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Heavy metal quantification of classroom dust in school environment and its impacts on children health from Rawang (Malaysia)

Tan SY, Praveena SM, Abidin EZ, Cheema MS

Environ Sci Pollut Res Int, 2018 Dec;25(34):34623-34635.
PMID: 30315534 DOI: 10.1007/s11356-018-3396-x

This study aimed to determine bioavailable heavy metal concentrations (As, Cd, Co, Cu, Cr, Ni, Pb, Zn) and their potential sources in classroom dust collected from children's hand palms in Rawang (Malaysia). This study also aimed to determine the association between bioavailable heavy metal concentration in classroom dust and children's respiratory symptoms. Health risk assessment (HRA) was applied to evaluate health risks (non-carcinogenic and carcinogenic) due to heavy metals in classroom dust. The mean of bioavailable heavy metal concentrations in classroom dust found on children's hand palms was shown in the following order: Zn (1.25E + 01 μg/g) > Cu (9.59E-01 μg/g) > Ni (5.34E-01 μg/g) > Cr (4.72E-02 μg/g) > Co (2.34E-02 μg/g) > As (1.77E-02 μg/g) > Cd (9.60E-03 μg/g) > Pb (5.00E-03 μg/g). Hierarchical cluster analysis has clustered 17 sampling locations into three clusters, whereby cluster 1 (S3, S4, S6, S15) located in residential areas and near to roads exposed to vehicle emissions, cluster 2 (S10, S12, S9, S7) located near Rawang town and cluster 3 (S13, S16, S1, S2, S8, S14, S11, S17, S5) located near industrial, residential and plantation areas. Emissions from vehicles, plantations and industrial activities were found as the main sources of heavy metals in classroom dust in Rawang. There is no association found between bioavailable heavy metal concentrations and respiratory symptoms, except for Cu (OR = 0.03). Health risks (non-carcinogenic and carcinogenic risks) indicated that there are no potential non-carcinogenic and carcinogenic risks of heavy metals in classroom dust toward children health.

Matched MeSH terms: Child Health*
Integrating health interventions for women, newborn babies, and children: a framework for action

Ekman B, Pathmanathan I, Liljestrand J

Lancet, 2008 Sep 13;372(9642):990-1000.
PMID: 18790321 DOI: 10.1016/S0140-6736(08)61408-7

For women and children, especially those who are poor and disadvantaged, to benefit from primary health care, they need to access and use cost-effective interventions for maternal, newborn, and child health. The challenge facing weak health systems is how to deliver such packages. Experiences from countries such as Iran, Malaysia, Sri Lanka, and China, and from projects in countries like Tanzania and India, show that outcomes in maternal, newborn, and child health can be improved through integrated packages of cost-effective health-care interventions that are implemented incrementally in accordance with the capacity of health systems. Such packages should include community-based interventions that act in combination with social protection and intersectoral action in education, infrastructure, and poverty reduction. Interventions need to be planned and implemented at the district level, which requires strengthening of district planning and management skills. Furthermore, districts need to be supported by national strategies and policies, and, in the case of the least developed countries, also by international donors and other partners. If packages for maternal, newborn and child health care can be integrated within a gradually strengthened primary health-care system, continuity of care will be improved, including access to basic referral care before and during pregnancy, birth, the postpartum period, and throughout childhood.

Matched MeSH terms: Child Health Services/organization & administration*; Child Health Services/trends
Fulltext Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study

Global Burden of Disease Child and Adolescent Health Collaboration, Kassebaum N, Kyu HH, Zoeckler L, Olsen HE, Thomas K, et al.

JAMA Pediatr, 2017 Jun 01;171(6):573-592.
PMID: 28384795 DOI: 10.1001/jamapediatrics.2017.0250

IMPORTANCE: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.
OBJECTIVE: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.
EVIDENCE REVIEW: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss.
FINDINGS: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries.
CONCLUSIONS AND RELEVANCE: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.

Matched MeSH terms: Child Health/trends*; Child Health/statistics & numerical data
Barriers to neonatal care in developing countries: parents' and providers' perceptions

Martinez AM, Khu DT, Boo NY, Neou L, Saysanasongkham B, Partridge JC

J Paediatr Child Health, 2012 Sep;48(9):852-8.
PMID: 22970681 DOI: 10.1111/j.1440-1754.2012.02544.x

Hospital care and advanced medical technologies for sick neonates are increasingly available, but not always readily accessible, in many countries. We characterised parents' and providers' perceptions of barriers to neonatal care in developing countries.

Matched MeSH terms: Child Health Services/supply & distribution*
Mortality rates decline in Malaysia

Popul Headl, 1991 Nov;?(200):2.
PMID: 12284509

PIP:
Experiencing remarkable decreases in mortality rates over the past 3 decades, Malaysia currently has one of the lowest mortality rates among developing countries, a rate that compares favorably with those of developed countries. Between 1957 and 1989, the crude death rate dropped from 12.4/1000 population to 4.6. Over the same period, Malaysia recorded even greater decreases in the infant mortality rate, from 75.5/1000 births to 15.2. The Maternal mortality rate also declined from 1.48 in 1970 to 0.24 in 1988. The data indicates that mortality rates vary from state to state, and that rural areas have a higher mortality than urban areas. According to a study by the National Population and Family Development Board, the use of maternal and child health services has played an important role in reducing neonatal, perinatal, infant, child, and maternal mortality rates. Nearly all women in Malaysia receive antenatal services. While the country has achieved great gains on mortality rates, programs focusing on specific age and socioeconomic groups could lead to even greater reductions. The Minister for National Unity and Social Development, Dato Napsiah Omar, has called for the development of programs designed to improve the population's quality of life.

Matched MeSH terms: Maternal-Child Health Centers*
Putting quality of life on the agenda

Kitatani K

Earthwatch, 1991;?(41):5-6.
PMID: 12284002

PIP: At the Population and Natural Resources Workshop of the World Conservation Union (IUCN) General Assembly in Perth, Australia, December 1990, population and quality of life issues were stressed as one of the central items to be placed on the 1992 Agenda of the UN Conference on Environment. The pace of environmental degradation is quickening, the causes are becoming more entrenched, and indecision will narrow our options. Poverty and population growth are making development unsustainable. Technological miracles will not appear to restore balance. Deforestation, soil erosion, decertification and loss of water resources are fueling urbanization. Therefore the World Commission on Environment and Development, known as the Brundtland Commission, ranks human resources development as a top priority in sustainable development and quality of life. Human resources can be improved by providing maternal and child care, family planning and improving the status of women. Successful family planning programs as seen in Thailand and Malaysia can show results very quickly once national population policies, institutions and capacity are in place.

Matched MeSH terms: Maternal-Child Health Centers*
Services for urban poor families in Kuala Lumpur, Malaysia: a case study

Low WY, Yusof K

Child Welfare, 1991 Mar-Apr;70(2):293-302.
PMID: 2036882

With 25% of its population living in over 148 squatter settlements, with a high incidence of communicable diseases, teenage pregnancies, and psychological and familial stress, the city of Kuala Lumpur has sought ways to improve conditions. This article describes one particularly promising approach: community-based centers integrating three socioeconomic components--preschool education, maternal and child health clinics, and income-generating activities.
PIP: The accomplishments of the Sang Kancil Intervention program, a project designed to improve the living conditions of squatter communities in Kuala Lumpur, Malaysia are described. 25% of Kuala Lumpur's population lives in 148 squatter settlements, where life is especially difficult for women and children. Hoping to improve the living conditions of the urban poor, Kuala Lumpur's City hall initiated the Sang Kancil Intervention program. This program contains 3 components: preschool education, maternal and child health, and income generation. The preschool component provides education, food supplements, and medical checkups and treatment to children in the squatter settlements. In order to foster community participation, the teachers of the preschool program are chosen from among the squatter community, and mothers are encouraged to become involved. Evaluations of the preschools reveal positive attitudes from mothers and teachers, high attendance rates, and higher IQ test scores among children attending the preschool than among children not in the program. Sang Kancil has also provided maternal and health services to the squatter communities. Once a week, nurse practitioners set up a clinic providing the following services: immunization, prenatal and postnatal care, health education, nutrition, family planning, and treatment of minor illnesses. Sang Kancil's income-generation program seeks to raise the living standards of poor families by creating employment opportunities for women. Sang Kancil has established companies staffed, owned, and managed entirely by women. Among other things, these companies manufacture toys, batik items, and ceramics. The success of the companies has pushed shareholders above the poverty line.

Matched MeSH terms: Maternal-Child Health Centers; Maternal-Child Health Centers/legislation & jurisprudence*
The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate

Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova K, Boykoff M, et al.

Lancet, 2019 11 16;394(10211):1836-1878.
PMID: 31733928 DOI: 10.1016/S0140-6736(19)32596-6
Matched MeSH terms: Child Health*
Protecting children and families from tobacco and tobacco-related NCDs in the Western Pacific: good practice examples from Malaysia, Philippines and Singapore

David AM, Mercado SP, Klein JD, Kaundan MSK, Koong HN, Garcia E

Child Care Health Dev, 2017 09;43(5):774-778.
PMID: 28480578 DOI: 10.1111/cch.12472

BACKGROUND: Non-communicable diseases (NCDs) are generally considered diseases of adulthood, but NCD risk factors like tobacco use often are taken up during childhood and adolescence, and second-hand smoke exposure affects child survival and development.
METHODS: At a regional meeting of the Asia Pacific Child and Family Health Alliance for Tobacco Control, members reviewed existing good practices of child-focused tobacco control approaches using health promotion strategies. These interventions were implemented nationally in Malaysia, the Philippines and Singapore.
RESULTS: Three good practice national examples were identified that focused on creating supportive tobacco-free environments and upgrading cessation skills among paediatricians. These country examples highlight strategic areas to protect children and families from the harms of tobacco, as part of NCD prevention and control. Training paediatricians in brief cessation advice has enabled them to address tobacco-using parents. Fully enforcing smoke-free public areas has led to an increase in smoke-free homes. The Tobacco Free Generation is a tobacco control 'endgame' strategy that taps into a social movement to deglamorize tobacco use and empower youth born in and after year 2000 to reject tobacco and nicotine addiction.
CONCLUSION: Tobacco control is pivotal in the fight against NCDs; health promotion strategies to protect children and youth from tobacco have a critical role to play in NCD prevention and control. Frontline health workers, including primary care paediatricians, need to step up and actively advocate for full implementation of the WHO Framework Convention on Tobacco Control, including tobacco tax increases and smoke-free areas, while monitoring patients and their parents for tobacco use and second-hand smoke exposure, preventing adolescent smoking uptake, and offering cessation support. A life-course approach incorporating child-focused efforts to prevent initiation of smoking and second-hand smoke exposure with measures promoting cessation among parents will offer the greatest chance of overcoming future tobacco-related NCD burden.

Matched MeSH terms: Child Health*
Providing maternal and child care in rural Malaysia

Chen PC

Trop Geogr Med, 1977 Dec;29(4):441-8.
PMID: 610030

Since Independence, gained in 1957, major changes have occurred in the rural areas of Malaysia not least amongst which has been the provision of maternal and child care services to hitherto neglected areas. In the first part of this paper, the demographic and disease patterns are described. The second part outlines the general development efforts and describes in greater detail the rural health services that have been organized in Malaysia. In the concluding section, changes in mortality and morbidity are examined.

Matched MeSH terms: Child Health Services/manpower*
Fulltext Knowledge on immunisation among nurses in Malaysia

Lidwina Edwin Amir

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):21-21.
MyJurnal

Introduction: The National Immunization Program in Malaysia began in the 1950s and was integrated into the Ma-ternal and Child Health Program. Administrative data showed that coverage for all vaccinations was more than 95% except for measles vaccination. Despite the high coverage, there were clusters of outbreaks of vaccine preventable diseases. One of the reasons is the increasing phenomena of vaccines refusals following the rapid spread of negative perception and concerns through social media. Nurses as front liners play an important role to communicate on vac-cine safety and adverse events (AEFI). A survey was conducted to identify the level of knowledge among nurses who deal with immunisation programme. Methods: Nurses from all states attending a National seminar on immunisation communication in Putrajaya were asked to answer a Digital online questionnaire. They were asked to answer 12 questions on knowledge of vaccines, immunization schedule and cold chain management. Results: A total of 74% (429) of the seminar participants responded to the questionnaire, of which 85% were from the government sector and 15% from private. Findings showed that although about 75% of the nurses had formal training on immunisation, 50% had lack of knowledge about vaccination schedule for defaulters and 63.2% (268) had knowledge gaps related to questions on vaccines and handling of vaccines. Conclusion: In view of the knowledge gap from this survey, there is a need for ongoing training for the nurses and evaluation by supervisors on the knowledge and practices among nurses.

Matched MeSH terms: Child Health
Fulltext Knowledge and attitude about child abuse and its reporting among childcare providers in Kemas preschools in Kota Bharu and Tumpat

Siti Mariam Ja’afa, Azriani Ab Rahman, Wan Nor Ariffin Wan Mansor

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):108-108.
MyJurnal

Introduction: Child abuse is an epidemic and in Malaysia, the numbers are rising. Statistic showed that 60% of the victims were below seven years old. Since most of them goes to preschool at this age, the role of childcare providers (CPs) in addressing this issue is crucial. However, previous data showed that referrals made by them to the author-ities was less than 1%. The objective of this study was to determine the knowledge and attitude of CPs in KEMAS preschools towards child abuse. Methods: This is a cross-sectional study involving CPs working in the KEMAS pre-schools in Kota Bharu and Tumpat, Kelantan, Malaysia, from April to June 2019. Results: From 218 respondents, 78% and 83% of them had good awareness on signs of neglect and physical abuse respectively compared to sexual abuse (64.6%). In terms of knowledge, 80% answered correctly about signs of abuse. However, only 18.8% an-swered correctly about sexual abuse. Moreover, 86.7% of CPs believed that they should be responsible to lodge a report, while only 6% of them objected. Although 76.1% were correct about the information to be prepared for reporting, only 4.6% of them realised that suspicions about a case would suffice to lodge a report. There were 94.5%, and 65.1% of CPs who correctly answered about the protection of the reporter under the law and its penalty respectively. But, only 26.6% of the CPs were correct about the category of mandated reporters according to the law. Conclusion: Although majority of CPs had good knowledge and awareness, there was still 26.6% who did not realise that they were mandated to report suspected cases. Therefore, educational programs need to be planned to increase awareness and knowledge on abuse and its legal aspects among CPs.

Matched MeSH terms: Child Health
Fulltext Prevention of Childhood Obesity: A Position Paper of the Global Federation of International Societies of Paediatric Gastroenterology, Hepatology and Nutrition (FISPGHAN)

Koletzko B, Fishbein M, Lee WS, Moreno L, Mouane N, Mouzaki M, et al.

J Pediatr Gastroenterol Nutr, 2020 05;70(5):702-710.
PMID: 32205768 DOI: 10.1097/MPG.0000000000002708

Global childhood obesity increased more than 8-fold over 40 years, inducing a very large personal, societal, and economic burden. Effects of available treatments are less than satisfactory; therefore, effective prevention is of high priority. In this narrative review, we explore preventive opportunities. The available evidence indicates large benefits of improving nutrition and lifestyle during early life, such as promoting breast-feeding and improving the quality of infant and early childhood feeding. Promoting healthy eating patterns and limiting sugar-containing beverage consumption from early childhood onwards are of great benefit. Regular physical activity and limited sedentary lifestyle and screen time alone have limited effects but are valuable elements in effective multicomponent strategies. The home environment is important, particularly for young children, and can be improved by educating and empowering families. School- and community-based interventions can be effective, such as installing water fountains, improving cafeteria menus, and facilitating regular physical activity. Reducing obesogenic risk factors through societal standards is essential for effective prevention and limiting socioeconomic disparity; these may comprise food, drink, and physical activity standards for day cares and schools, general food quality standards, front-of-pack food labeling, taxation of unhealthy foods, restriction of food advertisements to children, and others. Effective prevention of childhood obesity is not achieved by single interventions but by integrated multicomponent approaches involving multiple stakeholders that address children, families, and societal standards. Pediatricians and their organizations should be proactive in supporting and empowering families to support their children's health, and in promoting societal measures that protect children.

Matched MeSH terms: Child Health
Fulltext A qualitative study on malnutrition in children from the perspectives of health workers in Tumpat, Kelantan

Cheah WL, Wan Manan WM, Zabidi-Hussin ZM, Chang KH

Malays J Nutr, 2007 Mar;13(1):19-28.
PMID: 22692186 MyJurnal

Underlying causes of most nutrition related problems are diverse, including biological, social, cultural, and economic factors. Qualitative approaches complement quantitative methods in identifying the underlying meanings and patterns of relationships involved in managing malnutrition. This study examined perceptions regarding malnutrition among health workers from 7 clinics (community and health clinics) in Tumpat, Kelantan. A total of 18 nurses and 2 doctors, who were involved in monitoring child health and nutrition, were included in the study. These health workers were interviewed using a semi-structured questionnaire adapted from Sastry's framework on malnutrition (Sastry, 1996). The questionnaire included biological, behavioral and environmental factors that influence child health and nutrition. All the health workers perceived that mothers/caregivers play the main role in improving the health of malnourished children. The quality of childcare was rated as moderately satisfactory by the health workers. Most of the affected families who were given the Food Baskets did not fully use all the items for the malnourished child. Child feeding practice was based on the needs of the whole family rather than according to the target child's needs. Most of the mothers preferred processed cereals than rice porridge because the former is easier to prepare for the child. Although they were from a low socioeconomic background, most of the mothers were not earning additional income for the family. The qualitative methodology provided information that can be used as a basis for the designing of quantitative questionnaires to assess malnutrition among children. The induction characteristic of qualitative methods was used to gain an understanding of the underlying reasons or phenomena such as behaviours that are directly observable.
Study site: Klinik kesihatan, Tumpat, Kelantan, Malaysia

Matched MeSH terms: Maternal-Child Health Centers
Fulltext Anaemia during pregnancy in rural Kelantan

Ahmad Z, Jaafar R, Mohd Hassan MH, Othman MS, Hashim A

Malays J Nutr, 1997 Mar;3(1):83-90.
PMID: 22692237 MyJurnal

A retrospective study of anaemia in pregnancy in rural Kelantan was conducted. The study sample consist of 9,860 mothers who had antenatal care at one of the 102 rural health clinics selected and had delivered a live baby. Anaemia in pregnancy was determined by reviewing the antenatal records for the haemoglobin level recorded at the first and last antenatal visit. Estimation of haemoglobin was done either by photocalorimetric methods or the Sahli's method in these rural clinics. At the time of booking, 47.5% of the mothers were anaemic by WHO criteria (Hb < 11.0 g/dl), with 1.9% having less than 9.0 g/dl. Age of mother, parity and late gestational age at the first antenatal visit were associated with anaemia during pregnancy at the time of booking. However, practise of contraception by the mother did not show any association with anaemia in pregnancy. There were 594 mothers (6.0%) who delivered a baby weighing less than 2.5 kg. There was no association between the low birth weight of the child and the status of anaemia in the mother at the last antenatal visit.

Matched MeSH terms: Maternal-Child Health Centers
Fulltext Effects of unstable daily life on children's health in Baghdad City, Iraq: qualitative study

Hasanain Faisal Ghazi, Zaleha Md. Isa, Mohammed A. Abdal Qader, Tiba Nezar Hasan

Malaysian Journal of Public Health Medicine, 2014;14(1):82-89.
MyJurnal

The unstable living situation in Iraq in the last 10 years after 2003 war affected the daily life of most Iraqis, and especially the children. The objective of this study was to explore the effects of an unstable living environment on children’s health. A community-based qualitative study was done to collect data from 20 mothers of children (age 7 to 8years old) through in-depth interview (IDI). Data was recorded using tape recorders and was later transcribed and analyzed using qualitative thematic analysis techniques. The majority of mothers interviewed said the past nine years of unstable security in the capital had affected their daily life; some mothers also expressed concern about their child’s nutritional status, their eating habits during the school day, and the unhealthy food being sold at school canteens. As a conclusion, the unstable living situations in Baghdad city after the last war had affected the cognitive and nutritional development of children. More precautions should be taken by parents to ensure their children safety in the future.

Matched MeSH terms: Child Health
Fulltext Do pregnant women in Penang smoke? A cross sectional study among antenatal mothers attending Penang government health clinic in the year 2002

Mohd Yusoff Hasim, Rokiah Mohd, Rafidah Md Noor, Azizah Abd. Manan, Abd. Jamil Ahmad, Munsyi Abdullah, et al.

Malaysian Journal of Public Health Medicine, 2003;3(1):36-41.
MyJurnal

Health impact related to smoking is a critical public health predicament especially in pregnancy. However there is not much data available to describe the magnitude of the problem. Hence this study was conducted to determine the prevalence of smoking and its socioeconomic factors among antenatal mother and their opinion related to tobacco control measures. A cross sectional study was carried out involving newly registered antenatal mothers attending all government health clinics in Penang. Prevalence of ever smoking among antenatal mother is 1.4%, of which 42.4% is still smoking at first antenatal visit. It was found that single mothers are more likely to smoke (OR, 14.23: C12.52-53.27). It was also noted that spouse smoking (OR, 5,14: CI 1.95-17.09), primigravida (OR, 2.7: C1 1.3-5.62), age group less than 30 years old (OR, 2.41; CI 1.03-6.09) and living in urban area (OR, 2.33; CI 1.01 — 6.47) have a higher risk to indulge in smoking behaviour. Muslim OR 0.29; C1 0.14 - 0.60) and Malay (OR 0.22; CI 0.10 - 0.47) pregnant mothers are noted to be less likely to smoke as compared to non Muslim and non Malay. More than 85% of them agreed with the tobacco control measures regardless of their smoking status. Most of respondents agreed the influential people in community L;11T · such as medical personnel, teachers and parents should not smoke.

Matched MeSH terms: Maternal-Child Health Centers
Fulltext The role of traditional birth attendants in family planning programs in Southeast Asia

Peng JY

Int J Gynaecol Obstet, 1979 9 1;17(2):108-13.
PMID: 41751 DOI: 10.1002/j.1879-3479.1979.tb00128.x

The training and utilization of traditional birth attendants (TBAs) in maternal and child health and family planning programs in Indonesia, the Philippines, Thailand and Malaysia are discussed. Special efforts to organize and train TBAs for family planning in Malaysia are examined in detail. Import factors for successful utilization of TBAs include: (a) definite assignment of functions and tasks, (b) organization of good operational steps and (c) implementation of good supervisory activities.

Matched MeSH terms: Child Health Services
Fulltext Barriers to utilization of oral health care services among antenatal mothers in Kuantan, Pahang [Abstract]

Zurainie Ablla, Karimah Hanim Abdul Aziz, Nurjasmine Aida Jamani

International Medical Journal Malaysia, 2017;16(21):40.
MyJurnal

Introduction: During pregnancy, increased acidity in the mouth increases the risk of antenatal mother to get dental caries. It is worsen if antenatal mother has morning sickness like vomiting during pregnancy. It can aggravate the problem by exposing the teeth to more gastric acid. In addition, antenatal mothers have hormonal changes that they are more susceptible to periodontal problems. Therefore, it is important for antenatal mother to get dental treatment and use oral health service. This study aim is to describe barriers to utilisation of oral health care services among antenatal mothers attending the Klinik Kesihatan Ibu dan Anak around Kuantan. Materials and Methods: A cross sectional study which was conducted among purposely selected 296 antenatal mothers aged 18-45 years from Kuantan, Pahang in 18 months duration. Study used validated self-administered questionnaire to obtain information on the variables of interest. Results: Common barriers to utilization of services among antenatal mothers are fear to dental pain (45.6%), time constraints- busy at workplace (36.5%) and feeling of not having any dental problems (36.1%). Meanwhile the least barrier to oral health care services among antenatal mothers is attitude of the dentist (0.7%), followed by attitude of the staff (1.4%) and condition of treatment room (1.7%) Conclusion(s): Fear of dental pain is the main barrier to utilization of service among antenatal mothers and dissatisfaction of the service provided is the least barrier among other factors.
KEYWORDS: barriers, antenatal, pregnant mothers, dental caries, periodontal

Matched MeSH terms: Maternal-Child Health Centers
Fulltext Medical students' reflection on the family planning services at primary health clinics in Malaysia

Htay MNN, Than NN, Abas AL, Lwin H, Moe S

J Educ Health Promot, 2018;7:87.
PMID: 30079358 DOI: 10.4103/jehp.jehp_144_17

CONTEXT: Family planning is crucial for everyone within the reproductive age to promote the health and welfare of every member of the family. For the medical students, it is essential to have core knowledge, understanding of family planning concept, and competency in communication skills with the patients. The final-year medical students are posted in Maternal and Child Health Clinics for 3 weeks to gain the knowledge and practical experiences on the primary healthcare in the community.

AIMS: The aim of this study was to explore the experiences of final-year medical students on family planning services offered at community clinics in Malaysia.

SETTINGS AND DESIGN: This was qualitative study.

SUBJECTS AND METHODS: This qualitative study used the data of the students' reflection written in the case reports on family planning. Coding, identification of subthemes, and themes were done by two researchers independently using RQDA software.

STATISTICAL ANALYSIS USED: Thematic analysis.

RESULTS: Final-year medical students who had exposure to the clinical services at primary care clinic, regarding Malay word (Klinik Kesihatan) gained the learning opportunities during family planning session such as learning by observation, clerking, and counseling the patients, understanding the barriers to utilizing services and learning for their self-improvement. These learning opportunities lead to developing the positive attitudes on their learning experiences and the positive attitudes toward the concept and services of family planning.

CONCLUSIONS: To have the better understanding of family planning services and provide the better care to the community in the future, the clinical exposure at the primary care clinics should be promoted for medical students in Malaysia.

Matched MeSH terms: Child Health

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