The role of the Maternal and Child Health Handbook system in reducing perinatal mortality in Japan.
OBJECTIVE
The purpose of this paper is to demonstrate the direct and indirect roles of the Maternal and Child Health (MCH) Handbook in promoting overall improvement in maternal health and child care and to attempt to clarify the relationship between the use of the MCH Handbook and the reduced perinatal mortality in Japan. Another important objective is to propose possible future applications of the MCH Handbook, especially with respect to the networking function of providing client-care provider feedback, and the exchange of health data between the authorities and relevant medical societies.


RESULTS
Japan has achieved a decline in neonatal mortality in the 30-year period from 1960 to 1990, from 17.0 to 2.6 per 1,000 live births. There is a correlation between the ratio of the number of Handbooks distributed and the actual number of births and the perinatal mortality.


CONCLUSIONS
The wide use of the MCH Handbook system seems to have played an important role in bringing about this reduction and in maintaining the figure as one of the lowest in the world. The reduction of perinatal mortality through the use of the MCH Handbook in this country suggests a similar possibility for application in other nations. The Handbook could aid in the early recognition of high-risk pregnancy and thus reduce inappropriate use of medical resources. The system, with the establishment of a feedback system between the client and the authorities via the care provider, may improve health care in such areas as maternal mortality, toxemia of pregnancy, and diabetes mellitus.
Department of Healthcare Administration, Nippon Medical School, Tokyo, Japan.
K
K
Takayanagi
S
S
Iwasaki
Y
Y
Yoshinaka
D000328:Adult; D002662:Child Health Services / Q000592:standards*; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008427:Maternal Health Services / Q000592:standards*; D008428:Maternal Mortality; D011247:Pregnancy; D012014:Reference Books, Medical