Strengthening self-help and mutual aid in Japan’s community-based integrated care system based on the Thai health policy for the elderly

• Main Authors: Kyoko Sudo, Jun Kobayashi, Shinichiro Noda, Jiraporn Chompikul, Yoshiharu Fukuda, Kenzo Takahashi, เคียวโก๊ะ ซูโด๊ะ, จูน โคบายาชิ, ชินนิชิโร๊ะ โนด๊ะ, จิราพร ชมพิกุล, โยชิฮารุ ฟุกุดะ, เคนโซ๊ะ ทากาฮาชิ
• Other Authors: Mahidol University. ASEAN Institute for Health Development
• Format: Article
• Language: English
• Published: 2021
• Subjects: aging; long-term care; primary health care; universal health coverage; ความชรา; การดูแลระยะยาว; การสาธารณสุขมูลฐาน; หลักประกันสุขภาพถ้วนหน้า
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/62138
• Institution: Mahidol University

Aging is a global issue not especially in the developed world. Governments of both developed and developing countries struggle with the financial burdens of aging populations. The Japanese government is implementing the Community-based Integrated Care System (CbICS) for elderly individuals to provide comprehensive up-to-end-of-life support services in communities. This system proposes four elements: self-help (Ji-jo), mutual aid (Go-jo), social solidarity care (Kyo-jo), and government care (Ko-jo); self-help and mutual aid are expected to be strengthened for successful policy implementation. Thailand, with the highest aging rate in Southeast Asia, has a successful system based on primary health care (PHC). The authors discussed ideas from the Thai health policy for the elderly to address the challenges in the Japanese system. For a data collection method, the authors conducted document reviews. Interviews with officers from the relevant ministries were conducted to verify the evidence to strengthen self-help and mutual aid in Japan’s CbICS. Factors promoting the implementation of the Thai health policy for the elderly were extracted. Aging issues were influenced by the national strategy. The second National Plan for Older Persons focused on community-based care services following the PHC concept and tried to implement them comprehensively along with the ministries. The factors promoting the implementation of the Thai health policy for the elderly included “Clear and adequate government role distribution”, “Decentralization and authority of local governments”, “Earlier preparation”, “Empowerment and encouragement of preventive activities in the community”, “Evaluation system”, “Evidence-based”, “Fit for global concepts and national issues”, “Involvement of stakeholders”, and “Solutions to fragmentation”. The results indicated that the Thai health policy for the elderly was characterized by a strong central government, with emphasis on well-being and the prevention of diseases, and involvement of multiple ministries. Japan’s CbICS could provide more effective services when community activities adopt Thailand’s community-based elderly care. Relevant ministries should be more integrated for better service provision, and Japan’s PHC concept should be reconsidered for application to its peculiar situation.