PIP: The findings of the final phase of a 3-phase multivariate areal analysis study undertaken by the Economic and Social Commission for Asia and the Pacific (ESCAP) in 5 countries of the Asian and Pacific Region, including Malaysia, to examine the impact of family planning programs on fertility and reproduction are reported. The study used Malaysia's administrative district as the unit of analysis because the administration and implementation of socioeconomic development activities, as well as the family planning program, depend to a large extent on the decisions of local organizations at the district or state level. In phase 1, existing program and nonprogram data were analyzed using the multivariate technique to separate the impact of the family planning program net of other developmental efforts. The methodology in the 2nd phase consisted of in-depth investigation of selected areas in order to discern the dynamics and determinants of efficiency. The insights gained in phase 2 regarding dynamics of performance were used in phase 3 to refine the input variables of the phase 1 model. Thereafter, the phase 1 analysis was repeated. Insignificant variables and factors were trimmed in order to present a simplified model for studying the impact of environmental, socioeconomic development, family planning programs, and related factors on fertility. The inclusion of a set of family planning program and development variables in phase 3 increased the predictive power of the impact model. THe explained variance for total fertility rate (TFR) of women under 30 years increased from 71% in phase 1 to 79%. It also raised the explained variance of the efficiency model from 34% to 70%. For women age 30 years and older, their TFR was affected directly by the ethnic composition variable (.76), secondary educational status (-.45), and modern nonagricultural occupation (.42), among others. When controlled for other socioeconomic development and environmental indicators, the nonagricultural activities had a positive direct effect on TFR. No direct effects were found to come from other socioeconomic development indicators, once these factors were controlled. The 3 factors that had direct effects on the fertility of women below age 30 were ethnic composition (.33), contraceptive pevalence (-.32), and secondary educational status (-.25). Other family planning program variables (contraceptive knowledge) and socioeconomic development indicators (exposure to modernization as measured by television ownership and health/living conditions as measured by infant mortality rate) affected fertility significantly but indirectly.
Institutional aspects of flood hazards significantly affect their outcomes in Malaysia. Institutional arrangements to deal with floods include: legislative activity, organisational structures, attitudes and sub-culture, and policies and instruments. When assessed in terms of four specific criteria, institutional aspects of flood hazards are found to be largely inadequate. Disaster reduction programmes are over-dependent on a reactive approach based largely on technology and not even aimed at floods specifically. Structural flood reduction measures are the predominant management tool and, although the importance of non-structural measures is recognised, thus far they have been under-employed. Current laws and regulations with regard to flood management are also insufficient and both the financial and human resources of flood hazard organisations are generally found to be wanting. Finally, economic efficiency, equity and public accountability issues are not adequately addressed by institutional arrangements for flood hazards.
This paper presents a case for an intelligent agent based framework for knowledge discovery in a distributed healthcare environment comprising multiple heterogeneous healthcare data repositories. Data-mediated knowledge discovery, especially from multiple heterogeneous data resources, is a tedious process and imposes significant operational constraints on end-users. We demonstrate that autonomous, reactive and proactive intelligent agents provide an opportunity to generate end-user oriented, packaged, value-added decision-support/strategic planning services for healthcare professionals, manages and policy makers, without the need for a priori technical knowledge. Since effective healthcare is grounded in good communication, experience sharing, continuous learning and proactive actions, we use intelligent agents to implement an Agent based Data Mining Infostructure that provides a suite of healthcare-oriented decision-support/strategic planning services.
The equitable access to quality healthcare by Malaysians has consistently been the primary objective of the Ministry of Health (MOH). The epidemiological transition to chronic illnesses, advances in medical technology, escalating healthcare costs and rising patient expectations has necessitated the strategic use of information systems in healthcare delivery. Malaysia has broken new ground by implementing a nationwide network to address inadequate access to healthcare, as well as to lower costs and achieve better health outcomes. Teleconsultation refers to the electronic transmission of medical information and services from one site to another using telecommunication technologies. This technology transforms the healthcare system by rapidly matching patient needs with the appropriate level of care however geographically remote they may be. Our findings suggest that even in these early stages of implementation, teleconsultation has led to cost savings, a more efficient allocation of resources, enhanced diagnostic options and better health outcomes.
Health care reform is an intentional, sustained and systematic process of structural change to one or more health subsystems to improve efficiency, effectiveness, patient choices and equity. Health care all over the world is continuously reforming with time. Health care reform has become an increasingly important agenda for policy change in both developed and developing countries including Malaysia. This paper provides an overview of the Malaysian health care system, its achievements, and issues and challenges leading to ongoing reform towards a more efficient and equitable health care system that possess a better quality of life for the population.
Health promotion, a discipline fast growing, deals with the prevention of illness and injury at the workplace. This article review defines health promotion and suggests the means for planning an effective, organized and well-structured program. A properly executed program will benefit both employer and employee in managing workplace absenteeism, reducing staff turnover, improving morale and productivity and keeping health care costs at an acceptable level.
Ergonomics management is a process that will have a significant, positive effect on a company’s profits through cost reduction, quality improvement, performance improvement and productivity enhancement. Also known as human factors of human engineering, it basically describes the interaction between an employee and his/her job functions, with the emphasis being on reducing unnecessary physical stress in the workplace. The goal of ergonomics is to enable workers to be more effective by matching the requirements and demands of the job to the abilities and limitations of the workers rather than trying to force the workers to fit the job. This paper theoretically describes the benefits of understanding the ergonomics to the workplace. The components and activities required to implement ergonomics management also have been discussed. Besides that, the practical approach of ergonomics has been described by giving practical workplace improvement suggested by scholars. By approaching work practices (stretching, reaching, and sitting) from an ergonomically correct point of view, a worker actually becomes stronger, healthier and more productive.
All relevant and essential data of an existing vehicle seat assembly line such as the operating time and processes, material handling system, workstation layout, bill of materials, equipment and hand tools, were collected and analyzed. The time standards for each of the vehicle seat assembly elements were established using work study techniques. A simulation approach was used to determine the productivity and effi ciency of the existing and proposed lines. Simulation technique was also used to determine and identify bottle-necks in both existing and proposed systems. Comparison of the existing assembly line and the proposed assembly line in terms of their productivity and effi ciency are also highlighted.
Feedback on satisfaction with dental care is vital for continuous improvement of the service delivery process and outcome. The objective of this study was to assess the satisfaction with school dental service (SDS) provided via mobile dental squads in Selangor, Malaysia, under 4 domains of satisfaction: patient-personnel interaction, technical competency, administrative efficiency, and clinic setup using self-administered questionnaires. Among the 607 participants who had received treatment, 62% were satisfied with the services provided. In terms of domains, technical competency achieved the highest satisfaction score, whereas clinic setup was ranked the lowest. As for items within the domains, the most acceptable was "dental operator did not ask personal things which were not dentally related," whereas privacy of treatment was the least acceptable. In conclusion, whereas children were generally satisfied with the SDS, this study indicates that there are still areas for further improvement.
In a time of rising demands on hospital reimbursement levels, focus on efficient operations is becoming more imperative. In health care systems, the measurement of efficiency is usually the first step in auditing individual performance of production units, e.g. hospitals, health centers, etc. It constitutes the rational framework for the distribution of human and other resources between and within health care facilities. The term efficiency is broadly used in economics and refers to the best utilization of resources in production. Typical example of efficiency is technical efficiency, referring to the effective use of resources in producing outputs. In the Farrell framework, a hospital is judged to be technically efficient if it is operating on the best practice production frontier in its hospital industry. In general, there are two main frontier methods in measuring efficiency. The first is Data Envelopment Analysis (DEA), a linear programming method which enables the measurement of efficiency consistent with the theoretically based concept of production efficiency. DEA typically examines the relationship between inputs to a production process and the outputs of that process. The second technique for assessing efficiency that is employed is Stochastic Frontier Analysis (SFA). This is an econometric technique to estimate a conventional function; with the difference being that efficiency is measured using the residuals from the estimated equation. The error term is therefore divided into a stochastic error term and a systematic inefficiency term.
Data envelopment analysis (DEA) is a mathematical programming for evaluating the relative efficiency of decision making units (DMUs). The first DEA model (CCR model) assumed for exact data, later some authors introduced the applications of DEA which the data was imprecise. In imprecise data envelopment analysis (IDEA) the data can be ordinal, interval and fuzzy. Data envelopment analysis also can be used for the future programming of organizations and the response of the different policies, which is related to the target setting and resource allocation. The existing target model that conveys performance based targets in line with the policy making scenarios was defined for exact data. In this paper we improved the model for imprecise data such as fuzzy, ordinal and interval data. To deal with imprecise data we first established an interval DEA model. We used one of the methods to convert fuzzy and ordinal data into the interval data. A numerical experiment is used to illustrate the application to our interval model.
BACKGROUND: The aim of this study was to examine Malaysian contributions in the field of biomedical and health sciences.
METHODS: In this study, 3697 publications affiliated to Malaysian addresses from the sci database between 1990 and 2005 were sampled. This study also explored publication productivity trends, authorship and collaboration pattern, core journals used, and citations obtained.
RESULTS: Main contributions were journal articles (73.3%). Most authors (63.7%) contributed only one article and 16.1% produced over 30-68 publications. Multi-authored works were the norm. The productive authors were named either first or second in publications. There were active collaborations with authors from Asia-Pacific countries (35%) and Europe (30%). The majority of publications were contributed by institutions of higher learning (87%). Core journals used follow quite close to Bradford's zonal ratios of 44:152:581. The active research areas were identified. About 71.3% of publications received citations especially those published from 1995 to 1999.
CONCLUSION: This study helped librarians identify active researchers, active research areas and journals relevant to biomedical and health sciences researchers and useful when producing reports to university management and planning medical collection policies and deciding on journal subscriptions and cancellations.
A quantitative scale of public attitudes toward epilepsy is essential to determine the magnitude of social stigma against epilepsy. This study aims to develop and validate a cross-culturally applicable scale of public attitudes toward epilepsy.
In the health systems literature one can see discussions about the trade off between the equity achievable by the system and its efficiency. Essentially it is argued that as greater health equity is achieved, so the level of efficiency will diminish. This argument is borrowed from economics literature on market efficiency. In the application of the economic argument to health, however, serious errors have been made, because it is quite reasonable to talk of both health equity being a desirable output of a health system, and the efficient production of that output. In this article we discuss notions of efficiency, and the equity-efficiency trade off, before considering the implications of this for health systems.
The stock market is considered essential for economic growth and expected to contribute to improved productivity. An efficient pricing mechanism of the stock market can be a driving force for channeling savings into profitable investments and thus facilitating optimal allocation of capital. This study investigated the technical efficiency of selected groups of companies of Bangladesh Stock Market that is the Dhaka Stock Exchange (DSE) market, using the stochastic frontier production function approach. For this, the authors considered the Cobb-Douglas Stochastic frontier in which the technical inefficiency effects are defined by a model with two distributional assumptions. Truncated normal and half-normal distributions were used in the model and both time-variant and time-invariant inefficiency effects were estimated. The results reveal that technical efficiency decreased gradually over the reference period and that truncated normal distribution is preferable to half-normal distribution for technical inefficiency effects. The value of technical efficiency was high for the investment group and low for the bank group, as compared with other groups in the DSE market for both distributions in time-varying environment whereas it was high for the investment group but low for the ceramic group as compared with other groups in the DSE market for both distributions in time-invariant situation.
The objective of this paper is to apply the Translog Stochastic Frontier production model (SFA) and Data Envelopment Analysis (DEA) to estimate efficiencies over time and the Total Factor Productivity (TFP) growth rate for Bangladeshi rice crops (Aus, Aman and Boro) throughout the most recent data available comprising the period 1989-2008. Results indicate that technical efficiency was observed as higher for Boro among the three types of rice, but the overall technical efficiency of rice production was found around 50%. Although positive changes exist in TFP for the sample analyzed, the average growth rate of TFP for rice production was estimated at almost the same levels for both Translog SFA with half normal distribution and DEA. Estimated TFP from SFA is forecasted with ARIMA (2, 0, 0) model. ARIMA (1, 0, 0) model is used to forecast TFP of Aman from DEA estimation.
Banking system plays an important role in the economic development of any country. Domestic banks, which are the main components of the banking system, have to be efficient; otherwise, they may create obstacle in the process of development in any economy. This study examines the technical efficiency of the Malaysian domestic banks listed in the Kuala Lumpur Stock Exchange (KLSE) market over the period 2005-2010. A parametric approach, Stochastic Frontier Approach (SFA), is used in this analysis. The findings show that Malaysian domestic banks have exhibited an average overall efficiency of 94 percent, implying that sample banks have wasted an average of 6 percent of their inputs. Among the banks, RHBCAP is found to be highly efficient with a score of 0.986 and PBBANK is noted to have the lowest efficiency with a score of 0.918. The results also show that the level of efficiency has increased during the period of study, and that the technical efficiency effect has fluctuated considerably over time.