Hoshi T, Nakahara T, Takabayashi K, Gunji A
Tokyo Metropolitan University, Japan.
Nihon Koshu Eisei Zasshi. 1996 Apr;43(4):267-75.
In accordance with the Maternal and Child Health Service Act, public health centers and municipalities offer health education, health counseling, health examinations, and home visits for children and their mothers in their jurisdiction. On the basis of the new Maternal and Child Health Service Act, municipalities will have the responsibility to effectively promote health examination for three-year-old children beginning in 1997. To provide health examinations to infants and children, establishing a health personnel system, especially the public health nurse program, is extremely important. The purpose of this study is to determine fundamental facts concerning health manpower development among public health nurses in the municipalities, by reviewing research on health examinations for both infants and children. To determine personnel staffing requirements necessary for health examinations of infants and children in the municipalities of Japan, pertinent references were systematically reviewed. The main results are as follows; 1) The correlation coefficients between the total working hours of the public health nurse for MCH and the population per area and number of birth per year were significantly positive. 2) Total working hours for health examination of three-year-old children per 100 births per year, by the public health nurse were 143 hours, of which 79% were spent just for performing the examination itself. 3) Due to the lack of health personnel, rural towns and villages with small populations required public health nurses to be assisted by other staff, most often public health nurses from prefectural Health Centers. For example, in those areas with a population of less than 3,000, 43% of the total volume of work performed by public health nurses during the health examinations of three-year-old children required the assistance of prefectural public health nurses. 4) On the other hand, in those areas with populations more than 10,000, 88% of the total volume of work required to be performed by public health nurses during the health examinations for three-year-old children was covered by municipal public health nurses. 5) When the total number of working hours of the public health nurse for Maternal and Child Health was divided into the four parts of planning, implementation, evaluation and training, 86.7% of working hours were spent on implementation itself. 6) In those cities designated by the Government, the health personnel system was sufficient to carry out these health examinations. 7) It was found that in towns and villages with small populations, the health examinations for infants and children can be better carried out in combination with assistance by prefectural public health nurses. 8) The review of the findings suggests that it is important to clarify by further studies not only the relationship between the health manpower system and implementation of the health examination but also the relationship between this system and the effectiveness of the health examination in near future.
根据《母婴健康服务法》，公共卫生中心和各市镇为其辖区内的儿童及其母亲提供健康教育、健康咨询、健康检查和家访服务。根据新的《母婴健康服务法》，各市镇将有责任从1997年起切实推动对三岁儿童的健康检查。为婴儿和儿童提供健康检查，建立卫生人员体系，特别是公共卫生护士项目，极为重要。本研究的目的是通过回顾关于婴儿和儿童健康检查的研究，确定各市镇公共卫生护士健康人力发展的基本情况。为确定日本各市镇婴儿和儿童健康检查所需的人员配备要求，系统回顾了相关参考文献。主要结果如下：1）公共卫生护士从事母婴健康工作的总工作时长与每地区人口数和每年出生人数之间的相关系数呈显著正相关。2）公共卫生护士对每年每100例出生的三岁儿童进行健康检查的总工作时长为143小时，其中79%仅用于实际进行检查。3）由于卫生人员短缺，人口较少的农村乡镇需要公共卫生护士得到其他人员的协助，最常见的是县卫生中心的公共卫生护士。例如，在人口不足3000人的地区，公共卫生护士在对三岁儿童进行健康检查期间所完成工作总量的43%需要县公共卫生护士的协助。4）另一方面，在人口超过10000人的地区，公共卫生护士在对三岁儿童进行健康检查期间所需完成工作总量的88%由市公共卫生护士承担。5）当公共卫生护士从事母婴健康工作的总工作时长分为规划、实施、评估和培训四个部分时，86.7%的工作时长用于实际实施。6）在政府指定的城市，卫生人员体系足以开展这些健康检查。7）研究发现，在人口较少的乡镇，婴儿和儿童的健康检查在县公共卫生护士的协助下能开展得更好。8）对研究结果的回顾表明，重要的是通过进一步研究不仅要明确健康人力体系与健康检查实施之间的关系，还要明确该体系与近期健康检查效果之间的关系。
