Citation: Kasah A. Country report on nutrition communication activities in Malaysia. Kuala Lumpur: United Nations University; 1988
The primary health-care approach in Malaysia is an integral part of the government community development movement, or Gerakan Pembaharuan (Operation Renewal), launched in 1972. Nutrition communication activities form a major component of the existing basic health services. The activities are channelled through various health and nutrition services. Group talks, cooking demonstrations with group discussions, individual advice in clinics, and home visits are provided through maternal and child health services. The health education unit is responsible for producing educational materials such as posters and leaflets at both national and state levels. Health education mobile units, fully equipped with audio-visual aids, provide films and slide shows, arrange talks and dialogue sessions, and distribute leaflets. A mass media programme using radio and television was introduced in July 1983 as a joint effort of the ministries of Health and Information. The messages include a wide range of health and nutrition information. Health education materials are used extensively and local radio broadcasts will be utilized to overcome dialect problems. The applied nutrition programme started in 1969 uses an intersectoral approach towards PHC. Four main ministries are involved, namely, Health, Agriculture and Rural Development, Education, and Information. Health and nutrition education is one of the main tasks. Nutrition surveillance is also used as a channel for nutrition communications. In addition, both formal education, such as that provided in nursing schools, and in-service training for health personnel are being conducted by various training schools. The present trend of the health service is shifting from a clinic-based to a community-based approach, in which health staff work closely with community leaders. Attempts to encourage more active community participation in health activities are being made through committee meetings on development at the village and district levels.
An intensive health education programme geared towards increasing community's knowledge and inducing some changes in the attitude and behavioural factors towards the use of latrines.
A community based study was conducted on the understanding and knowledge of childhood diarrhoea and use of oral rehydration therapy (ORT), in four selected villages in Tumpat District, Kelantan. The calculated annual incidence of diarrhoeal disease in children aged 0 to four years in all study villages was 1.38 episodes for each child. The main care-givers of children aged 0 to four years were interviewed and asked to demonstrate how to mix a standard ORS (oral rehydration solution) sachet if they had previously used ORT. Forty percent of care-givers had heard of the locally available ORT and 30% had actually used ORT. Of those who had heard of or used ORT, 10% had good knowledge of what it was and what it was used for, 51% had some knowledge and 39% had either no knowledge or inaccurate knowledge. Of care-givers who had previously used ORT only 20.5% demonstrated the correct volume of water to add to one sachet of ORT, but 82% would discard an unused solution within 24 hours. Significantly more literate women had used ORT than those not literate (p = 0.002). Mothers, particularly those literate, are the primary target group for ORT intervention strategies. Components of health education should include advice on what ORS is, what it is used for, and how to correctly mix a standard sachet.
This paper examines the impact of cultural values and government policies on the content of AIDS educational literature prepared by public health agencies in Malaysia and the Philippines. The literature from these countries, which has been distributed to the public and is intended to inform them of the danger of AIDS, how the HIV is and is not transmitted, and how to avoid infection, is analyzed and evaluated for effectiveness and congruence with the dominant religious tenets and cultural practices in each country, and attitudes to sexual behavior. The paper also describes the response of these countries to the AIDS pandemic, and concludes with suggestions about how this form of AIDS education can be improved.
This study evaluates the level of dental knowledge among 328 antenatal mothers from different ethnic groups and ascertains the importance of the various sources of dental information. The mothers were interviewed based on a structured questionnaire. Most mothers knew about the number of sets of teeth they possessed throughout their life. This was most evident among the Chinese and least among the Malays. Only 42.7% of the mothers interviewed were positive about the preservation of their teeth throughout life. This belief was highest among the Chinese followed by the Indians. However about 40% of the Chinese believed that tooth decay is hereditary. Generally the principal sources of dental information cited by most mothers were television or radio followed by dentists, school and family. This order of importance was similarly observed among the Malays and Chinese. However, among Indians, family members represent the second most important source of dental information. The implications of these findings are discussed.
The prevalence of Enterobius vermicularis in four groups of adults, all trainee public health inspectors or public health nurses, aged 18-35 years and all living in hostels on campus was studied. The modified scotch tape technique was used and the subjects were taught to do the examination on themselves to detect the presence of eggs over a period of 6 successive mornings. Each was given an elaborately illustrated diagram on how and when to take the samples and given demonstration in groups. The samples were examined by trained people. Most of the subjects took samples on 6 consecutive days. Of the 119 subjects who returned samples, the overall prevalence of E. vermicularis was 9.2% and this was thought to be high for this particular age group. This was due to the higher prevalence (19.4%) in one group, whereas in the others the range was 3.5-8.0%. Based on the samples returned on the first day none of the subjects were detected as having the infection. After examination on 3 successive days (109 subjects) 10.1% were found to be infected (chi 2 = 10.704; d. f. = 1) and after examination on 6 successive days (72 subjects) 13.9% were found to be infected (chi 2 = 3.026; d. f. = 1). There was no significance between examination over 3 successive days and 6 consecutive days (chi 2 = 0.296; d. f. = 1). There was no difference in the prevalence between males and females.(ABSTRACT TRUNCATED AT 250 WORDS)
Non-communicable diseases with dietary implications, ischaemic heart disease, diabetes mellitus and cancers of the breast and colon are discussed in relation to their prevalence and mortality rates in peninsular Malaysia during the past few decades. The mortality rate due to diseases of the circulatory system has more than doubled since 1970, deaths due to ischaemic heart disease being the major cause. The prevalence of diabetes mellitus has risen from 0.65% in 1960 to about 4% currently. The mortality risk for both ischaemic heart disease and diabetes is highest in the Indian compared to Malay and Chinese populations. The Chinese show the highest mortality rate for cancers of the breast and colon. This could reflect, partly, because more people especially in the urban areas are seeking treatment and improved diagnosis. Empirical dietary data indicate an increase in the prevalence of hypercholesterolaemia among urban adults and overweight among urban and rural adults. Aggregate data from food balance sheets indicate increased availability of energy intake from fats and oils, sugar, and animal products, with concomitant decline in available energy from plant products. Continued public health education on the important linkage between diet and disease is called for.
As part of the student elective, the author organized a small research project into Government Dental Services in Sarawak, East Malaysia. The resulting article gives an insight into dentistry in this country.
The risk behavior in malaria has been identified as one of the factors contributing to malaria in Malaysia. The occurrence of malaria among illegal immigrants and indigenous groups, staying in risk prone areas where conditions are favorable for transmission, highlights the behavior pattern of these groups. In these areas the usual anti-malarial activities are less effective and thus there is a need to identify control measures suited to that particular condition and environment and to community groups. Some of the determinants contributing to the increase in malaria cases like man-vector contact, non-compliance to drugs, complications of the disease, and factors interfering with malaria control measures, factors favoring transmission and proposals to modify risk behavior, which can be applied in an endeavor to control the diseases, have been discussed.
This study investigated knowledge, attitudes, and preventive efforts of Malaysian college students regarding health risks associated with passive smoking, as well as possible directions for intervention and health education programs. Students responded anonymously to a structured written questionnaire. Statistical analyses were conducted to examine (1) differences in knowledge, attitudes, and preventive efforts between smokers and nonsmokers and between men and women; (2) the relationship between smoking by parents, siblings, and friends, and students' knowledge, attitudes, and preventive efforts; and (3) relationships between knowledge, attitudes, and preventive efforts. Peer groups and siblings had a substantial influence on students' attitudes toward passive smoking and their preventive efforts when exposed to passive smoke. A regression analysis revealed a statistically significant linear dependence of preventive efforts on knowledge and attitudes, with the attitude component playing the dominant role. This research suggests that educational efforts on passive smoking, directed toward young college students in developing countries such as Malaysia, should concentrate heavily on changing attitudes and reducing the effects of peer group and sibling influences.
Study site: Institut Teknologi Mara, Shah Alam; Stamford College, Petaling Jaya; Selangor, Malaysia
It is a common belief that a massive effort in law enforcement, preventive education and rehabilitation will result in the elimination of a country's drug problem. Based on this premise. Malaysia in 1983 implemented such a multifaceted anti-drug strategy, and the results of a 1987 study by the author suggested that Malaysia's effort had begun to contribute to a steady decrease in the number of identified drug abusers. Although the number of drug-addicted individuals declined, the country's recidivism rates were still high. Because of this high relapse rate, Malaysia expanded their rehabilitation effort and developed a community transition program. In order to determine the impact of these changes on the country's battle against drug abuse, a follow-up study was conducted in 1990. The results of this study did not clearly demonstrate that the Malaysian effort had been successful in eliminating the problem of drug abuse, and raised some questions concerning the effectiveness of the country's drug treatment programs.
The nutritional status of 896 Kadazan children below 6 years of age from 23 villages of Tambunan District were studied. When stunting and wasting were defined as those who were below two standard deviations of height-for-age and weight-for-height (Waterlow et al, 1977) and based on the National Center for Health Statistics reference population, 67.6% of boys and 66.8% of girls were stunted while 12.3% of boys and 8.3% of girls were wasted. Weaning foods and toddler feeding practices were unsatisfactory. The role of health education on child care and feeding practices is emphasized.
Disability self-help organizations have emerged as an important element of response to the advancement of people with disabilities throughout the developing world in recent years. There are now self-help organizations in all regions of the developing world, their memberships are growing, and the scope of their activities is enlarging. This paper draws on field research in Malaysia to present an organization developed by and for people with physical disabilities as a case study of self-help action in the Southeast Asian region. This paper reviews the origins and growth of the organization, describes its current programme of activities, and offers comment about the nature and future of disability self-help in the region and its continued advancement in the developing world generally. A combination of internal factors that relate to organization and programming, and external political and social conditions is indicated as important.
The Programme on Prevention and Management of Obesity in Preschool Children, aged three to six years, was implemented in 17 Primary Health Clinics in November 1991. The study sample comprised 1128 preschool children who qualified to enter the obesity register, using the defined criteria for obesity of 2 standard deviations above the normal weight for height and age. This group was divided into three categories, namely, mildly overweight (120% to below 140%), moderately overweight (140% to below 160%), and severely overweight (above 160%). The severely overweight category was referred to dietitians for follow-up management, while the other two categories were managed by the clinic staff through pre-planned nurse-conducted counselling sessions. In this paper, we analysed the first 1128 preschool children aged three to six years on the Programme with respect to their demographic characteristics; medical conditions; family history of obesity, diabetes, hypertension and ischaemic heart disease; number of siblings and parents' educational and occupational status. The Malay children showed significantly more severe grades of obesity compared to the Chinese and Indian children. A family history of obesity and hypertension among the three groups were significant (P < 0.001). After one year of follow-up with the intervention programme, the following were found: 40.4% (456) of the children improved in their obesity status and 20.2% (228) reached normal status. The severe, moderate and mild categories reduced from 6.3% to 5.9%, 29.3% to 23.2% and 64.4% to 50.7% respectively and was found to be statistically significant (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
In Malaysia, alpha-thalassaemia, beta-thalassaemia, haemoglobin (Hb) E, deltabeta-thalassaemia and Hb Constant Spring are prevalent. It has been estimated that 1 in 4 persons carries one of the above genetic abnormalities. In clinical practice, the major problems are: Hb Bart's hydrops fetalis (homozygous alpha(o)thalassaemia), homozygous 3(o)-thalassaemia, E-alpha thalassaemia and HbH disease. The laboratory procedures for diagnosis are standardised and the molecular basis of most of these genetic abnormalities are characterised. Thus it is possible to formulate a strategy for the detection and prevention of these disorders. The steps include the setting-up of population screening and genetic counselling service for the affected individuals, Society of Thalassaemias for public education and group support, and prenatal diagnosis with selective abortion of affected pregnancies. We embarked on such a programme between 1988 and 1992 in Kuala Lumpur General Hospital and hope to kindle similar effort in other state hospitals.