Japan and the US: The Bigger Picture

Japanese Notebook Turns the Page for Infant Health

Every day, refugees fleeing strife-torn countries have to make painful decisions about what to bring with them on harrowing journeys. Aboessa, a 20-year-old Syrian refugee and mother—in a story recounted by the International Rescue Committee—knew that besides medications, clothes, and baby food she absolutely had to have one thing for her and her 10-month-old infant inside her small bag: a colorful notebook.

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Aboessa is one of the millions of mothers around the world who have received a copy of “Boshi Kenko Techo” or Mother and Child Health Handbook. This deceptively simple notebook was first designed and distributed in Japan by the government in 1942, consisting only of records for pregnancy to birth. In 1948, the book was revised to include information throughout early childhood on topics like maternal care, health checkups, and food rations. Now distributed in many different languages across more than 20 countries worldwide, it has been customized based on the conditions within each country and has kept mothers and their babies healthy for over 50 years by empowering women with the information they need to take care of themselves and their children.

Where medical databases aren’t digitized or standardized across different medical facilities, the handbooks give mothers personal records of their babies’ health that they can bring from doctor to doctor. The vibrant illustrations solve for a problem taken for granted by those reading these very words: illiteracy. In countries with high levels of illiteracy or that lack health education programs, the visual aids on healthcare topics such as nutrition and wellness serve as a credible, easy-to-re- member baseline for health education material. Women may never have been exposed to this in their lives.

The handbooks also provide women with objective standards and data to make sure that their babies are born and stay healthy. Imagine if your only benchmark for yours and your babies’ health were your closest neighbors! Instead, for women who don’t have access to regular medical care or information, the handbooks help make sure they are taking care of themselves, providing confidence and peace of mind that they’re on the right track from pregnancy to delivery and early child- hood development.

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<p class=”p1″><span class=”s1 pull-quote” data-pullquote=”placeholder”>”8 million handbooks are distributed each year outside of Japan.” – Japan International Cooperation Agency</span></p>

While the conceptual idea of detailed record-keeping is distinctly Japanese, these handbooks are customized to each country’s local needs. Indonesia was one of the first places the handbooks were made available outside of Japan. In 1994, 3,000 books were distributed in local municipality Salatiga as a pilot trial conducted by the Japan International Cooperation Agency (JICA). Separate cards and leaflets were integrated into each handbook to ensure that they met the local needs. The books were so successful in teaching mothers about ante-natal care, immunizations, and other maternal health services that in 2004 the Indonesian Minister of Health declared everychild should be provided with a customized handbook and all healthcare workers should educate parents about maternal and infant health using the handbook. In 2015, 5 million books were distributed across the entire country.

Keiko Osaki, senior advisor on health for JICA, estimates that 8 million books are distributed each year outside of Japan thanks to JICA’s financial and technical support.

The emotional bond that mothers have with the books is strong. Many hold onto the books for years to remind them of the rewarding journey they took with their babies. Osaki says after natural disasters like Indonesia’s 2006 Yogyakarta earthquake and Japan’s Tōhoku earthquake in 2011, women returned to the devastated areas to find their handbooks— not just for sentimental value—but for the valuable medical information. Mothers like Aboessa consider the handbook to be priceless.

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