{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T14:02:33Z","timestamp":1793714553793,"version":"4.6.1"},"reference-count":45,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Eval Health Prof"],"abstract":"<jats:p>Japan\u2019s Technical Intern Training Program (TITP) has expanded into a major conduit for foreign labor, primarily from Vietnam, Indonesia, and the Philippines. While it was originally established to facilitate skill and technology transfer to developing nations, numerous reports indicate persistent issues of wage underpayment, excessive overtime, and limited access to healthcare. This commentary integrates evidence from legal, employment, and public health perspectives to illustrate systemic inequities affecting technical interns as they increasingly contribute to Japan\u2019s health and long-term care sector. It also addresses gender-related vulnerabilities and enforcement challenges. In addition, the Employment for Skill Development (ESD) framework is discussed, with attention to how targeted policy refinements can improve worker protection without undermining its core goals of skill development and workforce stability, alongside the cultural barriers that may constrain their effectiveness. The commentary proposes directions to align Japan\u2019s migrant labor systems with universal health coverage and labor law principles, emphasizing equitable protection and sustainable reform.<\/jats:p>","DOI":"10.1177\/01632787261446333","type":"journal-article","created":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T11:07:36Z","timestamp":1778411256000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Commentary: Systemic Inequities in Japan\u2019s Technical Intern Training Program (TITP): Health, Labor, and Legal Vulnerabilities of Foreign Trainees"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5272-1131","authenticated-orcid":false,"given":"Phu Nghia","family":"Nguyen","sequence":"first","affiliation":[{"name":"Nam Can Tho University"},{"name":"Online Research Club"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7688-725X","authenticated-orcid":false,"given":"Phuong Ngoc Anh","family":"Pham","sequence":"additional","affiliation":[{"name":"Online Research Club"},{"name":"Hanoi Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"My Kieu","family":"Phan","sequence":"additional","affiliation":[{"name":"Nam Can Tho University"},{"name":"Online Research Club"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thy Dinh Van","family":"Le","sequence":"additional","affiliation":[{"name":"Nam Can Tho University"},{"name":"Online Research Club"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dat Nguyen Tan","family":"Bui","sequence":"additional","affiliation":[{"name":"Online Research Club"},{"name":"Le Quy Don High School for the Gifted"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kawasaki","family":"Kasumi","sequence":"additional","affiliation":[{"name":"Nagasaki University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9543-9440","authenticated-orcid":false,"given":"Nguyen Tien","family":"Huy","sequence":"additional","affiliation":[{"name":"Nagasaki University"},{"name":"Duy Tan University"},{"name":"Duy Tan University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,10]]},"reference":[{"issue":"6","key":"e_1_3_2_2_1","first-page":"369","article-title":"Health of technical intern trainees: One-year qualitative longitudinal study after arrival in Japan","volume":"70","author":"Aida H.","year":"2023","unstructured":"Aida H., Mori S., Tsujimura H., Sato Y. 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