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Fulltext Work-Related Stress Among Healthcare Providers of Various Sectors in Peninsular Malaysia

Lua, P.L., Imilia, I.

Malaysian Journal of Psychiatry, 2011;20(2):1-15.
MyJurnal

Objectives: Occupational stress among healthcare workers is an important concern due to its crucial contribution in attaining maximum job output and optimal quality of working life. Our study aims to compare job stress levels of healthcare employees based on 1) sector, 2) category and 3) specialisation. Methods: Stress severity and frequency were evaluated using the 9-point scale Job Stress Survey (Job Stress, Job Pressure, Lack of Support). A crosssectional sample of 223 healthcare providers were enrolled from seven health institutions in Peninsular Malaysia (East Coast = 55%; mean age = 30 years; female = 78.9%; < 2 years experience = 35.9%; government-based = 48%; supportive = 62.8%). Results: No significant difference was found between government and private sector workers. Supportive staff reported significantly higher stress frequency in contrast to professionals who demonstrated significantly higher stress severity in all dimensions (p < .05). Within the supportive group, radiographers were the most stressed, followed by nurses and medical laboratory technologists (p > .05). Research-based professionals experienced significantly worse stress frequency in all components compared to professional practitioners (p < .05). Conclusion: Because stress levels are affected by job category and specialisation, flexible strategies to ensure employees’ job productivity, contentment and personal well-being should be implemented.

Matched MeSH terms: Private Sector
Fulltext Demographic and socioeconomic factors associated with access to public clinics

Makmor T., Khaled, T., Ahmad Farid O., Nurul Huda M.S.

JUMMEC, 2018;21(1):28-33.
MyJurnal

Introduction: Providing adequate and equal access to healthcare is a key goal towards achieving universal health coverage. However, social and demographic inequalities in accessing health care services exist in both developed and developing countries. This study examined the demographic and socio-economic factors associated with the lack of access to public clinics in the Greater Kuala Lumpur area.
Materials and Methods: The study employed a survey involving 1032 participants. Data were collected using self- administered questionnaires distributed between October and December 2015 in the Greater Kuala Lumpur area.
Results: Of the 1032 participants, 535 were public clinic users. A quarter (25.8%) of the users stated that they did not have access to public clinics in their residential area. A multiple logistic analysis showed that the elderly, the women, those from ethnic minority groups, those of lower family income, and the private sector workers were more likely not to have access to public clinics than their counterparts.
Conclusions: The existing level of accessibility to public clinics could be improved by increasing the number of clinics. Clinics should be established to focus more on reaching the elderly, the women, the ethnic minority groups, the poorer families, and the private sector employees.

Matched MeSH terms: Private Sector
Managing adolescent pregnancy: The unique roles and challenges of private general practitioners in Malaysia

Malek KA, Abdul-Razak S, Abu Hassan H, Othman S

Malays Fam Physician, 2019;14(3):37-45.
PMID: 32175039

Introduction: Managing adolescent pregnancy in the primary care setting is complex, as it requires doctors to navigate through a combination of medical, social, financial and legal needs. Objective: This study explores the perspectives of private general practitioners on their roles and challenges in managing adolescent pregnancy in Malaysia.
Methods: Nineteen private general practitioners in Selangor and Kuala Lumpur participated in in-depth interviews in 2015. A topic guide was used for interview navigation. Participants were asked to discuss their experiences and approaches in managing pregnant adolescents. We used purposive sampling to recruit consenting private general practitioners who had experience in managing adolescent pregnancy. The verbatim transcripts of the audio-recorded interviews were analyzed using thematic analysis. Data reached saturation at the nineteenth in-depth interview. Results: Two themes emerged. Under the theme 'inadvertent advocator,' participants described their tasks with regards to building trust, calming angry parents and delivering comprehensive counseling and care related to the sexual and reproductive health of adolescents, including requests for abortions. Theme two, 'challenges of private general practitioners,' refers mainly to personal and religious conflicts arising from a request for an abortion and deficiencies in support and multidisciplinary integration within their practice settings.
Conclusion: General practitioners practicing in the private sector identify themselves as active players in supporting pregnant adolescents but face many challenges arising from the personal, religious, professional and community levels. Addressing these challenges is important for optimal care delivery to pregnant adolescents in this community.

Matched MeSH terms: Private Sector
Fulltext The worst flood in 100 years : Johore experience

Marzukhi, M.I., Daud, A.R., Badrul Hisham, A.S.

Malaysian Journal of Community Health, 2009;15(3):1-14.
MyJurnal

Past major flooding events for the state of Johore, Malaysia were recorded in 1926, 1967, 1968 and 1971. However, major meteorological phenomena that hit Johore on the 19th December 2006 (first wave) and the 12th January 2007 (second wave) were claimed to be the worst flood disaster in Johore in a 100 years. All eight districts were affected displacing 157,018 and 155,368 population during the first and the second wave event respectively. The Johore Health Department deployed substantial number of medical and health personnel to deal with the Johore flood crisis. Flood-related data were collected on daily basis between 19th December 2006 and 19th February 2007 using spreadsheet format from Flood Operational Rooms located at respective District Health Offices. Among flood victims 34,530 were found to have non-communicable diseases and 19,670 with communicable diseases. No major food- and water-borne disease outbreaks, such as cholera and typhoid, were reported in Johore. High success of public health measures was depending on the workforce of medical and health personnel on the ground. On the other hand, voluntary services offered by non-governmental organisations (NGOs), private sector and other volunteers should be well coordinated without compromising regulatory and ethical requirements. Crisis guidelines and plan of actions shall be updated so that they would be more relevant to the crises encountered on the ground.

Matched MeSH terms: Private Sector
Fulltext Outcomes of HIV treatment from the private sector in low-income and middle-income countries: a systematic review protocol

Mburu G, Igbinedion E, Lim SH, Paing AZ, Yi S, Elbe S, et al.

BMJ Open, 2020 Jan 08;10(1):e031844.
PMID: 31919124 DOI: 10.1136/bmjopen-2019-031844

INTRODUCTION: Private sector provision of HIV treatment is increasing in low-income and middle-income countries (LMIC). However, there is limited documentation of its outcomes. This protocol reports a proposed systematic review that will synthesise clinical outcomes of private sector HIV treatment in LMIC.
METHODS AND ANALYSIS: This review will be conducted in accordance with the preferred reporting items for systematic review and meta-analyses protocols. Primary outcomes will include: (1) proportion of eligible patients initiating antiretroviral therapy (ART); (2) proportion of those on ART with <1000 copies/mL; (3) rate of all-cause mortality among ART recipients. Secondary outcomes will include: (1) proportion receiving Pneumocystis jiroveci pneumonia prophylaxis; (2) proportion with >90% ART adherence (based on any measure reported); (3) proportion screened for non-communicable diseases (specifically cervical cancer, diabetes, hypertension and mental ill health); (iv) proportion screened for tuberculosis. A search of five electronic bibliographical databases (Embase, Medline, PsychINFO, Web of Science and CINAHL) and reference lists of included articles will be conducted to identify relevant articles reporting HIV clinical outcomes. Searches will be limited to LMIC. No age, publication date, study-design or language limits will be applied. Authors of relevant studies will be contacted for clarification. Two reviewers will independently screen citations and abstracts, identify full text articles for inclusion, extract data and appraise the quality and bias of included studies. Outcome data will be pooled to generate aggregative proportions of primary and secondary outcomes. Descriptive statistics and a narrative synthesis will be presented. Heterogeneity and sensitivity assessments will be conducted to aid interpretation of results.
ETHICS AND DISSEMINATION: The results of this review will be disseminated through a peer-reviewed scientific manuscript and at international scientific conferences. Results will inform quality improvement strategies, replication of identified good practices, potential policy changes, and future research.
PROSPERO REGISTRATION NUMBER: CRD42016040053.

Matched MeSH terms: Private Sector/economics*
Fulltext Differential diffusion of pharmaceutical innovations in a mixed market middle - income economy

Md Hamzah N, See KF

BMC Health Serv Res, 2021 Oct 19;21(1):1119.
PMID: 34663311 DOI: 10.1186/s12913-021-06786-6

BACKGROUND: Policymakers are faced with the challenge of balancing patient's access for effective and affordable medicines to sustain the rising healthcare costs. In a mixed healthcare market such as Malaysia, coverage decisions of new medicines are different: public funded health system has a formulary listing process whereas for private sector, which is a market-based economy, depends on patient's willingness to pay and insurance coverage. There is little overlap between public and private healthcare service delivery with access to new innovative medicines, as differentiated by sources of funding. The objectives of this study were to examine the diffusion of New Chemical Entities (NCEs) into the public and private healthcare market between 2010 and 2014, and determine the factors explaining the diffusion.
METHODS: We matched medicines from the product registration database by medicine formulation to medicines in IQVIA National Pharmaceutical Audit database for each year. The price per Defined Daily Dose (DDD), market concentration and generic utilization share variables were calculated. A panel fixed effect model was performed to measure diffusion of NCEs for each year and test possible determinants of diffusion of NCEs for overall market and sector specifics.
RESULTS: The utilization of NCEs was larger in the private sector compared to the public sector but the speed of diffusion over time was higher in the public sector. Price per DDD was negatively associated with diffusion of NCEs, while generic utilization share was significantly regressive in the public sector. Market concentration was negatively associated with utilization of NCEs, however result tends to be mixed according to sector and Anatomical Therapeutic Chemical (ATC) category.
CONCLUSIONS: Understanding key aspects of sectoral variation in diffusion of NCEs are crucial to reduce the differences of access to new medicines within a country and ensure resources are used on cost effective treatments.

Matched MeSH terms: Private Sector
Fulltext Medical specialist training: views from stakeholders

Md Tahir M.A., Noor Hazilah, A.M., Azura, O.

International Medical Journal Malaysia, 2015;14(1):65-70.
MyJurnal

Introduction: In Malaysia, medical specialisation training is mainly carried out by the public universities. Methods: A survey was carried out to explore the views of medical specialists in the country on issues such as structure of medical specialty training, availability of human resource, public/private sector competition, competency and apprenticeship, and its impact on assurance and quality of medical specialty training. Results: Altogether 238 medical specialists from 30 hospitals and medical institutions in the country participated in the survey. Conclusion: Among the findings, competition for human resource between public and private sector and lack of uniformity on medical specialty training across universities in the country are among the issues found to be of concern. There is also a need to address governance issue which necessitates to clearly delineating what constitutes medical specialty and what constitutes a subspecialty so that an agreed uniformed nomenclature is exercised across all stakeholders. The respondents also strongly agreed on the need to ensure competence in medical specialist training.

Matched MeSH terms: Private Sector
Fulltext Outbreak of dengue in Bandar Baru Bangi

Meftahuddin, T., Anisah, A.B., Mohd Faizal, A.

Malaysian Journal of Public Health Medicine, 2004;4(1):22-28.
MyJurnal

An outbreak of dengue and dengue haemorrhagic fever was studied in Bandar Baru Bangi, Hulu Langat District which started from epidemiological week 51 of December 2001 until ]anuary 2002. Altogether, 53 cases were reported to the Hulu Langat District Health Office with 24 cases detected in Section I and Section 6, and 5 cases in Section 4 of Bandar Baru Bangi respectively. Two cases were confirmed as dengue haernorrhagic fever (DHF). The majority of the cases were female Malays. The age of the cases ranged from 3 to 60 years with a mean of 29.17 : 13.18 years old. The majority of patients were mainly private sector workers from factories or companies with 29 cases (54.7%) and university students with 14 cases (26.4%). No deaths were reported in this outbreak. On the average, the duration taken for a patient to be admitted from the date of onset was about 4.4 - 2.0 days and the duration taken for notification from the date of admission was about 2.0 - 1.7 days. The majority of cases reported were based on classical clinical features of dengue fever. Only 18 cases (34%) were IgM positive for dengue. The statistical analysis showed that the majority were male (P>0.05), Malays (P>0.05) , age group of 21»30 years (P>0.05), platelets level < 100,000 per mm3 (p>0.05) and the serological specimens obtained 5 days after the date of onset (p2.0%) within residential premises in this locality with 46 Aedes mosquito breeding places identified and a total amount of RM 6500 of fines imposed.

Matched MeSH terms: Private Sector
Fulltext To examine the level of knowledge and acceptance about social protection system among paddy farmers in agricultural areas of Muda Agricultural Development Authority (MADA)

Mohamad Noor Firdaus Sahul Hameed

Malaysian Journal of Social Sciences and Humanities, 2018;3(4):83-92.
MyJurnal

At present, social protection system is a requirement for those involved in all sectors of employment
such as pensions to Government employees and Employees Provident Fund (EPF) to private sector
workers. The primary basis of the system is to provide protection to address poverty, financial
assistance and future guarantees. However, no structured social protection system was introduced to
the informal sectors workers in Malaysia such as farmers and others. The purpose of this study is to
examine the level of knowledge and acceptance of social protection systems among farmers in the
Muda Agricultural Development Authority (MADA). This study involved 573 respondents covering 4
regions within the MADA area. In conclusion, this study will examine the level of knowledge and
acceptance of farmers on social protection systems in their communities.

Matched MeSH terms: Private Sector
Fulltext Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system

Mohd-Tahir NA, Paraidathathu T, Li SC

SAGE Open Med, 2015;3:2050312115596864.
PMID: 26770795 DOI: 10.1177/2050312115596864

Malaysia inherits a highly subsidized tax-based public healthcare system complemented by a fee-for-service private sector. Population health in Malaysia has considerably improved since independence using a relatively small amount of gross domestic product (~4%). Brain drain of highly specialized personnel, growth in healthcare spending, demographic and disease pattern changes and increase in patients' demands and expectations towards better medical care are exerting pressure on the sustainability of the system to continuously provide efficient and effective services at relatively low cost. Malaysia has adopted and implemented some of the quality use of medicine concepts such as National Essential Medicine List, health technology assessment and promotion of generic medicines in their health policy, but so far the results may not be optimal. Activities to further promote these strategies are needed for successful implementation to achieve more positive and sustained beneficial outcomes. Better strategic planning, management and collaboration between various stakeholders, considering the needs and barriers of the strategies, are important to ensure effective implementation of the strategies. More emphasis should be placed upon more equitable and rational distribution of healthcare resources to cater for rapid urbanization. Additionally, a sustainable health financing structure that is more progressive and does not encourage moral hazard should be established. In conclusion, Malaysia has achieved good outcomes in population health with relatively low financial inputs since independence. However, changes in the overall environment have created issues which would threaten the long-term viability of the healthcare system if not tackled properly. The numbers of internationally trialled strategies could be used to deal with these challenges. In addition, coordinated implementation of these strategies and effective engagement and communication between various stakeholders are necessary to further strengthen the Malaysian healthcare system effectively.

Matched MeSH terms: Private Sector
Funding renal replacement therapy in southeast Asia: building public-private partnerships in Singapore, Malaysia, Thailand, and Indonesia

Morad Z, Choong HL, Tungsanga K, Suhardjono

Am J Kidney Dis, 2015 May;65(5):799-805.
PMID: 25736214 DOI: 10.1053/j.ajkd.2014.09.031

The provision of renal replacement therapy (RRT) in developing economies is limited by lack of financial and other resources. There are no national reimbursement policies for RRT in many countries in Asia. The Southeast Asia countries of Singapore, Malaysia, Thailand, and Indonesia have adopted a strategy of encouraging public-private partnerships to increase the RRT rates in their respective countries. The private organizations include both for-profit and philanthropic bodies. The latter raise funds from ordinary citizens, corporations, and faith-based groups, as well as receive subsidies from the government to support RRT for patients in need. The kidney foundations of these countries play a leadership role in this public-private partnership. Many of the private organizations that support RRT are providers of treatment in addition to offering financial assistance to patients, with hemodialysis being the most frequently supported modality. Public-private partnership in funding RRT is sustainable over the long term with proper organization and facilitated by support from the government.

Matched MeSH terms: Public-Private Sector Partnerships/economics*; Public-Private Sector Partnerships/organization & administration*
Fulltext Rate of seroconversion in repeat blood donors at the national blood centre, Kuala Lumpur

Nafishah A, Asiah MN, Syimah AT, Mohd Zahari TH, Yasmin A, Normi M, et al.

Indian J Hematol Blood Transfus, 2014 Jun;30(2):105-10.
PMID: 24839364 DOI: 10.1007/s12288-012-0213-4

The World Health Organization (WHO) recommend that all donated blood are to be screened for at least three viral infections [human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV)]. The National Blood Centre, Kuala Lumpur (NBCKL) aims to reduce transfusion transmitted infections (TTI) as it still remains as one of the major risk for blood transfusion. A cross sectional study was conducted at the National Blood Centre, Kuala Lumpur from 1st January 2009 to 31st June 2010. Data from 581,020 donors were analyzed from year 2004 to 2008. All data were retrieved from NBCKL Blood Bank Information System (BBIS). A total of 201 repeat donors were included in the study based on the inclusion criteria but only 132 repeat donors agreed to participate. Information on sociodemographic, risk factors, knowledge of donors and high risk behavior were extracted from standardize questionnaire. Data were analyzed using SPSS version 14.0. The aim of this study was to determine the predictors of the seropositive infectivity among repeat blood donors at the NBCKL. The results showed Syphilis accounts for the highest and increasing seroconversion rate among other infections from 20.83 % in year 2004 to 44.6 % in year in year 2008. HIV and HCV infection also showed increasing seroconversion rate in 5 years' time from 6.41 % in year 2004 to 17.54 % in year 2008 and 4.8 % in year 2004 to 5.94 % in year 2008 respectively. However, HBV infection alone showed a decreasing seroconversion rate from 20.83 % in year 2004 to 10.4 % in year 2008. Level of donors' awareness regarding high risk factors (activities or behaviour) can lead to higher risk of TTI with significant p value in this predictors model(p sector predominates in all TTI markers. Majority of the respondents were aware about relation of high risk activities and risk of TTI.

Matched MeSH terms: Private Sector
Public Private Partnership - a case study of the Melaka-Manipal Medical College

Nagra JS

Kathmandu Univ Med J (KUMJ), 2005 Oct-Dec;3(4):451-4.
PMID: 16449856
Matched MeSH terms: Private Sector*
The transition to harm reduction: understanding the role of non-governmental organisations in Malaysia

Narayanan S, Vicknasingam B, Robson NM

Int J Drug Policy, 2011 Jul;22(4):311-7.
PMID: 21300533 DOI: 10.1016/j.drugpo.2011.01.002

The transition of drug policy from prohibition to harm reduction has never been easy. The deeply entrenched belief in prohibition shared by policy makers and religious leaders provided little room for alternatives, and change came only slowly. The non-governmental organisations (NGOs) in Malaysia played a pivotal role in effecting such a change. Understanding how they did so may be instructive for other similarly placed countries.

Matched MeSH terms: Public-Private Sector Partnerships*
Fulltext Survey on readership of professional journals among Malaysian dentists. part I: readership of professional dental journals

Ngeow, W.C., Mohd Noor, N.S., Mohd Tahir, N.N.

Malaysian Dental Journal, 2007;28(1):7-15.
MyJurnal

The objective of this survey was to understand the current trend of readership of professional dental journals among Malaysian dentists. A total of 225 questionnaires were sent out to Malaysian dentists who attended various dental related conferences throughout Peninsular Malaysia from February 2006 to July 2006. Questionnaires comprised of questions relating to dentists’ socio-demographic status and a list of journal(s) read by them. Malaysian dentists’ view on the content and quality of a particular dental journal, i.e. the Malaysian Dental Journal (MDJ) was also enquired. The details of this finding are highlighted in Part II of this study. A total of 156 questionnaires were returned; the respondents were made up of 61 male and 91 female dentists. Almost 80% of the respondents aged between 20-49 year-old and most respondents (n= 132; 84.62%) only had a basic Bachelor of Dental Surgery or equivalent degree while another 19 (12.18%) had in addition, a post-graduate degree. Almost equal numbers of respondents were working in the Ministry of Health (MOH) or Armed Force (n=73; 46.8%) and private practice (n=74; 47.4%). Also, equal number of respondents (n=67; 42.95%) were found to be working as single-handed practitioner and in a partnership/assistant/working-with-other specialties type of practice Almost two-thirds (n=103; 66%) of the respondents read more than one professional journal, and a majority of them worked in the private sector. The percentage of readers reading more than one journal from the private practice (n=67, 60.0%) was close to twice of that from the MOH (n=36, 35.0%). No specific age-group pattern was present but the least number of subscribers were from those 60 year-old and above (n=3), whereby none of them subscribed to any professional dental journal/magazine. The highest percentage of subscribers were from those in the age group of 40-49 year-old, whereby 86.49% (n=32) of dentists in this age-group subscribed to at least one professional dental journal/magazine. Out of the list of journals/magazines provided, it was found that the MDJ has the most number of readers. The MDJ was most read by dentists in the private practice while the Annals of Dentistry of the University of Malaya was most read by dentists in the MOH. In conclusion, it was found that almost two-third of the respondents read more than one professional journal, with the MDJ receiving the most number of readers. More dentists in the private practice read professional dental journals than dentists in the MOH.

Matched MeSH terms: Private Sector
Fulltext Dementia in Malaysia: issues and challenges

Nikmat AW, Hawthorne G, Al-Mashoor SHA

ASEAN Journal of Psychiatry, 2011;12(1):95-101.
MyJurnal

Objective: The number of people surviving until old age has been increasing worldwide. Reductions in both fertility and mortality rates, better living standards, nutrition and health care are claimed to be the key factors that increase the proportion of aged people within the population. Nevertheless, growing numbers of older adults also increases the susceptibility to diseases that commonly afflict the elderly, such as dementia. In this article, we discuss on the current issues of dementia in Malaysia and its challenge in providing a
better management and services for this population. Methods and Results:Review of literature by searching the databases CINAHL, SCOPUS, MEDLINE and PsychINFO from June 2010 to November 2010 was done on the issues involving dementia patients in Malaysia such as ageing trend, awareness and availability of services. Conclusion: Despite a limited number of studies on dementia in Malaysia, literature revealed the importance of
acknowledging the issues and improving the services for the patients. Efforts should be made by the government and private sectors to promote healthy ageing in Malaysia.

Matched MeSH terms: Private Sector
Fulltext Implementation of Building Information Modelling (BIM) in Malaysia: A review

Nuzul Azam Haron, Raja Putri Zarifh Ana Raja Soh, Aizul Nahar Harun

Pertanika Journal of Science & Technology, 2017;25(3):661-674.
MyJurnal

This paper seeks to clarify Building Information Modelling (BIM) and its implementation in Malaysia.
Most developed countries that have implemented BIM in the construction industry have found it effective. This paper reviews existing literature on the implementation of BIM and examines the implementation strategies that have been developed. The review highlights numerous advantages of BIM in construction, which include, among others, reducing cost, time, carbon burden and capital cost. BIM can also help increase broader efficiencies and improve coordination and communication between each party. However, implementing BIM is complicated and requires efforts from both the government and the private sector. While the implementation of BIM may reduce costs in developed countries, it may not do so in developing countries; in Malaysia, for instance, costs act as an initial barrier. Other obstacles to implementing BIM in Malaysia include application system requirements and lack of knowledge and readiness to change. To facilitate its implementation in the construction industry, the Malaysian government needs to hold seminars to promote a better understanding of BIM. They may also introduce a properly structured BIM course by preparing a standard code of practices and guidelines for BIM in the education sector.

Matched MeSH terms: Private Sector
Aquatic insect functional feeding groups in a mountain stream with a series of check dams in northern Thailand

Phuchiwan Suriyawong, Elizabeth A. Bergey

Sains Malaysiana, 2018;47:1379-1386.

A series of check dams (or small dams in shallow streams) have been placed on many streams throughout Thailand and
the number of them continue to increase. Check dam construction activities have been emphasized by the government
and private sector entities over the last decade to prevent severe flood or drought due to changes in rainfall patterns. This
study evaluated distribution of functional feeding groups (FFG) in a stream with a high density of check dams. Twelve
sampling sites at three altitudes (500, 900 and 1500 m asl) included undammed and nearby dammed sections (above
and below check dams) were used. Aquatic insects were collected monthly at each site for a year and categorized into
FFG. Aquatic insect composition of undammed and above dam sites was different. Abundance within each FFG at above
dam sites significantly differed from undammed sites. Taxonomic richness at 1500 and 900 m altitudes was decreased
at above dam sites compared with the corresponding undammed sites, whereas above dam sites of 500 m altitude had
higher richness than undammed site. High abundance of predators and collector-gatherers associated with reservoirs
and fine sediment accumulation above dams, where filter-feeders were scarce. Shredder abundance varied among sites
and was highest where leaf packs were most abundant. Scrapers were least abundant group and inconsistent with the
dams. Distribution of FFG was similar to changes in other regulated streams. The composition of FFG reflected the
stream ecosystem conditions through adaptation of communities to stream habitat and food resources, including those
associated with check dam construction.

Matched MeSH terms: Private Sector
Improving Health Care Coverage, Equity, And Financial Protection Through A Hybrid System: Malaysia's Experience

Rannan-Eliya RP, Anuranga C, Manual A, Sararaks S, Jailani AS, Hamid AJ, et al.

Health Aff (Millwood), 2016 May 01;35(5):838-46.
PMID: 27140990 DOI: 10.1377/hlthaff.2015.0863

Malaysia has made substantial progress in providing access to health care for its citizens and has been more successful than many other countries that are better known as models of universal health coverage. Malaysia's health care coverage and outcomes are now approaching levels achieved by member nations of the Organization for Economic Cooperation and Development. Malaysia's results are achieved through a mix of public services (funded by general revenues) and parallel private services (predominantly financed by out-of-pocket spending). We examined the distributional aspects of health financing and delivery and assessed financial protection in Malaysia's hybrid system. We found that this system has been effective for many decades in equalizing health care use and providing protection from financial risk, despite modest government spending. Our results also indicate that a high out-of-pocket share of total financing is not a consistent proxy for financial protection; greater attention is needed to the absolute level of out-of-pocket spending. Malaysia's hybrid health system presents continuing unresolved policy challenges, but the country's experience nonetheless provides lessons for other emerging economies that want to expand access to health care despite limited fiscal resources.

Matched MeSH terms: Private Sector/economics
Fulltext A study of the nature and level of trust between patients and healthcare providers, its dimensions and determinants: a scoping review protocol

Rasiah S, Jaafar S, Yusof S, Ponnudurai G, Chung KPY, Amirthalingam SD

BMJ Open, 2020 Jan 23;10(1):e028061.
PMID: 31980505 DOI: 10.1136/bmjopen-2018-028061

INTRODUCTION: The aim of this scoping review is to systematically search the literature to identify the nature and or level of trust between the patient, the users of health services (eg, clients seeking health promotion and preventive healthcare services) and the individual healthcare providers (doctors, nurses and physiotherapists/ occupational therapists), across public and private healthcare sectors, at all levels of care from primary through secondary to tertiary care. It also aims to identify the factors that influence trust between patients, users of health services (clients) and providers of healthcare at all levels of care from primary care to tertiary care, and across all health sectors (public and private). The study will also identify the tools used to measure trust in the healthcare provider.
METHODS AND ANALYSIS: The scoping review will be conducted based on the methodology developed by Arksey and O'Malley's scoping review methodology, and Levac et al 's methodological enhancement. An experienced information specialist (HM) searched the following databases MEDLINE, EMBASE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature. The search terms were both keywords in the title and/or abstract and subject headings (eg, MeSH, EMTREE) as appropriate. Search results were downloaded, imported and stored into a 'Refworks' folder specifically created for reference management. The preliminary search was conducted between 7 December 2017 and 14 December 2017. Quantitative methods using content analysis will be used to categorise study findings on factors associated with trust between patients, clients and healthcare providers. The collection of studies will be also examined for heterogeneity. Qualitative analysis on peer reviewed articles of qualitative interviews and focus group discussion will be conducted; it allows clear identification of themes arising from the data, facilitating prioritisation, higher order abstraction and theory development. A consultation exercise with stakeholders may be incorporated as a knowledge translation component of the scoping study methodology.
ETHICS AND DISSEMINATION: Ethical approval will be obtained for the research project from the Institutional Review Board. The International Medical University will use the findings of this scoping review research to improve the understanding of trust in healthcare, in its endeavour to improve health services delivery in its healthcare clinics and hospitals, and in its teaching and learning curriculum. The findings will also help faculty make evidence based decisions to focus resources and research as well as help to advance the science in this area. Dissemination of the results of the scoping review will be made through peer-reviewed publications, research reports and presentations at conferences and seminars.

Matched MeSH terms: Private Sector

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