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This course consisted of lectures on primary health care in Singapore and observation tours to the KK Women's and Children's Hospital and the Woodlands Polyclinic. The course participants were seven city administrators in charge of primary health care from Chittagong of Bangladesh, Tianjin of China, Surabaya of Indonesia, Faisalabad of Pakistan, Olongapo of Philippines, Khon Kaen of Thailand and Haiphong of Vietnam. The lectures were given by government officials and scholars of Singapore. Dr. Paul Cheung, Chief Statistician, Department of Statistics, explained the progress of aging and the increase of dependent population in eight Asian countries by using statistical data including the population growth rate, birth rate and life expectancy. Prof. S S Ratnam, Director, Graduate School of Medical Studies, National University of Singapore, gave two lectures on family planning and reproductive health. He explained that Singapore must add 50,000 newborns annually to grow in population and that efforts were being made to encourage single people to marry earlier and have more children. In the second lecture, he analysed population dynamics of Asian countries and pointed out problems of family planning and reproductive health, including wide-spreading AIDS. After indicating directions and measures to improve female primary health care and to lower maternal mortality, he concluded that there was a close correlation between socio-economic development and the size of the population and that development initiatives and family planning programs should go hand in hand as mutual contributors. Dr. S C Emmanuel, Director, Family Health Service, Ministry of Health, gave a lecture covering four areas; medical examination services provided at each stage of infancy, the roles of the government and the private sector in lowering the infant mortality rate, the change in the cause of death and the immunisation service in Singapore.  Lecture on "Primary Health Care for the First Year of Life in Singapore" by Dr. S C Emmanuel, Director, Family Health Service. Ministry of Health, Singapore Dr. Goh Lee Gan, Associate Professor, Department of Community, Occupational and Family Medicine (COFM), National University of Singapore, gave a lecture titled "Womb to Tomb". He explained Singapore's health care services, detailing the special care provided for different types of patients, such as children, women, elderly and people suffering from chronic diseases and tuberculosis.  General briefings of the KK Women's and Children's Hospital by Dr. Jennifer Lee, CEO of the hospital Dr. Phua Kai Hong, Health Economist, National University of Singapore, explained about the financial basis of Singapore's health care system called "3M", which is a three-tier system consisting of Medisave, Medishield and Medifund. Medisave is compulsory savings deducted from an income and forms the nucleus of Singapore's health care system. Medishield is an insurance program to supplement Medisave, and Medifund is an endowment fund set up by the government as a safety net to help indigent people pay for their medical needs. He pointed out the advantages of the medical savings system of Singapore in comparison with the social insurance systems adopted by Japan and the U.K. The observation tours of the two medical facilities impressed the participants greatly. At the KK Women's and Children's Hospital, Dr. Jennifer Lee, CEO of the hospital, lectured on its history, achievements and challenges. This was followed by the tour of the facilities guided by Ms. Tan Keet Yee, Director, Corporate Development of the hospital. The KK Women's and Children's Hospital was established in 1997, by expanding the former Kandang Kerbau Hospital, which was widely known for the successful delivery of the first test-tube baby in Asia. The hospital is designed for specialties in Obstetrics & Gynaecology, Neonatology and Paediatrics to work in an integrated manner. With 898 beds and 2,200 staff members, its rooms are classified into four according to the degree of service provided and the type of facilities. The hospital also offers both patients and their families such amenities as a shopping mall, children's playground, in-house TV programs and shows at the hall. At the Woodlands Polyclinic, one of 17 Polyclinics in Singapore which handle 18 percent of the total primary health care need, Dr. D Gowri explained about the polyclinic's function, services, role sharing with other medical institutions and future. The public-run clinics are located conveniently to provide each community with basic health services. The average daily attendance at the 17 polyclinics is about 10,000, or about 700-1,000 per polyclinic. Reasons for attendance are respiratory tract infection (21 percent), hypertension (13 percent), diabetes (9 percent), immunisation (8 percent), screening/examination/investigation (4 percent), developmental assessment (3 percent), family planning (2 percent) and others (40 percent). Polyclinics offer immunisation services free of charge. Roughly 95 percent of children in Singapore are immunised. Polyclinics charge the patients only S$8 at most. Dr. Toshio Kuroda, Director Emeritus, Population Research Institute, Nihon University, made a special lecture titled "Demography in Japan-Past, Present and Future" at the Singapore Ministry of Health. He gave an overview of the population history of Japan and suggested that Japan could solve its problems of the world's fastest aging of population by redefining the classification of productive population and dependent population based on the actual state of each age group.  Rehabilitation Center founded by a church organizaiton in the Woodlands Polyclinics This was the first overseas course organized by AUICK. AUICK thinks that it was very successful and offers our most sincere thanks to Singapore as host. AUICK intends to hold training courses in various cities in Asia to promote their mutual cooperation through exchange of information, experiences and ideas. *International Conference on Population and Development held in Cairo in 1994. Following are the course curriculum and participants' list. < Lectures & Lecturers > -Demography in Singapore Compared to Some Asian Countries (Dr. Paul Cheung, Chief Statistician, Department of Statistics, Singapore) -History and Development of Family Planning and Reproductive Health in Singapore -Current Trends in Family Planning and Reproductive Health in Asia (Prof. S S Ratnam, Director, Graduate School of Medical Studies, National University of Singapore) - Primary Health Care for the First Year of Life in Singapore (Dr. S C Emmanuel, Director, Family Health Service, Ministry of Health, Singapore) - Health Care Systems in Singapore Compared to Other Countries (Dr. Goh Lee Gan, Associate Professor, COFM, National University of Singapore) - Health Care Financing in Singapore and ASEAN (Dr. Phua Kai Hong, Health Economist, National University of Singapore) - Demography in Japan - Past, Present and Future (Dr. Toshio Kuroda, Director Emeritus, Population Research Institute, Nihon University, Japan) < Observation Tours & Lecturers > - KK Women's and Children's Hospital (Dr. Jennifer Lee, CEO, KK Women's and Children's Hospital) (Ms. Tan Keet Yee, Director, Corporate Development, KK Women's and Children's Hospital) - Woodlands Polyclinic (Dr. D Gowri, Woodlands Polyclinic)  Participants and organizers of the Study Course on ICPD and Health Care Followings are excerpts from the City Reports on the progress toward the targets of ICPD presented at the Study Course. Because of limitations of space, we include the reports from Chittagong, Tianjin, Faisalabad and Khon Kaen among the seven participating cities. |