There are many examples of JICA’s international cooperation in which the results achieved in developing countries have been returned to Japan, contributing to solving domestic issues and corporate activities. One such example is the perinatal telemedicine system that was born in Kagawa Prefecture, further developed in Thailand, and returned to Japan. In various parts of Japan, where obstetrician shortages are becoming increasingly serious, a small heart-shaped device is protecting the lives of pregnant women and their babies.
iCTG, a mobile fetal monitor that has become popular in Japan（Provided by Kameda General Hospital)
Fetal heartbeat, real-time at home and at the hospital
The number of maternity hospitals continues to decline on the Boso Peninsula of Chiba Prefecture due to depopulation and a declining birthrate. Kamogawa’s Kameda General Hospital serves as a center for perinatal care in the southern part of the prefecture, handling approximately 500 deliveries per year.
At the end of 2025, a woman diagnosed with delayed fetal development is admitted to the hospital for tests.
I was worried about taking care of my two older children if I stayed in the hospital too long, and the cost of hospitalization would also be high. But when the doctor told me about this equipment, I decided to go home and try it.
Two heart-shaped devices were handed to us: the iCTG, a mobile delivery monitoring device utilizing ICT (Information and Communication Technology). The pink device measures the heartbeat of the fetus, and the light blue measures the contractions of the uterus.
Twice daily, the woman takes a break from housework and childcare to lie down on the living room couch and wear the iCTG with a belt. The fetal heartbeat is then detected by ultrasound Doppler and the fetal heartbeat is heard tock-tocking.
A woman at home with an iCTG attached to her tummy, using a tablet to check the fetal heartbeat and other information (courtesy of the woman).
The data measured at home is transmitted in real time to the hospital, which is about 50 km away, and is checked by the attending physician on a monitor at hand.
I have the peace of mind that if there is something wrong at home, the doctor will find it right away.”
The woman gave birth safely in January 2026 to a healthy baby.
Dr. Mizuho Kadooka, Acting Director of the Department of Obstetrics and Gynecology at the hospital, said, “The introduction of iCTG has reduced the number of days that patients with fetal growth retardation and other conditions are hospitalized for pregnancy management, and by telemedicine collaboration with a family medicine clinic 30 km away, the frequency of long trips to our hospital for checkups by full-term pregnant women has also been reduced. In some cases, we have been able to quickly identify a decreased fetal heartbeat or a pregnant woman’s tummy tuck, resulting in a safe delivery,” he says.
Dr. Mizuho Kadooka (right) checks the iCTG measurement data received from the pregnant woman’s home with a midwife on a monitor in the hospital (courtesy of Kameda General Hospital).
Japan’s Ongoing Maternity Hospital and Obstetrician Shortage
Although Japan has one of the lowest maternal mortality rates among developed countries, the number of perinatal deaths of fetuses and babies (the total of stillbirths after 22 weeks gestation and early neonatal deaths) exceeds 2000 per year. Furthermore, in recent years, the number of medical facilities for childbirth outside of urban areas has been decreasing, making it difficult to have a safe and secure delivery in a familiar area.
We want to eliminate lives lost in childbirth. The iCTG, which was born from the developers’ earnest wish, has been selected as a recommended device by the World Health Organization (WHO) and is being used both in Japan and overseas. In fact, JICA’s international cooperation is deeply involved in its popularization.
Baby born safely at Kameda General Hospital using iCTG at home（provided by patient)
It all started with Kagawa Prefecture’s remote island medical care
iCTG is developed, manufactured, and marketed by Melody International Corporation, located in Takamatsu City. The founder, Yuko Ogata CCO, initially worked for an IT company and was involved in the development of electronic medical records, but was distressed by the serious maternity situation in Kagawa Prefecture, which has many isolated islands.
We heard stories of pregnant women on remote islands staying at a hotel in Takamatsu City to commute to the hospital when the birth was approaching. I wanted to solve such problems in Japan today. I wanted to help solve such issues.”
It was during this time that Mr. Ogata met Professor Emeritus Kazuhiro Hara of Kagawa University, a leading developer of the world’s first ultrasound-based fetal monitor in 1974.
Mr. Hara looks back. In the 1970s, Kagawa Prefecture had one of the worst neonatal mortality rates in Japan. The most reliable way to reduce the mortality rate was to detect fetal heart rate. However, the original equipment was large and expensive.
The two began to improve a small mobile fetal monitor using ICT. The tailwind for this project was the JICA Grassroots Technical Cooperation Project. Believing that the device was also needed in developing countries, they applied to JICA for a telemedicine support project in Thailand by industry, academia, and government, and the project was selected to begin in 2014. In collaboration with Chiang Mai University, with which Kagawa University has an exchange relationship, we were given the opportunity to demonstrate the fetal monitor we were improving in Chiang Mai Province.
Melody International Corporation CEO Yuko Ogata (center), who was certified as a “Kagawa University Venture” in 2018, with Kagawa University President Yoshiyuki Kakehi (left) and Specially Appointed Professor Kazuhiro Hara (right) (Courtesy of Melody International Corporation, all titles at time)
Adopted as a JICA project, and evolved through repeated improvements in Thailand.
In Chiang Mai Province, which has a population of approximately 1.65 million, approximately 20,000 babies are born each year, but there are only about 20 obstetricians at medical facilities under the jurisdiction of the Department of Health. Many pregnant women and babies were rushed to hospitals in the city center, but by the time they arrived it was already too late,” said Ogata.
Mr. Ogata and his team first deployed demonstration units of the small mobile fetal monitor at three community clinics to conduct antenatal checkups. Since expensive large fetal monitors were only available at large hospitals, Mr. Ogata was deeply moved when he saw pregnant women rejoicing that they could hear their babies’ heartbeats.
In response to requests from doctors, Mr. Ogata made a number of improvements to the demonstration device. For example, he found that data is lost when a pregnant woman enters a tunnel during emergency transport, so data is now recorded even when the signal is interrupted. We also developed an iPad app so that doctors can instantly check data wherever they are in the hospital.
Doctors at Chiang Mai University recommended that about 50 pregnant women be examined at a large hospital from among about 1,500 measurements sent from local clinics that did not have obstetricians. Of these, about 10 were found to have abnormalities, and five received emergency treatment, which saved their lives. The local officials gave high marks to the project, saying, “If it can save this many lives, we want to spread it to the entire area. The mobile fetal monitor “iCTG,” the final version of the improved demonstration model, was introduced to all public hospitals in the prefecture after receiving high evaluation from local officials.
Mr. Ogata recalls, “JICA supported us in building a local organization, and as a result, we were able to create a spirit of ‘let’s do it together’ among the people involved.
Medical professionals check measurement data after fitting a pregnant woman with a device in Chiang Mai, Thailand (courtesy of Melody International, Inc.).
Corona, accident, earthquake …… contingency
iCTG was certified as a medical device in Japan in May 2018. This was thanks to the improvements made in Thailand and the accumulation of clinical data. In Japan, telemedicine remained uncommon and did not attract much attention, but what changed the situation was a pandemic caused by a new type of coronavirus.
We want to reduce the risk of infection among pregnant women due to hospital visits and to manage infected pregnant women at home.” …… Beginning with Hokkaido, where the infection first spread, Melody received inquiries about iCTG one after another. The need for telemedicine quickly grew.
Yasuko Oka, Director of the Department of Obstetrics and Gynecology at Komatsu Municipal Hospital in Komatsu City, Ishikawa Prefecture, says, “The iCTG is working beyond our initial expectations. In particular, we have loaned iCTGs to pregnant women infected with coronas who were recovering in isolation wards or at home, and were able to detect abnormalities and perform emergency C-sections because of the face-to-face monitoring.”
In Ishikawa Prefecture, in 2021, a newborn baby died after the mother’s condition suddenly changed while the doctor was away at Wajima Municipal Wajima Hospital. This tragic medical accident occurred while only one obstetrician was covering two cities and two towns in Okunoto. In order to establish a safe perinatal care system, the prefectural government established the “Baby Council” and decided to introduce iCTG. The iCTG was also utilized during the Noto Peninsula earthquake in January 2012 for deliveries during power outages and for pregnancy management at evacuation centers.
Pregnant woman wearing iCTG at home. A child, looking forward to the birth of a sibling, asks, “How are you? and are very curious.
There are more lives to save.
Reverse innovation” refers to the “return” of innovations generated in developing countries by developed countries to their own countries. iCTG’s efforts are a typical example of this.
In January 2026, Mr. Hara and Mr. Ogata received the JICA International Cooperation Award in recognition of their past achievements.
JICA International Cooperation Award 2025 Award Ceremony. (From left to right) Akihiko Tanaka, JICA President; Kazuhiro Hara, Professor Emeritus, Kagawa University; Yuko Ogata, CCO, Melody International Inc.
Mr. Ogata looks back. Obtaining certification as a medical device in Japan was a very high hurdle for a small venture company,” says Ogata. However, thanks to JICA, which has established regular relationships with governments and related organizations in developing countries and connected us with the health ministries of those countries, the iCTG has been improved and has grown into a useful device both in Japan and abroad.
As of the end of 2025, iCTG has spread to 16 countries around the world, including Myanmar, Indonesia, and Bhutan. In Japan, iCTG has been introduced at approximately 130 medical institutions in 39 prefectures, saving many lives of mothers and children.
Yuko Ogata (second from left) teaching medical staff and pregnant women how to use iCTG at a private home in Myanmar (courtesy of Melody International, Inc.)
According to WHO data for 2023, more than 700 women worldwide die each day from preventable causes associated with pregnancy and childbirth.
I hope to work with JICA to further expand our activities.
International cooperation is the power of Japan.
JICA’s efforts are saving lives at home and abroad.
© Source JICA