 years
Athletes 1500
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Marathon 42.195km
Swim 3km
Bike 150km
Large Medical Team to cope with medical accidents
such as drowning(??)fracture(??)heat
stroke(???) .
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Medical Team

• More than 500 Volunteers

Medical AssociationDentist AssociationPharmacist
AssociationNursing AssociationKey
HospitalEmergency Service DivisionHealth Center
of MunicipalitiesMunicipalities
AssociationVolunteer Doctors from outsideHigh
School StudentsHealth and Welfare CenterMedical
Equipment Companies
It is like a Health-related Community
Most of Health related personnel in Miyako
participate in this team.
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Headquarter of Medical Team
Pink T Shirt is a symbol of Medical Team
Chief Nurse is a leader in each tents.Doctors
also should follow the order.
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Medical care after goal
Severely SickHeart Rate Monitor
Not Severe Injury CareIV
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Medical Team in Miyako Triathlon

• Historicity More than 20 years
• Identity As Medical team, Pink T shirts
• Mutuality Helping each other
• Plurality From high school students to Director
  of Doctors Association. From Hokkaido to
  Okinawa Mainland
• Autonomy Revising each year
• Voluntary Participation
• Integrity Shared goal

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Triathlon and Health-related Community in Miyako
Island
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Strong Community can be beneficial in any problems
Disaster Management
Strong Health-related Community
Diabetes Prevention Programs
Infection Prevention Programs
Triathlon every year
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Typhoon, 2003.9.10-11
Max Wind Speed 78.1m
Damage 13 billion Yen
Blackout Most of all houses
Suspension of Water Supply 5,000
Death 1 Severely Injured 7 Injured 89
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Triathlon experience enable quick response
against typhoon

• In the midst of typhoon, leaders of Medical
  Association, Key Hospital, Health Welfare
  Center, and Emergent Service gathered in a minute
  to discuss how to cope with.

Quick Response
Evaluate operations of each clinicsEvaluate
the damage of their outpatientsMaintain medical
service by clinics
Medical Association
Key Hospital
Medical Services to the injured
Triage of patientsCoordination among hospitals
and clinicsEvaluate damages
Health Welfare Center
Emergent Service
Report the numbers of injured
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Summary
Building Partnership and Citizen Participation

• Through Planning Process
• Easy to start, but difficult to maintain the
  passion of participants
• Not Serial Plan-Do-See, but Parallel Plan-Do-See!
• Through Annual Event
• Building and strong community
• Strong community can be beneficial in any
  problems
• This approach can be applied in limited situation