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Malaysia's Health

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Malaysia's Health MINISTRY OF HEALTH MALAYSIA MALAYSIA’S HEALTH 2008 Foreword The right to health is being recognised as a basic human right in the WHO Constitution. It is increasingly acknowledged that health is not just a result of development and poverty reduction, but also a precondition for development. Investing in health is investing in development. The Ministry of Health has over the years introduced various health programmes to improve patient safety and the population’s health. The actual implementation and their success depend on the rigourity of the planning processes and the quality of plans. In turn, this is dependent on the comprehensiveness and accuracy of information available for use at all levels. This edition of the report attempts to provide information on a comprehensive range of topics relating to health care services, population health, health system management and research undertaken by the Ministry of Health. It is broad ranging and attempts to not only provide a brief overview of the issues and challenges faced by the various programmes in their implemention, but also on the latest initiatives and their potential benefits. For example, the principles of primary health care have been universally accepted and yet the implementation varies widely throughout the world. How we have fared and where we move from here is shared in this edition. Other topics covered include overviews of newer initiatives such as Stem Cell research and the introduction of computer based multiple risk factor intervention in the prevention of cardiovascular and chronic kidney diseases (CORFIS). Prevention of non-communicable diseases (NCD) and their subsequent management remains a concern and challenge. There is much room for improvement and we need to revisit the way we have done things and be innovative. The work done on CORFIS is an attempt towards this. In our pursuant to provide the best care possible to the Malaysian population, it is my hope that the valuable information shared in this report will provide a better understanding of the health issues surrounding us and also the various endeavours that the Ministry has undertaken. DATO’ SRI DR HASAN BIN ABDUL RAHMAN DIRECTOR-GENERAL OF HEALTH MALAYSIA ision for health VMalaysia is to be a nation of healthy individuals, families and communities, through a health system that is equitable, affordable, efficient, technologically appropriate, environmentally-adaptable and consumer-friendly, with emphasis on quality, innovation, health promotion and respect of human dignity and which promotes individual responsibility and community participation towards an enhanced quality of life. ission Mof the Ministry of Health The mission of the Ministry of Health is to build partnership for health to facilitate and support the people to: • Attain fully their potential in health • Motivate them to appreciate health as valuable asset • Take positive action to improve further and sustain their health status to enjoy a better quality of life Contents Foreword Vision for Health ision Mission of the Ministry of Health for health Part1 VMalaysia is to be a nation of healthy individuals, families and CHAPTER 1- HEALTHCARE SERVICES communities, through a health system that is equitable, affordable, efficient, technologically appropriate, environmentally-adaptable and 1. Sustaining the Integrated School-Based Fissure Sealant Programme 11 consumer-friendly, with emphasis on quality, innovation, health promotion and respect of human dignity and which promotes 2. Initiating the Provision Of Anti-Retroviral (ARV) Treatment as 20 individual responsibility and community participation towards an Part of the Prevention and Control HIV/AIDS Programmes in enhanced quality of life. Malaysian Prisons 3. Prevention of Mother-to-Child Transmission of HIV infection in 28 Malaysia – a Programme Review 4. Quality of Diabetes Care in Primary Health Care Settings 57 st 5. 1 Global Patient Safety Challenge in MOH Hospitals: 67 ission ‘Clean Care Safer Care’ of the Ministry of Health 6. Future Challenges in the Development of Forensic Medicine Services at 78 M Ministry of Health Hospitals The mission of the Ministry of Health is to build partnership for health to facilitate and support the people to: 7. Dealing With Adolescents Using the HEADSS Assessment 89 • Attain fully their potential in health • Motivate them to appreciate health as valuable asset CHAPTER 2- POPULATION HEALTH • Take positive action to improve further and sustain 8. Developing Competencies for Field Epidemiology – the EIP Way 103 their health status to enjoy a better quality of life 9. 30 Years after Alma Ata Towards a New Outlook on Malaysia’s 113 Primary Health Care 10. Experience of Front-Liners in Handling Emergency Mental Health 124 Cases in Peninsular Malaysia 11. Food Poisoning in Malaysia 2008 – Issues and Challenges 135 CHAPTER 3- HEALTH SYSTEM MANAGEMENT 12. Consolidating the Pharmaceutical Sector through the Malaysian 151 National Medicines Policy (DUNAS) 13. Improving the Drug Delivery System in Hospitals and Health Clinics 173 14. Patient Safety: Identifying the Research Agenda for MOH in the 183 9th Malaysia Plan 15. Extended Hours in Primary Care - Is the Policy Effective? 191 CHAPTER 4- RESEARCH AND DEVELOPMENT 16. Showcasing Multisectoral Collaboration: The Oral Cancer 207 Research and Coordinating Centre (OCRCC) In Malaysia 17. Stem Cell Research in Ministry of Health 219 18. Accuracy of Diagnosis: Implications on Health Care Financing 229 19. Case Mix in Primary Care in Malaysia 235 20. Community Based Multiple Risk Factor Intervention to 248 Prevent Cardiovascular and Chronic Kidney Disease (CORFIS) 21. Total Arsenic Exposure through Dietary Intake in the Adult 264 Malaysian Population 22. Social Marketing: Anti-smoking Media Campaign 278 Part 2 EDITORIAL COMMITTEE 289 LIST OF CONTRIBUTORS 290 ACKNOWLEDGEMENT 293 CHAPTER 3- HEALTH SYSTEM MANAGEMENT 12. Consolidating the Pharmaceutical Sector through the Malaysian 151 National Medicines Policy (DUNAS) 13. Improving the Drug Delivery System in Hospitals and Health Clinics 173 14. Patient Safety: Identifying the Research Agenda for MOH in the 183 9th Malaysia Plan 15. Extended Hours in Primary Care - Is the Policy Effective? 191 Part 1 CHAPTER 1 - HEALTH CARE SERVICES CHAPTER 4- RESEARCH AND DEVELOPMENT CHAPTER 2 - POPULATION HEALTH 16. Showcasing Multisectoral Collaboration: The Oral Cancer 207 Research and Coordinating Centre (OCRCC) In Malaysia CHAPTER 3 - HEALTH SYSTEM MANAGEMENT 17. Stem Cell Research in Ministry of Health 219 CHAPTER 4 - RESEARCH AND DEVELOPMENT 18. Accuracy of Diagnosis: Implications on Health Care Financing 229 19. Case Mix in Primary Care in Malaysia 235 20. Community Based Multiple Risk Factor Intervention to 248 Prevent Cardiovascular and Chronic Kidney Disease (CORFIS) 21. Total Arsenic Exposure through Dietary Intake in the Adult 264 Malaysian Population 22. Social Marketing: Anti-smoking Media Campaign 278 Part 2 EDITORIAL COMMITTEE 289 LIST OF CONTRIBUTORS 290 ACKNOWLEDGEMENT 293 Chapter 1 HEALTH CARE SERVICES SUSTAINING THE INTEGRATED SCHOOL-BASED FISSURE SEALANT PROGRAMME SUMMARY Fissure sealants play an important role in caries prevention because they can protect caries susceptible surfaces, specifically the occlusal pits and fissures. The integrated school-based fissure sealant programme in Malaysia has been implemented for more than 10 years and has been reviewed from time to time. A targeting strategy has been employed for this programme, targeting schoolchildren considered “at high risk” to occlusal caries. Over the last 5 years, the percentage of children and teeth in need of fissure sealant rendered treatment increased annually. This means unmet fissure sealant need has decreased yearly. A longitudinal study on school-based fissure sealant programme showed that the programme is effective in preventing dental caries. This programme can be effectively carried out by dental officers and dental nurses at mobile dental team settings, irrespective of materials used. The aim of the programme is that all children and all teeth in need of fissure sealants will receive fissure sealants. Survey data showed oral health status of 12-year-old Malaysian schoolchildren has improved over the years. The National Oral Health Goal 2010 of having a mean decayed, missing and filled teeth (mean DMFT) less than 1.5 and 60% of schoolchildren with caries free permanent dentition has been met. This signifies Malaysia is among countries with very low caries level based on World Health Organisation (WHO) classification. To further improve the oral health of schoolchildren, the school-based fissure sealant programme need to be continued, strengthened and sustained. Introduction issure sealants are materials commonly placed on Fissure sealants occlusal fissures and palatal/buccal pits of permanent prevent occlusal molar teeth to prevent the occurrence of dental caries. caries There are two main types of fissure sealant materials, Fnamely resin-based sealants and glass ionomer cement (GIC) sealants. Fissure sealants play an important role in caries prevention, protecting the susceptible caries surfaces in the occlusal pits and Strong evidence fissures that are least protected by fluoride. Pits and fissures on effectiveness of are surfaces most prone to dental caries compared to other tooth fissure sealants surfaces due to their morphological characteristics. MALAYSIA’S HEALTH 2008 11 A number of systematic reviews had found strong evidence of effectiveness of fissure sealant in preventing
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