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Effectiveness and Challenges in Local Self-Governance: Multifunctional Autonomy in Japan

Author

Listed:
  • Ryuichi Ohta

    (Community Care, Unnan City Hospital, Unnan City 699-1221, Shimane, Japan)

  • Yoshinori Ryu

    (Community Care, Unnan City Hospital, Unnan City 699-1221, Shimane, Japan)

  • Daisuke Kataoka

    (Unnan Public Health Center, Unnan City 699-1311, Shimane, Japan)

  • Chiaki Sano

    (Department of Community Medicine Management, Faculty of Medicine, Shimane University, Izumo 693-8501, Shimane, Japan)

Abstract

Community organizing with government support, termed local self-governance (LSG), is a form of policy decentralization for community wellbeing through solutions tailored to local issues. One form of LSG is multifunctional autonomy, in which citizens can comprehensively manage their communities with government support. This study clarified the effect of multifunctional autonomy on healthy life expectancy by assessing related advantages and challenges in rural Japanese communities, using a mixed-methods approach. Disability-free life expectancy from 65 years (DFLE-65) was assessed to compare healthy life expectancies between two rural Japanese cities (with/without multifunctional autonomy). Comparisons revealed better DFLE-65 only among older men in a city with multifunctional autonomy. A cost-effectiveness analysis investigated the relationship between the budget and DFLE-65 change using questionnaire data. Cost-effectiveness analysis of multifunctional autonomy indicated 61,147 yen/DFLE-65. Thematic analysis revealed that multifunctional autonomy created new roles for older men, improving community relationships. However, sustainable multifunctional autonomy in LSG communities may be hindered by a generally aging society, generation gap, and lack of mutual understanding between rural communities and local governments. To ensure the sustainability of multifunctional autonomy, collaborations between local communities and governments and among various generations are critical.

Suggested Citation

  • Ryuichi Ohta & Yoshinori Ryu & Daisuke Kataoka & Chiaki Sano, 2021. "Effectiveness and Challenges in Local Self-Governance: Multifunctional Autonomy in Japan," IJERPH, MDPI, vol. 18(2), pages 1-14, January.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:2:p:574-:d:478720
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    Cited by:

    1. Ryuichi Ohta & Akiko Yata & Yuki Arakawa & Koichi Maiguma & Chiaki Sano, 2021. "Rural Social Participation through Osekkai during the COVID-19 Pandemic," IJERPH, MDPI, vol. 18(11), pages 1-9, May.
    2. Yumi Naito & Ryuichi Ohta & Chiaki Sano, 2021. "Solving Social Problems in Aging Rural Japanese Communities: The Development and Sustainability of the Osekkai Conference as a Social Prescribing during the COVID-19 Pandemic," IJERPH, MDPI, vol. 18(22), pages 1-15, November.
    3. Ryuichi Ohta & Yoshinori Ryu & Chiaki Sano, 2022. "Older People’s Help-Seeking Behaviors in Rural Contexts: A Systematic Review," IJERPH, MDPI, vol. 19(6), pages 1-12, March.
    4. Ryuichi Ohta & Mikiya Sato & Jun Kitayuguchi & Tetsuhiro Maeno & Chiaki Sano, 2021. "Potential Help-Seeking Behaviors Associated with Better Self-Rated Health among Rural Older Patients: A Cross-Sectional Study," IJERPH, MDPI, vol. 18(17), pages 1-8, August.
    5. Ryuichi Ohta & Emily Weiss & Magda Mekky & Chiaki Sano, 2022. "Relationship between Dysphagia and Home Discharge among Older Patients Receiving Hospital Rehabilitation in Rural Japan: A Retrospective Cohort Study," IJERPH, MDPI, vol. 19(16), pages 1-17, August.
    6. Ryuichi Ohta & Yoshinori Ryu & Chiaki Sano, 2022. "Improvement in Quality of Life through Self-Management of Mild Symptoms during the COVID-19 Pandemic: A Prospective Cohort Study," IJERPH, MDPI, vol. 19(11), pages 1-9, May.
    7. Ryuichi Ohta & Koichi Maiguma & Akiko Yata & Chiaki Sano, 2022. "Rebuilding Social Capital through Osekkai Conferences in Rural Communities: A Social Network Analysis," IJERPH, MDPI, vol. 19(13), pages 1-10, June.
    8. Ryuichi Ohta & Akinori Ueno & Chiaki Sano, 2021. "Changes in the Comprehensiveness of Rural Medical Care for Older Japanese Patients during the COVID-19 Pandemic," IJERPH, MDPI, vol. 18(20), pages 1-9, October.
    9. Moe Kuroda & Ryuichi Ohta & Kaku Kuroda & Seiji Yamashiro & Keiichiro Kita, 2021. "The Seamless Communication on a Rural Island in Japan: A Qualitative Study from the Perspective of Healthcare Professionals," IJERPH, MDPI, vol. 18(18), pages 1-12, September.
    10. Naoto Mouri & Ryuichi Ohta & Chiaki Sano, 2022. "Effects of Shopping Rehabilitation on Older People’s Daily Activities," IJERPH, MDPI, vol. 19(1), pages 1-9, January.
    11. Akiko Shimizu & Ryuichi Ohta & Hana Otani & Chiaki Sano, 2021. "The Contribution of Temporal Flat Lateral Position on the Mortality and Discharge Rates of Older Patients with Severe Dysphagia," IJERPH, MDPI, vol. 18(16), pages 1-9, August.
    12. Xinyu Xie & Ying Zhang & Xiaoping Qiu, 2023. "Spatial Distribution Characteristics and Influencing Factors of Rural Governance Demonstration Villages in China," IJERPH, MDPI, vol. 20(5), pages 1-20, March.
    13. Ryuichi Ohta & Koichi Maiguma & Akiko Yata & Chiaki Sano, 2022. "A Solution for Loneliness in Rural Populations: The Effects of Osekkai Conferences during the COVID-19 Pandemic," IJERPH, MDPI, vol. 19(9), pages 1-10, April.
    14. Ryuichi Ohta & Yoshinori Ryu & Chiaki Sano, 2021. "Family Medicine Education at a Rural Hospital in Japan: Impact on Institution and Trainees," IJERPH, MDPI, vol. 18(11), pages 1-14, June.
    15. Ryuichi Ohta & Mikiya Sato & Jun Kitayuguchi & Tetsuhiro Maeno & Chiaki Sano, 2021. "The Association between the Self-Management of Mild Symptoms and Quality of Life of Elderly Populations in Rural Communities: A Cross-Sectional Study," IJERPH, MDPI, vol. 18(16), pages 1-10, August.
    16. Ryuichi Ohta & Chiaki Sano, 2022. "Associations between Perception of Help-Seeking Behaviors and Quality of Life among Older People in Rural Communities: A Cross-Sectional Study," IJERPH, MDPI, vol. 19(20), pages 1-10, October.
    17. Ryuichi Ohta & Yoshinori Ryu & Jun Kitayuguchi & Chiaki Sano & Karen D. Könings, 2021. "Educational Intervention to Improve Citizen’s Healthcare Participation Perception in Rural Japanese Communities: A Pilot Study," IJERPH, MDPI, vol. 18(4), pages 1-11, February.

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