Introduction: Physiological changes in the oral cavity and dental-related complications may occur during pregnancy. These intraoral changes that occur during pregnancy combined with lack of routine dental check-ups and delays in treatment for oral disease, place pregnant women at higher risk for dental infections. The objectives of this study was to assess the knowledge and awareness of pregnant women on periodontal disease and its effect on pregnancy, to investigate the relationship of their knowledge and awareness with level of education and the barriers of oral healthcare utilization among pregnant women.
Methodology: A self-administered questionnaire with an introductory letter and consent form were given to pregnant women who came for their routine maternity check-up at the Obstetrics and Gynecology Clinic, Kuala Lumpur Hospital. Data entry and analysis was done using Statistical package for Social Sciences (SPSS) version 12.
Result: Ninety-two pregnant women responded to the questionnaire. Only 23.9% answered correctly to the question on what is plaque. However, 45.7% knew that plaque can cause gum disease and a majority of the respondents 72.8% also knew that bleeding gum is an indication to inflamed gums. The result shows that, although 59.8% of the respondents were aware that it is necessary to brush their teeth frequently during pregnancy, only less than half of the respondents (44.6%) were aware that dental plaque and poor plaque control may cause periodontal disease among pregnant women. The majority (33.7%) feels that the long waiting time in the clinic would be their main barrier in seeking dental treatment.
Conclusion: A majority of pregnant women have limited knowledge and poor awareness on periodontal disease and its effect on pregnancy.
Study site: Obstetrics and Gynecology Clinic, Kuala Lumpur Hospital
Background: Safety and health audit study is a part of occupational safety and health risk assesment. Thus, student’s residential audit is important in order tu ensure the safety rules which implemented by the management is appropriate and follow the standard set forth. Furthermore, it also important to determine places, area or situation that might lead to hazard risk so that prevention step could be plan and implement.
Objective: This study was to determine the safety level of students residential in physical aspects.
Methods: Safety inspection or audit conducted is in accordance with criteria and indicators listed in the checklists that have been formed based on the audit forms from the Department of Safety and Health (DOSH), National Institute of Safety and health (NIOSH) and the Occupational Safety and Health Committee of UKMs (JKKP). Several indicators are also included in the audit form as to ensure it covers all the technical aspect and suited with the college conditions. The safety level for each of the blocks in KDO is categorized using points and percentage score obtained.
Results: Based on the overall score, the average safety score in percentage for areas in KDO are preceded by general office with score 85.5% followed by residential blocks with 71.5%, facilities with score 71.2% and administration block with 70.9%. The results of the study show that most of the areas are at least in a safe level.
Conclusion: Roles of employer and college administration, significant OSH programme and safety audit are important factors as to ensure the safety of student's residential college.
Population ageing is inevitable in Malaysia as a result of declining fertility rates. Steps can be taken to face this challenge. These include ways to promote “healthy ageing” and “compression of morbidity” and ways to promote “productive ageing”, i.e., keeping the elderly economically and socially engaged. This article, based on a review of the literature, argues that it is illogical to force people into compulsory retirement at an arbitrary age when they can continue to contribute actively to society. Instead, ways can be devised to promote healthy ageing, prolonging independence and encouraging productive ageing through gradual economic and social disengagement of the individual depending on the individual’s physical health, mental health, contribution to society and personal inclination and preferences. Public policy in general and public health policy in particular can be designed or redesigned to help achieve this.
Introduction : The 2006 -2007 flood in Johore which displaced more than 312,386 residents of the state was an extraordinary event and tested everyone preparedness. The disaster caused massive material, economic and environmental losses exceeded the state and local community capacity, forcing them seeks help from other states. Needs assessment, effectiveness of health services as well as leadership and nongovernment organization involvement were evaluated and constitute lessons learnt from the experiences.
Methodology : This is a descriptive review of the Johore flood. The review was based on literature search using established data and published reports of previous disasters. Discussion will focus on the 4 S’s of the surge capacity that is Structure, Staffing, Supplies and System (policies & procedures). Result : Structure- although 49 or 14% of health facilities in the state were affected by the flood, health services continued to be given. Majority of the relief centers were schools with better facilities. Funding for repairs obtained early approval as estimation of damages was timely applied. Temporary isolation centers for the conjunctivitis outbreak was appropriate implemented. Staffing- Leadership was assumed by the Johore State Health Department, the strongest and most prepared health sector. Needs assessment resulted in additional staff being deployed from other states allowing local staff to have their break from work as well as personal stress. Local staff became multi-skilled players. Training in disaster preparedness has to be of utmost priority to support such needs. Supplies- Personnel protective and pest control equipment, and medical supplies were adequately supplied. The laboratory services were well prepared. Pamphlets, posters, buntings and banners were distributed including five new health promotion materials. System- Flood disaster plan of action was well in place resulting in efficient management of the operating rooms, data management, coordination of services and disease surveillance through early warning system.
Conclusion : Public health preparedness is a matter of good governance and management based on evidence and experience. There is a need for a permanent and stable program for the Ministry of Health to prepare and coordinate the response to all disasters.
Background: Somalia is a country that still practices Female Genital Mutilation (FGM). Female genital mutilation (FGM) constitutes all procedures, which involve partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural or any other nontherapeutic reasons.
Methodology: A cross-sectional community based study was conducted among males and females above 18 years of age attending the Out Patient Clinic and Mother & Child Clinic of Elder District, Rural Hospital Galgadud Region, Somalia in June 2006 using a structured questionnaire to access the respondents’ knowledge, attitude and practice.
Results: Four hundred respondents were interviewed and male respondents were noted to be more knowledgeable than their female counterparts (p 0.004) and so does respondents with formal education (p <0.001) and had occupation (p <0.001). Majority of the female respondents (97.1%) favors the practices of FGM and reasons such as to protect virginity (p <0.001), increase marital opportunity (p <0.001) and religious recommendations (p <0.001) were noted to be the important
factors in the continuation of FGM. All of the female respondents have had some form of FGM, giving the prevalence rate of 100% with 64.1% underwent the procedure at between the age of 5-10 years old and the commonest form of FGM were infibulations. Mother (69.4%) was the important decision maker for these women.
Conclusion: Aggressive education programme should be introduced targeting the women in this community. They should be well informed on the complication of FGM and its health effects. Providing clinics will help to alleviate some of the complications related to FGM. Law on protecting women from these practices should be introduced and enforced.
Key Words: female genital mutilation, knowledge, attitude, practice
Study site: Clinic of Elder District, Rural Hospital Galgadud Region, Somalia
Background: This cross-sectional study aimed to investigate the prevalence of the caregiving burden among women who are caregivers to elderly with stroke and factors influencing it. Respondents identified through purposive sampling at the Universiti Malaya Medical Centre from October to December 2007.
Methods: Direct methods of data collection (clinical and housing) and indirect (postal) used a structured questionnaire distributed to the guards. Measurements taken include sociodemographic variables of patients and caregivers, the patient, the care, relationships with caregivers and patients with information about stroke. Zarit Burden Interview (ZBI) short version was used to measure the burden of care. Carers' Assessment of Managing Index (Cami) was used to assess coping strategies. A total of 96 respondents took part in this study.
Results: The study showed that prevalence of caregiving burden was 35.4%. Burden of care was found to have significant relationships with factors such as marital status, caregivers (p = 0.017), family income (p = 0040) and the patients (p = 0.000). Significant correlation obtained for the coping strategies with the burden (r =- 0228, p 0026).
Conclusion: The conclusion shows that policy makers and program managers should appreciate and assist caregivers in performing the role of care. Intervention programs should be designed to suit the needs of the heterogeneous guardian.
Introduction : Studies on stress among diabetic patients with complications are not much conducted locally. In this study the researchers would like to find out the magnitude of the problem among the Malaysian.
Methodology : A cross- sectional study was conducted to determine the prevalence of stress and its associated factors among the diabetes mellitus patients with complications at Raja Perempuan Zainab II Hospital, Kota Bharu, Kelantan. The translated Personal Stress Inventory questionairse was used to measure the stress among the respondents.
Finding : The prevalence of stress was 36.8%. The study showed that the employment status of respondents has significant association with stress in which higher numbers of unemployed respondents were stressed as compared to the employed respondents. Other sociodemographic factors, namely duration of having diabetes mellitus and type of complications developed by the patients were not significant.
Conclusion : Once the poor and unemployed patients were diagnosed to have diabetes mellitus either with or without complication, the health staffs should refer them immediately to the relevant agencies for help. By doing so, these patients could be prevented from having stress later. Outreach programmes in the community should be carried out regularly for an early detection and treatment of chronic diseases including diabetes mellitus to prevent patients from developing any complication.
Introduction : AIDS stigma and incorrect HIV/AIDS information among health care workers will influence the quality of care received by persons living with HIV/AIDS (PLHA). A cross-sectional study was conducted amongst nurses in the Hospital University Kebangsaan Malaysia (HUKM) with the objective of determining their knowledge and attitudes regarding HIV/AIDS and Universal Precautions (UP).
Methods : A total of 450 female nurses were recruited in this study and data were collected via a self-administered questionnaire.
Results : A total of 393 female nurses had completed the questionnaires and majority of them were Malays (95.4%) with mean age of 28.4±3.9 years old. The mean duration of work in the hospital was 6.2±3.6 years. The study results showed a satisfactory level of good knowledge among nurses (69%) and this is statistically significant (p
Aims : The review was to determine the prevalence of needlestick injury especially among health care personnel and to determine the score of knowledge and compliance to the Standard Universal Precaution.
Method : Twelve theses were reviewed from year 1996 to 2007 of Master in Community Health Science, Master in Community Health and Postgraduate Diploma in Occupational Health of Community Health Department Universiti Kebangsaan Malaysia Medical Center involving of 1645 respondents of health care personnel, support staff and student of nursing and medical. Eleven studies were cross sectional design and only one study was retrospective.
Results : Respondents were dominated by female (74.6%) and Malay ethnicity (65%), as young as 19 years old to 56 years old of age. Majority had received Hepatitis B vaccination (79.4%) but only 37.1% had completed the 3 doses regime. The incidence of episodes of needle stick injury among health care personnel was double (53.7%) compared to final year medical students (20.9%). Needle stick injuries did not occur at random as there were a few health care personnel injured repeatedly. Those who had higher mean or median score for compliance to Standard Universal Precaution were non case of needlestick injury. Work practices had been highlighted in few studies of being risk factors for needlestick injury such as blood withdrawing related activities. Other risk factors were job category, predictive factor for compliance to Standard Universal Precaution, risk perception and training.
Conclusion : Even though the review could not extrapolated to general population of healthcare personnel but it gave some illustrated pictures to what had happened in small clustered locations. Episodes of needle stick injury was 53.7% for past 12 years, it was double in comparison to final year medical students in year 2001. 13.2% were injured repeatedly. The score of knowledge was more the 50% of range but compliance to Standard Precaution made differences in being cases or non cases among respondents. The seroconversion status till date was unknown.
Background: A cross sectional study was carried out to identify the level and factors associated with patients’ satisfaction in antenatal clinic at Hospital Universiti Kebangsaan Malaysia.
Methods: A total of 150 respondents were selected by using convenience sampling method. Data was collected via structured questionnaire with face to face interview. The obtained data was analyzed by using SPSS version 11.5.
Results: Majority of the respondents were Malay (72%), while Chinese (18%) and Indian (10%).
Age of the respondents around 19 to 40 years old with tertiary education level (50.7%) and most of them are working (76.4%). More than half of the respondents were satisfied with the service that they received (56.7%), while the others (43.3%) not satisfied. Generally, most of the respondents were satisfied with interpersonal aspects from the staff (62%), technical quality of the doctors (79.3%), efficacy (78%), availability (50.7%), and the financial aspect (70%). Meanwhile, the respondents were not satisfied with the several aspects i.e. accessibility (61.3%), convenience (51.3%), and continuity of care (81.3%). In bivariate analysis, the result of this study showed that there were only two factors significantly related with level of satisfaction (p
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Background : Two of the most common indicators of institutional healthcare quality are Hospital Accreditation Status and Patient Satisfaction. However, the relationship between them is not well understood. In Malaysia, only 20.48% hospitals have been accredited. This is very much less compared to hospitals in America, Europe, Australia and certain Asian countries whereby 90% of their hospitals have already been accredited.
Objective : The objective of this study was to compare the extent to which a patient’s satisfaction is related to hospital accreditation status, to examine the relationship between patient satisfaction and hospital work load and to determine factors that influence patients’ satisfaction.
Methodology : A cross-sectional study was conducted whereby 150 patients from each accredited and non-accredited hospital involved in this study group giving a total of 300 samples. `SERVQUAL’ instrument was used in this study. Patients were interviewed at 2 different times - during admission and upon discharge.
Result : Results showed 34.7% patients were satisfied with services in accredited hospital and 30.6% patients were satisfied with services in non-accredited hospital. `Corporate Culture’ component showed the lowest satisfaction score among the entire dimension in both categories hospitals. Patient satisfaction was noted to be reduced with increase in hospital work load. Other factors which significantly influence patient satisfaction include level of education, employment status and patient income. There was no significant difference in patient satisfaction between accredited and non-accredited hospital in all dimension measured.
Conclusion : Therefore there is no difference of patients’ satisfaction with regards to services provided by accredited and non-accredited hospitals.
Objective :This study was performed to determine changes in diet and lifestyle among breast cancer survivors in Malaysia.
Methods :This was a qualitative study done on fifteen survivors (8 Malays and 7 non-Malays) obtained from the Oncology and Surgery Department, National University of Malaysia Hospital. The study was conducted using a semi-structured interview format. The data obtained were sorted into various categories via content analysis.
Results :Majority of breast cancer survivors increased their fruit and vegetable intake following diagnosis. Some non-Malays changed to vegetarian whereas all the Malays remained on the same dietary pattern. As far as exercise was concerned, all Malays did not exercise before diagnosis, but did so after diagnosis, whereas most of non- Malays did not exercise either before or after diagnosis.
Conclusion : Some changes were noticed in dietary and lifestyle behaviors after diagnosis among some survivors. The differences were due to their different cultural and religious backgrounds.
Introduction : The purpose of this study is to explore the differences of quality of life (QOL) of Malay and non-Malay breast cancer survivors using qualitative method.
Methods : Data was collected using in-depth face to face interview. List of the patients were obtained from Oncology & Surgery Departments and contact numbers were obtained from the medical record. The interviews were conducted either in their home or in the hospital after the appointment has been made.
Results : The majority of the Malays were unable to fulfill the needs of their families. However, the non-Malays were able to fulfill the needs of their families. The majority were satisfied with social interaction and the relationships with their families and friends. In terms of feelings, most survivors felt sad, angry and sometimes they feel like they were going to die early. However the majority coped well with their illness. Regarding sleep, all Malays did not have any sleeping problems, but most of the non-Malays reported serious problems. All survivors were worried about the other female members of the family of getting the same illness. Most survivors did not have any problems with altered body image.
Conclusion : Malays did not have any sleeping problems, but most of the non-Malays reported serious problems. However, the majority of survivors coped well with their illnesses.
Floods are natural disasters that occur without much warning. Natural disasters can result in negative impact due to highly stressful event. Floods can cause mental and emotional disorders to the victims and could also induce stress and trauma either in the short or long terms. This research was carried out to recognize the psychological sequelae of floods and how to overcome them. This study describes the cross sectional descriptive pattern of flood victims in Johor. The DASS Test Questionnaire which is a measurement tool endorsed by the Family Development Institute, Ministry of Health Malaysia was used. We carried out the research in 3 districts of Johor which were the worst hit areas by the flood disaster. Twenty-three percent of the participants were males while 77% were females. The DASS Test Questionnaire showed that 13% were mildly depressed, 7% moderately depressed and 3% were severely depressed. It also revealed that 22% were mildly anxious, 19% moderately anxious, 5% severely anxious and 4% had very severe anxiety. On the stress scores, 15% suffered mild stress, 11% were moderately stressed while 2% were severely stressed. A committee to conduct the motivation programme for the state of Johor was formed by Jabatan Kesihatan Negeri Johor with the cooperation of the PROKEM committee from Hospital Permai, Johor Bahru. This committee headed by the Deputy Director of Health (Medical Division) attempted to overcome the psychological sequelae suffered by flood victims. The activities conducted by the PROKEM staff and staff from the Ministry of Health were monitored by the committee based at Hospital Permai, Johor Bahru. The Bilik Gerakan was in operation for 24 hours a day with meetings conducted every morning and evening to brief and debrief members of staff who were going to carry out the motivation programme. Feedback was also obtained from staff on their return from the various relief centres.
Introduction : Stillbirth is one of the important adverse pregnancy outcomes that has been used as a health indicator for the measurement of the health status of a country especially for its obstetric care management. However, the aetiology of the occurrence of the stillbirth was commonly difficult to identify because of limitations in the classification system.
Methods : A review of existing, available information published up to January 2007 on stillbirths in Malaysia was used to obtain the basic background on the determinant factors of stillbirths. Results : Malaysia, which is a fast developing country, reported a stillbirth rate in the range of 4 to 5 per 1000 births. Almost 30- 40% were recorded as normally formed macerated stillbirths. This was based on a rapid reporting system of perinatal deaths using the modified version of the Wigglesworth’s pathophysiology classification. Those of extreme maternal age (less than 19 years and more than 35 years), those reside in rural areas, of the ‘Bumiputera’ and Indian ethnic groups were at higher risk of stillbirth. On detailed analysis it was seen that the risks of having a normally formed macerated stillbirth increased among those who had a preterm delivery and hypertension. Stillbirth rates were also higher in those with shorter gestational age and in those with parity between 2 and 5. No other factors related to stillbirth were found in this review.
Conclusion : This is a review based on existing published data which has a lot of limitation when it comes to analysing other important factors that might be related with the risk of the stillbirth. However, extreme maternal age and mothers from rural areas are the two factors that were persistently found in almost all literature. When these factors are combined with signs of pre term delivery, they indicate that close monitoring needs to be done.
Background : Anemia in pregnancy is a worldwide problem. Ministry of Health Malaysia has conducted prophylaxis program to distribute hematinic pills to pregnant women since 3 decades ago.
Methodology : A cross sectional study was conducted among pregnant women who attended government health clinics in Johor Bahru district to assess the prevalence of taking iron tablet and factors associated with it by using a structured questionnaire.
Result : Prevalence of respondents taking ferrous pill daily was 68.6%. Anemia prevalence found in this study was 37.5%. Majority of the respondents did not take pills regularly said their reason as forgotten(54.0%), side effects caused by taking pill (39.3%) and did not like the taste (6.7%). The haemoglobin mean was directly inclined with frequency of ferrous pill intake. The significant associated factor in taking iron pill was only frequency of drinking tea. Multivariate logistic regression analyses revealed that drinking tea was the only factor that contributing to iron pills consumption.
Conclusion : Education is the most important factor in improving adherence to iron pill. Besides that, motivation and behaviour modification of pregnant women also needs to be taken into account.
Introduction: Diabetes Mellitus is a chronic disease and major cause of chronic renal disease. Chronic renal disease can be prevented if known risk factors were been early detected. Albuminuria is the earliest clinical evidence of chronic renal disease. Objectives of this study is to identify the incidence of albuminuria and relationship between albuminuria with socio demographic and clinical factors such as blood sugar control, blood pressure control, excessive body mass index and hypercholesterolemia.
Methodology: Data been collected from patient’s record that been regularly follow up at Primary Healthcare Clinics in Negeri Sembilan. Duration of study follow up was from the date of they been diagnosed of Diabetes Mellitus Type 2 until detection of albuminuria or 1st July 2007,end date of data collection then survival analysis been done.
Result: Majority of study population was female 60.9% and Malay 69.7%. Mean age was 59.9 ± 10.7 and duration having Diabetes Mellitus was 7.0 ± 6.3 years. Only 22% achieved optimum glucose (HbA1c < 6.5%), controlled blood preassure 130/80 mmHg 42.3%, level of cholesterol <4.5 mmol/L only 22.7 %, 11.4% of patients having ideal body weight < 23 kg/m2. The incidence of Diabetes Mellitus Type 2 was 24.4 cases per 1000 population. The median of follow up duration was 22 years; with minimum follow up was 7 months and maximum 42 years. Survival analysis showed that the median of free albuminuria among cases was 22 years (CI 95%:16.5 – 27.4). The log rank test showed no significant relationship between high blood pressure, excessive body mass index and hypercholesterolemia with albuminuria. This study noted that the occurrence of albuminuria seems to be higher among those were hypertensive (26.6%), and excessive body mass index (24.7%).
Conclusion: Percentage of Diabetes Mellitus Type 2 patient that achieved optimum clinical target still very low. Early detection of albuminuria is very important as preventive measure of diabetes nephropathy. Good blood pressure control and ideal body weight also prevent of occurring diabetes nephropathy complication.
Keywords: Diabetes Mellitus Type 2, albuminuria, survival analysis.
Introduction : The purpose of this study was to determine the quality of life (QOL) of breast cancer survivors based on socio-demographic and clinical characteristics.
Methods : A cross-sectional study was performed on 125 breast cancer survivors from the outpatient clinics. FACT-B (Functional Assessment of Cancer Therapy-Breast) questionnaire was used to assess survivors’ QOL.
Results : Survivors with low body mass index (BMI) (underweight) were found to have the lowest overall QOL. Those who were overweight had a higher overall QOL, and those who were normal-weight had the highest QOL. Low educational level, being underweight and low monthly household income were significantly associated with lower overall QOL Tamoxifen use and employment status were significantly associated with QOL in some domains. Time since diagnosis to QOL interview was significantly associated with greater scores in emotional well-being (EWB). Multiple linear regression indicated that age, marital status, monthly household income, surgery and histological grade were indicative of the patients QOL.
Conclusion : The four primary factors related to better QOL were high educational level, high income, normal body weight and greater duration from the time of diagnosis to the time of interview. Age, marital status, income, lumpectomy and histological grade were indicative of the patient QOL.
Study site: Oncology and Surgical clinics; Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Background : The worldwide prevalence of diabetes is increasing, as is the demand for and cost of medical care. Diabetic Mellitus (DM) prevalence in Malaysia rose from 6.3% of the population in 1986 to 8.3% in 1996 and costs need to be managed more effectively.
Objective : To estimate the financial burden of diabetic care, including providers’ and patients’ costs in government facilities in Selangor and to determine factors influencing cost of diabetic care.
Methodology : A cross-sectional study was conducted from September to November 2005 among Hospitals with and without Specialist and Health Clinics. Total sample of 361 subjects with type 2 diabetes representing both inpatient and outpatient were chosen randomly. Results were analyzed using SPSS version 13.0.
Results : The average cost for a diabetic patients’ admission in a Hospital with Specialist was RM1951 and RM1974 for patient admitted in a Hospital without Specialist and these cost difference was not statistically significant (p>0.05). Providers’ mean cost for outpatient care was RM772.69 and RM761.07 respectively for Hospital with Specialist and Hospital without Specialist per year. As for the health clinics the average providers’ cost for a patient was RM385.92 per year. The cost difference was statistically significant (p0.05). The mean total costs of outpatient care were RM841.46, RM832.80 and RM458.01 per year for Hospital with Specialist, Hospital without Specialist and Health Clinics respectively. Level of care and length of stay were the influencing factors for inpatient provider’s cost. The overall provider’s cost for outpatient diabetic care was influenced by level of care, number of visits and complications. Cost of treating diabetes mellitus year 2004, was estimated at RM18,956,021.51 which was equivalent to 3.3% of total state health expenditure.
Conclusion : As much as 60.2 % was spent on management of outpatient diabetic care and 39.8% for management of inpatient diabetic care. Financial burden of diabetic care is predominantly for outpatient care. Therefore, effective and efficient management of outpatient care is needed to improve allocate efficiency, equity, accessibility and appropriateness of the health care system so that the health care services delivered to the nation are of good quality.
Objective : This scientific writing is meant for describing the problems faced by pharmacy staffs during heavy flood situations in Johore and the actions to be taken for solving these problems.
Methodology : This finding is in accordance to the observations, experiences and interview of staffs (through questionnaires), who are involved directly and indirectly in preparations of emergency during flood. Efficiency of pharmaceutical services provided during flood is evaluated.
Result : Several problems were identified when providing pharmaceutical services, such as purchasing and supplying of items, pre-packing, preparing drug charts, visit to relief centers, post-flood health campaign, and doctors from NGOs prescibing medicines out of MOH drug formulary. During the period of flood, usage of drug and non-drug items increases drastically resulting in the current stock in store were not sufficient to compensate for the high demand. Moreover, inaccessibility of certain roads in districts such as Segamat and Kota Tinggi, aggravated and worsen the problems of obtaining goods from suppliers. Workload of pharmacy staffs increased especially in activities such as pre-packing and preparing drug charts due to shortage of manpower.
Conclusion : Even though workload increased drastically during flood, pharmaceutical services provided by the state pharmacy are still able to maintain good quality services to cater for the need of healthcare professionals and patients. Throughout the flood period, all the difficulties and hurdles faced by us had been solved; due to the cooperation from other agencies. Besides, by writing this article, a disaster preparedness guideline is produced for the purpose of improving management of future disasters.