Displaying publications 61 - 80 of 227 in total

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  1. Noh NA, Wahab HA, Bakar Ah SH, Islam MR
    Soc Work Public Health, 2016 Aug-Sep;31(5):419-30.
    PMID: 27177326 DOI: 10.1080/19371918.2015.1125321
    The objective of this study was to know the status of the foreign workers' access to public health services in Malaysia based on their utilization pattern. The utilization pattern covered a number of areas, such as frequency of using health services, status of using health services, choice and types of health institutions, and cost of health treatment. The study was conducted on six government hospitals in the Klang Valley area in Kuala Lumpur, Malaysia. Data were collected from 600 foreign patients working in the country, using an interview method with a structured questionnaire. The results showed that the foreign workers' access to public health services was very low. The findings would be an important guideline to formulate an effective health service policy for the foreign workers in Malaysia.
    Matched MeSH terms: Health Services Accessibility*
  2. Masood M, Sheiham A, Bernabé E
    PLoS One, 2015;10(4):e0123075.
    PMID: 25923691 DOI: 10.1371/journal.pone.0123075
    This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries) who participated in the WHO World Health Survey (WHS) were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or higher than 40% of the household capacity to pay. A number of individual and country-level factors were assessed as potential determinants of catastrophic dental health expenditure (CDHE) in multilevel logistic regression with individuals nested within countries. Up to 7% of households in low and middle income countries faced CDHE in the last 4 weeks. This proportion rose up to 35% among households that incurred some dental health expenditure within the same period. The multilevel model showed that wealthier, urban and larger households and more economically developed countries had higher odds of facing CDHE. The results of this study show that payments for dental health care can be a considerable burden on households, to the extent of preventing expenditure on basic necessities. They also help characterize households more likely to incur catastrophic expenditure on dental health care. Alternative health care financing strategies and policies targeted to improve fairness in financial contribution are urgently required in low and middle income countries.
    Study name: World Health Survey (Malaysia is a study site)
    Matched MeSH terms: Health Services Accessibility/economics
  3. Soc Mark Forum, 1984;1(4):1,5.
    PMID: 12266328
    Matched MeSH terms: Health Services Accessibility*
  4. Poi PJ, Forsyth DR, Chan DK
    Age Ageing, 2004 Sep;33(5):444-6.
    PMID: 15315917
    Matched MeSH terms: Health Services Accessibility/trends
  5. Rodríguez G
    Fam Plann Perspect, 1979 Jan-Feb;11(1):51-70.
    PMID: 421882
    Analysis of World Fertility Survey data from five countries--Colombia, Costa Rica, Korea, Malaysia and Nepal--shows that the availability of contraceptive services and supplies is a major determinant of use. In Nepal, where few women know where to obtain supplies, only two percent are contracepting. In Costa Rica, where almost all married women know an outlet nearby, 53 percent use effective methods.
    Matched MeSH terms: Health Services Accessibility*
  6. van der Eng P, Sohn K
    Econ Hum Biol, 2019 08;34:216-224.
    PMID: 30551996 DOI: 10.1016/j.ehb.2018.11.004
    This article analyses long-term changes in the mean age at menarche (MAM) as a biological indicator of changes in the standard of living in Indonesia. It finds that MAM was about 15.5 for birth cohorts in the late-19th century, decreasing to 14.5 by the 1930s, at which level it stagnated until the gradual decrease resumed since the early 1960s to around 12.5 in the mid-2000s. The article considers that long-term improvements in nutrition, educational attainment and health care explain these trends. An international comparison of long-term changes finds that MAM in Indonesia was much lower than in Korea and China until respectively 1970 and 1990, but comparable to Japan until 1950 and to Malaysia until 1930. The article presents reasons why these differences are unlikely to be related to dissimilarities in climate and ethnicity, and concludes that they are indicative of relative standards of living.
    Matched MeSH terms: Health Services Accessibility/statistics & numerical data
  7. Schaubel DE, Stewart DE, Morrison HI, Zimmerman DL, Cameron JI, Jeffery JJ, et al.
    Arch. Intern. Med., 2000 8 6;160(15):2349-54.
    PMID: 10927733 DOI: 10.1001/archinte.160.15.2349
    BACKGROUND: Men in the United States undergoing renal replacement therapy are more likely than women to receive a kidney transplant. However, the ability to pay may, in part, be responsible for this finding.

    OBJECTIVE: To compare adult male and female transplantation rates in a setting in which equal access to medical treatment is assumed.

    METHODS: Using data from the Canadian Organ Replacement Register, the rate of first transplantations was computed for the 20, 131 men and the 13,458 women aged 20 years or older who initiated renal replacement therapy between January 1, 1981, and December 31, 1996. Poisson regression analysis was used to estimate the male-female transplantation rate ratio, adjusting for age, race, province, calendar period, underlying disease leading to renal failure, and dialytic modality. Actuarial survival methods were used to compare transplantation probability for covariable-matched cohorts of men and women.

    RESULTS: Men experienced 20% greater covariable-adjusted kidney transplantation rates relative to women (rate ratio, 1.20; 95% confidence interval, 1.13-1.27). The sex disparity was stronger for cadaveric transplants (rate ratio, 1.23) compared with those from living donors (rate ratio, 1.10). The 5-year probability of receiving a transplant was 47% for men and 39% for women within covariable-matched cohorts (P
    Matched MeSH terms: Health Services Accessibility/statistics & numerical data
  8. Cheong WL, Mohan D, Warren N, Reidpath DD
    Mult Scler Relat Disord, 2019 Oct;35:86-91.
    PMID: 31357123 DOI: 10.1016/j.msard.2019.07.009
    BACKGROUND: Despite the global consensus on the importance of palliative care for patients with multiple sclerosis (MS), many patients in developing countries do not receive palliative care. Improving access to palliative care for MS requires a contextual understanding of how palliative care is perceived by patients and health professionals, the existing care pathways, and barriers to the provision of palliative care.

    OBJECTIVE: This study aims to examine and contrast the perceptions of MS patients, neurologists, and palliative care physicians towards providing palliative care for patients with MS in Malaysia.

    METHODS: 12 MS patients, 5 neurologists, and 5 palliative care physicians participated in this qualitative study. Each participant took part in a semi-structured interview. The interviews were transcribed verbatim, and analysed using an iterative thematic analysis approach.

    RESULTS: Patients and neurologists mostly associated palliative care with the end-of-life and struggled to understand the need for palliative care in MS. Another barrier was the lack of understanding about the palliative care needs of MS patients. Palliative care physicians also identified the scarcity of resources and their lack of experience with MS as barriers. The current referral-based care pathway itself was found to be a barrier to the provision of palliative care.

    CONCLUSIONS: MS patients in Malaysia face several barriers in accessing palliative care. Overcoming these barriers will require improving the shared understanding of palliative care and its role in MS. The existing care pathway also needs to be reformed to ensure that it improves access to palliative care for MS patients.

    Matched MeSH terms: Health Services Accessibility*
  9. Fadzil F, Jaafar S, Ismail R
    Prim Health Care Res Dev, 2020 02 24;21:e4.
    PMID: 32090729 DOI: 10.1017/S146342362000002X
    This paper illustrates the development of Primary Health Care (PHC) public sector in Malaysia, through a series of health reforms in addressing equitable access. Malaysia was a signatory to the Alma Ata Declaration in 1978. The opportunity provided the impetus to expand the Rural Health Services of the 1960s, guided by the principles of PHC which attempts to address the urban-rural divide to improve equity and accessibility. The review was made through several collation of literature searches from published and unpublished research papers, the Ministry of Health annual reports, the 5-year Malaysia Plans, National Statistics Department, on health systems programme and infrastructure developments in Malaysia. The Public Primary Care Health System has evolved progressively through five phases of organisational reforms and physical restructuring. It responded to growing needs over a 40-year period since the Alma Ata Declaration in 1978, keeping equity, accessibility, efficiency and universal health coverage consistently in the backdrop. There were improvements of maternal, infant mortality rates as well as accessibility to health services for the population. The PHC Reforms in Malaysia are the result of structured and strategic investment. However, there will be continuing dilemma between cost-effectiveness and equity. Hence, continuous efforts are required to look at opportunity costs of alternative strategies to provide the best available solution given the available resources and capacities. While recognising that health systems development is complex with several layers and influencing factors, this paper focuses on a small but crucial aspect that occupies much time and energies of front-line managers in the health.
    Matched MeSH terms: Health Services Accessibility*
  10. Kosiyaporn H, Julchoo S, Phaiyarom M, Sinam P, Kunpeuk W, Pudpong N, et al.
    Glob Health Res Policy, 2020 12 08;5(1):53.
    PMID: 33372646 DOI: 10.1186/s41256-020-00181-0
    BACKGROUND: In addition to healthcare entitlements, 'migrant-friendly health services' in Thailand include interpretation and cultural mediation services which aim to reduce language and cultural barriers between health personnel and migrants. Although the Thai Government started implementing these services in 2003, challenges in providing them still remain. This study aims to analyse the health system functions which support the interpretation and cultural mediation services of migrant health worker (MHW) and migrant health volunteer (MHV) programmes in Thailand.

    METHODS: In-depth interviews were conducted in two migrant-populated provinces using purposive and snowball sampling. A total of fifty key informants were recruited, including MHWs, MHWs, health professionals, non-governmental organisation (NGO) staff and policy stakeholders. Data were triangulated using information from policy documents. The deductive thematic analysis was classified into three main themes of evolving structure of MHW and MHV programmes, roles and responsibilities of MHWs and MHVs, and supporting systems.

    RESULTS: The introduction of the MHW and MHV programmes was one of the most prominent steps taken to improve the migrant-friendliness of Thai health services. MHWs mainly served as interpreters in public facilities, while MHVs served as cultural mediators in migrant communities. Operational challenges in providing services included insufficient budgets for employment and training, diverse training curricula, and lack of legal provisions to sustain the MHW and MHV programmes.

    CONCLUSION: Interpretation and cultural mediation services are hugely beneficial in addressing the health needs of migrants. To ensure the sustainability of current service provision, clear policy regulation and standardised training courses should be in place, alongside adequate and sustainable financial support from central government, NGOs, employers and migrant workers themselves. Moreover, regular monitoring and evaluation of the quality of services are recommended. Finally, a lead agency should be mandated to collaborate with stakeholders in planning the overall structure and resource allocation for the programmes.

    Matched MeSH terms: Health Services Accessibility/statistics & numerical data*
  11. Lim SC, Yap YC, Barmania S, Govender V, Danhoundo G, Remme M
    Sex Reprod Health Matters, 2020 Dec;28(2):1842153.
    PMID: 33236973 DOI: 10.1080/26410397.2020.1842153
    Despite increasing calls to integrate and prioritise sexual and reproductive health (SRH) services in universal health coverage (UHC) processes, several SRH services have remained a low priority in countries' UHC plans. This study aims to understand the priority-setting process of SRH interventions in the context of UHC, drawing on the Malaysian experience. A realist evaluation framework was adopted to examine the priority-setting process for three SRH tracer interventions: pregnancy, safe delivery and post-natal care; gender-based violence (GBV) services; and abortion-related services. The study used a qualitative multi-method design, including a literature and document review, and 20 in-depth key informant interviews, to explore the context-mechanism-outcome configurations that influenced and explained the priority-setting process. Four key advocacy strategies were identified for the effective prioritisation of SRH services, namely: (1) generating public demand and social support, (2) linking SRH issues with public agendas or international commitments, (3) engaging champions that are internal and external to the public health sector, and (4) reframing SRH issues as public health issues. While these strategies successfully triggered mechanisms, such as mutual understanding and increased buy-in of policymakers to prioritise SRH services, the level and extent of prioritisation was affected by both inner and outer contextual factors, in particular the socio-cultural and political context. Priority-setting is a political decision-making process that reflects societal values and norms. Efforts to integrate SRH services in UHC processes need both to make technical arguments and to find strategies to overcome barriers related to societal values (including certain socio-cultural and religious norms). This is particularly important for sensitive SRH services, like GBV and safe abortion, and for certain populations.
    Matched MeSH terms: Health Services Accessibility*
  12. Teo CH, Ng CJ, Booth A, White A
    Soc Sci Med, 2016 09;165:168-176.
    PMID: 27511617 DOI: 10.1016/j.socscimed.2016.07.023
    RATIONALE: Men have poorer health status and are less likely to attend health screening compared to women.

    OBJECTIVE: This systematic review presents current evidence on the barriers and facilitators to engaging men in health screening.

    METHODS: We included qualitative, quantitative and mixed-method studies identified through five electronic databases, contact with experts and reference mining. Two researchers selected and appraised the studies independently. Data extraction and synthesis were conducted using the 'best fit' framework synthesis method.

    RESULTS: 53 qualitative, 44 quantitative and 6 mixed-method studies were included. Factors influencing health screening uptake in men can be categorized into five domains: individual, social, health system, healthcare professional and screening procedure. The most commonly reported barriers are fear of getting the disease and low risk perception; for facilitators, they are perceived risk and benefits of screening. Male-dominant barriers include heterosexual -self-presentation, avoidance of femininity and lack of time. The partner's role is the most common male-dominant facilitator to screening.

    CONCLUSIONS: This systematic review provides a comprehensive overview of barriers and facilitators to health screening in men including the male-dominant factors. The findings are particularly useful for clinicians, researchers and policy makers who are developing interventions and policies to increase screening uptake in men.

    Matched MeSH terms: Health Services Accessibility/standards*
  13. Lim KK, Sivasampu S, Mahmud F
    Aust J Rural Health, 2017 Apr;25(2):102-109.
    PMID: 27377781 DOI: 10.1111/ajr.12298
    OBJECTIVE: To examine the extent of equity in access to health care, their determinants and reasons of unmet need of a rural population in Malaysia.

    DESIGN: Exploratory cross-sectional survey administered by trained interviewers among participants of a health screening program.

    SETTING: A rural plantation estate in the West Coast of Peninsular Malaysia.

    PARTICIPANTS: One hundred and thirty out of 142 adults above 18 years old who attended the program.

    MAIN OUTCOME MEASURE: Percentages of respondents reporting realised access and unmet need to health care, determinants of both access indicators and reasons for unmet need. Realised access associated with need but not predisposing or enabling factors and unmet need not associated with any variables were considered equitable.

    RESULTS: A total of 88 (67.7%) respondents had visited a doctor (realised access) in the past 6 months and 24.8% (n = 31) experienced unmet need in the past 12 months. Using logistic regression, realised access was associated with presence of chronic disease (OR 6.97, P health status (OR 6.03, P  RM 2000 per month) (OR 51.27, P health status and income. Despite not being generalisable, the findings highlight the need for a national level study on equity in access before the country reforms its health system.

    Matched MeSH terms: Health Services Accessibility*
  14. Aidalina M, Syed Mohamed ASJ
    Med J Malaysia, 2018 08;73(4):202-211.
    PMID: 30121682 MyJurnal
    INTRODUCTION: This review aimed to summarise the trend of mammogram screening uptake published in local studies between years 2006 and 2015 among the Malaysian women aged 40 years and above, and identify the associated factors and barriers, as well as discuss limitations of the studies and research gaps.

    METHODS: A systematic review was conducted on breast cancer screening studies among Malaysian women, published between January 2006 and December 2015. Online databases were searched using keywords: "mammogram", "mammography", "uptake", "breast cancer screening" and "Malaysia".

    RESULTS: Thirteen original articles were reviewed. The rate of mammography uptake ranged between 3.6% and 30.9% among the general population, and 80.3% among personnel of a tertiary hospital. Factors associated with mammogram screening were clinical breast examination, age, income, knowledge on breast cancer and mammogram, perceived susceptibility to breast cancer, ethnicity and education level. Barriers to mammogram screening were lack of knowledge, embarrassment, fear of cancer diagnosis, perception that breast screening was unnecessary, lack of coping skills and pain during procedure. However, almost all of the studies could not be generalised beyond the study sample because of the limited number of sites and respondents; and most data were self-reported with no objective measures of the responses.

    CONCLUSION: Mammogram screening uptake among women in selected communities were generally low. Further studies involving the general population are essential. Future studies should also explore the availability, affordability and accessibility of this service especially in the pursuit of achieving universal health coverage in breast cancer management.

    Matched MeSH terms: Health Services Accessibility/statistics & numerical data
  15. Chuah FLH, Tan ST, Yeo J, Legido-Quigley H
    Int J Equity Health, 2018 08 15;17(1):120.
    PMID: 30111329 DOI: 10.1186/s12939-018-0833-x
    BACKGROUND: In Malaysia, refugees and asylum-seekers are a vulnerable group that often face circumstances in which their health and wellbeing can be compromised. This qualitative study sought to examine the key health concerns and barriers to healthcare access among refugees and asylum-seekers in Malaysia through the lens of healthcare professionals, program staff and experts on refugee and migrant health.

    METHODS: We conducted 20 semi-structured in-depth interviews with experts, healthcare professionals, program managers or executives from UN agencies, public healthcare facilities, civil society organizations, and academic institutions in Malaysia. Interviews were transcribed and analyzed both deductively and inductively using thematic analysis.

    RESULTS: Participant narratives highlight that the health needs of refugees and asylum-seekers in Malaysia are complex. As reported, access to healthcare is underpinned by numerous social, cultural and economic determinants compounded by a legal environment that lacks inclusivity of refugees and asylum-seekers. Apart from the health risks associated with the migration process, limited access to comprehensive healthcare post-arrival remain a problem for refugees and asylum-seekers in Malaysia. Key barriers to healthcare access are linked to poor health literacy and the lack of awareness on one's right to healthcare; language and cultural differences; protection issues resulting from a lack of legal status; and an inability to afford healthcare due to inadequate livelihoods. Overall, poor access to healthcare is perceived to have detrimental consequences on the health status of refugees, asylum-seekers and its host population, and may incur greater costs to the health system in the long run.

    CONCLUSION: Comprehensive efforts in practice and research that tackle the social, cultural and economic determinants of health, and more inclusive health policies are crucial in strengthening healthcare access among refugees and asylum-seekers in Malaysia. Practical recommendations include improving the health literacy of refugees and asylum-seekers for better navigation of the health system; bridging language and cultural gaps through translation support and inter-cultural orientation; implementing policies grounded in the right to healthcare for all regardless of legal status and in the interest of public health; and establishing a larger evidence base to drive policy development and implementation for refugee health within the Malaysian context.

    Matched MeSH terms: Health Services Accessibility/statistics & numerical data*
  16. Omar Daw Hussin E, Wong LP, Chong MC, Subramanian P
    J Clin Nurs, 2018 Feb;27(3-4):e688-e702.
    PMID: 29076190 DOI: 10.1111/jocn.14130
    AIMS AND OBJECTIVES: To examine nurses' perceptions of barriers to and facilitators of end-of-life care, as well as their association with the quality of end-of-life care.

    BACKGROUND: Often, dying patients and their families receive their care from general nurses. The quality of end-of-life care in hospital wards is inadequate.

    METHOD: A self-administered questionnaire was completed by 553 nurses working in a tertiary teaching hospital in Malaysia.

    RESULTS: The barrier with the highest mean score was "dealing with distressed family members." The facilitator with the highest mean score was "providing a peaceful and dignified bedside scene for the family once the patient has died." With regard to barrier and facilitator categories, the barrier category with the highest total mean score was patient-related barriers and the facilitator category with the highest total mean score concerned facilitators related to healthcare professionals. In the multivariate analysis, age, patient family-related barriers and healthcare professional-related facilitators significantly predict the quality of end-of-life care.

    CONCLUSION: The results of this study suggest that there is an urgent need to overcome barriers related to the patient and family members that hinder the quality of care provided for dying patients, as well as to enhance and implement the facilitators related to healthcare providers. In addition, there is also a need to enhance the quality of end-of-life care provided by younger nurses through end-of-life care courses and training.

    RELEVANCE TO CLINICAL PRACTICE: Helping nurses overcome barriers and implement facilitators may lead to enhanced quality of care provided for dying patients.

    Matched MeSH terms: Health Services Accessibility*
  17. Mortell M, Abdullah KL, Ahmad C
    Br J Nurs, 2017 Sep 28;26(17):965-971.
    PMID: 28956990 DOI: 10.12968/bjon.2017.26.17.965
    AIM: To explore the perceptions of patient advocacy among Saudi Arabian intensive care unit (ICU) nurses.

    BACKGROUND: Despite advocacy being a crucial role for nurses, its scope is often limited in clinical practice. Although numerous studies have identified barriers to patient advocacy, their recommendations for resolution were unclear.

    METHOD: The study employed a constructivist grounded theory methodology, with 13 Saudi Arabian registered nurses, working in critical care, in a tertiary academic teaching hospital. Semi-structured interviews, with broad open-ended questions, and reflective participant journals were used to collect data. All interviews were concurrently analysed and transcribed verbatim.

    RESULTS: Gender, culture, education, subjugation, communal patronage, organisational support and repercussions, and role-associated risks were all revealed as factors affecting their ability to act as advocates for critically ill patients.

    CONCLUSION: Saudi Arabian ICU nurses in the study believed that advocacy is problematic. Despite attempting to advocate for their patients, they are unable to act to an optimal level, instead choosing avoidance of the potential risks associated with the role, or confrontation, which often had undesirable outcomes. Patient advocacy from a Saudi Arabian nursing perspective is contextually complex, controversial and remains uncertain. Further research is needed to ensure patient safety is supported by nurses as effective advocates.

    Matched MeSH terms: Health Services Accessibility*
  18. Gan SY, Saedon NI, Sukanya S, Fairuz NHA, Sakinah SMN, Fatin NIAH, et al.
    Med J Malaysia, 2017 08;72(4):203-208.
    PMID: 28889130 MyJurnal
    No abstract available.
    Matched MeSH terms: Health Services Accessibility/organization & administration
  19. Bemma A
    Lancet, 2018 01 13;391(10116):107-108.
    PMID: 29353607 DOI: 10.1016/S0140-6736(18)30052-7
    Matched MeSH terms: Health Services Accessibility/organization & administration*
  20. Shahar S, Lau H, Puteh SEW, Amara S, Razak NA
    BMC Public Health, 2019 Jun 13;19(Suppl 4):552.
    PMID: 31196021 DOI: 10.1186/s12889-019-6852-8
    The current issue of BMC Public Health presents work by the Consortium of Low Income Population Research (CB40R), highlighting a comprehensive aspect of health, i.e., physical health, mental health, health behaviour and health financing; and also nutrition involving all stages of lifespan of the socioeconomic deprived group in Malaysia.Consortium of B40 Research (CB40R) reposited and harmonised shared, non-identifiable data from epidemiological studies involving low income population (B40) in Malaysia. CB40R also performed joint or mega-analyses using combined, harmonised data sets that yield collated results with enhanced statistical power, more variabilities (study population, geographical regions, ethnicities and sociocultural groups) to better understand the needs, characteristics and issues of B40 groups in Malaysia. It also aimed to develope a system/framework of minimum/standard variables to be collected in research involving B40 in future. For this special issues, members of the consortium have been invited to contribute an original article involving analysis of the health aspects, access to health and nutritional issues of the B40 samples.All the papers in this special issue have successfully highlighted the health and nutritional issues (i.e., non-communicable disease (NCD), inflammatory bowel disease (IBD), knowledge towards sexually transmitted disease (STD), low birth weight, Motoric Cognitive Risk (MCR) syndrome, urinary incontinence), mental health, oral health and inequalities among the low-income group in Malaysia, including the rural population and also the urban poor. The low-income population in Malaysia is also at risk of both under- and over nutrition, of which specific cost effective strategies are indeed needed to improve their quality of life.The low income population in Malaysia is facing various health challenges, particularly related to NCD and poor mental health, nutritional and physical function. There is a need for a sustainable intervention model to tackle the issues. It is also important to highlight that reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health.
    Matched MeSH terms: Health Services Accessibility/trends*
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