Health screening system to ensure the children' health and development in Japan.

INTRODUCTION Establishment of health screening system for children is important. However, the systems are not always well-established in developing countries. Japan has conducted health screenings for children at the nationwide level. This study aimed to elicit lessons for improving the screening systems in developing countries, by analyzing factors of health screening system for enabling continuous and proper screenings at various governmental levels in Japan. METHODS We reviewed the history and screening systems of children's health and development in Japan and examined enabling factors for regular and nationwide implementation. RESULTS We identified the six points as enabling factors: 1) existing relevant laws and regulations in health and education for health checkups, 2) specified position and detailed conditions for health checkups within the frameworks of both school health and community health, 3) existing guidelines and manuals for health checkups, 4) a sufficient number of professionals for health checkups, 5) clear criteria for evaluating and interpreting health checkup results, and 6) understanding among teachers, children, and guardians regarding the importance of health checkup. CONCLUSION We proposed the following six points to the governments in the developing countries: 1) clear description about the need for regular and continuous health checkups in relevant laws, regulations, and policies, 2) specifying position and detailed conditions of the activities, 3) providing manuals for health workers and teachers, 4) providing enough number of well-trained professionals and training system, 5) studying growth and development curves for children, and 6) promoting understanding among stakeholders about the importance of health checkups.