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  1. Fulltext Factors influencing physical activity level among secondary school adolescents in Petaling District, Selangor
    Aniza I, Fairuz MR
    Med J Malaysia, 2009 Sep;64(3):228-32.
    PMID: 20527274 MyJurnal
    Physical activity is the first line approach and one of the main factors in preventing chronic diseases. Currently there is the increasing percentage of sedentary life style or lack of exercise among adolescents. The main objectives of the study were to determine the prevalence of inactivity and the factors influencing physical activity in adolescents. A cross sectional study was carried out among secondary school students aged 14 and 16 in Petaling District, Selangor, Malaysia. A total of 519 respondents participated in this study. Their physical activity level was measured using the International Physical Activity Questionnaire (IPAQ). The active group was classified as those having levels of equal or more than 600 met-min per week while less than 600 met-min per week was considered inactive. Response rate in this study was 95.4%. The prevalence of inactive in adolescents was 20.8%. Female adolescents, non-working mother, time constraint, exercise only when having ample time and stretching before exercise are predictor factors for being inactive among adolescents. Steps need to be taken to persistently ensure that the physical activity among adolescents be increased continuously.
  2. Fulltext Obesity related hypertension - gender specific analysis among adults in Tanjung Karang, Selangor, Malaysia
    Aniza, I., Hayati, K., Juhaida, M.N., Ahmad Taufik, J., Idayu Badilla, I., Khalib, L.
    Malaysian Journal of Public Health Medicine, 2015;15(1):0-0.
    MyJurnal
    Obesity is a major health concern and the growing rate raises important issues specific to concurrent rise of the related diseases especially hypertension. This study aimed to determine the relationship between hypertension and obesity based on body mass index and waist circumference besides relevant sociodemographic factors according to gender specific analysis. The analysis is important to determine in depth insight of two genders. This cross-sectional study was conducted among community in Tanjung Karang, Selangor, Malaysia in 2009 and included a total of 439 male and 668 female respondents aged 18-59 years old. Data was collected by interview-guided questionnaire and anthropometric measurements. SPSS version 21.0 was used for analysis of the relationship between socio demographic factors, smoking, body mass index and waist circumference with hypertension. Finally logistic regression analysis was used to assess the predictors of hypertension according to gender. The prevalence of hypertension was 25.5% in males and 23.1% in females, giving a total of 24%. Significantly higher prevalence of hypertension was found in overweight and obese categories (42.2% and 60.5% in males; 39.5% and 48.9% in females). Those with abdominal obesity also had significantly greater risk in having hypertension (41.6% in males and 33.2% in females). The logistic regression analysis indicated that age, high BMI and abdominal obesity were significantly associated with hypertension in women, and on the other hand age and BMI only for men. Both obesity and abdominal obesity are significantly important predictors of hypertension in females but BMI obesity only in males. Effective weight management strategies targeting obese people and abdominally obese women should be implemented in order to prevent hypertension and related cardiovascular diseases.
  3. Fulltext Cost analysis of treating incomplete miscarriage with dilatation and curettage in Universiti Kebangsaan Malaysia Medical Centre in 2010
    Rizal, A.M., Aniza, I., Jannatul Madihah, A.B., Ahma Fareed, A.R., Natrah, M.S.
    Malaysian Journal of Community Health, 2010;16(1):54-59.
    MyJurnal
    Background : Miscarriage is a common problem in pregnancy which can occur during early, mid or late pregnancy. Incomplete miscarriage can be treated expectantly, medically or surgically. The most preferred method used in UKMMC is using sharp curettage.
    Methodology : This study is conducted in the UKMMC from 1st January 2010 to 30th March 2010. The purpose of this study is to analyze the cost of treating incomplete miscarriage using metal sharp curettage from the provider’s perspective per patient-day.
    Result : A total of 17 samples were eligible for analysis from 46 patients who fulfilled the inclusion and exclusion criteria. The cost is derived from cost calculation on capital and recurrent costs. Results showed that the average cost for treating incomplete miscarriage using sharp curettage per day is RM252.56. Recurrent costs contributed 83.3% of the total treatment with overhead cost was the biggest percentage (51.6%). Discussion The treatment cost for incomplete miscarriage using sharp curettage is found to be higher as compared to medical approach according to literatures. The higher cost of surgical approach was mainly attributed to the recurrent cost which is included in the calculation.
    Conclusion : Effective usage of the operation theatre and all resources should be managed and utilized well in order to achieve optimum outcome.
  4. Fulltext Factors affecting outpatients’ satisfactionat at University Kebangsaan Malaysia Medical Centre (UKMMC)
    Hasyimah, R., Aniza, I., Ahmad Taufik, J., Jamsiah, M., Azimatun Noor, A.
    Malaysian Journal of Public Health Medicine, 2014;14(2):77-85.
    MyJurnal
    The level of patient satisfaction is important for service quality in hospitals. This study aims to measure the level of patient satisfaction at University Kebangsaan Malaysia Medical Centre (UKMMC) and the factors affecting it. A cross-sectional study was conducted on 520 respondents at the outpatient department in four clinics in UKMMC by using self-administered questionnaires. Respondents were selected using a systematic sampling method based on the list of patient appointments. The level of patient satisfaction was measured using the PSQIII domain. Less than half of the respondents were satisfied with the overall service provided (41.0%), while the others (59.0%) were not satisfied. Based on the domain studied, the level of satisfaction varies widely: the highest satisfaction were interpersonal relationships (75.8%) followed by the registration process (73.8%), technical quality (71.3%), communication (66.7%), physical facilities (64.6%), accessibility (60.2%), and financial (47.3%). The level of patient satisfaction was low and financial domain should be given more attention to in order to ensure an increase in patient satisfaction levels.
    Study site: Surgery, Orthopaedic, Obstetric and Gynaecology, and Medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  5. Fulltext Clients satisfactions in ISO certified health clinic in Klinik Kesihatan Bandar Baru Bangi, Selangor and its associated factors
    Aniza I, Suhaila A
    Malaysian Journal of Community Health, 2011;17(1):18-25.
    MyJurnal
    Background: All healthcare services are moving towards quality management system including ISO 9000 due to pressure from various stakeholders involves and also to improve healthcare quality. The objective of this study was to measure the satisfaction level among the outpatients in ISO Certified Klinik Kesihatan Bandar Baru Bangi, Selangor. Also to identify the relations of patient’s satisfaction with the sociodemographic factors and service dimensions such as general satisfactions, technical quality of clinic staffs, interpersonal aspect of clinic staffs, time with doctors, communications with clinic staffs and availability/accessibility of clinic.
    Methodology: A cross sectional study was carried out from February 2008 to Jun 2008 and a total of 240 respondents in the clinic were selected using universal sampling. Only those who are Malaysians aged 18 and above and complied with the inclusions criteria’s were selected as the respondents to fill up the Patient’s Satisfaction Questionnaire III.
    Results: The study found that the satisfaction level of the respondents in Klinik Kesihatan Bandar Baru Bangi, Selangor were remarkable with 78.8%.It has been shown that the predictor factors of total patient’s satisfaction were general satisfaction (AOR=5.06, CI= 1.51-16.96), technical quality of clinic staff (AOR = 3.09, CI= 1.13-8.43), interpersonal aspect of clinic staff (AOR = 2.96,CI= 1.04-8.42), availability/accessibility of clinic (AOR = 9.38, CI= 9.37-87.95) and communication of clinic staff ( AOR=17.90, CI=3.74-85.73) with the R2 = 67.7%.
    Conclusion: The satisfaction level among the respondents in Klinik Kesihatan Bandar Baru Bangi, Selangor were remarkable with percentages of 78.8%. The study has shown that service dimensions factor influenced the patient’s satisfaction such as general satisfaction, interpersonal aspect of staff, communication of staff, technical quality of clinic staff and availability/accessibility of clinic. It could have also been contributed by the implementation of ISO and it can only be confirmed by carrying out a comparison study of patient’s satisfaction in clinics with and without ISO certification.
    Study site: Klinik Kesihatan Bandar Baru Bangi, Selangor, Malaysia
  6. Fulltext Developing the cost for uncomplicated acute ST Elevated Myocardial Infarction (STEMI primary percutaneous coronary intervention) using step down and activity based costing at UKMMC
    Aniza, I., Syafrawati, Saperi, S., Zafar, M., Amrizal, M.N., Ika Fazura, M.N.
    Malaysian Journal of Community Health, 2011;17(1):26-31.
    MyJurnal
    Background: Cardiovascular disease is the number one cause of death globally and is projected to remain the leading cause of death. If the trend is allowed to continue, by 2015 an estimated 20 million people will die from cardiovascular disease (mainly because of myocardial infarction and strokes). The number of cardiovascular disease cases in Malaysia has increased to 14% in five years from 96,000 cases in 1995 to 110,000 cases in 2000.

    Methods: The cost to treat patients admitted to Universiti Kebangsaan Malaysia Medical Center (UKMMC) Malaysia, diagnosed with Acute Uncomplicated ST Elevated Myocardial Infarction (STEMI) was calculated by using two different methodologies, namely step down costing methodology and activity based costing using clinical pathway.

    Results: Cost for each stay per day at the cardiology ward using the step down methodology is RM596.42. The treatment cost is estimated from RM1, 789.26 to RM 4,771.36. The average cost per episode for STEMI care with the average length of stay for 5.6 days is RM3, 340(SD ±596.42. The cost of coronary PCI procedure in step costing is RM 13,950.00. Hence, the total cost incurs for STEMI with PCI is RM 17,290.00(SD ±596.42) by using step down method. (an average cost per episode is RM3,340, plus the cost of coronary procedure of RM 13,950.00 . However by using the ABC the cost of STEMI (PCI) with an average length of stay for 5.6 days is RM 20,431.39. The study showed the ABC method was higher by 15.3% than the step down costing.

    Conclusion: The cost in managing STEMI (PCI) with the average length of stay of 5.6 days was calculated by using two different methodologies, namely step down costing methodology and activity based costing. Cost of treatment calculated by using activity based costing are higher because all resources used are incorporated in detail. The ABC method was higher by 15.3% than the step down costing. The difference is within 80-20 rules and the biggest percentage of cost in both methodsis procedure or PCI cost.
  7. Fulltext Prevalence of visual acuity impairment and its associated factors among secondary school students in Beranang, Selangor
    Aniza, I., Azmawati, M.N., Jamsiah, M., Idayu, B.I., Mae Lynn, C.B.
    Malaysian Journal of Public Health Medicine, 2012;12(1):39-44.
    MyJurnal
    Prevalence of visual impairment among students is increasing in trends especially in rural area. A cross sectional study was conducted among secondary school students in Taman PKNS Beranang, Selangor in March 2008 with the objective of determining the prevalence of visual acuity impairment and its influencing factors. A total of 77 secondary school students were interviewed using guided questionnaire. The prevalence of visual acuity impairment among the respondents was 25.0% and study found that being female and have been watching television at a distance of less than two meters were significantly associated with visual acuity impairment. In conclusion, the problem occurred maybe due to the students sit nearer to the television (
  8. Fulltext A study on level of mother involvement, the influencing factors and its relationship between the glycemic control in managing children with type I diabetes mellitus at tertiary health care centre in Selangor
    ldanerina, M.S., Aniza, I., Jamsiah, M., Mohd. Hasni, J., Idayu, B.
    Malaysian Journal of Public Health Medicine, 2007;7(2):29-34.
    MyJurnal
    Diabetes mellitus is the most common endocrine defect among children. Good diabetes management is important to give better health for both the children and the whole family. The goal of this study was to identify the level of mother involvement in children type·1 Diabetes Mellitus management, to identify factors related with mother involvement and to determine the relationships between mother
    involvement and glycemic control. A cross·sectional study was carried out with 92 respondents selected by universal sampling from mothers who had diabetic children aged 5-15 years old and from medical visit appointment at University Kebangsaan Malaysia Medical Centre (UKMMC) and Putrajaya Hospital (HP1). Data was obtained through medical record and self reporting questionnaire. The study shown that 58.6% mothers had high involvement and 41.4% mothers had low involvement. Mothers' education level had a significant (p=0.0Z) relationship with a level of mother involvement. Most mothers gave high involvement in diet management (64.1%) and blood glucose monitoring (52. 7%), however most mothers gave low involvement in exercise management (63.0%) and insulin injection (60.9%). Mothers involvement in four management tasks were not statistically significant (p>0,05) with glycemic control. Mothers involvement in children diabetic management was high. There was high mother involvement in children's insulin injection and dietary intake and low mother involvement in children`s blood glucose monitoring and exercise, This study abo showed that there was no significant relationship between level of mother involvement and glycemic control.
  9. Fulltext Comparing cost for elective lower segment caesarean section costing using top-down and activity based costing methods
    Aniza I., Putri, N., Azimatun Noor, A., Amrizal, M.N., Saperi, S., Aljunid, S.M.
    Malaysian Journal of Public Health Medicine, 2011;11(1):36-46.
    MyJurnal
    Top-down costing and activity based costing are the most frequent costing methodologies used for analyzing cost. Top-down costing is accomplished by assigning total expenditure of hospital to patient by apportioning the expenditure of cost centers (unit of service) in hospital to give the cost per patient per visit, per day or per admission. Conversely, activity based costing is accomplished by tracking every resource used by patient individually. Since this study started in 2009, Top-down costing calculation was based on financial year in 2009 with adjusted up to 12.6% from 2008 data. This percentage was taken based on the trend of hospital expenditure during 2005 till 2008. An assumption was made that non-financial data (performance and administrative data) for 2009 was similar to 2008. Top-down costing was calculated using Clinical Cost Modeling Software developed by Unit Case-mix of UKMMC to obtain cost of elective lower segment caesarean section (LSCS) per day at ward which was RM922. Whereas activity based costing was calculated using clinical pathway of elective LSCS. Given the average length of stay in 2009 was 4 days, the cost of elective LSCS according to top-down costing was RM3, 688 and activity based costing was RM1774. As a result, cost of elective LSCS is 108% higher using top-down costing.
  10. Fulltext Cost analysis of psoriasis treatment modalities in Malaysian public hospitals
    Azizam, N.A., Saperi, S., Aniza, I., Norazirah, M.N., Azura, M.A., Zafar, A., et al.
    Medicine & Health, 2019;14(1):23-33.
    MyJurnal
    Psoriasis imposes a great economic burden as a result of higher expenditures for different interventions, diagnostic procedures, pharmaceuticals and loss of productivity. Less is known about the economic impact of psoriasis treatment in Asean region. The aim of this research was to calculate the costs associated with four psoriasis treatment modalities. A prospective cohort study was conducted in five hospitals involving 91 moderate to severe psoriasis patients. Costs were calculated from the societal perspective using the principle of Step Down and Activity Based Costing (ABC) within a six (6) months follow-up duration. The components of the costs borne by the provider were inpatient cost, cost of medication, laboratory investigation and radiology. Patient’s cost included out of pocket expenses, travelling cost and loss of productivity. Cost per patient per day was RM1,105.24 (inpatient) (US$315.94) and RM298.02 (outpatient) (US$85.19). Medication accounted for almost 90% (RM457,014.00) (US$130 638.45) of the total provider cost. Meanwhile, loss of productivity represented 84% (RM167,439.00) (US$47,862.80) of the total patient’s cost. Biologic treatment exhibited the highest cost which was RM342,377.00 (US$97,869.21), followed by systemic treatment (RM105,607.00) (US$30,187.99), topical treatment (RM38,280.00) (US$10,942.42) and topical phototherapy treatment (RM21,824.00) (US$6,238.44). Understanding the relationship between direct and indirect costs from both perspectives is important to accurately identify and evaluate effective treatment for psoriasis.
  11. Fulltext A casemix: congestive heart failure readmission rate and its associated factors in a tertiary teaching Hospital in Kuala Lumpur
    Wong, C.M., Abdullah Aliff, A.W., Mohd Shahrol, A.W., Diana Safraa, S., Lavanyah, S., Aniza, I., et al.
    Medicine & Health, 2020;15(1):141-155.
    MyJurnal
    Penyakit lemah jantung merupakan antara lima punca utama kematian penyakit kronik tidak berjangkit berdasarkan rujukan World Health Organization. Sekitar 20% pesakit kegagalan jantung di seluruh dunia memasuki wad semula dalam jangka masa 30 hari selepas discaj. Hal ini demikian biasanya akibat daripada tidak mematuhi penyekatan sukatan air diminum atau pun perkembangan penyakit. Kajian ini bertujuan untuk mengenalpasti kadar masuk wad dalam 30 hari selepas discaj daripada kegagalan jantung dan faktor berkaitan di Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) pada tahun 2016-2017 dengan menggunakan data casemix. Berdasarkan data kod, perbelanjaan digunakan untuk masuk wad semula dalam 30 hari diambilkira. Kadar masuk wad untuk kegagalan jantung dalam 30 hari selepas discaj bagi punca yang sama adalah 53.5% dan 43.5% bagi tahun 2016 dan 2017, sama kadar dengan hospital mengajar yang lain tetapi lebih tinggi daripada kadar di negara maju. Selepas diselaraskan, hanya faktor umur pesakit dan tahap keterukan penyakit menunjukkan kaitan yang bermakna dengan kemasukan wad dalam 30 hari selepas discaj bagi kegagalan jantung. Jangka masa berada dalam wad dan perbelanjaan untuk kemasukkan wad adalah lebih rendah daripada yang sepatutnya dicapai. Sebanyak RM80,329.73 telah dijimatkan pada tahun 2017 atas rawatan yang pantas dan rancangan penjagaan yang komprehensif diberi kepada 19.3% pesakit gagal jantung tahap keterukan tiga. Penurunan kadar kemasukan wad semula dalam 30 hari selepas discaj juga menjimatkan kos pesakit dan menunjukkan penjagaan klinikal yang mantap dan strategi rawatan yang rapi. Kajian casemix ini boleh digunakan sebagai rujukan untuk penentuan bajet bagi unit kardiologi di PPUKM.
  12. Fulltext Clinical microsystem approach-a method for health care improvement
    Samiei, V., Aniza, I., Sharifa Ezat, W.P., Alsheikh, H.I., Kari, H.A., Saleh, M., et al.
    Malaysian Journal of Public Health Medicine, 2011;11(1):16-28.
    MyJurnal
    The quality of the health care services has been always a big responsibility and sensitive issue. Health care delivery is complex and critical for many reasons related to management and organizational planning and development. Health system reorganization is one of the approaches that health care managers adopt to overcome dysfunction. Clinical Microsystems (CM) is believed to be a one of vital steps in providing a high quality of patient care through system reorganization. CM has the potential to drive the health care to greater success through proper understanding, process and resource planning and health outcomes continuous assessment and improvements. CM integrate patients, providers and family needs and roles to form a vision of community system that cooperate for better outcomes .The components of an effective CM are produce quality, patient safety, and cost outcomes at the front line of care. This article aims to explore the concept, characteristics models and components of these Clinical Microsystems. It also highlights the steps to initiate, plan and sustain this innovation in hospitals in a systematic manner.
  13. Fulltext Comparing extracorporeal shock wave lithotripsy and ureteroscopy for treatment of proximal ureteric calculi: a cost-effectiveness study
    Izamin I, Aniza I, Rizal AM, Aljunid SM
    Med J Malaysia, 2009 Mar;64(1):12-21.
    PMID: 19852314
    Extracorporeal shockwave lithotripsy (ESWL) and ureteroscopy (URS) are two main methods of treating proximal ureteric stones. Success rates and cost-effectiveness of the two methods were compared. A total of 67 patients who underwent treatment between January 2007 and July 2007 at a state general hospital were included in the study. The success rate for ESWL group was 81.8% and for URS group was 84.6%. ESWL technique produced a significant higher overall cost per patient than URS (RM930.02 versus RM621.95 respectively). There was no significant difference in quality of patient's life. Cost-effectiveness ratio was lower for URS. The analysis suggested that URS was more cost-effective than ESWL.
  14. Fulltext Kajian analisa kos pembekal perkhidmatan kesihatan bagi rawatan diabetic foot wad ortopedik Pusat Perubatan Universiti Kebangsaan Malaysia dalam tahun 2006
    Amin, S.A., Ali, M., Aniza, I., Rizal, A.M., Saperi, S., Amrizal, M., et al.
    Malaysian Journal of Community Health, 2009;15(1):32-38.
    MyJurnal
    Introduction : Diabetes mellitus is recognized as a major public health problem worldwide. The burden of diabetes to society are morbidity, mortality and extensive usage of health care services.
    Methodology : This study aimed to determine the provider’s cost in treating diabetic foot patient per day in orthopaedic ward, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in year 2006. Result : A total of 54 patients fulfilled the inclusion and exclusion criteria, only 29 were eligible for analysis. The cost of health care providers derived from cost calculation on capital and recurrent costs. Results showed that the average cost for treating diabetic foot patient per day is RM 634.57. Recurrent costs contributed 75.3% of the total diabetic foot treatment and Intensive Care Unit costs was the biggest percentage (40.5%).
    Discussion : The results were comparable with findings by Case-Mix Unit of UKMMC. Treatment cost of diabetic foot is substantial and therefore avoidance of this complication must be emphasized to all diabetic patients.
  15. Fulltext Cost analysis of hypertension management in an urban Primary Medical Centre Kuala Lumpur
    Azimatun Noor, A., Amrizal, M.N., Weng Kang, T, Rafidah, A.R., Hong, Y Geok, Adibah, A, et al.
    Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
    MyJurnal
    Hypertension is one of the commonest health problems in Malaysia and its cases are on a rise. In conjunction with the above statement, it is predictable that the cost of healthcare services will further increase in the future. Therefore, cost study is necessary to estimate the health related economic burden of hypertension in Malaysia. A cross sectional study was carried out to quantify the direct treatment cost of hypertension. Three hundred and ninety one hypertensive patients’ data from Bandar Tasik Selatan Primary Medical Centre in year 2010 were collected and analysed. The direct treatment costs were calculated. The result showed that out of 391 hypertensive patients, 12.5% was diagnosed hypertensive without any co-morbidity, 25.3% with 1 co-morbidity dyslipidemia only; 4.3% with diabetes mellitus type 2 only; 0.5% with chronic kidney disease only and none with ischaemic heart disease. Patients with 2 co-morbidities (dyslipidemia and diabetes mellitus type 2) were 42.2%; with 3 co-morbidities (diabetes mellitus type 2, dyslipidemia and chronic kidney disease) was 4.3%. The mean cost of direct treatment of hypertension per visit/ year was RM289.42 ±196.71 with the breakdown costs for each component were medicines 72.2%, salary 14.6%, laboratory tests 5.0%, administration 4.4% and radiology tests 3.8%. Dyslipidemia is by far the commonest co-morbidity among hypertensive patients. Direct costs of treating hypertension are mostly dependent on present of co-morbidity and numbers of drugs used. Thus, the annual budget could be calculated precisely in the future especially for drugs.
  16. Evaluation of Communication for Behavioral Impact (COMBI) Program in Dengue Prevention: A Qualitative and Quantitative Study in Selangor, Malaysia
    Azmawati MN, Aniza I, Ali M
    Iran J Public Health, 2013;42(5):538-9.
    PMID: 23802114
  17. Fulltext A cross sectional study was conducted among married women in Kg. Sasapan Kelubi, Hulu Langat, Selangor, Malaysia. [Amalan calitan pap dan faktor hubungkait di kalangan wanita berkahwin di Kg. Sesapan Kelubi , Daerah Hulu Langat, Selangor D.E. Malaysia]
    Jamsiah M, Shamsul AS, Aniza I, Rozhan S, Sharifah Ezat WP
    Malaysian Journal of Community Health, 2008;14(1):52-61.
    MyJurnal
    Introduction : A cross sectional study was conducted among married women in Kg. Sasapan Kelubi, Hulu Langat, Selangor, Malaysia. The objective of the study was to identify the prevalence of Pap Smear practice and it`s influencing factors.
    Methodology : Universal sampling was conducted from door to door to all married women who agreed to be involved in this study. Guided questionnaire was used as the main instrument in this study. The data was analyzed using SPSS version 12.0.
    Result : A total of 154 respondents gave their feedback. Mean age in this study was 23.3±4.4.years. Only 66 respondents (42.9%) have had the pap smear with only 6 respondents (3.9%) practiced as per recommended schedule. The reasons for the respondents never practicing pap smear were no knowledge (n=46,52.3%), scared (n=22, 42.5%), shyness (n=21,23.9%), no free time(n-6,6.8%), unconcerned (n=3,3.4%), no female doctors (n= 6,6.8%), not bother, health clinic too far and high cost (n=1,1.1%). The only factor that showed significant association with pap smear practice was the score of knowledge about smear whereby respondents who underwent pap smear showed higher score compared to those respondents who never underwent pap smear.
    Conclusion : The study showed that more efforts is required to improve knowledge and awareness among married women in rural area in order to overcome the knowledge gap, wrong perception and other reasons that prevent acceptance pap smear practice among them.
    Keywords : married women, pap smear practice, rural area, Malaysia
  18. Fulltext The Malaysian health reform in primary health care services
    Aniza I, Jamsiah M, Amin SA, Ali M, Munizam AM
    Malaysian Journal of Community Health, 2008;14(2):1-10.
    MyJurnal
    Introduction : Family Health Development Division is one of the earliest divisions in Public Health Department, Ministry of Health Malaysia. The division has progressed each year with the extension and expansion of the scopes of services since the establishment of Maternal and Child Health Unit in 1956. The services currently include school children, adolescent, adult and elderly health and also known as life-course perspective: from womb to tomb.
    Objectives : The objective is to elaborate and explain the reformation of primary health care services implemented in the past and present.
    Methods : The methodology applied is compilation, data review and comparison from annual report, action plan report, articles, speeches, specialists and stake holder view.
    Results : The focus of Primary Health Care Service is covering health promotion, disease prevention, early detection and treatment, acute disease care, disease limitation and rehabilitation, clinical support services and teleprimary care. The reformation is caused by factors such as globalization, modernization, growth of health market, emergence and re-emergence of diseases, and development of medical technology. Three health fields that have underwent and under going reformation are concept and wellness practise in primary healthcare, primary healthcare clinical support services development and primary healthcare informatics development. The outcome of these reformations is the increment of service quality and outstanding services for patients and health staffs.
    Conclusion : Health reformation in primary healthcare is greatly needed to give excellent services for primary health care for today and future.
  19. Fulltext Caregivers' satisfaction of healthcare delivery at paediatric clinics of Universiti Kebangsaan Malaysia Medical Centre in 2009
    Aniza I, Rizal AM, Ng YS, Mardhiyyah M, Helmi I, Syamimi BK, et al.
    Med J Malaysia, 2011 Jun;66(2):84-8.
    PMID: 22106682
    Patient's satisfaction has become increasingly important as patients evaluate healthcare services for both medical cost and quality. The purpose of this study was to measure the prevalence and the factors influencing caregivers' satisfaction. A cross sectional study of 262 respondents using universal sampling method was conducted at the paediatric clinics of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Overall, 90.5% were satisfied with the services provided. Satisfaction rates based on various healthcare delivery domains were: 95.0% for communication skills, 88.5% for interpersonal aspect, 83.6% for technical quality, 82.1% for financial aspect, 72.9% for time spent with doctors and 64.9% for ease of contact. This study shows that the caregivers (an unpaid person who helps a person cope with disease) were highly satisfied with the communicational aspect delivered by the clinic. However, there is still room for improvement on ease of contact domain and waiting time in order to produce high quality service.

    Study site: Paediatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  20. Drone versus ambulance for blood products transportation: an economic evaluation study
    Zailani MA, Azma RZ, Aniza I, Rahana AR, Ismail MS, Shahnaz IS, et al.
    BMC Health Serv Res, 2021 Dec 05;21(1):1308.
    PMID: 34863156 DOI: 10.1186/s12913-021-07321-3
    BACKGROUND: Medical transportation is an essential step in health care services, and includes ground, air and water transportation. Among the important uses of medical transportation is the delivery of blood products in the event of a clinical emergency. Drone technology is the latest technological advancement that may revolutionize medical transportation globally. Nonetheless, its economic evaluation is scant and insufficient, whilst its cost-effectiveness remains controversial. The aim of this study was to compare the cost-effectiveness of drone transportation versus the ambulance.

    METHODS: The setting of the study was within a developing nation. An economic evaluation study of drone versus ambulance for emergency blood products transportation between the Sabah Women and Children Hospital (SWACH) and the Queen Elizabeth II Hospital (QEH2) on Borneo Island was conducted using the Cost-Effectiveness Analysis (CEA) technique. The total cost of each mode of transportation was calculated using the Activity Based Costing (ABC) method. Travel time was used as a denominator to estimate the Incremental Cost Effectiveness Ratio (ICER).

    RESULTS: For one clinical emergency in SWACH, a round trip of blood products transportation from SWACH to QEH2 costs RM1,266.02 (USD307.09) when using the ambulance, while the drone costs RM1,313.28 (USD319.36). The travel time for the drone was much shorter (18 min) compared to the ambulance (34 min). The Cost-Effectiveness Ratio (CER) of ambulance transportation was RM37.23 (USD9.05) per minute whilst the CER of drone transportation was RM72.96 (USD17.74) per minute. The ICER of drone versus ambulance was - 2.95, implying an increase of RM2.95 in cost for every minute saved using a drone instead of an ambulance.

    CONCLUSION: Although drone transportation of blood products costs more per minute compared to the ambulance, the significantly shorter transport time of the drone offset its cost. Thus, we believe there is good economic potential for drone usage for blood products transportation in developing nations particularly if the drone price decreases and its operational lifespan increases. Our limitation of a non-clinical denominator used in this study leads to the recommendation for use of clinical outcomes in future studies.

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