Japan is one of the countries with the highest rate of falling birthrates and an ageing population [7]. We believe that it is important to introduce this situation in English. In the background, supplement figures were presented. The data used to create these figures are published by the Japanese government on its website and are presented in Japanese. In order to make the figures comprehensible to readers of other languages, they have been converted into English.
Measures to secure nursing care workers are divided into three main areas: promoting entry into the nursing care market, improving the working environment and treatment of workers, and improving the quality of nursing care workers [6]. The aim of entry promotion is to expand the field of nursing care workers. These include support for international students, the creation of a welcoming environment, loans for the training of care workers, introductory training, seminars on care work, care assistants, and the promotion of the attractiveness of the care profession.
The second, improving the working environment and treatment, aims to reduce the number of early leavers and promote retention. These include improving the treatment of nursing care workers at the leadership level, the use of nursing care robots and ICT, third-party evaluation of welfare services, a system for the certification of nursing care establishments, and support for the establishment and operation of childcare facilities in nursing care establishments.
The third, improving qualifications, aims to develop highly specialized personnel and to differentiate functions. Items such as the career tier system and practical training for care support specialists are mentioned [8].
Analysis of the survey results resulted in three main findings. The first is that national care recruitment policies are generally considered to be well-developed. A strategic approach has been devised for each target group, for example: by promoting the attractiveness of the care profession to young people and those raising children through the use of work experience and advertising; by improving the treatment of care workers and preventing them from leaving the workforce through the development and dissemination of guidelines; and, for foreign nationals, it was suggested that the environment for accepting foreign nationals be improved and that support be enhanced.
It was confirmed that measures are in place throughout the country.
Second, regional differences were identified in the evaluation systems of care establishments. Based on the results of the Accreditation System for Nursing Care Establishments and "Third-Party Assessment of Welfare Services studies, it can be inferred that the need for care workers is higher in urban areas, and establishments are making efforts to differentiate themselves by undergoing evaluation.
Third, care establishments are using the evaluation system to improve the environment, but the job market is strong. This is particularly noticeable in urban areas. The salaries of those employed in urban care workplaces are likely to be relatively low.
The proportion of rural areas with an evaluation system is lower than in urban areas, suggesting that there is still room for improvement in rural areas, for example by adopting an evaluation system as in urban areas.
On the other hand, the shortage of care workers in urban areas is critical, as shown by the effective job offer ratio [9]. Despite the fact that it is easy for applicants to choose between jobs, facilities are forced to compete with each other. Despite the various measures taken by the prefectures, it is still difficult to recruit care workers. In view of this situation, it is necessary to improve salaries and working conditions in order to ensure that care workers are financially, physically, and emotionally satisfied. It is also important to promote health and well-being without the need for care. Huang et al. reported that in Taiwan, where the population is ageing, there is a significant relationship between environmental level factors and physical activity among older people, with parks and green spaces being associated with achieving the recommended amount of physical activity [10]. It is thought that the development of social infrastructure can lead to improved health. A multi-pronged approach to the problem of the shortage of care workers is needed, including health, social care, technological innovation and changes in the care system.