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  1. Contraceptive method switching in Peninsular Malaysia: ethnic differences, 1940s-1970s
    Davanzo J, Starbird E, Reboussin D, Tan Boon Ann, Abdullah SH
    Malays J Reprod Health, 1988 Jun;6(1):1-21.
    PMID: 12281591
    Matched MeSH terms: Public Policy; Family Planning Policy
  2. Fulltext Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries
    Chow CK, Corsi DJ, Gilmore AB, Kruger A, Igumbor E, Chifamba J, et al.
    BMJ Open, 2017 03 31;7(3):e013817.
    PMID: 28363924 DOI: 10.1136/bmjopen-2016-013817
    OBJECTIVES: This study examines in a cross-sectional study 'the tobacco control environment' including tobacco policy implementation and its association with quit ratio.

    SETTING: 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014.

    PARTICIPANTS: Community audits and surveys of adults (35-70 years, n=12 953).

    PRIMARY AND SECONDARY OUTCOME MEASURES: Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models.

    RESULTS: Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had >2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example, communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5·0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1).

    CONCLUSIONS: This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and knowledge suggest that different strategies to promoting quitting may need to be implemented in men compared to women.

    Matched MeSH terms: Health Policy*
  3. Policy and priorities for national cancer control planning in low- and middle-income countries: Lessons from the Association of Southeast Asian Nations (ASEAN) Costs in Oncology prospective cohort study
    ACTION Study Group
    Eur J Cancer, 2017 03;74:26-37.
    PMID: 28335885 DOI: 10.1016/j.ejca.2016.12.014
    BACKGROUND: Evidence to guide policymakers in developing affordable and equitable cancer control plans are scarce in low- and middle-income countries (LMIC).

    METHODS: The 2012-2014 ASEAN Costs in Oncology Study prospectively followed-up 9513 newly diagnosed cancer patients from eight LMIC in Southeast Asia for 12 months. Overall and country-specific incidence of financial catastrophe (out-of-pocket health costs ≥ 30% of annual household income), economic hardship (inability to make necessary household payments), poverty (living below national poverty line), and all-cause mortality were determined. Stepwise multinomial regression was used to estimate the extent to which health insurance, cancer stage and treatment explained these outcomes.

    RESULTS: The one-year incidence of mortality (12% in Malaysia to 45% in Myanmar) and financial catastrophe (24% in Thailand to 68% in Vietnam) were high. Economic hardship was reported by a third of families, including inability to pay for medicines (45%), mortgages (18%) and utilities (12%), with 28% taking personal loans, and 20% selling assets (not mutually exclusive). Out of households that initially reported incomes above the national poverty levels, 4·9% were pushed into poverty at one year. The adverse economic outcomes in this study were mainly attributed to medical costs for inpatient/outpatient care, and purchase of drugs and medical supplies. In all the countries, cancer stage largely explained the risk of adverse outcomes. Stage-stratified analysis however showed that low-income patients remained vulnerable to adverse outcomes even when diagnosed with earlier cancer stages.

    CONCLUSION: The LMIC need to realign their focus on early detection of cancer and provision of affordable cancer care, while ensuring adequate financial risk protection, particularly for the poor.
    Matched MeSH terms: Health Policy/economics
  4. Effective family planning programs
    Rosenfield AG
    Med Today, 1973;7(3-4):80-94.
    PMID: 12309877
    PIP: Organizational and content features of various national family planning programs are reviewed. The Thai program is cited as an example of a family planning program organized on a massive unipurpose compaign basis. The Korean and Taiwan programs have utilized special field workers while upgrading the general health care network. 3 major problems with family planning programs are: 1) the lack of experience with such programs; 2) lack of commitment at the highest political levels; and 3) medical conservatism. Utilization of all available contraceptive methods instead of reliance on 1 method would improve most programs. Nursing and auxiliary personnel could be trained to take over the work of physicians in family planning programs. This is already being done with IUD insertion and pill prescription in several programs. The postpartum tubal ligation approach has proven effective and should be extended. There is a place in all national programs for both the private and the commercial sectors. Incentives for clinics, personnel, and acceptors might spread family planning more rapidly.
    Matched MeSH terms: Public Policy*
  5. How federal health-care policies interface with urban and rural areas: a comparison of three systems
    Baracskay D
    Glob Public Health, 2012;7(4):317-36.
    PMID: 22043815 DOI: 10.1080/17441692.2011.621962
    Global public health policies span national borders and affect multitudes of people. The spread of infectious disease has neither political nor economic boundaries, and when elevated to a status of pandemic proportions, immediate action is required. In federal systems of government, the national level leads the policy formation and implementation process, but also collaborates with supranational organisations as part of the global health network. Likewise, the national level of government cooperates with sub-national governments located in both urban and rural areas. Rural areas, particularly in less developed countries, tend to have higher poverty rates and lack the benefits of proper medical facilities, communication modes and technology to prevent the spread of disease. From the perspective of epidemiological surveillance and intervention, this article will examine federal health policies in three federal systems: Australia, Malaysia and the USA. Using the theoretical foundations of collaborative federalism, this article specifically examines how collaborative arrangements and interactions among governmental and non-governmental actors help to address the inherent discrepancies that exist between policy implementation and reactions to outbreaks in urban and rural areas. This is considered in the context of the recent H1N1 influenza pandemic, which spread significantly across the globe in 2009 and is now in what has been termed the 'post-pandemic era'.
    Matched MeSH terms: Health Policy*
  6. Determining optimal gestational weight gain in a multiethnic Asian population
    Ee TX, Allen JC, Malhotra R, Koh H, Østbye T, Tan TC
    J Obstet Gynaecol Res, 2014 Apr;40(4):1002-8.
    PMID: 24611987 DOI: 10.1111/jog.12307
    To define the optimal gestational weight gain (GWG) for the multiethnic Singaporean population.
    Matched MeSH terms: Nutrition Policy*
  7. Fulltext Support for and reported compliance among smokers with smoke-free policies in air-conditioned hospitality venues in Malaysia and Thailand: findings from the International Tobacco Control Southeast Asia Survey
    Yong HH, Foong K, Borland R, Omar M, Hamann S, Sirirassamee B, et al.
    Asia Pac J Public Health, 2010 Jan;22(1):98-109.
    PMID: 20032039 DOI: 10.1177/1010539509351303
    This study examined support for and reported compliance with smoke-free policy in air-conditioned restaurants and other similar places among adult smokers in Malaysia and Thailand. Baseline data (early 2005) from the International Tobacco Control Southeast Asia Survey (ITC-SEA), conducted face-to-face in Malaysia and Thailand (n = 4005), were used. Among those attending venues, reported total smoking bans in indoor air-conditioned places such as restaurants, coffee shops, and karaoke lounges were 40% and 57% in Malaysia and Thailand, respectively. Support for a total ban in air-conditioned venues was high and similar for both countries (82% Malaysian and 90% Thai smokers who believed there was a total ban), but self-reported compliance with bans in such venues was significantly higher in Thailand than in Malaysia (95% vs 51%, P < .001). As expected, reporting a ban in air-conditioned venues was associated with a greater support for a ban in such venues in both countries.
    Matched MeSH terms: Health Policy*
  8. Reducing maternal mortality: can we derive policy guidance from developing country experiences?
    Liljestrand J, Pathmanathan I
    J Public Health Policy, 2004;25(3-4):299-314.
    PMID: 15683067 DOI: 10.1057/palgrave.jphp.3190030
    Developing countries are floundering in their efforts to meet the Millennium Development Goal of reducing maternal mortality by 75% by 2015. Two issues are being debated. Is it doable within this time frame? And is it affordable? Malaysia and Sri Lanka have in the past 50 years repeatedly halved their maternal mortality ratio (MMR) every 7-10 years to reduce MMR from over 500 to below 50. Experience from four other developing countries--Bolivia, Yunan in China, Egypt, and Jamaica-confirms that each was able to halve MMR in less than 10 years beginning from levels of 200-300. Malaysia and Sri Lanka, invested modestly (but wisely)--less than 0.4% of GDP--on maternal health throughout the period of decline, although the large majority of women depended on publicly funded maternal health care. Analysis of their experience suggests that provision of access to and removal of barriers for the use of skilled birth attendance has been the key. This included professionalization of midwifery and phasing out of traditional birth attendants; monitoring births and maternal deaths and use of such information for high profile advocacy on the importance of reducing maternal death; and addressing critical gaps in the health system; and reducing disparities between different groups through special attention to the poor and disadvantaged populations.
    Matched MeSH terms: Health Policy/legislation & jurisprudence*
  9. A nationwide study on generic medicines substitution practices of Australian community pharmacists and patient acceptance
    Chong CP, March G, Clark A, Gilbert A, Hassali MA, Bahari MB
    Health Policy, 2011 Feb;99(2):139-48.
    PMID: 20732723 DOI: 10.1016/j.healthpol.2010.08.002
    This study evaluated Australian community pharmacists' rate of generic medicine substitution, patient acceptance of generic substitution and cost-savings achieved for patients from substitution.
    Matched MeSH terms: Health Policy/trends*
  10. Application of theory-based evaluation for the critical analysis of national biofuel policy: A case study in Malaysia
    Abdul-Manan AF, Baharuddin A, Chang LW
    Eval Program Plann, 2015 Oct;52:39-49.
    PMID: 25898073 DOI: 10.1016/j.evalprogplan.2015.03.007
    Theory-based evaluation (TBE) is an effectiveness assessment technique that critically analyses the theory underlying an intervention. Whilst its use has been widely reported in the area of social programmes, it is less applied in the field of energy and climate change policy evaluations. This paper reports a recent study that has evaluated the effectiveness of the national biofuel policy (NBP) for the transport sector in Malaysia by adapting a TBE approach. Three evaluation criteria were derived from the official goals of the NBP, those are (i) improve sustainability and environmental friendliness, (ii) reduce fossil fuel dependency, and (iii) enhance stakeholders' welfare. The policy theory underlying the NBP has been reconstructed through critical examination of the policy and regulatory documents followed by a rigorous appraisal of the causal link within the policy theory through the application of scientific knowledge. This study has identified several weaknesses in the policy framework that may engender the policy to be ineffective. Experiences with the use of a TBE approach for policy evaluations are also shared in this report.
    Matched MeSH terms: Public Policy*
  11. Dietary patterns and cognitive ability among 12- to 13 year-old adolescents in Selangor, Malaysia
    Nurliyana AR, Mohd Nasir MT, Zalilah MS, Rohani A
    Public Health Nutr, 2015 Feb;18(2):303-12.
    PMID: 24507623 DOI: 10.1017/S1368980014000068
    OBJECTIVE: The present study aimed to identify dietary patterns and determine the relationship between dietary patterns and cognitive ability among 12- to 13 year-old Malay adolescents in the urban areas of Gombak district in Selangor, Malaysia.

    DESIGN: Data on sociodemographic background were obtained from parents. Height and weight were measured and BMI-for-age was determined. Adolescents were interviewed on their habitual dietary intakes using a semi-quantitative FFQ. Cognitive ability was assessed using the Wechsler Nonverbal Scale of Ability in a one-to-one manner. Dietary patterns were constructed using principal component analysis based on thirty-eight food groups of the semi-quantitative FFQ.

    SETTING: Urban secondary public schools in the district of Gombak in Selangor, Malaysia.

    SUBJECTS: Malay adolescents aged 12 to 13 years (n 416).

    RESULTS: The mean general cognitive ability score was 101·8 (sd 12·4). Four major dietary patterns were identified and labelled as 'refined-grain pattern', 'snack-food pattern', 'plant-based food pattern' and 'high-energy food pattern'. These dietary patterns explained 39·1 % of the variance in the habitual dietary intakes of the adolescents. The refined-grain pattern was negatively associated with processing speed, which is a construct of general cognitive ability. The high-energy food pattern was negatively associated with general cognitive ability, perceptual reasoning and processing speed. Monthly household income and parents' educational attainment were positively associated with all of the cognitive measures. In multivariate analysis, only the high-energy food pattern was found to contribute significantly towards general cognitive ability after controlling for socio-economic status.

    CONCLUSIONS: Consumption of foods in the high-energy food pattern contributed towards general cognitive ability after controlling for socio-economic status. However, the contribution was small.

    Matched MeSH terms: Nutrition Policy*
  12. What has been achieved in HIV prevention, treatment and care for people who inject drugs, 2010-2012? A review of the six highest burden countries
    Degenhardt L, Mathers BM, Wirtz AL, Wolfe D, Kamarulzaman A, Carrieri MP, et al.
    Int J Drug Policy, 2014 Jan;25(1):53-60.
    PMID: 24113623 DOI: 10.1016/j.drugpo.2013.08.004
    In 2010 the international HIV/AIDS community called on countries to take action to prevent HIV transmission among people who inject drugs (PWID). To set a baseline we proposed an "accountability matrix", focusing upon six countries accounting for half of the global population of PWID: China, Malaysia, Russia, Ukraine, Vietnam and the USA. Two years on, we review progress.
    Matched MeSH terms: Health Policy*
  13. Fulltext Impact of Point-of-Sale Tobacco Display Bans in Thailand: Findings from the International Tobacco Control (ITC) Southeast Asia Survey
    Li L, Borland R, Yong HH, Sirirassamee B, Hamann S, Omar M, et al.
    Int J Environ Res Public Health, 2015 Aug;12(8):9508-22.
    PMID: 26287219 DOI: 10.3390/ijerph120809508
    In September 2005 Thailand became the first Asian country to implement a complete ban on the display of cigarettes and other tobacco products at point-of-sale (POS). This paper examined the impact of the POS tobacco display ban in Thailand, with Malaysia (which did not impose bans) serving as a comparison. The data came from the International Tobacco Control Southeast Asia Survey (2005-2011), a prospective cohort survey designed to evaluate the psychosocial and behavioral impacts of tobacco control policies. Main measures included smokers' reported awareness of tobacco displays and advertising at POS. At the first post-ban survey wave over 90% of smokers in Thailand were aware of the display ban policy and supported it, and about three quarters thought the ban was effective. Noticing tobacco displays in stores was lowest (16.9%) at the first post-ban survey wave, but increased at later survey waves; however, the levels were consistently lower than those in Malaysia. Similarly, exposure to POS tobacco advertising was lower in Thailand. The display ban has reduced exposure to tobacco marketing at POS. The trend toward increased noticing is likely at least in part due to some increase in violations of the display bans and/or strategies to circumvent them.
    Matched MeSH terms: Health Policy*
  14. A supply model for nurse workforce projection in Malaysia
    Abas ZA, Ramli MR, Desa MI, Saleh N, Hanafiah AN, Aziz N, et al.
    Health Care Manag Sci, 2018 Dec;21(4):573-586.
    PMID: 28822005 DOI: 10.1007/s10729-017-9413-7
    The paper aims to provide an insight into the significance of having a simulation model to forecast the supply of registered nurses for health workforce planning policy using System Dynamics. A model is highly in demand to predict the workforce demand for nurses in the future, which it supports for complete development of a needs-based nurse workforce projection using Malaysia as a case study. The supply model consists of three sub-models to forecast the number of registered nurses for the next 15 years: training model, population model and Full Time Equivalent (FTE) model. In fact, the training model is for predicting the number of newly registered nurses after training is completed. Furthermore, the population model is for indicating the number of registered nurses in the nation and the FTE model is useful for counting the number of registered nurses with direct patient care. Each model is described in detail with the logical connection and mathematical governing equation for accurate forecasting. The supply model is validated using error analysis approach in terms of the root mean square percent error and the Theil inequality statistics, which is mportant for evaluating the simulation results. Moreover, the output of simulation results provides a useful insight for policy makers as a what-if analysis is conducted. Some recommendations are proposed in order to deal with the nursing deficit. It must be noted that the results from the simulation model will be used for the next stage of the Needs-Based Nurse Workforce projection project. The impact of this study is that it provides the ability for greater planning and policy making with better predictions.
    Matched MeSH terms: Health Policy
  15. Historical epidemiology of hepatitis C virus in select countries-volume 4
    Maaroufi A, Vince A, Himatt SM, Mohamed R, Fung J, Opare-Sem O, et al.
    J Viral Hepat, 2017 10;24 Suppl 2:8-24.
    PMID: 29105285 DOI: 10.1111/jvh.12762
    Due to the introduction of newer, more efficacious treatment options, there is a pressing need for policy makers and public health officials to develop or adapt national hepatitis C virus (HCV) control strategies to the changing epidemiological landscape. To do so, detailed, country-specific data are needed to characterize the burden of chronic HCV infection. In this study of 17 countries, a literature review of published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates was conducted, and inputs were validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Hong Kong to 2.4% in Taiwan, while the largest viraemic populations were in Nigeria (2 597 000 cases) and Taiwan (569 000 cases). Diagnosis, treatment and liver transplant rates varied widely across the countries included in this analysis, as did the availability of reliable data. Addressing data gaps will be critical for the development of future strategies to manage and minimize the disease burden of hepatitis C.
    Matched MeSH terms: Health Policy
  16. The present and future disease burden of hepatitis C virus infections with today's treatment paradigm: Volume 4
    Chan HLY, Chen CJ, Omede O, Al Qamish J, Al Naamani K, Bane A, et al.
    J Viral Hepat, 2017 10;24 Suppl 2:25-43.
    PMID: 29105283 DOI: 10.1111/jvh.12760
    Factors influencing the morbidity and mortality associated with viremic hepatitis C virus (HCV) infection change over time and place, making it difficult to compare reported estimates. Models were developed for 17 countries (Bahrain, Bulgaria, Cameroon, Colombia, Croatia, Dominican Republic, Ethiopia, Ghana, Hong Kong, Jordan, Kazakhstan, Malaysia, Morocco, Nigeria, Qatar and Taiwan) to quantify and characterize the viremic population as well as forecast the changes in the infected population and the corresponding disease burden from 2015 to 2030. Model inputs were agreed upon through expert consensus, and a standardized methodology was followed to allow for comparison across countries. The viremic prevalence is expected to remain constant or decline in all but four countries (Ethiopia, Ghana, Jordan and Oman); however, HCV-related morbidity and mortality will increase in all countries except Qatar and Taiwan. In Qatar, the high-treatment rate will contribute to a reduction in total cases and HCV-related morbidity by 2030. In the remaining countries, however, the current treatment paradigm will be insufficient to achieve large reductions in HCV-related morbidity and mortality.
    Matched MeSH terms: Health Policy
  17. Organizational Update: Asia Pacific Stroke Organization
    Venketasubramanian N, Anderson C, Mehndiratta M, Lin RT, Tan KS, Huang CY
    Stroke, 2017 09;48(9):e252-e254.
    PMID: 28754827 DOI: 10.1161/STROKEAHA.117.017044
    Matched MeSH terms: Health Policy
  18. Fulltext Promoting Malaysians to spend on health: what it takes to encourage Malaysians to spend on health promotion?
    Yong, Kang Cheah
    Int J Public Health Res, 2014;4(1):391-398.
    MyJurnal
    Introduction. In light of the important role of health-promoting expenditure in health, the objective of this study was to investigate the socio-demographic determinants of health-promoting expenditure such as purchase of medical equipment and services, food supplements and health education services and products among Malaysian adults.
    Methods Third National Health and Morbidity Survey (NHMS III) consisting of 28771 observations was used for analysis. It was the latest nationally representative cross-sectional population-based survey conducted by the Ministry of Health Malaysia from April 2006 to January 2007. A censored regression model
    (Tobit) was applied to examine the factors affecting health-promoting expenditure.
    Results The results showed that age, income, gender, ethnicity, education, marital status, employment status and location of residence were able to affect health promoting expenditure. In particular, individuals who were younger, poor, males, Indian/others, less educated, unmarried, unemployed and residing in rural areas tended to spend less money on health promotion compared to others.
    Conclusions This study reached a conclusion that socio-demographic factors were significantly associated with individual’s preferences for health promotion. Therefore, the government should devote its attention to these factors when
    formulating nationwide health policies.
    Study name: National Health and Morbidity Survey III (NHMS-2006)
    Matched MeSH terms: Health Policy
  19. Development of emergency food assistance design: a nutritionally balanced, culturally tailored and cost-effective strategy for flood mitigation
    Balachanthar S, Zakaria NA, Lee LK
    Ecol Food Nutr, 2018 07 10;57(4):314-329.
    PMID: 29989434 DOI: 10.1080/03670244.2018.1492380
    Emergency food assistance forms an integral component of flood mitigation in Malaysia. A cross-sectional survey investigating emergency food assistance among 202 flood victims was conducted and alternative food assistance plan was developed using linear programming targeting post-disaster food requirement scenarios. From the study, the receipt of food aid was significantly associated with ethnicity, household income, residential area and evacuation into temporary shelters. Linear programming analysis identified nutritionally appropriate food assistance targeting mass feeding, emergency food basket, and immediate food requirement for as low as MYR 6.07 (1.55 USD), MYR 7.14 (1.82 USD), and MYR 8.00 (2.04 USD), respectively. This study provides nutritional guidelines for disaster food assistance policy.
    Matched MeSH terms: Nutrition Policy
  20. A review of the Australian healthcare system: A policy perspective
    Dixit SK, Sambasivan M
    SAGE Open Med, 2018;6:2050312118769211.
    PMID: 29686869 DOI: 10.1177/2050312118769211
    This article seeks to review the Australian healthcare system and compare it to similar systems in other countries to highlight the main issues and problems. A literature search for articles relating to the Australian and other developed countries' healthcare systems was conducted by using Google and the library of Victoria University, Melbourne. Data from the websites of the Commonwealth of Australia, the Australian Institute of Health and Welfare, the Australian Productivity Commission, the Organisation for Economic Co-operation and Development and the World Bank have also been used. Although care within the Australian healthcare system is among the best in the world, there is a need to change the paradigm currently being used to measure the outcomes and allocate resources. The Australian healthcare system is potentially dealing with two main problems: (a) resource allocation, and (b) performance and patient outcomes improvements. An interdisciplinary research approach in the areas of performance measurement, quality and patient outcomes improvement could be adopted to discover new insights, by using the policy implementation error/efficiency and bureaucratic capacity. Hospital managers, executives and healthcare management practitioners could use an interdisciplinary approach to design new performance measurement models, in which financial performance, quality, healthcare and patient outcomes are blended in, for resource allocation and performance improvement. This article recommends that public policy implementation error and the bureaucratic capacity models be applied to healthcare to optimise the outcomes for the healthcare system in Australia. In addition, it highlights the need for evaluation of the current reimbursement method, freedom of choice to patients and a regular scrutiny of the appropriateness of care.
    Matched MeSH terms: Public Policy
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