Design/methodology/approach: This study uses multi-directional efficiency analysis to measure the technical inefficiency scores on a sample of 200 farm observations and single-bootstrap truncated regression model to define factors affecting technical inefficiency.
Findings: Managerial and program inefficiency scores are presented for intensive and semi-intensive production systems. The results reveal marked differences in the inefficiency scores across inputs and between production systems.
Practical implications: Intensive systems generally have lowest managerial and program inefficiency scores in the Malaysian dairy farming sector. Policy makers could use this information to advise dairy farmers to convert their farming system to the intensive system.
Social implications: The results suggest that the Malaysian Government should redefine its policy for providing farm finance and should target young farmers when designing training and extension programs in order to improve the performance of the dairy sector.
Originality/value: The existing literature on Southeast Asian dairy farming has neither focused on investigating input-specific efficiency nor on comparing managerial and program efficiency. This paper aims to fill this gap.
METHODS: We recruited 48 peers (median age: 46 (IQR = 11) years old) into four peer groups, who underwent 3 months of PERSUADE, followed by 3 months of follow-up period. Statistical analyses were conducted at post-intervention and post-follow-up to assess the changes in nutrition intake, anthropometry, and metabolic parameters.
RESULTS: Although there were significant overall increases in total carbohydrate intake and glycemic load (both p < 0.001), we noted significant reductions in the intakes of total energy and fat (both p < 0.001). Physical activity (total METS/week) also showed a significant improvement (p < 0.001). Overall, significant but marginal improvements in anthropometric and vital metabolic parameters were also observed.
CONCLUSIONS: The feasibility trial supported the adoption of PERSUADE, though there is a need to assess the long-term impact of the peer support program in local community settings.
METHODS: Consecutive participants aged 18 years or older with a primary diagnosis of asthma, allergic rhinitis, chronic obstructive pulmonary disease, or rhinosinusitis were enrolled. Participants completed a survey detailing respiratory symptoms, HCRU, work productivity and activity impairment, and HRQOL. Locally sourced unit costs for each country were used in the calculation of total costs.
RESULTS: The study enrolled 5250 patients. Overall, the mean annual cost for patients with a respiratory disease was US $4191 (SGD 8489) per patient. For patients who reported impairment at work, the mean annual cost was US $7315 (SGD 10,244), with productivity loss being the highest cost component for all four diseases (US $6310 [SGD 9100]). On average, patients were impaired for one-third of their time at work and 5% of their work time missed because of respiratory disease, which resulted in a 36% reduction in productivity. Patients with a primary diagnosis of chronic obstructive pulmonary disease had the greatest impact on HRQOL.
CONCLUSIONS: In the Asia-Pacific, respiratory diseases have a significant impact on HCRU and associated costs, along with work productivity. Timely and effective management of these diseases has the potential to reduce disease burden and health care costs and improve work productivity and HRQOL.