Two Practices to Encourage a Community to be Sustainable by Supporting the Children from their Birth to the Self-realization in (i) Kenya and (ii) Japan

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Description

Intro

Despite that future productivity in the community is severe problem in the world, there are communities where still exist high child mortality rate because of less access of welfare services as well as where children who feel difficulty in living because of developmental disorders including autism and ADHD. Under the circumstances, Shionogi is conducting two practices (i) in the local community in Kenya so that children could survive and be brought up and (ii) in the local community in Japan so that children who feel difficulty in living could be provided relief allowing fulfillment of their innate abilities.

Objective of the practice

As stated in Introduction, Shionogi is conducting the following two projects (1 and 2) toward the respective objectives in addition to the providing innovative new drugs in anti-infectious diseases and CNS (central nervous system) area based upon the advanced science and technology as ordinary pharmaceutical businesses for the purpose of the SDGs Agenda 3. 
Project 1: The objective of project 1 is the reduction of child mortality by developing a sustainable community for the children and mothers in Narok County, Kenya. Within the project community, there are high levels of poverty, food inadequencies and low access to medical services, especially affecting pregnant and nursing mothers due to gender inequity. To implement the SDGs Agenda 3-1, 3-2, 3-3, 3-7, 3-8, 3.C, 4-5, & 4-7, we try to strengthen the community to promote healthcare of children, pregnant women, and nursing mothers in a sustainable and self-reliant way through partnership with NGO and local government (Agenda 17-16 & 17). Therefore, along with arrangement of healthcare systems, we focus on education for children and parents to support them to raise awareness about health and call for action to further improvement. 
Project 2: The objective of project 2 is to encourage all children in Japan to be vigorous, specially a child having developmental disorders (DDs) gets proper nurturing, support, and education in Japan. It is said that the total support to the DDs should be consisted of four regions: family, education, welfare, and medicine. So, we started to work into the non-medication region to contribute the desirable support of DDs. DDs are also called “invisible disorders” because it is difficult to realize whether a person has DDs unlike the physically challenged. Japanese children seem to receive good education, but some children with DDs are left behind in school life. Actually, they come to school but cannot keep up their classes, however, it sometimes leads to the secondary disabilities like hikikomori, i.e. withdrawn from school or society and having difficulties in social activities and/or communications. In project 2, we planned to establish the partnerships with a local government to support the children since local governments are in an effort to arrange education for children with DDs under law-enforcement guideline in Japan. To implement the SDGs Agenda 4-5, 4-7, 8-5, 8-6, 17-16 & 17, we started to support the children with a local government by empowering their parents, teachers, and supporters including caregivers from early 2017. We believe that our practices make them keep up lessons or trainings in school and eventually lead to reduce the number of people who are not in education, employment, or training.

Partners

Project 1: Beneficiaries are people in the target area including children. We construct healthcare facilities and educate to community through trained community health workers under partnership with county, government, and NGO.
Project 2: Beneficiaries are children with developmental disorders in the target areas. Based on a project partnership agreement between Shionogi and the local governments, such as Osaka, Shiga, Hiroshima, and Iwate prefectures, we give the stakeholders, like their parents, teachers, and supporters, an opportunity to learn correctly what and how developmental disorders are.

Implementation of the Project/Activity

Project 1: We can contact and directly confirm the needs of the target area and implement our programs through NGO, World Vision (WV) Kenya who originally has operated a long-term regional program to support community development. Prior to kick-off the project, we developed a relationship with the community resident. Then, we increased the capacity of health systems to deliver maternal, newborn and child health (MNCH) and improve utilization of essential health services. From 2016, along with these arrangement of infrastructures, we strengthen community level health structures and local health advocacy. To establish or strengthen Mother-to-Mothers (M2M) support groups to enhance peer education on MNCH, we trained Community Health Workers (CHWs) and also supported the groups to establishing and strengthen income generation activities. Community Health Extension Workers (CHEWs) are also important role as trainers of trainees who then facilitate peer education among M2M groups. Furthermore, we addressed other critical problems such as lack of water by supplying water tanks near the hospital, sanitation issues and support income generating activities such as beekeeping, growing vegetables, and flour milling. These activities have a positive effect on nutritional condition and education about nutrition to people in the area. WV has provided the services and report to Shionogi to track the improvement and progress of the project.
Project 2: Prior to kick-off the project 2, we collected information about the children’s surroundings. We caught many parents in Japan were unaware that there were developmental disorders (DDs) as a cause of hard-to-raise child. And teachers and supporters were in trouble with how to communicate with the children, and a local government could partially provide the learning system to people surrounding the children (parents, teachers, and supporters). As a result, children having DDs tend to spill out from Japanese standard education system. That’s why we planned to provide the opportunity in learning DDs for parents and/or people surrounding the children, that is, public lectures about DDs and how to take care of them. Further, we increased the number of supporters who can communicate properly with the children, by holding skill-up seminars about DDs for pre-school teachers and parent training seminars for supporters. We also offered the seminars for enterprise mangers about how to put a person with DDs to work moderately.

Results/Outputs/Impacts

Project 1: We have constructed healthcare facility, maternal ward, general ward and water tanks. A trainers training of 10 Community Health Extension Workers (CHEWs) and community strategy persons was done in December 2016. Three follow up training sessions of Community Health Volunteers (CHVs) in each location by the trainers were done to educate i) maternal infant and young child, ii) nutrition, water treatment and safe storage, iii) hand washing and food hygiene. People in the area feel going to health facility is terrifying and unbrave action according cultural background. However, they alter such consciousness through regular educational activities for residents along with offering basic medical services and the experience of delivery in health facility with low discomforts. There is a gradual increase in the number of visit to health facilities and mothers who receive prenatal check-up including HIV test and deliver in health facility. Men gradually recommend women to give birth in health facility in community meeting and support their wives to access to health facility. It contributes to improvement on gender inequality as well as health of children and mothers. As a cause of the increase number of deliveries in health facility, traditional birth attendants (TBA) lose their job. We support TBA to start up the savings-and-loan group as alternative job and raise working capital for community healthcare activities. Over the course of nearly three years, there has been a gradual increase in the immunization rate in children under five.
Project 2: We performed some practices with local governments such as four prefectures (Osaka, Shiga, Hiroshima, and Iwate) and two small cities. The total number of participants about the seminars for parents was 300, for all residents was 1200, for supporters was 700, and for enterprise managers was 340 for these 2 years. Altogether, more than 85% of participants in the seminars understood the developmental disorders. Three local governments, our partners, convinced the effect of the practice about helping parents, and started to carry out it as budgeted programs by themselves.
During the implementation of the practices, we noticed the differences of the way of thinking between Shionogi and the local government. For example, we would put the importance on simplicity and accessibility while local governments prioritize accuracy of information. These two concepts were sometimes conflicting.
As a negative impact, it is assumed that some people misunderstand that it may be acting to sell medicines for developmental disorders. We repeatedly explained our intention to support the children and encourage understanding what we want to do.

Enabling factors and constraints

In both project 1 and 2, we have similar constrains: The hurdle resulted from law and regulations and limitations of funds and budgets. We seek the way of project management to achieve win-win corporation with all stakeholders through partnership with NGO, local governments and university (project1), local governments, parents, teachers, and supporters (project 2), united under common goals and put the ideas into action for desirable future. Unification to corporate vision lead to donation by Shionogi employees and providing funds from a portion of the sales from multi vitamin Popon S series in project 1. Through this project, we connect mothers between Japan and Africa. In project 2, private-public partnership would be useful to overcome the limit of budgets and resources for a local government. As a result, the residents can receive better social services.

Sustainability and replicability

Project 1: The action for improvement of public health and support for self-sustainability in the target area is feasible to commit for any categories of industry. A certain amount of budget is needed to construct facilities, but continual expense is not required for designing the project along with local NGO activities in order to improve the action and achieve the goals. We support grassroots organizations such as Community Health Volunteers (CHVs) and M2M support groups to implement the activities in a sustainable way. To create evidence that can encourage further expansion of the project, we are planning to collect epidemiological data with Nagasaki University to assess impact of health improvement activities in the target area (death caused by diarrhea, impact of access to medical services)
Project 2: The practices in one local government for supporting children with DDs can be carried out by about 25% of a Japanese median annual income. We believe that encouraging children to be self-reliant will promote productivity in future.
In our current project, we focus on promoting better understanding of DDs, but the scheme of our approach can be applicable to other disabilities or minority challenges. Our commitment is project management based on general business knowledge.

Conclusions

In conclusion, we would like to emphasize that it is important to get partnered among several players, including but not limited to regional governments, to support and educate the community toward the world that no one left behind. 
Shionogi continues to provide innovative medicines to the world to contribute health and well-being as stated in company’s philosophy toward the SDGs Agenda 3. In addition to our ongoing business, Shionogi also contributes to the society to support local government, community welfare officers, school teachers and medical personnel if needed to help the community under our programs as explained herein. To summarize, our program consists of five steps which will be provided to the society according to the social needs as follows; 
Step1: To support community environment enables citizens to live safely. -Ensuring a clean water by preparing water tanks. 
Step2: To support community infrastructure enables pregnant women deliver their babies safely. -Building obstetrics in the area with sufficient medical access and equipment to reduce the child mortality. 
Step3: To support the community to supply the citizens several services for keeping their physical and mental health. -Building healthcare facilities and providing medicines for treatment of AIDS through patent pool. 
Step4: To support the community to provide the education continuously so that citizens could become self-reliance. -Training the community to learn how to treat maternal and new-born children in clean and safety environment, train teachers and welfare supporters to avoid children’s undesirable withdrawal from the society with local government. Both approaches are aiming to save and bring up the children in the community. 
Step5: To advocate the society as a whole to accept all people who has various backgrounds. -Providing information continuously to help their understanding to the government, on the web, by partnering with NPOs and NGOs, etc. 
Goals to be achieved: The community becomes independent by the employment creation and the economic growth in the community, procuring the environment considers human rights and securing the future productivity in the community. 
It is extremely challenging to achieve the goals in the community since we need to proceed these five steps one by one while our capability is limited to contribute such challenging. As explained, we plan to complete Step 1 to Step 3 in our project 1 and further plan to complete Step 4 to Step 5 in our project 2 respectively. These steps would be valuable even in both of Developed countries and/or Emerging countries taking into consideration future population and economy in the countries. So, we believe our approaches could contribute toward the achievement of Sustainable Development Goals and it should be proceeded by partnership among multi stakeholders broadly and aggressively. Since our contribution to the community is still limited and we are assessing the outcome of our project, we will continue our approaches toward the goals.

Other sources of information

https://docs.wixstatic.com/ugd/37a51e_a9fcd702345447dca7331ca802bb0971…

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