ラオス農村部の母子保健と衛生の改善に寄与する保健教育手法について、ICT活用の可能性の検討を行ない、保健教育のデジタルコンテンツ開発に向けた基礎資料を得ることを目的に調査を実施した。
１．妊産婦検診の実施状況と母子手帳の活用状況
ヴィエンチャン特別市パークグム郡パークグム村の母子保健教室に参加した妊産婦6名、助産師3名、ルアンパバーン県チョンペット郡ノンチョン村の8世帯の女性、ヘルスセンターの医療従事者3名、村の健康ボランティア3名にヒアリングを行なった。妊産婦検診は約9割が規定の検診回数を満たしていが、民族により参加状況が異なっていた。2005年から母子手帳が無料配布でされ、全ての妊産婦が所持していた。しかし、女性の識字率が約6割と低いこともあり、十分に活用されていなかった。電子母子手帳に対する妊産婦のニーズは低くかったが、医療従事者からは教育ツールとして利用したいという要望があった。
２．農村部のデジタル機器利用実態調査
ノンチョン村（257世帯，1,528人）の村長と8世帯の住民にヒアリングを行なった。村内ほぼ全域でインターネットが利用できた。携帯電話は概ね8割の世帯が所有してたが、スマホン・タブレットの所有は1割以下であった。健康学習に関するアプリ等を利用している世帯は少なかった。しかし、若者を中心に増加傾向に、あり小学生も上手に操作していた。
３．水と衛生に関する調査および衛生教育の実施
ノンチョン村の3民族のうち、2民族は全戸にトイレがあったが、1民族はない世帯が多かった。飲料水は水質が確認された地下水を利用していた。小学校の衛生関連施設に安定して水供給をするために水タンクを設置し、小学生250名を対象に手洗い・歯みがき等の衛生教育を実施した。
以上より、今後は将来のアプリ等の普及の可能性を考慮し、衛生行動の習慣化や母子手帳活用促進に資するデジタル教材などの教育ツール開発に着手する。
A survey was conducted aiming at obtaining basic information for development of digital contents for health education based on review of possibility of ICT utilization for health education approaches to contribute to improvement of mother-child health and sanitation at rural districts in Laos.
1. Status of prenatal/ postpartum checkup practice and maternal and child health handbook utilization
Hearing was conducted for six pregnant women and three midwives who participated in a mother-child health class held in Pakngum village, Pakngum district, Vientiane Capital city as well as women of eight households, three health-care professionals of Health Center and three health volunteers in Nong Chong village, Chomphet district, Luang Prabang province. Approximately 90% of pregnant women had satisfied specified times of prenatal checkup but participation situation differed depending on the ethnicities. All of pregnant women held maternal and child health handbook which has been distributed for free since 2005. Due to women's low literacy rate of approx. 60%, however, the book had not been fully utilized. Even though there was less needs of electronic maternal and child health handbook from pregnant women, healthcare professionals requested to use it as a educational tool.
2. Survey of actual utilization of digital equipment in rural districts
Hearing was conducted for a mayor of Nong Chong village (257 households/1,528 residents) and residents of eight households. Internet was available almost over the whole village. Almost 80% of households owned cell phones, while possession of smart phone and tablet was 10% or less. Applications regarding health learning were used by only a small number of households. However, the usage was on the rise led by young people and even elementary school students were operating such applications well.
3. Implementation of survey on water and sanitation as well as hygiene education
Toilet was equipped with in all households of two out of three ethnic groups in Nong Chong village, while many households in the remaining ethnic group were not equipped with toilet. Ground water with ensured quality was used for drinking water. With a water tank installed for stable supply of water to sanitation-related facilities in elementary schools, hygiene education including hand washing and tooth-cleaning was implemented for 250 elementary school students.
From those described above, we will embark on development of educational tools from now on such as digital educational materials to contribute to habituation of hygiene activity and promotion of maternal and child health handbook utilization in consideration of possibility of spread of applications in the future.