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How does healthy ageing affect economic growth?

Globally, decision-makers are concerned that population ageing will result in slower economic growth and therefore greater demands for health and social care. 

However, a new set of six country studies by the European Observatory for Health Systems and Policies, WHO Western Pacific Regional Office, and WKC, shows how country investments in healthy ageing could positively affect economic growth across a range of country settings (Australia, Japan, Korea, Mongolia, New Zealand and Viet Nam) in the Western Pacific Region with over a third of the world's population 65 years and older.

Investments in healthy ageing can health countries realize the full potential of its older population and contribute to economic growth.

Read the 6 case studies here

Message of WKC Director for International Universal Health Coverage Day 2020

This International Universal Health Coverage Day on 12 December finds the world in a crisis. The coronavirus disease (COVID-19) pandemic has exposed inadequate health systems, gaps in social protection and inequalities. It has highlighted the importance of basic public health, strong health systems and emergency preparedness.

Universal health coverage (UHC) means that all people have access to the health services they need, when and where they need them, without financial hardship. The theme this year is “Health for all: protect everyone.” This means everyone - no matter their age, gender or ability - has a right to health care. Health for all is not wishful thinking. It is the basis of stable, equitable and peaceful societies that protect everyone.

COVID-19 and health emergencies disproportionately affect older people, those with multiple health problems and those who can least afford it.  A WHO survey found that COVID-19 disrupted essential health services in 90% of countries studied, including services for immunizations, chronic diseases, mental health and others. Better investments in resilient health systems will ensure that a crisis doesn’t derail progress ever again.

Primary health providers, such as nurses, midwives and community health workers, are the backbone of health systems. They are critical partners in driving health for all, bringing care directly to the people that need it most. Health for all means supporting them by ensuring they are first in line for treatment and a future vaccine so that they can provide health care. 

The WHO Centre for Health Development (Kobe Centre (WKC)) makes available accurate, scientific information accessible to professionals and the public in Hyogo Prefecture through translations of technical guidance and general information documents.

Safe and effective vaccines, diagnostics and therapeutics are vital for ending the pandemic, but will only be effective if they are available to those most vulnerable, in all countries. Over 180 countries have joined the COVID-19 Vaccine Global Access (COVAX) facility to ensure equitable global vaccine delivery. The pandemic isn’t over anywhere until it’s over everywhere.

We all must work together to ensure no one is left behind this UHC Day and every day going forward.

Advisory Committee expresses appreciation for WKC contributions to COVID-19

The Advisory Committee of the WHO Centre for Health Development in Kobe (WKC) has concluded its 24th annual meeting which was held virtually for the first time this year due to the unprecedented situation of COVID-19. 

The Director-General of WHO appoints the Advisory Committee which comprises representatives from each of the six WHO Regions, the host country, the local area, and the Kobe Group [1] which provides generous material and financial support to the work of WKC.

The Advisory Committee deeply appreciated the Centre’s central role in disseminating COVID-19 information for health professionals managing the outbreak and preventing outbreaks in Japan. At the same time, the Centre has maintained its research focus during such difficult times.

The new member to the Advisory Committee, Dr Teiji Takei, Assistant Minister for Global Health and Welfare, Ministry of Health, Labour and Welfare (MOHLW) in Japan, thanked WKC for the central role it has  played during COVID-19, including translation of documents. WKC worked with UN agencies and local Japanese experts to translate over 100 WHO technical guidance and public information documents about COVID-19. 

The Committee acknowledged the breadth of WKC’s research of 29 projects across multiple countries, and its impressive scientific output of 33 scientific publications, including the WHO Guidance on Research Methods for Health Emergency and Disaster Risk Management, the world’s first reference book to guide research during health emergencies.

The chair of the 2020 Advisory Committee, Professor Irene Agyepong of the Public Health Faculty of the Ghana College of Physicians and Surgeons and the Dodowa Health Research Center, representing WHO’s Africa region, said: “We congratulate WKC on progress and excellent response to the 2019 recommendations, in particular the impressive output including the Guidance. It is good that the Centre is focusing on its niche areas of Universal Health Coverage and ageing, health emergencies and disaster risk management, which are its comparative advantage.”

The Committee also commended the Centre’s expanded partnerships within WHO and with academic institutes globally and in the Kansai region of Japan, and recommended that it use opportunities such as WHO’s Regional Committee meetings to disseminate its work to key decision makers to impact on health policy and practice.

“I am really impressed with the number of publications WKC has produced over the year which reflects good quality work, and its expanded collaboration, globally and in Japan,” said Professor Maged Al- Sherbiny, Higher Education Senior Advisor of Direct Aid International in Kuwait representing WHO’s Eastern Mediterranean Region.

The Committee endorsed WKC as a Centre of Excellence and Innovation, and recommended that WKC secure core financing from WHO to expand its work even further. The impact of COVID-19 with respect to equity, access to care and ageing populations was identified as an emerging niche area for future research.

Iranian study identifies gaps in monitoring Universal Health Coverage in the context of population ageing

WKC supported researchers in Iran conducted a study on “Measuring Universal Health Coverage (UHC) to Ensure Continuing Care for Older People,”  to be presented virtually in a poster at the 6th Global Symposium on Health Systems Research on 11 November 2020.

One of the investigators, Dr Sedighe Hosseinijebeli, explained that the team aimed to fill a gap and propose a new framework to measure UHC progress that is relevant for health systems to respond to population ageing. "We undertook a scoping review and conducted panel reviews of academics and policy-makers in Iran to examine the feasibility of recommended indicators for the Iranian context,” she said.

Of the 35 relevant documents analysed, the findings confirmed that no specific framework exists for measuring UHC in the context of ageing. Existing frameworks for monitoring UHC lack specific indicators of care for older people. Furthermore, in Iran and other low- and middle-income countries where long-term care systems are not fully developed, much of the care for older people relies on informal care and there are little or no data on the coverage and quality of care.

“This study highlights how neglected the measurement of health system performance in relation to older people’s care is in comparison to other areas like maternal and child care, and communicable diseases,” said Dr Hosseinijebeli.

The study proposes indicators that could be used for monitoring quality of care, service coverage, expenditure patterns on long-term care, and financial and social protection for older people. The researchers urge the inclusion of key indicators of healthy ageing and older person’s care in future UHC measurement frameworks.

New study using ‘Big Data’ shows evidence of priority treatment for Japan’s older people

As Japan celebrates Respect for Older People’s Day (21 September), researchers published a novel study in BMC Health Services Research with WKC support on using information from large-scale health care databases to analyse access to health care associated with population ageing in Japan.

Few studies have been conducted about the quality of care for older patients with dementia, and even fewer have investigated the care they receive in acute care settings when they have accompanying medical conditions such as hip fractures.

This research explored whether acute hospital care was equitable and responsive to the needs of older people, and whether older people, and specifically those with dementia, had less access to surgery for hip fractures.

The researchers analysed secondary data from the Diagnosis Procedure Combination (DPC) Database, a national health care insurance claims database, and found 214,601 patients, 65 years old and over, with first-time diagnosis of hip fracture. Of these, 27% had mild dementia, nearly 21% had severe dementia, and 74% received hip surgery.

Among these patients who were treated in acute care hospitals, those with severe dementia were more likely to receive hip surgery and more likely to experience a shorter waiting time for the surgery than those without dementia. People in their 80s and 90s were less likely to receive the surgery compared to the younger-old, but those aged 90 years and above experienced a shorter waiting time before the surgery.

“I think the physicians recognize that patients with severe dementia can suffer greater consequences from the loss of function due to the hip fracture and want to treat their injury as soon as possible to prevent the dementia from worsening. This study presents some evidence of equity in the healthcare system in Japan,” said lead researcher, Dr Shinichi Tomioka of Hiroshima University at the time of the study.

“There are high quality data sets in each local hospital in Japan, but they are not fully utilized for health services research like this. We have provided trainings for hospital management staff from around the country on how to use the data, for example, to understand what types of care are most utilized at their hospital and which other facilities in the area it would be important to coordinate with. Through the trainings, we are cultivating potential leaders of the field for the future,” he said.

This study demonstrated that patients with dementia in Japan may be prioritized for hip surgery. It also found that patients living in remote areas were just as likely to receive surgery without delay as those living in urban areas, as long as they sought care in high-functioning hospitals. The research showed the usefulness of using big data to answer questions around health care and equity and adds to the global knowledge base of equity in health services.

For more on this study, click here:  https://extranet.who.int/kobe_centre/en/project-details/evidence-improving-health-care-provision-ensure-universal-health-coverage-amid-rapid

Information dissemination during a global pandemic: Experiences from WHO

On 26 August, Dr Sarah Barber, Director of WHO’s Centre for Health Development in Kobe (WKC) joined Dr David Malone, Rector of the United Nations University in Tokyo, in a virtual discussion on information dissemination during a global pandemic.

“The current COVID-19 pandemic has yielded overwhelming amounts of information. We are fighting an infodemic as well as an epidemic,” explained Dr Barber. “Too much information makes it difficult to identify what is factual and what is not. In turn, people struggle to know what to believe and what actions they should take.”

Thousands of rumours, conspiracy theories and reports of stigma around COVID-19 have spread rapidly on social media channels and in the media, fuelling mistrust of government and health workers, and contributing to unhealthy practices such as ingesting harmful substances in the hope of counteracting COVID. In doing so, these rumours undermine the people carrying out the pandemic response.

WHO has used a number of strategies to debunk myths and disseminate accurate scientific information for the public and decision-makers. EPI-WIN is an information network for epidemics which provides resources and regular updates, using a whole-of-society approach. It works with specific groups such as youth, journalists and faith-based organizations to co-develop guidance tailored to specific contexts and communities, to enable people respected in their communities to amplify the messages. A series of myth-busters were developed for social media platforms to dispel common and potentially harmful myths and curb stigmatizing behaviour.

“Importantly, individuals need to get information from trusted, reliable sources of health information like WHO, trusted academics or local public health institutes. The United Nations has a programme called “Take care before you share” to stress the need for everyone to verify the information first before sharing, and call out those who spread incorrect information. We can all play a role in saving lives and protecting people from misinformation. Each individual does have a responsibility to create a healthy neighbourhood in these social media environments,” concluded Dr Barber.

The UNU discussion may be viewed here.

WKC’s Silver Jubilee: Recognising 25 years Advancing Health Development

WHO’s Centre for Health Development in Kobe (WKC) is marking 25 years of advancing health development since its inception on 22 August 1995. 

The idea of creating a research centre in Kobe, Japan was first proposed to WHO by the Governor of Hyogo Prefecture and the Mayor of Kobe City in 1990, as a contribution to international health, through the generous support of the Kobe Group[1].

As an outposted office of WHO’s Headquarters, WKC was to conduct global research which would demonstrate the place of the health system in society and investigate the ways that health improvements contribute to increased economic and social productivity. This vision is the foundation of WKC’s research today on Universal Health Coverage.

The Centre was established in the aftermath of the Great Hanshin-Awaji Earthquake. It is uniquely positioned to contribute to the health systems response to health emergency and disaster risk preparedness and advancing universal health coverage (UHC) in the context of population ageing, while playing a key role in sharing lessons from Kobe, Hyogo Prefecture to other countries facing similar challenges. The Centre is located in Kobe, Hyogo in Japan, and its activities benefit the local community.

Over the years, the Centre has also been acclaimed for its work on urbanization, mental health, women’s health and health promotion and noncommunicable disease prevention and control. More recently, WKC has worked with local and international researchers and institutions to create new understanding of sustainable financing in the context of UHC, service delivery models and social innovations, and metrics and measurement in monitoring the progressive realization of UHC.

WKC’s establishment in Kobe has made the city a fixture on the global public health stage, hosting meetings and multidisciplinary discussions of global impact over the years. The Centre also contributes to the local community through partnerships with universities in the Kansai area, dissemination of research results in local WKC fora, participation in local technical committees, and more recently, through disseminating information to professionals and the public about COVID-19.

The work of WKC in Kobe would not have been possible without the sustained support over 25 years of the Kobe group and the Hyogo and Kobe communities, for which WHO and the Centre are sincerely grateful. WKC looks forward to furthering its work with partners across the Kansai region of Japan to fulfil both the global health mandate and the needs of the local community.

WKC’s Director to participate in an event “Information Dissemination During a Global Pandemic: Experiences from the WHO” hosted by UNU

On 26 August 2020, Dr Sarah Barber, Director of the WHO Centre for Health Development (WHO Kobe Centre, WKC) will speak at a virtual conversation event “Information Dissemination During a Global Pandemic: Experiences from the WHO”, hosted by the United Nations University (UNU).

The ongoing COVID-19 pandemic has transfixed global attention in 2020. Media coverage on the topic has penetrated every aspect of daily life, serving the public with overwhelming amounts of information. This is further complicated by misinformation and the near-daily emergence of new facts on the virus and implications. All of this has led to a depreciation of public trust in information, frustrating efforts to minimize infections while time is bought for the development of a vaccine. How can the right information be effectively disseminated? How can the public discern factually accurate information? How can misunderstandings, mistakes, and developments be communicated without inviting controversy?

UNU Rector David M. Malone will join Dr Barber to discuss how the World Health Organization (WHO) has sought to provide reliable information to the public and blunt the impact of an infodemic. This event will be held via Zoom Webinar at 18:30 (JST).

For more details and registration, please visit the UNU’s event page

WKC contributes book chapter in new reference book on global health

WKC’s Director, Dr Sarah L. Barber and technical officer, Paul Ong, collaborated with Zee A. Han of WHO’s Department of Maternal, Child, Adolescent Health and Ageing and Health in Geneva to produce a chapter on “Long-term Care in Ageing Populations” in the Handbook of Global Health published by Springer in July 2020. 

Public health successes have led to global population ageing. Many countries rely on household members and the community to provide long-term care (LTC) to help people live independently and safely when they can no longer routinely care for themselves. However, as populations age, the supply of informal caregivers is declining. Governments are playing a larger role in organizing and funding formal LTC services and institutions yet financing this has posed challenges.

The authors conclude that even with the expanded role of governments in LTC, households, communities and skilled care providers are needed to assist with LTC. More research is required on how to improve recruitment of LTC workers, incentivise informal care givers, and expand coverage to ensure access to quality care for the whole population without financial hardship for older persons and their families.

WKC gives first online lecture to high school students

The COVID-19 pandemic has impacted life around the world, but has not stopped the WHO Centre for Health Development from engaging with local communities through online lectures in line with WHO's guidance to staff for controlling the spread of the disease.

On Thursday, 18 June 2020, Dr Ryoma Kayano presented to 160 2^nd and 3^rd year students from Fukiai High School in Kobe on WHO, global health and COVID-19. He explained the current situation of the pandemic and reminded the students of the importance of continuing to follow the basic prevention measures, such as handwashing, respiratory hygiene, physical distancing, frequent cleaning of surfaces, and staying at home if they feel sick.

The students asked the role of local health security in global health security, whether developed countries should focus on their own second wave prevention measures or assist developing countries in controlling the pandemic; and what skills are needed for a career with WHO.

From their feedback, the students gained a better understanding of WHO’s role in providing guidance to countries, and how to protect themselves from COVID-19 infection.