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Award-winning OB-GYN: Japanese health advisor achieves global recognition for efforts in Laos

Dr Hiromi Obara presented with FIGO Award at World Congress in Rio de Janeiro, Brazil.

Laos-based medic Doctor Hiromi Obara from Japan is one of twenty women practitioners in the field worldwide awarded in 2018 by the International Federation of Gynecology and Obstetrics’ (FIGO) at its World Congress in Brazil. The recognition comes amid contributions to improving the health of women in low and middle-income countries and other resource-limited settings.

As the winter snows fall on Japan’s rural and windswept northern coastal Aomori prefecture, the cool, dry season of Laos in tropical South-East Asia may seem somewhat distant indeed.

For award-winning medic, Dr Hiromi Obara, the connection between the two places and their people is clear when it comes to maternal and child health.

Growing up in this part of rural Japan helped put this women’s reproductive health specialist on a long path to the international impact that has now seen formal recognition. Her inspiration to pursue a career in this critical field of medicine was born of experiences of people in her homeland, whose geographically remote and less populated parts have long-faced the challenges of deficits of access to medical care due to distance and related issues.

Her career since has seen her obtaining her MSc in Epidemiology at the London School of Hygiene and Tropical Medicine to contributing in joint efforts with counterparts to improve access to quality care for rural and remote communities in the Southeast Asian nation of Laos and beyond.

Dedication and capacity developed over the intervening years has led to present focus on the health of women and children in Laos. In this south-east Asian nation, she actively supports policymakers and practitioners to assist more women and children in rural and remote parts to achieve better health outcomes thanks to increased access.

Serving as a Health Policy Advisor to Laos’ Ministry of Health on behalf of Japan International Cooperation Agency (JICA), Dr Obara is working closely with fellow officials and programme managers in the country to improve access to the services provided by professional health personnel nationwide.

Now, these efforts have been formally recognised by her fellows in the field. FIGO, a peak body representing national societies in some 130 countries worldwide, awards women obstetricians and gynecologists, predominantly from low- and middle-income countries, who have contributed significantly to the improvement of health care for women in their daily practice or via research.
FIGO Award winning Dr Hiromi Obara

Among the twenty FIGO awardees announced at the triennial global congress held in October in Brazil, Dr Obara was one of a handful to hail from a developed country.

Asked what she is most proud of, it’s the impact of the results of the work of her counterparts and the achievements they have been able to make with women, their children, families and communities.

“Compared to other countries, the situation in Lao PDR was notorious concerning inequity in access to Maternal and Child Health Care, as recently as 2011/12.”

“However, thanks to the government’s commitment, investment in reproductive, maternal, newborn, child health has increased by various means such as the development of midwives, free MCH access schemes, resulting in improved pro-poor access to maternal and child health at scale.”

Among these achievements is the increased percentage of births attended by professional health personnel. As average, the proportion of deliveries attended by professional health personnel increased from 42% in 2011/12 to 64% in 2017.
More mothers and children benefit from access to professional health personnel. – Image JICA

Credit for such improvements she ascribes primarily to efforts of counterparts in the ministry at every level, from leadership to those delivering lifesaving and protecting services across the country.

“My counterparts (MoH officials) have strong ownership and leadership which,  together with the inputs from JICA and other Development Partners, has contributed to the recent health outcomes, in particular, pro-poor and equitable access to maternal and child health services.

“Without enough dialogue, it is not possible for me to offer technical support. As such, I appreciate their kind collaboration. I have learned a lot from MoH officials here in the Lao PDR.”

On secondment from the National Center for Global Health and Medicine (NCGM) Japan, Dr Obara has over 18 years’ experience providing technical, programmatic and management support in reproductive, maternal and newborn health (RMNH).

Her career has since seen her contributing across several locations in the Western Pacific Region and beyond, focusing on resource-limited settings in particular.

At home in Japan, she has served as Deputy Director of the International Affairs Division of the Ministry of Health, Labour and Welfare and as a doctor at Jichi Medical University Hospital.

Apart from Laos, she has also worked as a reproductive Health Medical Officer in World Health Organization (WHO) Regional Office for the Western Pacific and as Chief Advisor to JICA’s MCH project in Cambodia.

Dr Obara counts among her areas of expertise country policies, strategies, plans, clinical guidelines, and efforts to improve financial access to and equitable access to and quality of care. Her efforts include contributing to regional and global meetings as an RMNH expert and to WHO publications as a member of several Guideline Development Groups and the Independent Review Group.

Such contributions have seen her well placed to offer advice to health authorities in how to best conduct maternal death reviews, improve newborn care, eliminate unsafe abortions, develop policy strategy frameworks and conduct monitoring both at country and regional levels.

Japan Overseas Cooperation Volunteer (JOCV) supports Lao medical professionals to deliver MCH services. (Credit Steven A Cleary/JICA)

Japan Overseas Cooperation Volunteer (JOCV) supports Lao medical professionals to deliver MCH services. (Credit Steven A Cleary/JICA)

Looking forward, Dr Obara is optimistic about the trends and prospects for better access and outcomes for women and their children in Laos as the developing nation closes in on its 2020 goals.

To achieve these goals and continually improve the health outcomes for women and infants in 2020 and beyond necessitates appropriate funding allocation to the sector in terms of facilities, equipment and medicine as well as providing targeted incentives for ongoing improvement of human resource capacity to deliver result-based, family-centered services and clinical care countrywide, Dr Obara said.

Dr Hiromi Obara presented with FIGO Award at World Congress in Rio de Janeiro, Brazil.

Dr Hiromi Obara presented with FIGO Award at World Congress in Rio de Janeiro, Brazil.

PFHA Assesses Health Activities

A project aiming to improve health service quality for local people in Laos’ northern provinces was one of the achievements highlighted at a meeting of the Promotion of Family Health Association (PFHA).

The health initiative known as the Safe Motherhood project has been targeting the provinces of Luang Namtha, Bokeo, Oudomxay and Vientiane promoting nutrition for newborns, distributing information on reproductive health to youth while giving communities better access to health services.

Chair of the PFHA, Dr Chansy Phimphachanh noted the achievements in Vientiane on Thursday at the annual PFHA meeting to review its activities.

Although maternal, newborn and child death rates across Laos have continued to decline she said we need to promote to mothers and children how they can gain access to more health services at hospitals and dispensaries.

Many poor women living in remote areas of these provinces can’t access health services because they don’t have enough money to pay for a hospital visit and still lack knowledge on healthcare for their children.

She also noted that providing individuals with family planning services not only dramatically cut infant and maternal deaths, but also improved the health of mothers and children.

Complications around pregnancy remain the greatest killer of girls and women in the developing world, including Laos, she added.

She explained that sexual reproductive health and rights along with family planning were key pillars for reducing maternal mortality and improving mother and child health in target provinces.

According to the PFHA, the association is part of the International Planned Parenthood Federation which has had presence in Laos since 2004.

Their vision is to provide Lao people with innovative and up-to-date reproductive health information and quality services for a healthy society, contributing towards lifting Laos out of least developed country status.

Their work is based in 4 four key strategies: promoting family health for those in the remote areas of the country, empowering individuals through awareness-raising on reproductive health knowledge, information and services, supporting health service providers at the local level to have adequate knowledge, information and skills and work in collaboration with government authorities, relevant stakeholders, and other civil society organisations.

According to the Lao Social Indicator Survey 2016, the mortality rate of infants was 86 per 1,000 live births. The mortality rate of mothers was 200 for 100,000 births.

Source: Vientiane Times

Ministry To Draft New Health Insurance Law

Health Insurance Law Laos

The Ministry of Health plans to introduce a Health Insurance Law to improve the healthcare system and ensure patients benefit as intended.

It is expected the law will come into effect in late 2018. It will ensure that money is available to pay patients who are members of the Health Insurance Fund for medical costs specified in the insurance agreement.

A legal expert at the ministry, Dr Chansamone Phengsavanh, told Vientiane Times yesterday the law is needed in response to public demand for an improved healthcare service system for members of the fund.

For several years now, members of the Health Insurance Fund have been complaining of the poor service they have received from hospitals. Patients say that doctors, nurses and other staff don’t provide them with good quality care.

In Laos, they say, health workers still practice old-fashioned working methods just as they did many years ago.

This means they don’t take proper care of hospital patients, believing they need only provide minimal services as they are not required by law to do otherwise.

The Health Insurance Fund is operated by the Social Insurance Agency of the Ministry of Labour and Social Welfare. But there have been problems with coordination between hospitals and the ministry concerning the reimbursement of treatment costs.

The ministry has been unable to resolve this problem because of the lack of a Healthcare Insurance Law, Dr Chansamone said.

We think that members of the fund will benefit from such a law because the Health Insurance Fund is operated by the Ministry of Health, he added.

The scheme would be administered by a government agency under the ministry so that it would be more efficient and provide a better system for patients, he said.

In 2017-2018, the ministry also plans to strengthen the Law on Disease Control, Hygiene and Health Promotion.

From 2011 to 2015 the following laws have been passed to improve the health sector: Law on Alcoholic Beverages; Healthcare Law; Law on Food; Law on Drugs and Medical Products; Law on Hygiene, Disease Prevention and Health Promotion; Law on HIV/AIDS Control and Prevention; and the Law on Tobacco Control.

According to the National Assembly, Laos now has more than 100 laws in effect.

Source: Vientiane Times

Deputy PM Pushes for Speedy Mother and Child Health Improvements

Deputy Prime Minister has called on the Ministry of Health to speed up improvements to health services for mothers and their children especially at district and community levels.

Dr Sonexay Siphandone made the call in his address at a meeting held last week to review implementation of the Strategy and Action Plan for Integrated Service on Reproductive Maternal, Newborn and Child Health.

The strategy focuses on improving reproductive health, safe birthing, emergency care at birth, basic care needs of newborns, children’s healthcare, immunisation, nutrition, health personnel, health financing, and medical information.

Speaking at the meeting on Friday Deputy PM Sonexay reminded the audience about the government giving priority to mother and child healthcare by putting disease prevention and health promotion alongside the quality treatment and coverage of service delivery.

He stressed for women to receive health services during pregnancy and to have a doctor or midwife assisting at birth and after-birth monitoring.

Dr Sonexay referred to results of the 2015 National Population and Housing Census, which showed the mortality rate for children under one year of age decreased from 70 per 1,000 in 2005 to 61 per 1,000 last year.

Meanwhile, the mortality rate of children under five fell from 98 per 1,000 to 71 per 1,000 and the maternal mortality rate fell from 260 per 100,000 births to 206 per 100,000. The country has been third-ranked by the United Nations regarding the progress in reducing maternal mortality.

Dr Sonexay, representing the government, praised the ministry for the achievements.

However, according to the ministry, access to reproductive health, family planning services and health information was still limited for many communities, especially people living in remote rural areas, who rely on subsistence farming for making a living.

Moreover, the quality of the mother and child services, especially healthcare during pregnancy, emergency births and newborn childcare was not in place for many communities with a lack of appropriate facilities, capable staff and equipment.

This caused some mothers to be unaware of using appropriate health services, and only 50 percent of pregnant women utilised them.

I propose the ministry speed up improvements that can make people confident in our healthcare services, DPM Sonexay said.

He noted the medical staff needed for the communities alongside building integrated service facilities that met the ministry’s standards and were accepted by the World Health Organisation.

He called on provincial authorities to facilitate the health sector to fully implement its duty, with the establishment of clearly mandated health committees at village level.

On financing, the deputy prime minister proposed the ministry continue coordinating with the government in building a financial plan and mobilise support from international development partners so that state health allocations could reach 9 percent of total expenditure as approved by the National Assembly.

He also called on provincial authorities to actively contribute to the government action.

 

Source: Vientiane Times

ASEAN Health Experts Discuss Opthalmology

Health experts from Laos and ASEAN member countries met in Vientiane on Sunday for the 9th Annual Lao Ophthalmologist Conference to discuss the latest developments in ophthalmology in the efforttoraiseLaos’treatment standards to international levels.

The participants discussed advanced techniques and modern treatment methods in order to bring better vision to their patients.

The meeting was not only an exchange of ideas, but also included the strengthening of assistance programmes between the participating countries, a health official said.

Speaking at the opening ceremony, Minister of Health, associate Prof. Dr Bounkong Syhavong, said such meetings are an important manner for ASEAN member states to develop and build the ASEAN medical community.

He noted, “I would like to express my thanks to all the speakers from ASEAN member countries, organisers,

technical officers and other relevant persons, who devoted their efforts to organising this meeting.”

“We strongly believe the result of this meeting will highly benefit our people by improving ophthalmological services through higher quality of treatment and technical innovation”, he said.

The President of the Lao Ophthalmological Society, Dr Vithoune Visonnavong, said, “We had the opportunity to meet well known ophthalmological experts from many countries around the ASEAN region who are willing to assist us in bettering our treatment programmes”.

“We also wish to invite all national and international organisations who are interested in the field of ophthalmology in ASEAN to join in this important congress,” he continued.

“The convention is not only dedicated to furthering participants’ academic knowledge, but is a centre of opportunity to meet other ophthalmologists from different organisations from ASEAN countries,” he added.

Cataracts are a challenging issue in Laos as many people have difficulty accessing treatment for the disease. Other issues like glaucoma continue to present challenges for doctors because practise standards are not up to par with international levels, making treatment more difficult. Through meetings like the Annual Lao Ophthalmologist Conference, the latest developments and treatments can be shared by global experts with Lao doctors, who can use their new found knowledge to better treat their patients.

 

Source: Vientiane Times

Ministry of Health, UNICEF Discuss Nutrition Project

The Ministry of Health and UNICEF are reviewing the progress of UNICEF’s health and nutrition programme as they plan for the year ahead.

A review of past work and planning for the next year took place at the meeting about the Health and Nutrition Programme on Thursday in Vientiane, attended by the Director General of the Hygiene and Health Promotion Department under the Ministry of Health, Dr Phath Keungsaneth, and the Deputy Representative of UNICEF in the Lao PDR, Dr Myo-Zin Nyunt.

The purpose of the meeting was to review the entire Country Programme Cycle (2012- 2016), supported by UNICEF in addition to presenting the Country Programme Development Outputs and other areas wherein UNICEF supports interventions for the new Country Development Programme.

The Health and Nutrition Programme will ensure that children and their families, especially the most vulnerable, have access to immunisation, proper nutrition, deworming and management of childhood illnesses.

Meanwhile, the Wash and Climate Change Resilience Programme will ensure that the most disadvantaged children and their families have equitable access to sustainable water sources and sanitation facilities in addition to education on the adoption of good hygiene practises. The programme will

support community resilience- building in response to climate change and natural disasters.

During the period 2012- 2016, the Ministry of Health and UNICEF successfully ran disaster mitigation projects in five provinces and supported hygiene programmes at 100 schools in Saravan province. Many people in the rural areas gained access to clean water sources and hygiene education for the first time through the programme.

The country programme goal and strategy of 2017-2021 is to ensure that children, especially the most disadvantaged, fully enjoy their rights to survival, development and protection.

Speaking at the meeting, Dr Myo-Zin Nyunt said, “UNICEF is proud of its long and fruitful partnership with the Ministry of Health to improve maternal and child health and nutrition, as well as to provide access to improved sources of water, basic sanitation and hygiene promotion in schools and communities for the most disadvantaged children and their families”.

“During the next five years, UNICEF will continue to support the Ministry of Health in addressing the challenges that the most vulnerable children and their families face. UNICEF support will include improving access to vaccinations and the nation’s capacity for mass immunisation campaigns. In addition, we plan to improve access to nutrition to stem the issue of severe acute malnutrition,” Dr Myo-Zin Nyunt concluded.

 

Source: Vientiane Times

Doctors’ Training Course Boosts Health Prospects for Newborns

Paediatric experts need to learn more about infectious diseases, hematology, cancer, heart disease, kidney disease and neurology if they are to improve the health of newborns and children.

Speaking at the opening ceremony of the Second Paediatrician Training on Monday, President of the Paediatrics Association of Laos, Associate Prof. Dr Khampe Phongsavath, said it is necessary to provide more training for paediatricians if they are to save the lives of more children.

Deputy Director of the Children’s Hospital, Dr Somxay Billamay, said he hoped the training would help to improve the skills of the 38 paediatricians attending the one-day session.

Topics covered included accurate diagnosis, cardiology, infection, parasitological diseases, nephrology, neonatology, hematology, allergies and respiratory conditions, radiology, emergency medicine, pathology, gastrointestinal problems, nutrition and obstetrics.

An official from the Department of Pathology at Kyungpook National University in the Republic of Korea, Prof. Yong-Jin Kim, also attended the event.

The I-HOPE project run by the Korea International Cooperation Agency supported the training course.

 

Source: Vientiane Times

Regional Health Officials Mull Ways to Control Infectious Diseases

The prevention and control of infectious diseases will be more effective in the Mekong Sub-Region and Asia-Pacific Region after international health officials met for talks in Champassak province last week.

Health officials from Cambodia, Laos, Malaysia, Myanmar, Thailand and Vietnam discussed how to combat emerging diseases and public health emergencies that are now threatening people’s health in the region.

Speaking at the opening ceremony of the Regional Workshop on Implementing Asia-Pacific Strategy for Emerging Diseases and Public Health Emergencies in the Mekong Sub-region, Minister of Health Associate Prof. Dr Bounkong Syhavong said that over the past few years, countries in the Mekong Sub-Region and Asia-Pacific Region have faced outbreaks of various infectious diseases like SARS, bird flu and Zika.

I hope that discussions among health officials in the region will help us keep diseases at bay and prevent future outbreaks, he said.

In addition, the workshop encouraged medical professionals in the region to work in a more coordinated manner to combat diseases.

Measures adopted by health officials included capacity building and good standards preparedness for preventing and handling infectious diseases.

Participants agreed the workshop would promote coordination and cooperation among health officials in Laos and other countries in the region.

This included an agreement to work closely together in the event of a future outbreak of infectious disease.

Lao health officials from Phongsaly, Luang Namtha, Oudomxay, Bokeo, Huaphan, Xieng Khuang, Khammuan, Saravan, Xekong, Attapeu and Champassak provinces attended the workshop.

 

Source: Vientiane Times