MALAYSIAN JOURNAL OF
ISSN: 1675-0306
Volume 13 (Supplement 2) 2013
Official Publication of the
MALAYSIAN PUBLIC HEALTH PHYSICIANS’ ASSOCIATION
PUBLIC HEALTH
MJPHM
Official Journal of Malaysian
Public Health Specialist Association
EDITORIAL BOARD
Chief Editor
Prof. Dato’ Dr. Syed Mohamed Aljunid
(United Nations University – International Institute for Global Health)
Deputy Chief Editor
Assoc. Prof. Dr. Sharifa Ezat Wan Puteh
(Universiti Kebangsaan Malaysia)
Members:
Chief Editor
Malaysian Journal of Public Health Medicine (MJPHM)
United Nations University - International Institute for Global Health (UNU-IIGH) Universiti Kebangsaan Malaysia Medical Centre (UKMMC)
Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur Malaysia
ISSN: 1675–0306
The Malaysian Journal of Public Health Medicine is published twice a year
Copyright reserved @ 2001
Malaysian Public Health Physicians’ Association
Secretariate Address:
The Secretariate
United Nations University - International Institute for Global Health (UNU-IIGH) Universiti Kebangsaan Malaysia Medical Centre (UKMMC)
Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur Malaysia
Tel: 03-91715394 Faks: 03-91715402 Email: [email protected]
Assoc. Prof. Sharifah Zainiyah Syed Yahya University Putra Malaysia
Dr. Lokman Hakim Sulaiman Ministry of Health Malaysia
Assoc. Prof. Dr Retneswari Masilamani University Malaya
Assoc. Prof. Dr. Mohamed Rusli Abdullah University Sains Malaysia
Assoc. Prof. Dr Saperi Sulong University Kebangsaan Malaysia
Assoc. Prof. Dr Maznah Dahlui University Malaya
Dr. Roslan Johari Ministry of Health Malaysia
Dr. Othman Warijo
Dr. Norfazilah Ahmad Ministry of Health Malaysia University Kebangsaan Malaysia
Dr. Amrizal Muhd Nur United Nations University–International Institute for
MJPHM
Official Journal of Malaysian
Public Health Specialist Association
7thNATIONAL PUBLIC HEALTH CONFERENCE 2013
11 – 13thNOVEMBER 2013
CONCORDE HOTEL SHAH ALAM, SELANGOR
Organized by
Ministry of Health Malaysia &
The Malaysian public health physicians’ association
In collaboration with
Public Health Department of:
(UKM, UM, USM, UPM, UiTM, IMU, UPNM, UMS, UNISZA, USIM, UNIMAS, UIA) Academy of Medicine of Malaysia, Malaysian Association of Health Education Officer
Angkatan Tentera Malaysia
EDITORIAL BOARD
CHAIRMAN:
DR. TAHIR BIN ARIS
SECRETARY:
SALSABILAH BINTI MOHAMAD MUKHTAR
MEMBERS:
DR. ROSLINAH ALI, MOH
DR. NIK JASMIN NIK MAHIR, MOH DATIN DR SITI HANIZA MAHMUD, MOH DR FADZILAH KAMALUDIN, MOH DR NOR ASIAH MUHAMAD, MOH AP DR HEJAR ABDUL RAHMAN, UPM DR JAMAIYAH HANIFF, MOH
PROF MADYA DR. MAZNAH DAHLUI, UM DR. MUHAMMAD FADHLI MOHD YUSOF,\ DR. NOR IZZAH BINTI HJ AHMAD SHAUKI
DR MOHAMAD IKHSAN SELAMAT, UITM DR. OTHMAN WARIJO, MOH
DR. NOOR ANI AHMAD, MOH DR. MOHD AZAHADI OMAR, MOH DR AMAL NASIR MUSTAPA, MOH DR RAFIZA SHAHARUDIN, MOH DR FATANAH ISMAIL, MOH
7TH NATIONAL PUBLIC HEALTH CONFERENCE
The
national public health conference was initiated in 1995 by the then Deputy Director General
of Health (Public Health), YBhg Dato’ Dr Wan Mahmud Othman. The conference was organised
in collaboration of the Ministry of Health and Malaysian Public Health Physicians Association
(PPPKAM) with other public health related professional bodies as well as public health
departments of the local medical faculties. The main objective of this conference is to gather
public health professional from various sectors to discuss relevant public health issues and
share experiences in order to upgrade and maintain their professionalism and the discipline of
public health medicine.
The 7th national public health conference is organized by
Malaysian Public Health Physicians Association (Persatuan Pakar Perubatan Kesihatan Awam
Malaysia) and the Ministry of Health Malaysia, co-organized by the public health departments of
Universiti Kebangsaan Malaysia, Universiti Malaya, Universiti Sains Malaysia, Universiti
Teknologi MARA, International Islamic University Of Malaysia and Universiti Pertahanan
Nasional Malaysia in collaboration with the Collage of Public Health Medicine (Academy of
Medicine, Malaysia)
Objectives of this conference
Enhance professionalism among Malaysian public health professionals through a strong
understanding and knowledge transformation and update of the national health system and
public health issues at local and international levels.
To discuss the opportunities and challenges and the role of public health professionals in
improving the fairness and efficiency of public health services in line with the country's health
system transformation.
Foster the spirit of cooperation of all public and private sectors from various fields and sectors of
public health.
Conference format
The 7th National Public Health Conference is held on 11 - 13 November 2013
at Concorde
Hotel, Shah Alam, Selangor and will be officiated by the Minister of Health, Malaysia, YB Datuk
Seri Dr. S. Subramaniam.
The conference theme is Public-Private Partnership towards Achieving Universal Health
Coverage.
Keynote address will be delivered by the Director General of Health, Malaysia, YBhg Datuk Dr.
Noor Hisham bin Abdullah which will focus on the conference theme.
Three plenary papers will be presented by distinguished speakers i.e. To’ Puan Dr. Safurah binti
Jaafar (Director of Family Health Development Division, MOH), YBhg Datin Paduka Siti Sa’diah
Shiekh Bakir (Corporate Advisor, KPJ Healthcare Berhad) and YBhg Datuk Dr. Lokman Hakim
bin Sulaiman (Deputy Director General of Health [Public Health]). Six symposia will also be
conducted besides 3 forums, 6 pre-conference seminar/workshops and scientific paper
presentations (oral and poster); in total 100 scientific papers will be presented.
The conference is expected to attract 400-500 participants consisting of public health
physicians, medical doctors, health service managers, public health nurses, public health dental
specialists, health educators, health inspectors and various other public health professionals
from the Ministry of Health, institutions of higher learning, local authorities, private hospitals,
armed-forces and private practices.
12 commercial booths on various health products will be displayed.
PHC 2013 Secretariat
i
CONTENTS
PAGES
KEY-NOTE ADDRESS
PUBLIC-PRIVATE PARTNERSHIP TOWARDS ACHIEVING UNIVERSAL HEALTH COVERAGE YBhg. Datuk Dr. Noor Hisham bin Abdullah
1
PLENARY
PL 01 ROLE OF PUBLIC SECTOR IN ENCHANCING PUBLIC PRIVATE PARTNERSHIP TOWARDS
ACHIEVING UNIVERSAL COVERAGE IN PUBLIC HEALTH To' Puan Dr Safurah binti Jaafar
4
PL 03
TRANSFORMING PUBLIC HEALTH TO MEET TODAY’S HEALTH THREATS
YBhg. Datuk Dr Lokman Hakim b. Sulaiman
5
SYMPOSIUM S1TAP1
QUALITY SERVICE DELIVERY
YBhg.Tan Sri Dato Dr Abu Bakar bin Suleiman
6
S1TAP3 OPTIMIZING HEALTH CARE RESOURCES FOR UNIVERSAL COVERAGE
Prof. Dato’ Dr. Syed Mohamed Aljunid
7
S1TBP1
GOALS AND TARGETS FOR VACCINE PREVENTABLE DISEASES PROGRAMME Dr. Rohani Jahis
7
S1TBP2 PUBLIC-PRIVATE COLLABORATION IN PROMOTING VACCINE PREVENTABLE DISEASE PROGRAM
Mr. Sasitheran KK Nair
8
S1TCP1
INFORMATION MANAGEMENT IN PUBLIC HEALTH Prof. Madya Dr. Jamalludin bin Ab Rahman
9
S1TCP2
HEALTH INFORMATICS Dr. Ariffin Marzuki bin Mokhtar
9
S1TCP3 BARRIERS TO INFORMATION TECHNOLOGY
Dr. Fadhlullah Suhaimi Abdul Malek
10
S1TDP2 A CONTEMPORARY REVIEW OF RHEUMATIC HEART DISEASE REGISTRY IN A TERTIARY CENTER IN SABAH
Dr. Narwani bt Hussin
ii
S1TDP3CHRONIC RHEUMATIC HEART DISEASE SECONDARY PROPHYLAXIS MONITORING IN PRIMARY CARE CLINIC: IS 80% ADHERENCE ACHIEVABLE? Dr. Rumihati bt Abd Hamid
11
S1TEP1 DO COMMUNITY – WIDE INTERVENTIONS INCREASE PHYSICAL ACTIVITY?
Prof. Philip R Baker
12
S1TEP2
EVIDENCE OF EFFECTIVENESS: HIGH LEVEL SYNTHESIS OF RESEARCH TO PREVENT OBESITY ABD INCREASE PHYSICAL ACTIVITY IN CHILDREN
Prof. Philip R Baker
12
S1TEP3
POPULATION BASED VERSUS TARGETED HIGH RISK POPULATION FOR CANCER SCREENING Prof. Madya Dr. Nur Aishah bt Mohd Taib
13
S1TFP1 CLIMATE CHANGE AND CLIMATE VARIABILITY AND ITS EFFECT ON CLIMATE SENSITIVE DISEASES
Dr. Muhammad Amir bin Kamaluddin
14
S1TFP2 EFFECTS OF ELECTROMAGNETIC RADIATION FROM TELECOMMUNICATION TOWERS Prof. Dr. Adlina Suleiman
14
S1TFP3
SAFETY AND SECURITY OF NUCLEAR POWER PLANT Prof. Emeritus Dato’ Dr. Noramly Muslim
15
ORAL PRESENTATION Oral 01
OVERVIEW OF PLASMODIUM KNOWLESI MALARIAIN SELANGOR (2011-SEPTEMBER 2013) Sharifah Malihah WM1, Venugopalan B1, Muhammad Afi S1
16
Oral 02
E. COLI FOOD POISONING OUTBREAK AMONG ATHLETE AT TELUK KEKE, MALAYSIA 2012 Liza AL, Razan S, Ummi Nadiah Y, Ismail I, Ahmad Nazri S, Rosli Y, Yusmaliza MY, Tg Johanoordin TZ, Intan Hawani AD, Wan Nur Farhana WA, Kamil SM, Mazlizaini G, Mohd J, Anwa S
16
Oral 03
SHARING MEASLES ELIMINATION ACTIVITIES IN KUALA LANGAT DISTRICT Lasa I, Shuaita MN, Anuratha S, Zabedah LS, Hasniza MR, Nurulizzah AK, Noraziani K
17
Oral 04
ROLE OF TODDY DRINKS IN HEPATITIS A OUTBREAK: A MALAYSIAN EXPERIENCE Ahmad Faudzi Y, Rusdi AR, Rohani J
17
Oral 05
THE FIRST METHANOL POISONING OUTBREAK IN MALAYSIA - A MULTIAGENCY ROLES AND RESPONSIBILITIES COULD HALT THE ILLEGAL PRODUCTION OF ILLICIT ALCOHOL
ACTIVITIES - SELANGOR 2013
HarishahT, J Norli , A Rosemawati, M Omar , K Fadzilah , Dr Raja A
iii
Oral 06AN OUTBREAK OF GASTROENTERITIS AMONG COMMANDO TRAINING RECRUITS IN SELANGOR, NOVEMBER 2011, WAS IT LEPTOSPIROSIS?
Harishah T, Rosemawati A, Fadzilah 2, Lasa , Siti Sabariah S ,Sazidah MK
18
Oral 07
A PRELIMINARY STUDY OF INTESTINAL PARASITES PREVALENCE AND INTENSITY IN SOME SELECTED LOCAL GOVERNMENT AREAS OF ZAMFARA STATES, NORTH-WESTERN REGION OF NIGERIA
Mohammed K, Ikeh Eugene I2,Aziah I,Julia O,Fabiyi Joseph P, Mohamed Rusli A
19
Oral 08
ORAL HEALTH RELATED QUALITY OF LIFE AND HEALTH RELATED QUALITY OF LIFE AMONG HIV PATIENTS IN KOTA BHARU
Mohamed NA, Yusoff A, Saddki N, Anilawati MJ
19
Oral 09
KNOWLEDGE AND ATTITUDES OF ANTENATAL MOTHERS ON INFANT ORAL HEALTH Mohd Hulaime MN, Zaim S, Mahmood Z, Saddki N
20
Oral 10
ALCOHOL AND ITS CO MORBIDITIES AMONG ADOLESCENTS IN MALAYSIA; FINDINGS FROM GLOBAL SCHOOL-BASED STUDENT HEALTH SURVEY 2012
Mala AM, Hamizatul AH, Hatta M, Rozanim K, Yussof S, Chong ZL, Norhafizah S, Diana Y, Hashimah I, Gurpreet K
20
Oral 11
SEXUAL ACTIVITY AMONG MALAYSIAN ADOLESCENTS: WHAT ARE THE RISK AND PROTECTIVE FACTORS?
Noor Ani A, S Maria A, Hasimah I, Norazilah MR, Nik Rubiah AR, Hamizatul Akmal AH, Tee GH, Norhafizah S, Diana M
21
Oral 12
MENTAL HEALTH PROBLEMS AMONG STUDENTS OF SEKOLAH MENENGAH KEBANGSAAN METHODIST, NIBONG TEBAL, PULAU PINANG
Rozaini MS , Thiruloga Guna Venthi K , Raveena Visha M , Fazilah Y
21
Oral 13
UNDERSTANDINGS ADOLESCENTS EATING BEHAVIOUR IN MALAYSIA Suhaila AG, NorhafizahS, Ahmad Ali Z, Azli B, Hatta M, Yeo PS
22
Oral 14
PREVALENCE AND DETERMINANTS OF DIETARY SUPPLEMENTS USE AMONG ADOLESCENTS IN MALAYSIA
Yeo PS, Norhafizah S, Hatta M, Nor Azian MZ,Suhaila AG
22
Oral 15
PHYSICAL ACTIVITY AND ASSOCIATION WITH NUTRITIONAL STATUS (BMI) AMONG MALAYSIAN ADOLESCENTS: FINDING FROM MALAYSIAN SCHOOL-BASED NUTRITION SURVEY, MSNS2012
iv
Oral 16BURDEN AND CORRELATES OF DEPRESSION AMONG ADOLESCENTS IN MALAYSIA
Jasvindar K,Gurpreet K, Balkish MN, Noor Ani MN, Helen Tee GH, Diana M, Cheong SM, Siti Fatimah MH, Fadli Y,Nurashikin I &Azriman R
23
Oral 17
IDENTIFIED RESEARCH PRIORITY AREAS IN OCCUPATIONAL HEALTH FOR TENTH MALAYSIA PLAN (10MP)
Lasa I, Yahya B, Juliana SP, Gurdeesh K, Ridhuan MD, Hazrin H
23
Oral 18
CORPORATE CULTURE IMPLEMANTATION AMONG HEALTHCARE PROVIDER IN MOH: WHERE ARE WE!
Dr. Nor Filzatun B, Noriah B, Roslinah A, Mohd Idris O, Roziana S, Fariz Sakina A, Aishah M
24
Oral 19
THE ECONOMIC BURDEN OF OCCUPATIONAL NOISE INDUCED HEARING LOSS IN MANUFACTURING INDUSTRIES IN MALAYSIA
Noraita T, Jamal Hisham, Syed Aljunid
24
Oral 20
ACTUAL COST OF DENTAL RESTORATIONS IN GOVERNMENT DENTAL CLINIC IN KELANTAN Abdullah MZ, Yusof A, Abd Rahman N, Sulong S, Mohd Nur A
25
Oral 21
EVALUATION OF ICPMS AND GFAAS FOR ANALYSES OF LEAD IN BLOOD
Rafiza S, Wan Nurul Farah WA, Yuvaneswary V, Mohd Fitri R, Mohd HairulHisam H & Muhammad Amir K
25
Oral 22
CODING ERRORS OF DIAGNOSIS AND PROCEDURES CLASSIFICATION: IMPACT ON IMPLEMENTATION OF CASEMIX SYSTEM
SA Zafirah, Syed Aljunid, Sharifa Ezat WP, Amrizal MN
26
Oral 23
WORKPLACE VIOLENCE AMONG HEALTHCARE WORKERS IN EMERGENCY DEPARTMENT, HOSPITAL UNIVERSITI SAINS MALAYSIA
Zulraini J, Zaliha , Aziah D, YN Azwany
26
Oral 24
DETERMINANTS OF SICK LEAVE DURATION AND RETURN TO WORK POST-ACUTE CORONARY SYNDROME: A REVIEW OF THE LITERATURE
Sahrol Nizam Abu Bakar, Mohd Nazri Shafei, Norsa’adah Bachok, Zurkurnai Yusof, Mansor Yahya
27
Oral 25
PUBLIC ACCEPTANCE TOWARDS SMOKE FREE INITIATIVES IN PERLIS Zulhizzam A, Ghazali O, Kamariah H and Azmi A
27
Oral 26
EFFECT OF ELECTRONIC MEDICAL RECORD UTILIZATION ON DEPRESSION, ANXIETY AND STRESS AMONG DOCTORS AND NURSES IN JOHOR
Ahmad Fairuz M, Mohd Ismail I, Mohd Nazri S
v
Oral 27FACTORS INFLUENCING HEALTH SEEKING BEHAVIOR AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS IN PRIMARY CARE SETTING
LL Low, SF Tong, WY Low
28
Oral 28
THE IMPACT OF CIGARETTE PACKAGING AND HEALTH WARNINGS ON RISK PERCEPTION IN YOUNG CHILDREN IN RELATION TO THEIR PARENTS SMOKING STATUS
Siti Munira Y, Noridayu A, NurQaasimah M, Wan Nor Atiqah WM, Wan Muhammad Hafiz WJ, Mohd Hafiz MH2
29
Oral 29
KNOWLEDGE, ATTITUDE AND PRACTICE ON FAMILY PLANNING AMONG ORANG ASLI WOMEN IN ROMPIN DISTRICT, PAHANG
Aznita Iryany MN, Mohd Hashim MH
29
Oral 30
SEXUAL AND REPRODUCTIVE HEALTH KNOWLEDGE OF PREMARITAL PREGNANT ADOLESENTS IN RAUDHATUS SAKINAH
A Safiya, Mohd Yusof Sidek, KI Musa
30
Oral 31
CORRELATES OF CURRENT SMOKING AMONG ADOLESCENT SCHOOL CHILDREN GH Tee, Gurpreet K, KH Lim, Muhammad Fadhli MY, Hamizatul Akmal AH, Hazrin H
30
Oral 32
PREVALENCE AND PREDICTORS OF ILLICIT DRUG USE AMONG SCHOOL-GOING ADOLESCENTS IN MALAYSIA: GLOBAL SCHOOL HEALTH SURVEY
Mohamad Naim MR, Norhafizah S, Fadhli MY, Yusoff S, Lim KH, Norzawati Y, Noor Ani A
31
Oral 33
ALEGIONELLA OUTBREAK AT A HOSPITAL IN KUALA LUMPUR
Rohani I, Thilaka C, Rosmawati A, Zakiah MY, Deenesh K, Ummi Kalthum S, Balachandran S
31
Oral 34
A MEASLES OUTBREAK AT A PRIVATE WELFARE CENTRE IN KUALA LUMPUR, FEBRUARY 2012
Rohani I, Nurul Hafizah MY,Norhaida U, Sarah Hassan, Tarmizie N
31
Oral 35
EPIDEMIOLOGICAL ANALYSIS OF TYPHOID FEVER IN SELANGOR FROM A RETRIEVED REGISTRY 2013
Mas Norehan A ,Harishah T ,Wan Nor Fareeda W.Y, Mohmad Farhan K
32
Oral 36
DENGUE VIRUS INFECTION AMONG FOREIGNERS IN KUALA LUMPUR AND PUTRAJAYA, 2010 TO 2012
Wong YM, Zainal Abidin AB
32
Oral 37
QUIT SMOKING SERVICES IN KLANG HEALTH DISTRICT: FACTORS ASSOCIATED WITH FAILURE OF QUIT ATTEMPTS
Ho BK, Nelli Y, Menaga M, Parimala D, Daisy V, Nor Izah D, Che Azlan S
vi
Oral 38CERVICAL CANCER SCREENING COVERAGE AT HEALTH CLINICS, KUALA LUMPUR IN 2012
Shanthi V, Chia SY, Ummi Kalthom S 33
Oral 39
A CROSS SECTIONAL STUDY ON PREVALENCE, KNOWLEDGE AND PRACTICE ON DIABETES IN A VILLAGE IN KINTA DISTRICT, PERAK
Davinder S, Sandheep S, MM Soe
34
Oral 40
EARLY DETECTION OF AIRFLOW OBSTRUCTION IN A POPULATION EXPOSED TO OCCUPATIONAL LUNG CARCINOGENS
Fauziah N, Booton R, Barber PV, T Frank, F.de Vocht,, Povey AC
34
Oral 41
PREVALENCE AND FACTORS ASSOCIATED WITH OVERWEIGHT AMONG ADOLESCENTS Rampal L, Garba JA, Hejar AR, Salmiah MS
34
Oral 42
MAJOR DIETARY INTAKE AMONG ADOLESCENTS AND THEIR ASSOCIATION WITH OVERWEIGHT
Rampal L, Garba JA, Hejar AR, Salmiah MS
35
Oral 43
BULLYING AND ITS ASSOCIATED FACTORS AMONG SCHOOL ADOLESCENTS IN MALAYSIA Diana M,Rosnah R, Siti Fatimah MH,Riyanti S, NurShahida AA, MohdHazrin H, HamizatulAkmal AH, Cheong SM, Noor Safiza MN
35
Oral 44
NUTRITIONAL STATUS AND BODY WEIGHT PERCEPTION AMONG ADOLESCENTS IN MALAYSIA
Ahmad Ali Z, Suhaila AG, Azli B, Norhafizah S, Cheong SM, Noor Ani A, Balkish MN, Mala M
36
Oral 45
AWARENESS ON COMMON EYE DISEASES AND BARRIERS TO EYE CARE AMONG JAKUN SUB-ETHNIC COMMUNITY OF ORANG ASLI (INDIGENOUS PEOPLE) IN KUANTAN, MALAYSIA Azuwan M, Sheeladevi S, Williams JD
36
Oral 46
OCCUPATIONAL AND ENVIRONMENTAL CHARACTERISTICS AMONG SEROPOSITIVE TOWN SERVICE WORKERS FOR LEPTOSPIROSIS IN KELANTAN, MALAYSIA
Mohamad Azfar Z, Aziah D, Mohd Nazri S, Mohamed Rusli A, Maizurah O, Zahiruddin WM, Nor Azwany Y, Nabilah I, Siti Asma’ H, Mohd Nikman A
37
Oral 47
IMPLEMENTATION OF WEB-BASED GEOGRAPHICAL INFORMATION SYSTEM (GIS) APPLICATION FOR MAPPING OF HEALTH FACILITIES, SERVICES AND PROVIDERS IN MALAYSIA
Hazrin H, Tahir A, Fadhli Y
37
Oral 48
VALIDITY AND RELIABILITY OF THE MALAY VERSION OF THE STROKE KNOWLEDGE, ATTITUDE AND PRACTICE QUESTIONNAIRE
Noriah M, Mohd Ismail I, Norsa’adah B
vii
POSTER PRESENTATIONPoster 01
THE PRIVATE HAEMODIALYSIS CENTRE FINANCIAL ARRANGEMENTS IN MALAYSIA: AN EXPLORATORY STUDY
Adilius M, Siti Haniza M
39
Poster 02
LEPTOSPIROSIS IN TERENGGANU, MALAYSIA 2010 – 2012.
Liza AL, Ummi Nadiah Y, Ismail I, Ahmad Nazri S, Yusmaliza MY, Wan Nur Farhana WA, Kamil SM, Mazlizaini G, Mohd J, Anwa S
39
Poster 03
STUDIES ON MALAYSIAN HEALTHCARE SYSTEM: LISTENING TO THE PEOPLE'S VOICE Najwa M , Hasmuny O , Nordin S , Siti Sa’adiah HN
40
Poster 04
DEPRESSION AND RESILIENCE IN RELATION TO ACADEMIC PERFORMANCE AMONG MEDICAL STUDENTS IN A PUBLIC UNIVERSITY
Siti Munira Y, Nurhuda I, Nor Aini MN, Imran Z, Muhammad Ammar AR, Elisa Shafura S, Fatheen Atheerah AR, „Aisyatul Najiha H
40
Poster 05
REFERRAL PATTERN OF PRIMARY CARE PROVIDERS IN THE MALAYSIAN PUBLIC HEALTHCARE SYSTEM
Ang KT, Ho BK, Mimi O, Salmah N, Salmiah MS, Magesiwaran M, Noridah MS
40
Poster 06
HOW WELL DO WE KNOW OUR PARTNERS?
Siti Haniza M, Adilius M, Sarah J, Sai Gaayathri S, Wan Shihabuddin WM, Look CH, Halim AH, Rozita Halina TH, Nordin S
41
Poster 07
FACTORS ASSOCIATED WITH NO ANTENATAL BOOKING AMONG PREGNANT WOMEN WITH HIV IN SELANGOR
Dr Fazlina Mohamed Yusoff, Dr Ho Bee Kiau, Dr Salmiah Sharif, Dr Vickneswari Ayadurai , Dr. Noranizah Muzaid, , Dr Masitah Mohamad, Dr. Rosnah Mat Isa
41
Poster 08
COST OF OPERATING KLINIK 1MALAYSIA (K1M) WITH A MEDICAL OFFICER Mazura M & Ramli Z
42
Poster 09
PERINATAL MORTALITY REVIEW: OPPORTUNITY FOR INTERVENTION IN KUALA LANGAT DISTRICT
Noraziani K, Lasa I, Shuaita MN, Siti Harirotul A, Nor Azila MI
42
Poster 10
MANAGING ACUTE DIARRHOEAL DISEASES AMONG UNIVERSITY STUDENTS USING SYNDROMIC NOTIFICATION APPROACH
Noraliza NM, Fazar AJ, Maryam AG, Rohani I
viii
Poster 111MALAYSIA MOBILE CLINICS – AN INNOVATION TOWARDS UNIVERSAL PRIMARY HEALTH CARE COVERAGE IN MALAYSIA
Kawselyah Juval, Kamaliah Mohamad Noh, Noridah Mohd Salleh, Rachel Koshy, Muhamad Nazimim
43
Poster 12
ACCESS OF ANTENATAL HEALTHCARE AMONG NON-CITIZENS AT GOVERNMENT
MATERNAL & CHILD HEALTH (MCH) CLINICS, FEDERAL TERRITORY OF KUALA LUMPUR IN 2012
Chia SY, Shanthi V, Balachandran S1
44
Poster 13
DENGUE CASES IN SEPANG, SELANGOR OVER 5 YEARS – A REVIEW Ruhaini I, Fariza F, Meftahuddin T, Latifah M, Mohd Zahrulnizam S
44
Poster 14
TRADITIONAL POSTPARTUM PRACTICES AMONG MALAYSIAN MOTHERS: A REVIEW Fariza F, Shamsuddin K, Sharifa Ezat WP
45
Poster 15
INVESTIGATING SUSPECTED LEPTOSPIROSIS DEATH IN A DETENTION CENTRE (DTS) Rahimah N, Othman BW, Norerwana M, Azlinda H, Ruzaimy AR
45
Poster 16
INVESTIGATING LEGIONELLOSIS: NEED FOR A PROPER COMPREHENSIVE GUIDELINES Othman BW, Lily Rmz, Imran A, Saman Mb
45
Poster 17
SUSCEPTIBILITY TO SEVERE DENGUE INFECTIONS IN AN URBAN DISTRICT IN MALAYSIA: A CASE CONTROL STUDY
Siti Munira Yasin, Ariza Zakaria, Ruziyah Omar, Rozlan Ishak, Aminuddin Makpol, Siti Zakiah Mesbah, Azura Abul Hasan Ashari
46
Poster 18
TREND OF MATERNAL MORTALITY IN FEDERAL TERRITORY OF KUALA LUMPUR FROM 2008 TO 2012
Noriah H, Noorzila I
46
Poster 19
A URTI OUTBREAK AT A GOVERNMENT SCHOOL IN KUALA LUMPUR Asyraf Z, Haliza AM, Mokhtar O, Rohani I
47
Poster 20
ACUTE DIARRHEA AND HYGIENE PRACTICE AMONG WOMEN WHO MANAGE HOMES AT KUALA TERENGGANU DISTRICT
Azmawati MN, Dalila M
47
Poster 21
THE WILLINGNESS TO PAY FOR DRUGS AMONG SELANGOR STATE POPULATION Siti Nurul Akma A, Sharifa Ezat WP, Azimatun Noor A, Ramli Z, Ruhaini I
48
Poster 22
LEVEL OF CATASTROPHIC HEALTH EXPENDITURE AND ITS INFLUENCING FACTORS AMONG INPATIENTS ADMITTED TO HOSPITAL KUALA LUMPUR
Yang Rashidi A, Azimatun Noor A, Shamsul Azhar S
ix
Poster 23HIGH PREVALENCE OF CARDIOVASCULAR DISEASE RISK FACTORS AMONG COMMUNITY LEADERS IN KELANTAN
Zulraini J, AA Ismail, YN Azwany, Tengku MA, Ismail MS
49
Poster 24
DO PATIENTS ADMITTED WITH DENGUE FEVER HAVE A COMPLETE DIAGNOSIS AND ENOUGH FLUID?
Norfarahdina R, Nurulraziquin MJ, Nurain MN
49
Poster 25
REDUCING THE OCCURRENCE OF DENGUE FEVER IN PPA DESA REJANG SETAPAK THROUGH INTEGRATED VECTOR MANAGEMENT (IVM) APPROACH, 2013-2014 Zainal Abidin AB, Dahlia B, Zakiah Y, Khadijah K
50
Poster 26
DIETARY FACTORS INFLUENCING O6-ALKYLGUANINE-DNA ALKYLTRANSFERASE (MGMT)
ACTIVITY IN PATIENTS ATTENDING A BRONCHOSCOPY CLINIC
Fauziah N, O’Donnell PNS, Barber PV, Booton R,Billson H, Derbyshire E, Margison GP, Povey AC
50
Poster 27
MALNUTRITION AND ITS RISK FACTORS AMONG HOSPITALISED PATIENTS AT KUALA LUMPUR GENERAL HOSPITAL
Nor Azian MZ, Suzana S, Romzi A, Azahadi O
51
Poster 28
SEXUAL RISK BEHAVIOR: TEENS’ EXPERIENCES
Hatta M., Fadzilah K., Balkish MN., Faizah P., Norzawati Y., Yussof S., Hazrin H.
51
Poster 29
THE ASSOCIATION OF PORNOGRAPHY EXPOSURE WITH ADOLESCENTS’ SEXUAL BEHAVIOR Hazrin H, Hatta M, Norzawati Y, Faizah P, Yussof M, Fadzilah K
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Poster 30
SUSCEPTIBILITY TO INITIATE SMOKING AMONG SECONDARY SCHOOL NON-SMOKERS IN MALAYSIA
Lim KH, Hasimah I, Helen Tee GH, Gurpreet K, Jasvindar K, Lim KK
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Poster 31
VIOLENCE RELATED BEHAVIOURS AMONG ADOLESCENTS IN MALAYSIA; A CROSS SECTIONAL SURVEY AMONG SECONDARY SCHOOL STUDENTS
Nur Shahida AA, Diana M, Siti Fatimah MH, Rosnah R,Mohd Hazrin H
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Poster 32
SUICIDAL BEHAVIOURS AMONG MALAYSIAN ADOLESCENTS: WHAT’S THE CURRENT SITUATION?
Noor Ani A, Cheong SM,Azriman R, Nurashikin, Mala M, Fadhli MY, Siti Fatimah, Gurpreet K, Noor Safiza MN
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Poster 33
PHYSICALLY ACTIVE ADOLESCENTS: WHAT ARE THE PREDICTORS?
Chan YY, Lim KK, Teh CH, Azahadi O, Azli B, Hamizatul Akmal AH, Norhafizah S, Leni T, Tee GH, Noor Ani A
x
Poster 34WHAT PARENTS AND SCHOOLS CAN DO TO BUILD PROTECTIVE FACTORS AMONG ADOLESCENTS?
Noor Safiza MN, Nik Rubiah NR, Norzawati Y, Diana M, Leni T, Afiq A , Noor Ani A
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Poster 35
ADOLESCENTS BREAKFAST HABITS IN MALAYSIA: MALAYSIA SCHOOL BASED NUTRITION SURVEY 2012
Suhaila AG, Hafizah Mohd Shahril, Ahmad Ali Z, Azli B, Hatta M, Yeo Pei Sien
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Poster 36
ORAL HEALTH PRACTICES AMONG ADOLESCENTS IN MALAYSIA Riyanti S, Yaw SL, Nurrul A, Khairiyah AM, Balkish MN, Yeo PS
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Poster 37
ALCOHOL CONSUMPTION AMONG ADOLESCENTS IN MALAYSIA Hamizatul Akmal AH, Hatta M, Mala M, Rozanim K, Yusoff S, Chong ZL
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Poster 38
ADOLESCENTS IN MALAYSIA: IS ANXIETY ASSOCIATED WITH SOCIO-DEMOGRAPHIC, MENTAL HEALTH, ENVIRONMENTAL, AND NUTRITIONAL FACTORS?
Cheong SM, Jasvindar K, Balkish MN, Dr. Noor Ani A, Gurpreet K, Helen Tee Guat Hiong, Azriman R, Nurashikin I, Diana Mahat, Siti Fatimah MH, Leni T, Suhaila AG
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DIRECTOR GENERAL’S KEYNOTE
PUBLIC-PRIVATE PARTNERSHIP TOWARDS ACHIEVING UNIVERSAL
HEALTH COVERAGE
YBhg. Datuk Dr. Noor Hisham bin Abdullah Director General of Health
Ministry of Health Malaysia
Ladies and Gentlemen,
I would like to express my gratitude to the organising committee of the National Public Health Conference 2013. It is an honour for me to present the keynote speech for this conference with the theme: Public-Private Partnership towards Achieving Universal Health Coverage.
The Malaysian healthcare system consists of the public and private sector which provide healthcare services from the primary care to to the tertiary care services at hospital level which consist of promotive, preventive, curative, rehabilitative and palliative care .According to 2013 Health Facts published by the Heath Informatics Centre of Planning Division, there are 6675 registered private medical clinics in contrary to only 2856 public health and community clinics. There are 209 registered private hospitals as compared to 140 public hospitals in Malaysia. Thus, it is suffice to say that there is plenty of resource in the private sector and relative heavy burden of public sector with less resource but more workload.
It is therefore logical to think of Public-Private Partnership (PPP) as a partnership in bringing together available resources for the common goal of improving the health of a population based on the mutually agreed roles and principles. The Organisation for Economic Co-operation and Development (OECD) defines the partnership as a long term agreement between the government and a private partner whereby the private partner delivers and funds public services using a capital asset, sharing the associated risks.
Universal Health Coverage (UNIVERSAL HEALTH COVERAGE) as expounded by the World Health organization in 2005, envisages a situation where there is access to appropriate promotive, preventive, curative and rehabilitative health services for those who need them at an affordable cost. Since then, it has gained increased recognition as a framework for embracing various global health priorities. In 2008, this was further reinforced by International Labour organisation (ILO) that defines it as the effective access to affordable health care and financial protection in case of sickness.
Ladies and Gentlemen,
Going back to the theme of our conference, Public-Private Partnershiptowards achieving UNIVERSAL HEALTH COVERAGE is all about the collaboration and sharing responsibilities between public and private sectors which can bring about synergetical positive effects on the efficiency, equity and quality of health care services.
I would like to quotepart of the opening speech given by the ex-Director General of WHO, Dr Margaret Chan during the launch of the World Health Report 2010. „The World Health Report is designed to encourage every country in the world to adopt at least some policies that will extend coverage to more people, and reduce the number of people who risk financial ruin when they fall ill. All countries, at all stages of development, can take immediate steps to move towards universal coverage and to maintain their achievements. Countries that adopt the right policies can achieve vastly improved service coverage and protection against financial risks for any given level of expenditure.‟
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Ladies and Gentlemen,
How does Malaysia fare in providing Universal Health Coverage to its people? A case study report published in the Biomedical Centre of Public Health Journal in 2012 reported that Malaysia did well with total health expenditure close to 5% of its GDP (4.75%), out-of-pocket payment below 40% of total health expenditure (30.7%), comprehensive social safety nets for vulnerable populations, tax-based financing system that fundamentally poses as a national risk pooled scheme for the population. This was based on the 4 indicators under the WHO Health Financing Strategy for the Asia Pacific Region (2010-2015) which was used as the framework to evaluate the Malaysian healthcare financing system in terms of the provision of universal coverage for the population. Even though we are on the right track, nevertheless, there‟re always rooms for improvement.
In the present day, the majority of primary care consultations are paid out-of-pocket with private physicians but free or highly-subsidized care of reasonable quality is available throughout the country at public healthcare facilities. The majority of Malaysians still seek treatment at government hospitals which provide highly-subsidized general wards. Thus, the PUBLIC-PRIVATE PARTNERSHIP can act as a tool to further enhance accessibility, provide higher quality service and promote equity in delivering the desired optimum healthcare service for the public.
Let us look at the pros of the PUBLIC-PRIVATE PARTNERSHIP first. First of all, it contributes in reducing fiscal pressures of governments to reallocate resources. It also enables private providers both non-profit or for profit oriented play an important role in social service provision and fostering of voluntary engagement of private sectors. PUBLIC-PRIVATE PARTNERSHIP also enhances the efficiency of public service delivery by reducing bureaucracy. In addition, improving access through increased private sector provision and government‟s commitment to universal and equitable health coverage is reaffirmed.
Although PUBLIC-PRIVATE PARTNERSHIP can promote universal health coverage, there‟s also the down-side of it. For example, increase transaction costs, e.g. for negotiating and monitoring can be transpired into increased healthcare costs thus leads to Increased inequity in access and use of health care. Secondly, introduction of contact may lead to lack of co-ordination within the broader public health system, brain drain and drive scarce resources into a particular allocation. Moreover, private providers may take advantage of patients by supplying more health care than is required and providing low-quality health care.
Ladies and Gentlemen,
Towards realization of the Government Transformation Program and holding steadfast to the motto “1Malaysia: People First, Achievement Now”, the MINISTRY OF HEALTHMinistry of Health strives to provide the highest quality and yet affordable healthcare service in Malaysia. As Malaysia‟s plan of transformation towards achieving high-income status and global competitiveness, there are 12 National Key Economic Area (NKEA) were chosen to lead the country‟s economic growth. The example of the entry point projects (EPP) of the NKEA Healthcare, the government has introduced the compulsory private health insurance for foreign workers. Since 2011, the Government has introduced a compulsory low premium private health insurance scheme for foreign workers. With an annual premium of RM120, foreign workers have access for hospitalisation and medical coverage for all sickness and injuries requiring admission into Ministry of Health hospitals for up to a total coverage of RM10,000 per annum. If the treatment charges exceed RM10,000.00, the additional charges will be borne by the worker or the employer.This is an excellent example of the collaboration between the public and private sector in improving health coverage for the foreign workers in Malaysia.
To date, Ministry of Health has embarked upon several Partnership with the private sectors. Examples of the current Partnership between MINISTRY OF HEALTHMinistry of Health and the private sectors are the outsourcing medical services e.g. Cancer treatment, imaging, lab, surgery, palliative care and hospital support services e.g. linen & laundry, clinical waste management, cleaning, maintenance, food catering, security. These Partnership not only benefit the healthcare provision, in addition, it also enhances the national economy by generating wealth, contributing to economical activities and providing jobs to many.
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In hastening development, but at the same time without too much financial initial commitment, the MINISTRY OF HEALTH rents the Women and Child Hospital infrastructurefrom the private sector which then transfers the ownership to government. This is not new as the similar concept was used for the development of the Federal government complexes in Putrajaya. In the example of land swap agreement with the private developer, the existing MINISTRY OF HEALTH institutions on the prized, high-valued commercial land such as the National Institutes for Health Complex in Bangsar (IHM, IKU & IPTK) will be moved to the 1NIH research complex once the developerhas completed the new complex.
Ladies and Gentlemen,
The MINISTRY OF HEALTH has continuously worked tirelessly to enhance our healthcare service delivery. The MINISTRY OF HEALTH is collaborating with several private training colleges which train medical students, nurses and allied health workers which whom to be employed at the public facilities upon graduation. In the implementation of the methadone programme, MINISTRY OF HEALTH and the 21 authorized private clinics are collaborating in which government, through the MINISTRY OF HEALTH has provided the methadone (free-of-charge) F.O.C. while the clients will pay the private GP consultation fees when using the service.With the collaboration of Pos Malaysia, the MINISTRY OF HEALTH has initiated the „Pharmacy Home Delivery‟ service which enables patients to receive their medical prescriptions via PosLaju at a minimal charge.
In terms of human resource, locum arrangements have been made where public doctors are able to provide their services in the private facilities. Vice versa, the MINISTRY OF HEALTH has also contracted private doctors in Primary Healthcare clinics and hospital on session‟s basis and at the traditional and complementary care (TCM) point of care.
Looking at the successful and promising outcomes from the existing public-private Partnership, the MINISTRY OF HEALTH is in the midst of planning for several potential future Partnership with the private sector. For examples, the public-private collaboration in managing patients with chronic diseases (HPT & DM) in the public clinics who are outsourced to private general practitionersis being looked at. In addition, integrated health care system of public and private sectors providers as a component of the health system transformation plan is currently being studied.
There is no “one size fits all” solution for governance and management structures that is conducive to attaining UNIVERSAL HEALTH COVERAGE. Nevertheless, in the context of our society, if well designed and implemented in stages, PUBLIC-PRIVATE PARTNERSHIP is an innovative mechanism that benefits the society in general.
Ladies and Gentlemen,
In conclusion, PUBLIC-PRIVATE PARTNERSHIP will allow government and non governmental bodies to achieve efficiency by risk sharing and shouldering the responsibilities. This can also allows private sector a chance to bring on board new innovation and to contribute towards construction, operation, maintenance of public infrastructure.
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PL-01
ROLE OF PUBLIC SECTOR IN ENHANCING PUBLIC-PRIVATE
PARTNERSHIP TOWARDS ACHIEVING UNIVERSAL COVERAGE IN
HEALTH
To’ Puan Dr Safurah Bt Jaafar
Director Family Health Development Division Ministry of Health Malaysia
There has been recent surge in many countries to take on the path towards Universal Health Coverage. From Thailand to Nigeria, or Ghana to the Obama administration, many of them are in different phases making efforts implementing different universal health coverage schemes, marking a rise in interest and political will for universal health coverage. The core initiatives in health have seen a moved from not just diseases and prevention but looking inwardly more into sustainability and strengthening of their health system.
UHC, as defined by the World Bank, refers to health systems providing both access to health services and financial protection which includes avoiding out-of-pocket payments that reduce the affordability of services, and ideally some compensation for productivity loss due to illness The debate continues, what is the best model and what models are appropriate for a given country with their various predisposition.
Most of these models however focus on the role of the public sector health services for the provision of healthcare to all citizens covered under UHC. The questions on the role of the private sector in such predominantly public domain platform have received many competing views. The most common stand on the public-private partnerships is an optimistic one, ie: PPPs promote sharing of risks, stimulate additional private resources and avoid crowding out and foster innovation that can help reduce costs and improve efficiency.
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PL-03 TRANSFORMING PUBLIC HEALTH TO MEET TODAY’S HEALTH
THREATS
YBhg. Datuk Dr Lokman Hakim b. Sulaiman Deputy Director General of Health (Public Health) Ministry of Health Malaysia
World Health Organisation (WHO) recently reported that the greatest threat to public health is not infectious diseases but non-communicable diseases (NCDs).
The recent Health Minister‟s Retreat articulated an overarching goal for the nation‟s health: ‘towards community-care and self-community-care through empowerment and partnership thus ensuring a healthy Malaysian at every stage of life’. To achieve this goal will require a strong and vital healthcare system. Our healthcare system is going through a transformation process that will allow universal health coverage. There is a need to create more integrated approaches to prevention, primary care and overall health delivery system that is more efficient and effective. This will require public health professionals to reassess their role in relationship to the larger healthcare system of which public-private will be an integral part along with non-profit and for profit organisations in the community.
Responding to this shift requires a different approach in both the health care and community settings. Public healthcare providers need to embrace new tools and train or retain their workforce with new skills in order to lead a „health for all policies‟ approach that addresses the social determinants of health.
Changing circumstances require public health officials to be deft and flexible – in the face of current financially austere times. They are required to possess a vast array of knowledge, skills and attitudes to be effective providers of healthcare i.e. developing effective evidence based public health policies, effective communication, mobilizing the community and forging partnership, cultivating leadership, management and business skills. They need to be more engaged and visible in building partnerships.
National efforts towards universal health coverage create a timely opportunity to realign primary care services in ways not previously possible. As a „health in all policies‟ approach becomes more accepted and the definition of health and its determinants broadened, it will be important to recognize that not all public health activities or functions must run/organised by MOH or using MOH‟s budget.
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S1TAP1 QUALITY SERVICE DELIVERY
YBhg.Tan Sri Dato Dr Abu Bakar bin Suleiman President
International Medical University (IMU) Bukit Jalil
The goal of universal health coverage is to ensure people obtain the health services needed without suffering financial hardship when paying for them. Universal health coverage can occur in a setting of a strong, efficient, well run health system supported by a system of health financing. There must be access to essential medicine and technologies, with a sufficient capacity of well trained, motivated health work force. It must be supported by health information and other resources, and there must be a sound governance system that emphasizes patient safety and quality improvement in health services delivery.
While Malaysians would claim to have universal access to healthcare, what is the actual quality of our “universal health coverage”?
Do we have data to evaluate this? What is the quality of access to healthcare, and how equitable is it? The concerns with equity must surely be evaluated, carefully, especially when out-of-pocket spending on healthcare is at such a high level in our country. This cannot be good for our concern about equity in healthcare coverage.
Porter had observed that the American Health Care System is fragmented, fractured, inefficient and had made recommendations on transforming the healthcare system to a system that achieves universal coverage, and is a value-based system for patients. Berwick‟s “triple aim” relating to care, health and costs are important initiatives in the healthcare transformation process in the USA, and is relevant in other countries as well.
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S1TAP3 OPTIMIZING HEALTH CARE RESOURCES FOR UNIVERSAL
COVERAGE
Prof. Dato’ Dr. Syed Mohamed Aljunid UNU-International Institute for Global Health
Health expenditure has been showing an increasing trend globally in the last three decades. Rise in prevalence of chronic non-communicable diseases, aged population, and increasing demand for specialised care and uncontrolled infusion of new technology in healthcare are among the factors causing raise in the overall health spending. However in many developing countries, the total health expenditure remains below 5% of GDP. With universal coverage as the new health system objectives, health policy makers may have to make unpopular decisions to use the limited resources available to spread the services to every individual in the population. Social health insurance (SHI) programme will become the main source of funding for universal coverage. Comprehensive strategies covering both supply and demand side should be developed in order to optimise the limited resources. The demand side strategy should include the effective use of health promotion and preventive services to promote health and well being of the population. Benefit package of SHI should cover only proven cost-effective interventions to ensure value for money spend. The supply side measures should cover efforts to promote efficient use of resources by health providers. Providers in SHI should be reimbursed based on prospective payment methods such as capitation and casemix system. Incentives and disincentives should be built in SHI programme to encourage efficiency and quality. Pay-for-performance methods should be developed and implemented in larger scale to provide incentives for efficient practice and to control moral hazards of providers. In conclusion, with limited resources allocated for health care, it is unlikely that the current health spending is sustainable in long term. There is an urgent need for policy makers especially in developing countries to address this crucial issue.
S1TBP1
GOALS AND TARGETS FOR VACCINE PREVENTABLE DISEASES
PROGRAMME
Dr. Rohani Jahis
Head of The Vaccine Prevention Of Disease/Food & Water Borne
Ministry of Health Malaysia
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S1TBP2 PUBLIC-PRIVATE COLLABORATION IN PROMOTING VACCINE
PREVENTABLE DISEASE PROGRAM
Mr. Sasitheran KK Nair Health Education Officer, Health Education Division, Ministry of Health Malaysia
Introduction: Public-Private Partnerships have become an accepted norm in various sectors in most of the developed countries. Malaysia, under the leadership of Prime Minister,Dato' Sri Najib had set up The Public Private Partnership Unit to steer private sector participation and stimulate private sector investment through public-private partnership (PPP) in the national development agenda. The partnership ventures allows for sharing of costs and optimization of resources and facilities. Thus, the establishment of Immunise4Life Programmes (IFL) too is based on the principles of PPP and also in line with the Ottawa Charter (1986) on health promotion through community strengthening. Two NGOs in collaboration with four major private companies has partnered with the Ministry of Health in promoting the immunisation programme.
Method: The Smart partnership between MOH, the NGOs and private companies was established with the intention to increase awareness of vaccine-preventable diseases and their respective vaccine solutions, counter anti-vaccine lobby, promote full compliance with the MOH Expanded Programme on Immunisation (EPI) for children, while advocating optional vaccines for wider protection, promote general and gender-specific vaccination for adult individuals, advocate immunisation of foreign workers & personnel in selected industries. This programme is structure into Core Programme and Ancillary campaigns. The core programme covers all immunisable diseases and all participating companies contribute to the operational fund. The ancillary allows opportunity individual participation to emphasise selected areas of interest. This allows competition based on first-come, first-served basis. Thus, IFL promotes a platform for healthy partnership and as well as competition under the supervision and guidance of MOH.
Results : This programme has so far succeeded in establishing a dedicated website to promote immunization through videos (15 public service announcements, 21 doctor talks) and 36 articles, produced (printed) 10,000 copies of booklets. All the videos and the booklets are uploaded for public use on www.immunise4life.my. Those who contributed to the videos, includes the Director General of Health, MOH, specialists from government and private sector, and as well as celebrities. The establishment of the website has resulted in an increase of buzz among the public, especially the netizens. Many are sharing experiences, opinions and seeking advice from experts in the social media. The queries are a sign that many in the public are not fully aware of immunisation and the benefits. The experts wish to help the public make informed decisions on immunisation for themselves and their loved ones.
Discussion: This partnership complements and promotes compliance with the MOH‟s Expanded Programme on Immunisation (EPI) for children, while advocating optional vaccines for wider protection as well as providing a platform for the public to seek further information to make informed decision on immunization. This partnership strategy does not financially burden the MOH; instead the pooled sponsorship by the participating companies has financed the production of the videos, articles, booklets and other educational materials amounting to almost half a million Ringgit Malaysia in the first year, and the total saving of the tax payers‟ money for 3 years is estimated to be around RM2million.
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S1TCP1 INFORMATION MANAGEMENT IN PUBLIC HEALTH
Prof. Madya Dr. Jamalludin bin Ab Rahman Department of Commuity Medicine
IIUM Kuantan
Efficient and reliable management of information is critical to the success of any organisation. Public health generates a lot of data and in return requires a lot of information to monitor and measure its purpose and function in the population. The development of good information management system starts form identifying organisations‟ own needs and direction. Well defined data structure and properly planed method of data collection are essential. This paper will discuss all these matters and proposed general guidelines of how to achieve it.
S1TCP2 HEALTH INFORMATICS
Dr. Ariffin Marzuki bin Mokhtar National Heart Institute of Malaysia
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S1TCP3 BARRIERS TO INFORMATION TECHNOLOGY
Dr. Fadhlullah Suhaimi Abdul Malek
Performance Management and Delivery Unit (PEMANDU),
The expectations of consumers (patients) have been shaped by the advent of technology advancement and its adoption into the daily lives. This very change imposes greater demand on the healthcare system. Definition of universal health coverage is impacted by the market, depending on supplier or demand driven in perspective. The paper provides a view of the behavioral change in light of technology, where the new demands will come from, where everything is now an ASAP-syndrome. This behavioural change will further be affected and cemented by the trends in technology. In crafting the behavioural and technology scenario, an attempt is made to analyse the healthcare system and elucidate the barriers to information technology from a financial, policy and operational perspective. Concluding on how best to deal with such barriers both for healthcare providers in private and public.
S1TDP2 A CONTEMPORARY REVIEW OF RHEUMATIC HEART DISEASE
REGISTRY IN A TERTIARY CENTER IN SABAH
Dr. Narwani bt Hussin Public Health Physician, Clinical Research Center, Hospital Queen Elizabeth II
Rheumatic fever and Rheumatic Heart Disease (RHD) have been almost eradicated in areas with establish economies. However it is still endemic in developing countries & indigenous population in wealthy countries. There are between 15.6-19.6 million existing cases of RHD and there are around 282,000 new cases each year. An estimated 233,000 to 468,164 individuals die from RHD each year, and hundreds of thousands of people are disabled by this disease and its long-term complications.
Malaysia has been lacking incomprehensive data on rheumatic heart disease patients. There is still no nationwide registry or nationwide survey on rheumatic heart disease has been implemented specifically in Sabah and generally for the whole Malaysia.
The Cardiology Unit together with the Clinical Research Centre, Queen Elizabethll Hospital, Kota Kinabalu, Sabah has made an initiative and developed this small scale hospital based registry to assess the burden of rheumatic heart disease especially in terms of socio demographic profile of the patients involved, the severity of the disease, types of valve problem faced by patients and practice of secondary prophylaxis.
The registry was first initiated in December 2010. We included all patients with a diagnosis of rheumatic heart disease who attended or referred to the Cardiology Clinic, Queen Elizabeth ll Hospital, Kota Kinabalu. Data were recorded using a data collection form designed by a team of cardiologist and medical officer.
The variables included the socio demographic profile of the patients namely age, sex, home address and ethnicity. In addition, the current disease status, types of secondary prophylaxis medication, ECG changes and disease extent in term of valves abnormality were also obtained.
A two and a half year review of patients registered under this registry from Dec 2010 to August 2013 revealed that a total of 593 rheumatic heart disease patients were been able to be registered.
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registration. 33.9% received secondary antibiotic prophylaxis: 12.9% were on IM BenzathinePenicilin (IM Ben Pen) while the rest (21.0%) received oral antibiotic (either Oral Penicillin V or Erythromycin).
However there was an increase in percentage of patients received secondary prophylaxis (both type – oral and IM) by year (23.2% in 2010, 74.4% in 2013 with p value < 0.001). For those who received no secondary prophylaxis, majority of them aged more than 40-year-old who was less vulnerableto recurrent RHD.
With this knowledge, we hope to gain further insight into the problem and eventually create more awareness and advocacy to RHD. World Heart Federation has advocated Ministry of Health not to forget to include rheumatic heart disease prevention and control in the national Non Communicable Disease plan, in an effort to reach the goal of reducing mortality by 25% by 2025 - among individuals under the age of 25.
S1TDP3 CHRONIC RHEUMATIC HEART DISEASE SECONDARY
PROPHYLAXIS MONITORING IN PRIMARY CARE CLINIC: IS 80%
ADHERENCE ACHIEVABLE?
Dr. Rumihati bt Abd Hamid Klinik Kesihatan Putatan,Sabah Ministry of Health Malaysia
Background: Chronic Rheumatic Heart Disease (CRHD) is still fairly common in Sabah. A registry audit done by Cardiac department of Queen Elizabeth Hospital in 2011 showed Putatan area is one of the highest prevalence of CRHD. Secondary prophylaxis plays an important role in decreasing the valvular damages and complications. Adherence to secondary prophylaxis had been shown to increase when patients are given personalized care and enrolled into recall systems in primary care whereby hospital being a place for education and establishment of secondary prophylaxis. Hence a primary-tertiary collaborative project between the Cardiology Department at the tertiary centre and Primary Health Clinic , had been initiated which involving a close monitoring of patients receiving secondary prophylaxis.
Objectives: This study was conducted as to assess if good adherence to scheduled injections (target > 80 %) based on Australian Guidelines On Rheumatic Heart Disease is achievable with the personalized care and recall system in primary care setting.
Methodology: All CRHD patients who attended Klinik Kesihatan Putatan for their secondary prophylaxis were registered and given monitoring book with the scheduled dates for injection. A monitoring tool was used to check whether the patient had their injection as scheduled. The patient will be called if they missed their injections. The study period was from April 2012 to January 2013.
Results: A total of 11 patients were enrolled in the study. There were 9 female and 2 male. The age range from 14 to 39 years old. One patient changed back to oral antibiotic due to fear of injection. About 8 out of 10 patients had more than 80% adherence to appointment given for injection and the remaining 2 patients achieved between 70%-72 %.
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S1TEP1 DO COMMUNITY – WIDE INTERVENTIONS INCREASE PHYSICAL
ACTIVITY?
Prof. Philip R Baker
School of Public Health and Social Work Queensland University of Technology Brisbane, Australia
Background: Not getting enough physical activity leads to poorer health. Regular physical activity can reduce the risk of chronic disease and improve one‟s health and well-being. The lack of physical activity is a common and growing problem in many countries. We sought to evaluate the effects of community wide, multi-strategic interventions upon the physical activity patterns of populations.
Method: We undertook a Cochrane Systematic Review which included an extensive search of databases, including studies which met pre-determined criteria, and conducted independent risk of bias assessment and data extraction.
Results: After the selection process, 25 studies were included in the review. The strategies varied by the number and type of components and their intensity. No studies were identified as low risk of bias. Sixteen studies were identified as having a high risk of bias and thus untrustworthy. Nine studies were of considered to have an unclear risk of bias and some studies held back data they collected. The effects reported were inconsistent across the studies and the measures. Some of the better designed studies showed no improvement in measures of physical activity. Interventions which have an environmental change component seemed to be a promising direction. Those interventions which were primarily a mass media campaign were less likely to be successful.
Conclusions: Although numerous studies have been undertaken, there is considerable inconsistency in the findings of the available studies and this is confounded by serious methodological issues within the included studies. Simply combining interventions does not necessarily result in increased physical activity as many such studies, including some long term programs, failed to demonstrate efficacy. There is a clear need for well-designed studies and these studies should focus on the quality of measurement of physical activity. The review is currently being updated with newer studies.
S1TEP2 EVIDENCE OF EFFECTIVENESS: HIGH LEVEL SYNTHESIS OF
RESEARCH TO PREVENT OBESITY ABD INCREASE PHYSICAL
ACTIVITY IN CHILDREN
Prof. Philip R Baker
School of Public Health and Social Work Queensland University of Technology Brisbane, Australia
Background: Prevention of childhood obesity is a public health priority for Malaysia and many other countries. Physical activity for children is also decreasing at an alarming rate. Both conditions are associated with non-communicable diseases and with significant morbidity and mortality in later life.
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This presentation provides a “birds eye” overview based upon recent (since 2007 to present) high quality systematic reviews of public health interventions.
Method: HealthEvidece.org and the Cochrane Library were searched for systematic reviews which evaluated interventions targeting obesity prevention and increasing physical activity for children. The findings of the included reviews were themed and summarized.
Results: Seven reviews were identified addressing obesity in the early years, and fifteen reviews addressing obesity more broadly in childhood. Additional reviews were identified aimed at increasing physical activity. The synthesis shows several strategies to be effective, however many popular strategies clearly are not. Several of the reviews were inconclusive due to an absence of robust primary studies. Amongst the findings, interventions undertaken in the school setting appear very promising.
Conclusions: There is significant evidence from systematic reviews to guide public health practice and policy, and to inform future research.
S1TEP3 POPULATION BASED VERSUS TARGETED HIGH RISK POPULATION
FOR CANCER SCREENING
Prof. Madya Dr. Nur Aishah bt Mohd Taib University of Malaya
Breast cancer is a treatable cancer; worldwide about 1.6 million people are diagnosed with it each year and about 4 million lives with this cancer due to the high survival rates in the more developed world. In Malaysia about 4000 women are diagnosed in the Peninsular of Malaysia. It is the second cause of death in women after cardiovascular disease.
In a low incidence country, how does one improve excellent outcomes that we know that can be achievable with early breast cancer. The ASR of breast cancer in Malaysia is 47.7 per 100000 as compared to rates in Australia of 115.5 per 100000. The relative survival of breast cancer for 2006 to 2010 was 89.1% in Australia. There are no published figures in Malaysia on relative survival to 5-year overall survival of 43.5 per cent in HKL for patients diagnosed in 2005-2009 and 75.4% in UMMC for patients diagnosed 1998-2002. The difference is due to early presentation.
Early presentation and treatment are the best method to prevent this disease as most of the time there is no discernable risk factor. Risk factors that confer a high risk predisposition to breast cancer. The factors are older age, being female, having dense breasts, having past history of precursor lesions in the breast like ADH, LCIS and DCIS, having significant family history, fertility factors like early menarche, late menopause and nulliparity. Factors affecting outcomes of cancer include early stage at presentation and better treatments.
There are many reasons why women present late. In a public health perspective the understanding of the breast cancer trajectory can be understood with the points of delay in breast cancer model. And to understand why individuals present late can be understood through the BCDE model, which include information on disease and treatments; having adequate resources ie. coping skills, support and finances and lastly what their role preference is when faced with symptoms or diagnosis ie whether they prefer to be autonomous or they need their significant others to make decisions for them.
The literature on the efficacy of population screening with mammogram is now at the crossroads, where the effect of treatment have been attributed to be a main reason for improvement in survival since the introduction of better adjuvant therapies and also a smaller proportion is attributed to earlier presentation due to screening mammogram.
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centres. Planning health education materials with the use of the BCDE model; where information on the curability of breast cancer, good outcomes of treatment and the need to understand evidence based medicine in order to reduce the rampant use of alternative treatment.
Recognising signs and symptoms of breast cancer and knowledge on navigating to diagnostic centres are important in the primary health care and primary care settings.
The hospital perspective would be to improve the timeliness of diagnosis and treatment. Providing good counseling when recommending treatment is important. Using the BCDE model provides a framework on areas to be covered and awareness of the practitioner on the resources and the roles patients play in their decision making would help practitioners to effectively communicate with their patients.
Identifying high risk women to enable early presentation would be to educate women on what is a significant family history, providing genetic services, providing quality mammogram services that are audited. Ensuring surgeons are educated on risk assessment and risk management of high risk individuals would be imperative.
S1TFP1 CLIMATE CHANGE AND CLIMATE VARIABILITY AND ITS EFFECT
ON CLIMATE SENSITIVE DISEASES
Dr. Muhammad Amir bin Kamaluddin
Head, Environmental Health Research Centre, Institute for Medical Research
Ministry of Health Malaysia
This paper described the relationship between weather, climate variability factors and climate change and focus on impact of climate sensitive diseases relevant to Malaysia. The climate sensitive diseases as reported in Malaysia‟s second national communication document (NC2: 2011) to United Nation Framework Convention on Climate Change (UNFCCC) include vector borne disease namely dengue, chikungunya and malaria; Food and water-borne disease include cholera and typhoid; Flooding has been associated with higher incidence of zoonotic diseases namely leptospirosis.
Health issues are also influenced by climate change through the occurrence of more frequent extreme weather events leading to floods and heat waves. Sea-level rise and salt water intrusion is another observed event with climate change leading to changes in mangrove eco-health systems and spreading a bigger area for malaria vectors.
The concept of climatological normals is introduced as a foundation to understand weather, climate variability and climate change. Temperature, precipitation and relative humidity are weather factors commonly used to show relationship with risk of diseases. Climate change is slow and gradual and impact of climate change on future projection of disease distribution, need to model disease trends to local regional climate change model. Climate change impact on climate sensitive diseases is important in formulating future health policies and plan resources.
S1TFP2 EFFECTS OF ELECTROMAGNETIC RADIATION FROM
TELECOMMUNICATION TOWERS
Prof. Dr. Adlina Suleiman
National Defence University of Malaysia
