This paper is based on literature review on the legal, political and social context of Malaysia regarding child welfare and social work. Children are an asset and younger generations will become the leaders of the country in future. In the Malaysian context, a variety of factors impact on how children are defined. These include the Islamic perspective, local cultural practices, approaches based on biological growth and relevant legislation. Such varying definitions can cause confusion in the application of law and could result in injustice. When talking regarding the social problems concerning children in Malaysia, there include abuse, neglect, abandonment of babies, street children, children beyond parental control, children involved with crime, underage marriage, prostitution and child trafficking.However, the shortage of professional social workers who can effectively manage abuse and child neglect cases is a serious problem.
One of the hardest challenges in marriage are how to face negative thoughts that arised from difficult
situations such as feeling inferior, abandoned, mistrust, and excessive jealousy. From the Cognitive-
Behavioral perspective, these feelings are being exacerbated by unhealthy individual thought patterns
originating from society and family upbringing. This article discusses the unhealthy thought patterns
that are common in marriage, and strategies in changing these thought patterns by using healthy
templates of Islamic thought patterns.
Background and Objectives: Unmet need for contraception is the gap between women's reproductive intentions and their contraceptive behavior. This community based interventional study was carried out to determine the unmet needs for contraception, the reasons for this and to assess the impact of interventional measures on acceptance of contraception.
Subjects and Methods: This study was conducted in 52 villages in the state of Maharashtra, India, among 363 married women selected by cluster sampling. Data was collected using an interview guide. An intervention was done for the women who had an unmet need and an assessment of the change was done subsequently. Data was analyzed by using SPSS.
Results The prevalence of contraceptive usage was 59.2% and the prevalence of unmet need for contraception was 44% (160). The unmet need for spacing births was 53.8%, 38.7% for limiting births and 7.5% women were dissatisfied with the current contraceptive method. The reasons ranged from side effects to contraceptives to source of obtaining contraceptives. Age of the respondents, education and number of living children showed statistically significant association with unmet needs. Post intervention, the contraceptive prevalence rate increased significantly 85.7% and there was a significant reduction in the unmet needs for spacing and limiting births, equally there was a significant reduction of dissatisfaction with using contraception.
Conclusion: Improvement in the use of contraception and addressing the unmet need for contraception requires community involvement and ongoing, sustained efforts by health workers to ensure quality care to the beneficiaries.
Cervical cancer is the seventh most common cancer among women in Iraq. This study aimed to assess the factors influencing Pap smear practice among married primary school teachers in Diyala City, Iraq. A total of 222 teachers (aged 20 years to 63 years) residing in Diyala City were enrolled in a cross sectional study from 1st August till 30th September 2012. The sampling method was a self-administered survey using a multistage sampling technique. The prevalence of Pap smear practice was very low (12.6%). Relatives and friends were the main source of information about the Pap smear test for more than one third (41.9%) of the respondents. However, the medical doctor’s advice was the most important reason for undergoing a Pap smear test in more than two third (60.7%) of respondents. Only 32.4% of the teachers have good knowledge about cervical cancer and Pap smear test, but 76.1% of them showed a positive attitude toward learning about cervical cancer and Pap smear. Based on multiple logistic regression analysis results only the husband’s encouragement (p= 0.003, prevalence odds ratio [POR] = 0.256, 95%CI 0.10-0.63) was significantly associated with Pap smear practice. A more effective educational program is needed to educate Iraqi women about cervical cancer and screening tests, including Pap smear.
This study aims to explore the life experience of the husbands of women who survived breast cancer for more than five years following breast removal. Basic interpretative of qualitative methodology was applied in order to construct the phenomenon of breast cancer from the perspective of husbands. This approach allowed researchers to explore in-depth the experience of husbands in facing breast cancer of their wives. Four themes were identified. These are marital
challenges, pattern of life, supportive atmosphere and psychological defenses. Health strategies should direct the family member to the specific pathway in order to facilitate them towards the effective action of healthcare at their level. Evidence from this study is a direction for future research and health planning for better health policy.
Cancer of the cervix is the second most common cancer among Malaysian women. Pap smear screening can detect precursors of cervical cancer. This paper attempts to determine the factors that influence the uptake of Pap smear screening. This was a cross sectional study with 112 Malay women recruited from a public university. A questionnaire enquiring sociademographic characteristics and health seeking behaviour based on the Health Belief Model was modified, translated and pre·tested. Testeretest reliability was also conducted. The mean age of the participants was 35.8 + 9.1 years. Majority was married and had at least secondary education. Only 62% of them had ever undergone Pap smear screening. Multiple logistic regression analysis showed women who were married or divorced (OR: 50.79, 95% C1: 4.33; 596.36), older age (OR: 1.12, 95% CI: 1.03; 1.22) or perceived higher benefits of Pap smear (OR; 4.80, 95% CI: 1.14; 20.15)
were more lilcely to have undergone Pap smear screening. Measures in reducing barriers and educating the public on the benefits of Pap smear are strongly recommended.
Undergoing a Pap smear screening is widely accepted as a costeffective screening for detection of cervical abnormalities. In Peninsular Malaysia, cervical cancer was the second commonest cancer among women with incidence rate of 17.8 per 100,000 populations in 2002. Despite the high incidence of cervical cancer, only 26% of eligible woman had undergone Pap smear screening. To determine the prevalence of Pap smear screening, reasons for not undergoing the screening as well as the associated sociodemographic factors among women in Mukim Jaya Setia, a crass-sectional study was conducted in ]anuary 2005. Two hundred and ninety five from 350 households were randomly selected by using a Random Digit Table. Two hundred and eighty consented married women, aged 18 years and above were interviewed by the trained interviewers using structured
questionnaires. The questionnaires consisted of socio-demographic characteristic, Pap smear screening practice and risk factors of cervical cancer. There were 280 women who responded to the questionnaires. Majority of them were housewives (75%) and with low income (84.3%). Most ofthe women completed their education up to lower secondary school only (95%). Only 144 (51.4%) women undergo Pap smear screening but not on a regular basis. Most of them were screened only once, which was more than 3 years ago. Lack of knowledge, no accommodation, feel unnecessary and shy and no time were among the reasons that deterred the women from Pop smear screening. Women who were younger and with higher education level had more Pap smear screening compared to the older and with low education level. The practices of Pap smear screening among women in these villages were still low and was associated with age and educational level.
Hysterectomy is one of the most common non-obstetric surgical procedures performed on women. Little is known about the factors affecting decision making process regarding hysterectomy in Malaysia. The study aimed to explore factors affecting women decision regarding hysterectomy among Malaysian women. This study has enrolled 100 women eligible for hysterectomy in the department of general gynecology ward in the university of Malaya hospital, Malaysia. A structured questionnaire was administered by interview. Descriptive analysis was used to obtain the frequencies. Chi square test and simple logistic regression test were performed to assess the association between variables. The majority of participants aged 41-50 years (52%) and married (74%). Twenty seven out of 100 participants made their decision on the operation within one month while 73 women decided after one month. Some complications were only known by the minority of patients such as injury to ureter (47%), injury to nerve (8%), incision hernia (18%), vault prolapse (21 %), and deep vein thrombosis (43%). Most of women delay their decision on the surgery (73%). Factors associated significantly with decision were ethnicity, religion, knowledge on complication, discussion with spouse and doctor.. Cultural factors, opinion of husband and doctors and knowledge of the complication play an important role in the decision of women. It is important to provide suitable information and social support for patients to help them in their decision-making. Participation and support from spouses and doctors should also be encouraged.
A cross»sectional study was undertaken between April 2005 to _1 uly 2005 to determine the extent of the health problems experienced by individuals involved in the December 2004 tsunami wave disaster in the Northeast District of Penang, Malaysia. The overall health status of the respondents were evaluated using the Short Form 36 (SF-36) questionnaire. Out of 171 respondents, 160(93 .6%) were Malays, 8(4.7%) were Chinese and 3(1.8%) were Indians. The mean age ofrespondents was 45.4 years, 15.9 years. Ninety-four of the respondents were males (55.0%) while 7 7(45.0%) were females. The overall mean physical component score was significantly lower (66.9:23 .O) amongst respondents with low education level compared with those with high education level (76.3:19.1, p=0.004). This mean score was also significantly much lower ( 68.7:22 .3) amongst those who are married compared to those who were not married (79.8:1 7.4, p=0.003) . The overall mental health score was significantly much higher (78.8:14.6) amongst those who were not married compared to those who were married (68.5:19.2, p=0.001). The overall mental health score was also significantly higher amongst those in the younger age»group (62.3:16.1) compared to those in the older age»group (72.4:18.9, p=0.005). Based on the scores obtained on the Physical Health and Mental Health dimensions of the SF-36 questionnaire, it can be concluded that the health of victims with low education, elderly and those who were married were more adversely affected than others. Therefore, it is vital that medical as well as psychological attention should be channeled to these risk groups who responded more adversely to disasters.
Ageing anxiety is commoner among women compared to men. However, little is known on the possible contributing factors towards the development of ageing related anxiety among Malaysian women. This study aimed to explore ageing anxiety among the middle-aged women in Malaysia in facing the ageing process. Series of 6 focus group discussions (FGD) were conducted involving a total of 36 women aged between 35 and 59 years old. Each FGD consisted of 5 to 7 respondents and was conducted for an average of 1 to 2 hours. The respondents were selected using the maximum variation sampling method focussing on five age categories, between 35 to 39, 40 to 44, 45 to 49, 50 to 54 and 55 to 59 years old. Representative from several residential areas in the area of Putrajaya Federal Territory and Seri Kembangan, Selangor were involved in the selection of respondents. The interviews revealed that, majority of the respondents were seriously thinking of the possible negative experiences associated with ageing and being old, but very few experiencing ageing anxiety. Three main themes that were identified to contribute to the ageing anxiety were issues related to caregiving at old age and fear of loneliness, the welfare and care of their children when they are old and eventually die and also physical changes that occurred with ageing process. These themes were not specifically associated with any particular age groups, marital or income status. However, the development of the ageing anxiety was found to be related to their personal experiences and observations from the surrounding community. The findings show that women in Malaysia are still emphasizing on the importance of traditional caregiving system, where elderly parents are looked after by the children or extended family members rather than living in formal institutions. Despite the important role of formal institutions in the care of elderly people in the future, it is still negatively perceived. With the shrinking of the size of nuclear family and massive involvement of women in employment sector, more elderly will be expected to reside in formal institutions in the near future. Relevant authorities should be made aware on the importance to maintain the quality of care in the formal institution for elderly, in order to tackle the negative perceptions.
Family planning is a method of controlling fertility which helps to prevent unwanted pregnancies among couples. Unwanted pregnancy has negative effects for mothers and children. The aims of this study were to determine the prevalence of family planning practices among women in Serdang area and associated factors with their family planning practices. A cross sectional study was conducted with a systematic random sampling of 349 women of reproductive age, who attended Sri Kembangan Polyclinic. Descriptive analysis with chi-square and multiple regression analysis were conducted to identify factors associated with the family planning practice. The prevalence of family planning practice was 38.4%. Family planning was significantly associated with age (p=0.001), marital status (p=0.001), mode of delivery of the last pregnancy (p=0.001), number of children (p=0.001), source of information (p=0.004), level of knowledge (p=0.001), and the attitude (p=0.004). Using multiple logistic regression, four factors contributed to family planning practice, were identified as statistically significant: marital status (married OR=40, 95% CI: 9.45, 169.8), religion (Muslim OR=1.9, 95% CI: 1.14, 3.4), number of children (children>4 OR=2.98, 95% CI:1. 74, 5.09) and attitude (positive attitude OR=1.88, 95% CI:1.11, 3.18). The prevalence of family planning practice in Serdang was low even though knowledge was sufficient. The use of pamphlets and booklets are still needed to enhance efforts in health education. Currently, practice on family planning will determine the future structure of the community and the economic wellbeing of a country. Future study should focus on family planning practice among teenager and types of methods for women.
Background: Community based epidemiological data on postpartum depression in Malaysia is scarce. Aim: To determine the prevalence and risk factors for developing postpartum depression among Malay women from a rural area in Kedah, North West of Peninsular Malaysia. Method: We screened 185 women at 4-12 weeks postpartum attending the selected health centers using the Malay versions of Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory II (BDI-11). Those scoring 12 and / or 9/10 on BDI-11 were interviewed using the Composite International Diagnostic Interview (CIDI) and the 17-items Hamilton Rating Scale for Depression (HDRS-17). All diagnoses were based on the Tenth Edition of the International Classification for Disease: Diagnostic Criteria for Research (ICD-I0: DCR-10). Results: The prevalence of postpartum depression was 21.08%. The condition was found to be significantly linked to polygamous marriages, high number of life events and financial problems over the last one year prior to delivery, and low scores on the Malay version of the MOS Social Support Survey and all its components (overall support index, informational support, affectionate support/ positive social interactions and instrumental support). Conclusions: Postpartum depression is indeed a reality among Malay women in rural areas In Kedah, North West of Peninsular Malaysia. These findings have implications for policies regarding maternal and childcare programs.
This two-phase study examined the prevalence of depressive disorders among married working women in a sub-urban area in Malaysia. The Malay version of the General Health Questionnaire-12 (GHQ-12) was used for initial screening. Using multistage cluster sampling, there were 700 subjects from 25 workplaces that were approached, of which 307 filled out GHQ-12 in the initial phase. The prevalence of psychological distress (GHQ 2/3 cut off) is 22.8% (n=70, 95% CI 18.1-27.5). In the second phase, all 49 consenting patients who were screened positive for severe psychological distress (GHQ 3/4 cut off point) were telephone-interviewed by a trained psychiatrist with the Malay version of Mini International Neuropsychiatric Interview (M.I.N.I) to diagnose depressive disorders. The prevalence of depressive disorders was 5.5% (n=17, 95% CI 3.5-7.5). The prevalence of depressive disorders is comparable to those found in the working population worldwide.
Introduction: Women are exposed to stress such as working full time while still being responsible for the family and house.
Objective: The objective of this study was to determine the prevalence of depressive symptoms among adult women in Selangor, and to determine the potential risk factors associated with depression.
Method: A community based cross sectional study was conducted in all districts of Selangor state, Malaysia in July 2004. Multi stage stratified proportionate to size sampling method was used to collect data. The Patient Health Questionnaire (PHQ-9) was used to determine the presence or absence of depressive symptoms among the respondents. All respondents aged 20 to 59 years old in the selected households were interviewed.
Results: Out of 1032 women, 972 agreed to participate in this study, giving a response rate of 94.2%. The mean age of the respondents was 37.91 ± 10.91. Majority were Malays (54.9%), married (83.8%) and had secondary education (54.5%). The results showed that the prevalence of depressive symptoms was 8.3% in Selangor. Race, religion, education level, history of having a miscarriage within the last 6 months and history of difficulty in getting pregnant were significantly associated with depressive symptoms (p<0.05). Women with history of a miscarriage within the last 6 months and absence of formal education were potential risk factors for depressive symptoms (OR, CI = 2.576 (1.165-5.696), p<0.01 and OR, CI = 5.766 (1.949-17.053), p < 0.01).
Conclusion: Depressive symptoms among adult women in Selangor was 8.3% and was associated with race, religion, education, history of miscarriage and difficulty in getting pregnant. The main potential risk factors were having a miscarriage within the last 6 months and absence of formal education.
Keywords: Depressive symptoms, Prevalence and Risk Factors, Selangor Women
Objective: This preliminary investigation intended to evaluate the healthrelated quality of life (HRQoL) profile of HIV/AIDS family caregivers residing in Kuala Terengganu, Malaysia and to explore the psychometric properties of the Malay Caregiver Quality of Life (MCQoL) questionnaire in this sample. Methods: A convenient sample of family caregivers of HIV/AIDS patients who were aware of the diagnosis was enrolled. They were recruited from the Infectious Disease Clinic, Hospital Sultanah Nur Zahirah, Terengganu. Data was analysed using SPSS16 employing descriptive and non-parametric statistical methods. Results: Thirty respondents consented participation [median age = 43.0 years (range 19.0-81.0); female = 63.3%, married = 70.0%; ≤ primary school qualification = 46.7%; self-employed = 66.7% and rural residents = 56.7%]. Across all patients, the highest domain score was for Disruptiveness (median = 3.3; range 1.4-4.0) while Burden was the lowest (median = 2.3; range 1.0-3.6). As expected, males reported significantly better Financial Concerns and Burden (p
Living with epilepsy is equally demanding for both patients and their caregivers. The caregivers’ tasks are not limited to caring for the patients only but also the need to improve their awareness, knowledge and attitude (AKA) level as lack of understanding has a major impact on health-related quality of life (HRQoL). Little is known about the influence of AKA on family caregivers’ HRQoL. Objective: Therefore, this study aimed to assess and relate the AKA and HRQoL profiles of epilepsy carers. Methods: This prospective, cross-sectional study included a sample of 32 epilepsy family caregivers who were recruited from the Neurology and Paediatric Clinics of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu. Results: Majority were Muslims (93.8%), married (65.6%), housewives (31.2%), who earning monthly income of not more than RM 1000 (34.4%) and was the patients’ mothers (40.6%). The Total AKA score was generally good (mean=123.4±16.8, median 122.5) with awareness being good, knowledge moderate and attitude positive whereas HRQoL score for Disruptiveness was the highest (good) compared to other domains. There were significantly higher scores for Sexual Functioning (p = 0.039) among Poor AKA group and Pain Management (p = 0.040) among Good AKA. Conclusion: The overall outcomes signified that family caregivers with Good AKA experienced better well-being compared to those with Poor AKA while carrying out their roles as caregivers. Consequently, carers clearly require constant epilepsy education to enhance skill-building in order to understand and keep updates with the disease, thus indirectly sustaining their desired HRQoL status from time to time.
Study site: Neurology and Paediatric Clinics of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu
Introduction: According to PDRM statistic, in average, 100 babies are dumped every year, in Malaysia. The stig-ma of having babies out of wedlock, feeling of desperation and lack of support are some reasons why babies were dumped at the unimaginable places. Even if they were found and saved, these babies will be placed and raised at institutions. This will lead to the negative effects of institutionalisation as they do not receive appropriate adult care and attention which is crucial in developing their potential. OrphanCare Foundation advocates and provides services that ensure babies and children who are in institutions and those whose lives are at risk grow up in the care of a loving family. Methods: OrpahnCare Foundation provides a safe haven for babies that are being abandoned through baby hatch centres, finding a family for these babies through a legal adoption programme, and deinstitutionalisation (DI) i.e. removing all children currently in institutions, to family based care. Results: Since 2010, OrphanCare Foun-dation has saved a total of 369 babies and successfully arranged for the adoption of 221 babies. Forty even children were taken out from institutions and brought home to their families. Conclusion: The best place for a child to grow up is in the love and care of a family. They will receive personalised guidance, support and love that they need to develop to their full potential.
Introduction: With the increasing number of international students joining various universities worldwide, including Malaysia, acculturative stress resulting from their attempts to adjust to the cultures of host countries is one of the most challenging issues affecting their life in general and academic life in particular. The purpose of this study is to determine the level of acculturative stress and intention to dropout among new postgraduate international students in public universities, Malaysia. Methods: a cross-sectional study was conducted among 522 new international post-graduate students joining Malaysian public universities on their first semester. A multistage sampling method was adapted, and data were collected via self-administered questionnaire by using a validated questionnaire. Results: Out of the overall number of 522 respondents, (68.60%) of them were males while (31.40%) were females, the mean age of respondents was 28.95 ±5.91 years. The majority of the participants 60.54% (326) were single, whereas those who are married students represented 205 (39.3%). This study showed that 410 (78.5%) of the new postgraduate international students experienced a moderate level of acculturative stress with a median value of 107.00, while 63 (12.1 %) high level of stress and 49 (4.9 %) experience low level of acculturative stress .Consequently224 ,42.1 % of the participants students they have intention to dropout from the university for any reason , while 298 (57.1 % ) they don’t have any intention to dropout from the university Conclusions: This study showed the importance of educational intervention program among new international postgraduate students towards adapting to the Malaysian culture, in relation with increasing their cultural knowledge and interaction with host nationals and to reduce their acculturative stress and their intention to dropout from the university.
Introduction: Female Genital Cutting (FGC) is a sensitive issue as this topic is always associated with religion and culture in Malaysia. In the past, FGC is performed by the traditional midwives. However, this practice has been med-icalized nowadays. This study aimed to understand the reasons of performing FGC, the decision making, the practice and the future of FGC among rural community in Northern Malaysia. Methods: Focus group discussions (FGD) were conducted on three groups of young women aged 18-45, older women aged 45 and above and a group of married adult men. All of them were Malay Muslims who were conveniently selected from a rural village in Northern Malay-sia. A semi-structured interview guide was used to conduct the FGD focusing on the reasons, decision making, the practice and the future of FGC. Data was collected until saturation of information was achieved. These participants were chosen based on their willingness to take part in the discussion and also based on their personality of being talkative and able to give feedback to the questions. Results: The result of the interviews revealed that religion is the reason of practicing FGC. All of the participants from each FGD prefer to go to the doctor in the clinic compared to the traditional midwives. The men in this FGD mentioned that they rarely involved in the decision making of the FGC and only the mother or the grandmother to take the responsibility to decide. Conclusion: Generally, majority Malay Muslims community from the rural areas in Northern Malaysia believed that FGC is compulsory in Islam and they prefer to go to the doctors to perform FGC.
Introduction: Wet markets are predisposed to Aedes breeding due to nature of daily activities that involve frequent water storage and usage of water collecting containers. Large numbers of visitors patronising wet markets could cause rapid spread of dengue infection. This study aimed to determine the level of dengue prevention practices among wet market traders in Hilir Perak District and their associated socioecological factors. Methods: A cross sectional study using stratified sampling method was conducted where 246 wet market traders were interviewed to collect data on dengue prevention practices (prevention of Aedes mosquitoes breeding and prevention of mosquito bites), and so-cioecological factors. Chi square test and logistic regression modelling were performed to identify socioecological factors associated with dengue prevention practices. Results: Response rate for this study was 88.9%. Majority of the respondents were male, above 40 years old, had secondary education and above, had monthly income of above MYR2000, were owner of the shop lots, was or had ever married and sold fish, vegetable or groceries products. Most of the respondents had high level of dengue prevention practices (78%). Those who were owner of shop lots, had high perceived susceptibility, high family support, and high perceived dengue prevention and control laws and reg-ulations were predicted to have high level of dengue prevention practices. Conclusion: Level of dengue prevention practices is determined not only by individual factors, but also other factors from relationship to societal level which must also be considered in planning or evaluating current dengue control programmes.