Japan+Terms+of+Reference

= **Terms of Reference** =

**Country:** Japan

**Project:** // Japan’s Aging Population and the Associated Health and Financial Concerns //**. **

**Consultants:** Two consultants needed. Primary consultant will present the Final Consultancy Report and the minutes of the discussion session where the Final Consultancy Report will be presented to the group. The Secondary consultant will assist the primary consultant.

Consultants are required to have at least 2 years of experience and an advanced degree in one of the following fields: Experience with grant development preferred but not required. Excellent communication skills required.
 * Health Services Management
 * Public Health
 * Health Policy/Regulation
 * Human Resources
 * Business Management
 * Finance

**Submission Process and Starting Date:** Consultants need to submit their expression of interest no later than the end of Week 5. Consultancy work will begin on Week 6.

**Deadlines and Products:**
 * A Draft Consultancy Report is due on **Week 10, October 27.**
 * Presentation and Discussion of the Report will be on **Week 13, November 11-17.**
 * The Consultant's Minutes of the Group Discussion are due on **November 18.**
 * The Final Consultancy Report is due on **November 21.**

**Goal:** This goal of this grant is to provide Japan with an understanding of the effects its elderly population will have on their country from a healthcare perspective. It will examine both the financial and resource issues surrounding this matter and assist in developing plans to best address these concerns.

**Consultation Meetings:** The Consultants and the executive team need to hold at least two meetings during the weeks 6 to 10 of the course using the "Chat" tool to exchange findings and discuss ideas concerning the Project.

**Background Information:** When looking at the world’s aging population, Japan has one of the highest proportions of elderly citizens. The Japanese also have one of the highest life expectancies in the world at 80 for males and 86 for females (WHO, 2011). By 2030, it is estimated that 1 in every 3 of Japan’s citizens will be 65 or older and 1 in 5 will be 75 or older. Contributing to this, there has been a rapid decline in fertility rates in Japan (Muramatsu & Akiyama, 2011). A growing elderly population is causing a financial strain on the current system and increasing costs in areas such as long-term care. Japan has a national pension program with universal healthcare. One problem that arises from a shrinking younger population is that it provides a smaller pool contributing to these national programs.

Compared to the United States’ 16.2% of GDP spent on healthcare costs, Japan’s 8.3% is relatively low (WHO, 2011). However, the diminishing younger population means less funds paying into national programs and therefore equals less available resources to match the growing needs of the aging population. Compounding the issue is that Japan’s elderly population is demanding even greater medical benefits and have a high utilization rate of their health care system.

An additional component to consider is that Japan fosters a culture of its elderly living within the homes of the adult children. With Japan having one of the highest life expectancies in the world, this places an ever growing, ever aging population under the care of their adult children. As longevity increases, health issues increase proportionally, however these growing issues prevent challenges at homes and financial strain on their children. Because of Japan’s culture of generational living, there are too few elderly care facilities to meet the growing needs of Japan’s society and they are utilizing hospitals as substitutes for nursing homes.

**Scope of the Work:** Consultants will work in collaboration with the Minister of Health and the Deputy Minister on the following activities:
 * Analyze current demographic information and forecast future demographics
 * Research other countries health care systems as models to follow
 * Assessment of the current health care system and its issues relating to the elderly population
 * Assessment of the current pension system and develop plans to reform the system
 * Develop plans to address the elderly related healthcare system issues
 * Assessment of the current low fertility rates
 * Develop plans to increase fertility rates
 * Identify and analyze associated costs with implementing new programs
 * Preparation of a Health Sector Report with the recommendations and detailed plans to support the grant project
 * Preparation of a Consultant's Report and participation in the "Global Healthcare Management Assembly Symposium"
 * Presentation and discussion of the Consultant's Report

**Other References:** See country profile

**Contact Information:** MOH - Marybel Zabel Email: marybel_r@knights.ucf.edu

References: Muramatsu, N., & Akiyama, H. (2011). Japan: Super-Aging Society Preparing for the Future. //Gerontologist//, 51(4), 425-432. Retrieved September 12, 2011, from EBSCO//host database//.

World Health Organization. (2011). Japan. Retrieved September 12, 2011, from http://www.who.int/countries/jpn/en/