A study of knowledge, attitude and practice was carried out among sixty nine married Orang Asli women in the district of Kuaia Langat. The study showed that oniy a smail proportion of the women were using family planning methods. About half of the study women were stiil uncertain with regards to their attitude towards family planning. The findings aiso showed that there was no diversity of the methods with oral contraceptive being the major choice. Majority of the husbands had indeed positive feeling towards family planning. The women also considered breastfeeding as a major method of contraception.
PIP: A knowledge-attitude-practice (KAP) study of 69 married Orang Asli women from Kuala Langat district, Malaysia is reported. The Orang Asli comprise 2744 people in 412 households served by rural health services and a few private practitioners. The median age of the sample was 16.3 years, of whom 18.8% were married before age 15. 47.8% knew of family planning methods. 53.6% of the women said that they and their husbands approved of family planning, 2.9% disapproved, and the rest were undecided. Only 30.4% had discussed family planning with their husbands. 21.7% stated that they would use contraception, either the pill or sterilization, after their family was completed.
PIP: Contraceptive prevalence was determined in the Kelantan region of Malaysia, an area with relatively poor health indices. 350 women attending health clinics on rubber and palm-oil estates and living in surrounding suburbs were surveyed by clinic workers or during home visits. The sample included 273 Malays, 64 Indians and 13 Chinese. This area of Peninsular Malaysia is noted for the highest infant mortality rate (17.7), second highest crude birth rate (35.2) and highest dependency ratio (88%) in the country. 44.9% practiced contraception, highest in Chinese and lowest in Indians. Methods used were pills by (55%), traditional methods (19%), tubal ligation (18%), safe period (14%), injections (5.5%), IUD (4.7%), and condom (2.3%). The Malaysian traditional methods are herbal preparations from tree bark or roots, herb pills, and exercises after coitus. 34% of the non contraceptors had used contraception before but stopped because of side effects, religious or spousal objections, or desire to conceive. 74% had married in their teens. 46% of the non-contraceptors were spacing their children by prolonged breastfeeding.
"Based on surveys conducted among different ethnic groups in rural and urban settings in Peninsular Malaysia in 1981-82, this paper analyses changes in patterns of marriage and household formation among Malays, Chinese, and Indians. Aspects covered include social mixing before marriage, choice of spouse, comparison of spouses' characteristics, and place of residence after marriage. There are important cultural differences between the main Malaysian ethnic groups in matters related to marriage, but in many important respects, attitudes and practice are tending to converge...."
A case of Koro is described in a Malaysian Chinese man in the setting of martial dysharmony and sexual rejection. A distinction is suggested between the epidemic form of Koro and the Koro symptom occurring sporadically. Existence of the sporadic Koro syndrome is discussed and a unified classificatory system is proposed.
PIP:
Fertility trends and prospects for east and southeast Asian countries including cities in China, Taiwan, the Republic of Korea, Thailand, Indonesia, Malaysia, the Philippines, Myanmar, and Viet Nam are described. Additional discussion focuses on family planning methods, marriage patterns, fertility prospects, theories of fertility change, and policy implications for the labor supply, labor migrants, increased female participation in the labor force (LFP), human resource development, and social policy measures. Figures provide graphic descriptions of total fertility rates (TFRS) for 12 countries/areas for selected years between 1960-90, TFR for selected Chinese cities between 1955-90, the % of currently married women 15-44 years using contraception by main method for selected years and for 10 countries, actual and projected TFR and annual growth rates between 1990-2020 for Korea and Indonesia. It is noted that the 1st southeast Asian country to experience a revolution in reproductive behavior was Japan with below replacement level fertility by 1960. This was accomplished by massive postponement in age at marriage and rapid reduction in marital fertility. Fertility was controlled primarily through abortion. Thereafter every southeast Asian country experienced fertility declines. Hong Kong, Penang, Shanghai, Singapore, and Taipei and declining fertility before the major thrust of family planning (FP). Chinese fertility declines were reflected in the 1970s to the early 1980s and paralleled the longer, later, fewer campaign and policy which set ambitious targets which were strictly enforced at all levels of administration. Korea and Taiwan's declines were a result of individual decision making to restrict fertility which was encouraged by private and government programs to provide FP information and subsidized services. The context was social and economic change. Indonesia's almost replacement level fertility was achieved dramatically through the 1970s and 1980s by institutional change in ideas about families and schooling and material welfare, changes in the structure of governance, and changes in state ideology. Thailand's decline began in the 1960s and is attributed to social change, change in cultural setting, demand, and FP efforts. Modest declines characterize Malaysia and the Philippines, which have been surpassed by Myanmar and Viet Nam. The policy implications are that there are shortages in labor supply which can be remedied with labor migration, pronatalist policy, more capital intensive industries, and preparation for a changing economy.
PIP:
In the Philippines the number of children per woman is envisioned to be 2 by the year 2000 to reach simple replacement level. The crude birth rate had dropped from 43.6% in 1960 to 32.3% during 1980-85 corresponding to 4.2 children/woman. However, the corresponding rates for Thailand and Malaysia were 28% and 32.1%, respectively. The total fertility rate (TFR) was still a high 4.7% in 1988. In 1980 TFR was 3 in Manila, but 3/4 of the provinces still had TFR of 5-6.8 in 1985. Yet the World Fertility Survey of 1970 indicated that the total married fertility rate had decreased from 9.6 in 1970 to 9.1 in 1977. Married women had an average of 4.5 children in 1968 and still 4 children in 1983. Only 1/2 of married women aged 15-45 used contraception. In 1983, only 26.2% of all fertile married women used effective contraception. 63% of Moslim women, 70% of Catholics and Protestants, and 83% of members of the Church of Christ advocate modern contraceptives. From 1967 the National Population Outreach Program of the state sent out family planning advisers to unserviced areas. In 1983 only 37% of married women knew about such a service within their locality, and in 1988 a World Bank investigation showed that 67% could not afford contraceptives. The education, employment, income, urbanization of the household as well as medical care of women and children strongly influenced reproduction. The lifting of living standards and improvement of the condition of women is a central tenet of Philippine family planning policy. A multiple regression analysis of the World Fertility Survey proved that professional women tended to have smaller family size, however, most women worked out of economic necessity not because of avocation. The higher the urban family income, the lower marital fertility; but the reverse is true in rural areas where traditionally large families have had more income, and children have provided future material security. In 1983 1/3 of women with children over 18 received regular financial remittances from them. Thus, appropriate family planning program evaluation has to be concerned with the relationships of fertility and rural areas, the economic development of the community, and the physical access to a family planning clinic.
Familial Paroxysmal Rhabdomyolysis of the non-exertional variety is a rare but treatable disorder previously not described in Malaysia. We report 3 Malay siblings of a consanguinous marriage who developed myoglobulinuria during a febrile illness. The first 2 died without being investigated, but the last had creatinine kinase levels of 24,800 UIL suggesting acute rhabdomyolysis. Fasting appears to be a major precipitating factor, and glucose infusions combined with alkaline diuresis may be life-saving.
A cross-sectional survey of 568 married women aged 21-65 years in the Pasir Panjang Constituency was conducted to determine the prevalence of cervical cancer screening in the community and the factors affecting acceptance of this screening test. Results show that 309 (54.4%) of the respondents had ever had a Pap smear. The women who reported having had a smear were more likely to be below 45 years of age (prevalence ratio 1.47, 95% confidence interval 1.15 to 1.88), Chinese and of a higher socioeconomic status (1.68, 1.33 to 2.12). They were also more likely to have married at a later age (1.68, 1.21 to 2.31) than women who had not had a smear. Age and socioeconomic status remained independent predictors on multivariate analysis. The findings suggest that an important task of public health practitioners is to increase the uptake of screening among older and socially disadvantaged women who are known to be at the highest risk of cervical cancer. In addition, strategies to encourage younger women to continue regular attendance at screening clinics beyond their childbearing years will be important for the future.
Data from the 1984 Malaysian Population and Family Survey were matched with birth registration records for 1985-87 to determine the accuracy of statements regarding desired family size that were reported in a household survey in predicting subsequent reproductive behavior. The findings of this study were that stated fertility intention provides fairly accurate forecasts of fertility behavior in the subsequent period. In other words, whether a woman has another child is predicted closely by whether she wanted an additional child. Informational, educational, and motivational activities of family planning programs would, therefore, have greater success in reducing family size if fertility intentions were taken into account.
In this paper we use data from the Second Malaysian Family Life Survey (MFLS-2) to examine the extent to which ethnic differences in the living arrangements of the older population in Peninsular Malaysia can be explained by ethnic differences in demographic and socioeconomic characteristics. We also investigate whether the three main ethnic groups of Malaysia differ in the extent to which their living arrangements are influenced by these factors. For the married, the higher incidence of remarriage and lower housing costs for Malays each contribute importantly to their lower coresidence rates. The relatively poorer health of Indians and better health of Malays also contribute to the ethnic differences in coresidence rates for the married, as does the higher incidence of daughter-only families among Malays. The explanatory variables considered here explain less of the ethnic differences in coresidence rates for the unmarried.
Study name: Malaysian Family Life Survey (MFLS-2)
This study investigates the reasons for entry to medicine and the career perspectives of phase III medical students of the Universiti Sains Malaysia (USM). The majority of the students were Malays from low socio-economic backgrounds who entered medical school after completing a 2-year matriculation course. An interest in medicine and helping people were the two main stated reasons for entry to medical school. A group of students wishing to work in private practice was identified. In comparison to the rest of the study body, students in the group were: not well prepared to enter medical school; dissatisfied with the course; and subject to family influences. A desire for monetary gain motivated their choice of medicine as a career. Overall, 13% of the students wished to change career because they were dissatisfied with their experience of medicine as undergraduates. The study did not find a significant difference in career intentions between female and male medical students. However, women were less likely to seek entrance into private practice or pursue formal postgraduate education. The choice of surgery as a career was confined to men. About 90% of the students had already decided on their future specialty. Four well-established specialties were their most popular choices. The gender of the students had no significant influences of the decision to continue into postgraduate education. The proportion of female students who wished to marry doctors was significantly higher than for male students.
In this paper we discuss a number of hypotheses about motives for intergenerational transfers within the family. We use data on time and money transfers between generations in Malaysia, where there is neither Social Security nor Medicare, to explore these hypotheses empirically. We find evidence supporting the hypotheses that children are an important source of old age security and that old age security is, in part, children's repayment for parental investments in their education. This repayment is partly a function of the children's income and, in the case of females, a function of their spouse's income. We also find evidence supporting the hypotheses that parents and children engage in the exchange of time help for money.
"The impact of family migration on women's economic position in a developing country setting is an area that has received relatively little research attention. Incorporating a lifetime perspective, this study makes use of the retrospective migration histories of husbands and wives from the second round of the Malaysian Family Life Survey to estimate how joint migration with the husband affects women's socioeconomic achievement. The findings show that family migration depresses the chances of working, but it does not significantly reduce socioeconomic attainment of those who do work. However, when a woman migrates with her husband she does forgo the substantial advantage she could have derived had she moved alone."