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Ensuring a healthy lifestyle for the increasing number of Vietnamese migrants living in Japan is a key public health issue, including infectious disease responses such as tuberculosis (TB). To develop risk communication in relation to the TB response, this study aimed to explore the health issues and health-related behaviors of Vietnamese migrants living in Japan using a mixed method. A survey was conducted on Vietnam-born migrants, aged 18 years and over, in Tokyo. The survey consisted of questions on the following components: (1) demographics; (2) health-related issues and behavior; and (3) health-seeking behavior, information, and communication. A total 165 participants participated in the survey. The majority of the participants were young adults. 13% of the participants responded that they were concerned about their health. Moreover, 22% and 7% of the participants reported weight loss and respiratory symptoms, respectively. 44% of the participants answered they had no one to consult about their health in Japan when they needed it, and 58% answered they had no awareness of any Vietnamese-language health consultation services. Logistic regression analysis revealed that people who contact family members living in Vietnam or overseas using social networking services (SNSs) when they needed to consult someone about their health (adjusted odds ratio (AOR) = 6.09, 95% confidence interval (CI) 1.52–24.43) were more likely to present with one or more of the typical TB symptoms, compared to those who did not consult someone in this manner. Current smokers (OR = 3.08, 95% CI 1.15–8.23) were more likely to have health problems compared to non-smokers. The key informant interviews revealed that individual factors, the health system, and socio-environmental factors may hinder Vietnamese migrants’ health-seeking and health-information-seeking behaviors in Japan. TB risk communication approaches for migrants need to be developed considering their health-related behaviors while addressing their health needs.

Introduction In response to global outbreaks of infectious diseases, the need for support from organizations such as the World Health Organization Global Outbreak Alert and Response Network (GOARN) is increasing. Identifying the obstacles and support needs for applicants could increase GOARN deployments from Japan. Methods This cross-sectional study involved a web-based, self-administered questionnaire survey targeting Japanese participants in the GOARN Tier 1.5 training workshop, held in Tokyo in December 2019. Results All 47 Japanese participants in the workshop responded to the survey. Most responders were male and in their 30s and 40s. Participants specialized in case management (42.6%), infection prevention and control (25.6%), epidemiology and surveillance (19.1%). Only two participants (4.6%) had experienced a GOARN deployment. Their motivations for joining the GOARN training workshop were “Desire to be part of an international emerging infectious disease response team” (44.6%), “Interest in making an international contribution” (19.1%), and “Interest in working for the Japanese government in the field of international infectious diseases” (14.9%). Obstacles to GOARN deployments were “Making time for deployments” (45.7%) and “Lack of required professional skills and knowledge” (40.4%). The support needs for GOARN deployments constituted “Periodic simulation training” (51.1%), “Financial support during deployments” (44.7%), and “Technical support for deployments” (40.4%). Conclusions Our study revealed the obstacles and support needs of Japanese candidates for GOARN deployment. Making time and upskilling for GOARN deployment were the main obstacles. More practical training (like GOARN Tier 2.0) with other supports are needed. The national framework is desirable to realize these supports.

This study aimed to describe characteristics and treatment outcomes of overseas-born pulmonary tuberculosis (PTB) patients in Japan, and identify the factors associated with “treatment non-success”. We conducted a retrospective analysis of overseas-born patients with drug-susceptible PTB using cohort data of PTB cases newly registered in the Japan tuberculosis (TB) surveillance system between 2009 and 2018. Overall, 9151 overseas-born PTB cases were included in this study, and 70.3% were aged 34 years old or younger. “Students of high school and higher” (28.6%) and “regular workers other than service related sectors” (28.5%) accounted for over half of the study population, and they have continued to increase. Overall, the treatment success rate was 67.1%. Transferred-out constituted the largest proportion (14.8%) among the treatment non-success rate (32.9%). Multiple logistic regression analysis revealed patients whose health insurance type was “others and unknown”, including the uninsured (adjusted OR (AOR) = 3.43: 95% Confidence Intervals (CI) 2.57–4.58), those diagnosed as TB within “one year” (AOR = 2.61, 95% CI 1.97–3.46) and “1–5 years” (AOR = 2.44, 95% CI 1.88–3.17) of arrival in Japan, and males (AOR = 1.34, 95% CI 1.16–1.54), which were the main factors associated with treatment non-success. These findings imply that Japan needs to develop TB control activities considering the increasing trends of overseas-born PTB patients, the majority of whom are young and highly mobile. There is a need to pay greater attention to overseas-born PTB patients diagnosed within a short duration after entering Japan, who may be socially and economically disadvantaged for their treatment completion.

Additional file 2: Table S1. Development assistance for health by target region, 2012–2016 (2016 USD in million, %): (A) bilateral (loans), (B) bilateral (grants), (C) multilateral, (D) total. WHO: World Health Organization; UNAIDS: Joint United Nations Programme on HIV/AIDS; UNFPA: United Nations Population Fund; UNICEF: United Nations Children’s Fund; UNDP: United Nations Development Programme; AfDB: African Development Bank; AsDB: Asian Development Bank; IADB: Inter-American Development Bank; Global Fund: The Global Fund to Fight AIDS, Tuberculosis and Malaria; Gavi: Gavi, The Vaccine Alliance; JICA: Japan International Cooperation Agency. Other UN agencies include Food and Agriculture Organization (FAO), United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), World Food Programme (WFP), etc. NGOs include International Planned Parenthood Federation, etc. Others include Global Environment Facility (GEF), etc. Table S2. Development assistance for health by channel, 2012–2016 (2016 USD in million, %). WHO: World Health Organization; UNAIDS: Joint United Nations Programme on HIV/AIDS; UNFPA: United Nations Population Fund; UNICEF: United Nations Children's Fund; UNDP: United Nations Development Programme; AfDB: African Development Bank; AsDB: Asian Development Bank; IADB: Inter-American Development Bank; Global Fund: The Global Fund to Fight AIDS, Tuberculosis and Malaria; Gavi: Gavi, The Vaccine Alliance; JICA: Japan International Cooperation Agency. Other UN agencies include Food and Agriculture Organization (FAO), United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), World Food Programme (WFP), etc. NGOs include International Planned Parenthood Federation, etc. Others include Global Environment Facility (GEF), etc. Table S3. Developing assistance for health channeled through multilateral agencies, 2012–2016 (2016 USD in million, %). WHO: World Health Organization; UNAIDS: Joint United Nations Programme on HIV/AIDS; UNFPA: United Nations Population Fund; UNICEF: United Nations Children’s Fund; UNDP: United Nations Development Programme; AfDB: African Development Bank; AsDB: Asian Development Bank; IADB: Inter-American Development Bank; Global Fund: The Global Fund to Fight AIDS, Tuberculosis and Malaria; Gavi: Gavi, The Vaccine Alliance; JICA: Japan International Cooperation Agency. Other UN agencies include Food and Agriculture Organization (FAO), United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), World Food Programme (WFP), etc. Table S4. Development assistance for health by health focus area, 2012–2016 (2016 USD in million, %): (A) bilateral (loans), (B) bilateral (grants), (C) multilateral, (D) total. STD: sexually transmitted disease. CRS purpose code: Basic health care = 12220; Basic health infrastructure = 12230; Basic nutrition = 12240; Health education = 12261; Health personnel development = 12281; Reproductive health care = 13020; Family planning = 13030; Infectious disease control = 12250; Malaria control = 12262; Tuberculosis control = 12263; STD control including HIV/AIDS = 13040; Health policy and administrative management = 12110; Medical education/training = 12181; Medical research = 12182; Medical services = 12191; Population policy and administrative management = 13010; Personnel development for population and reproductive health = 13081. Table S5. Development assistance for health for primary healthcare and health system strengthening, 2012–2016 (2016 USD in million, %): (A) bilateral (loans), (B) bilateral (grants), (C) multilateral, (D) total. PHC: public health care; HSS: health system strengthening. PHC definition #1 = Basic health care and infrastructure (CRS purpose codes: 12220, 12230, 12240, 12261, 12281); PHC definition #2 = Reproductive health care and family planning (13020, 13030); PHC definition #3 = Infectious disease control, including malaria and tuberculosis (12250, 12262, 12263); PHC definition #4 = Sexually transmitted disease (STD) control including HIV/AIDS (13040); Broader PHC definition = Definition #1 + #2 + #3 + #4; HSS definition #1 = Health policy, administration & management (12110); HSS definition #2 = Medical services, training & research (12181, 12182, 12191); HSS definition #3 = Population policy & administration (13010, 13081); Broader HSS definition = Definition #1 + #2 + #3.

Additional file 2: Supplementary Table 1. Development assistance for health by target region, 2012–2016 (2016 USD in million, %): (A) bilateral (loans), (B) bilateral (grants), (C) multilateral, (D) total. Supplementary Table 2. Development assistance for health by channel, 2012–2016 (2016 USD in million, %). Supplementary Table 3. Developing assistance for health channeled through multilateral agencies, 2012–2016 (2016 USD in million, %). Supplementary Table 4. Development assistance for health by health focus area, 2012–2016 (2016 USD in million, %): (A) bilateral (loans), (B) bilateral (grants), (C) multilateral, (D) total. Supplementary Table 5. Development assistance for health for primary healthcare and health system strengthening, 2012–2016 (2016 USD in million, %): (A) bilateral (loans), (B) bilateral (grants), (C) multilateral, (D) total.

Background To achieve Universal Health Coverage (UHC), which is the core driver of health Sustainable Development Goals (SDGs), by 2030, Japan strives to strengthen its development cooperation by mobilizing various resources. However, the involvement and roles of various actors from Japan in development cooperation for health have not been revealed across various entities of the Japanese government or to the public. This study is the first to systematically assess the overall picture of Japan’s publicly funded cooperation mobilizing Official Development Assistance (ODA) and non-ODA public resources to improve people’s health in Vietnam. A cross-sectional analysis of Japanese publicly funded projects implemented for health cooperation in Vietnam during December 2016 was conducted. A framework based on the six building blocks of health system defined by the World Health Organization was adopted in order to assess the target projects. Results Overall, 68 projects implemented through Japanese public funding were included in the final analysis. These 68 projects under 15 types of schemes were managed by seven different scheme-operating organizations and funded by five ministries. Forty-four of these (64.7%) were ODA and 24 (35.3%) were non-ODA projects. Among the recategorized six building blocks of the health system, the focus area of the largest proportion of projects was health service delivery (44%), followed by health workforces (25%) and health information systems (15%). Almost half the projects were implemented together with the central hospitals as Vietnamese counterparts. Only 10% projects were conducted at the local level. This study was unable to capture the synergetic effects of potential collaboration or harmonization among Japanese funded projects. Conclusions Several Japanese-funded projects addressed a wide range of health issues across all six building blocks of the health system in Vietnam. However, there is room for improvement in developing coordination and harmonization among the Japanese projects that are diversifying. Furthermore, establishing a target-country-specific mechanism for strategic coordination across Japanese ministries’ schemes can yield efficient and effective development cooperation for health. Our analytic approach using the recategorized six building blocks contributes to a more comprehensive understanding of efforts on strengthening the health system.

BackgroundDevelopment assistance for health (DAH) is one of the most important means for Japan to promote diplomacy with developing countries and contribute to the international community. This study, for the first time, estimated the gross disbursement of Japan’s DAH from 2012 to 2016 and clarified its flows, including source, aid type, channel, target region, and target health focus area.MethodsData on Japan Tracker, the first data platform of Japan’s DAH, were used. The DAH definition was based on the Organisation for Economic Co-operation and Development’s (OECD) sector classification. Regarding core funding to non-health-specific multilateral agencies, we estimated DAH and its flows based on the OECD methodology for calculating imputed multilateral official development assistance (ODA).ResultsJapan’s DAH was estimated at 853.87 (2012), 718.16 (2013), 824.95 (2014), 873.04 (2015), and 894.57 million USD (2016) in constant prices of 2016. Multilateral agencies received the largest DAH share of 44.96–57.01% in these periods, followed by bilateral grants (34.59–53.08%) and bilateral loans (1.96–15.04%). Ministry of Foreign Affairs (MOFA) was the largest contributors to the DAH (76.26–82.68%), followed by Ministry of Finance (MOF) (10.86–16.25%). Japan’s DAH was most heavily distributed in the African region with 41.64–53.48% share. The channel through which the most DAH went was Global Fund to Fight AIDS, Tuberculosis, and Malaria (20.04–34.89%). Between 2012 and 2016, approximately 70% was allocated to primary health care and the rest to health system strengthening.ConclusionsWith many major high-level health related meetings ahead, coming years will play a powerful opportunity to reevaluate DAH and shape the future of DAH for Japan. We hope that the results of this study will enhance the social debate for and contribute to the implementation of Japan’s DAH with a more efficient and effective strategy.

Additional file 1: Figure S1. Developing assistance for health channeled through multilateral agencies, 2012–2016. WHO: World Health Organization; UNAIDS: Joint United Nations Programme on HIV/AIDS; UNFPA: United Nations Population Fund; UNICEF: United Nations Children’s Fund; UNDP: United Nations Development Programme; AfDB: African Development Bank; AsDB: Asian Development Bank; IADB: Inter-American Development Bank; Global Fund: The Global Fund to Fight AIDS, Tuberculosis and Malaria; Gavi: Gavi, The Vaccine Alliance.

The Meetings of Health Ministers of the Group of Twenty (G20) that started at the G20 Summit in Berlin, Germany in 2017 have provided a platform for the discussion of global health matters such as antimicrobial resistance (AMR), public health emergencies, and universal health coverage. Similar issues are also discussed at meetings of the G7 and the World Health Assembly (WHA). This article will examine recent data to explore the characteristics of the G20 and its potential for improving health outcomes. G20 countries have a leading role to play in helping other countries improve global health outcomes because member countries have already faced many issues associated with aging society and increased prevalence of non-communicable diseases (NCDs). Indeed, 71% of the world's elderly population lives in the G20 countries and most of these countries have a high proportional mortality from NCDs of more than 70%. G20 countries are also responsible for a disproportionate share of global impacts. For instance, 72% of CO2 emissions are produced by G20 countries. Migration dynamics and its consequences also need to be considered from the perspective of optimizing health outcomes. Moreover, 78% of the world's top 50 pharmaceutical companies are located in the G20 countries. There is ample room for G20 countries to pursue collaborative and cooperative approaches that can complement the roles of the G7 and WHA in similar health issues. The G20 could, for example, share experiences on dealing with aging and NCDs, reduce their CO2 emissions, prohibit the production of low-quality medicines, and use standardized health check-up formats for migrants and refugees to transfer their own health information. As a group, the G20 countries have the potential to solve global health problems and other issues. The convening of high-level health meetings at G20 summits has the potential to facilitate such endeavors.