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A proposal to help achieve equitable treatment of transgender people in the health system

Ahmadi K, Allotey P, Reidpath DD

Acad Med, 2013 May;88(5):559.
PMID: 23611970 DOI: 10.1097/ACM.0b013e31828a0d46
Matched MeSH terms: Health Policy
Bridging the science-policy divide

Reid WV

PLoS Biol, 2004 Feb;2(2):E27.
PMID: 14966530
Matched MeSH terms: Health Policy/trends*
Historical epidemiology of hepatitis C virus in select countries-volume 4

Maaroufi A, Vince A, Himatt SM, Mohamed R, Fung J, Opare-Sem O, et al.

J Viral Hepat, 2017 10;24 Suppl 2:8-24.
PMID: 29105285 DOI: 10.1111/jvh.12762

Due to the introduction of newer, more efficacious treatment options, there is a pressing need for policy makers and public health officials to develop or adapt national hepatitis C virus (HCV) control strategies to the changing epidemiological landscape. To do so, detailed, country-specific data are needed to characterize the burden of chronic HCV infection. In this study of 17 countries, a literature review of published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates was conducted, and inputs were validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Hong Kong to 2.4% in Taiwan, while the largest viraemic populations were in Nigeria (2 597 000 cases) and Taiwan (569 000 cases). Diagnosis, treatment and liver transplant rates varied widely across the countries included in this analysis, as did the availability of reliable data. Addressing data gaps will be critical for the development of future strategies to manage and minimize the disease burden of hepatitis C.

Matched MeSH terms: Health Policy
A critique of the policy discourse on primary health care under the Aardram mission of Kerala

Sreekumar S, Ravindran TKS

Health Policy Plan, 2023 Sep 18;38(8):949-959.
PMID: 37354455 DOI: 10.1093/heapol/czad041

In 2017, the State of Kerala in India, launched the 'Aardram' mission for health. One of the aims of the mission was to enhance the primary health care (PHC) provisioning in the state through the family health centre (FHC) initiative. This was envisaged through a comprehensive PHC approach that prioritized preventive, promotive, curative, rehabilitative and palliative services, and social determinants of health. Given this backdrop, the study aimed to examine the renewed policy commitment towards comprehensive PHC and the extent to which it remains true to the globally accepted ideals of PHC. This was undertaken using a critical discourse analysis (CDA) of the policy discourse on PHC. This included examining the policy documents related to FHC and Aardram as well as the narratives of policy-level actors on PHC and innovations for them. Through CDA we examined the discursive representation of PHC and innovations for improving it at the level of local governments in the state. Though the mission envisaged a shift from the influence of market-driven ideas of health, analysis of the current policy discourse on PHC suggested otherwise. The discourse continues to carry a curative care bias within its ideas of PHC. The disproportionate emphasis on strategies for early detection, treatment and infrastructural improvements meant limited space for preventive, protective and promotive dimensions, thus digressing from the gatekeeping role of PHC. The reduced emphasis on preventive and promotive dimensions and depoliticization of social determinants of health within the PHC discourse indicates that, in the long run, the mission puts at risk its stated goals of social justice and health equity envisioned in the FHC initiative.

Matched MeSH terms: Health Policy
Fulltext Knowledge and beliefs about breastfeeding are not determinants for successful breastfeeding

Ishak S, Adzan NA, Quan LK, Shafie MH, Rani NA, Ramli KG

Breastfeed Med, 2014;9(6):308-12.
PMID: 24893127 DOI: 10.1089/bfm.2013.0124

A cross-sectional prospective study was performed to assess knowledge and attitude toward breastfeeding among mothers in a tertiary hospital in Malaysia and its influence on their breastfeeding practices. Two hundred thirteen women who had delivered healthy babies at term were enrolled. A structured questionnaire containing demographic data and the Iowa Infant Feeding Attitude Score were used, followed by a telephone interview after 8 weeks to determine the feeding outcome. Women of Malay ethnicity with higher education level who had received breastfeeding counseling had a significantly more favorable attitude toward breastfeeding. Ethnicity was found to be a significant determinant in the success of breastfeeding, whereas returning to work was a major reason for discontinuing breastfeeding. In ensuring a successful breastfeeding practice, apart from knowledge and attitude, issues surrounding culture and traditions as well as improving deliverance of readily available support should be addressed.

Matched MeSH terms: Health Policy
Fulltext Cervical cancer in Brunei Darussalam

Lee MY, Telisinghe PU, Ramasamy R

Singapore Med J, 2012 Sep;53(9):604-7.
PMID: 23023903

Introduction Cervical cancer caused by the human papilloma virus (HPV) is a common cancer in women. There is no published data on the recent incidence of cervical dysplasia, cervical cancer and genital warts caused by the different types of HPVs in Brunei Darussalam.
Methods A cross-sectional, retrospective study was conducted utilising data from patients diagnosed with cervical cancer during the period 2005–2009 in Brunei Darussalam. The varying incidences of different types of cervical lesions among various ethnic and age groups, and in the overall population, were determined.
Results The mean age-standardised incidence of invasive cervical cancer during the five-year period was 24.9 per 100,000 women per year (95% confidence interval [CI] 21.7, 28.1). Age-specific invasive cervical cancer incidence peaked in the age group 45–59 years. Chinese females tended to have a higher incidence of invasive cervical cancer (28.2 per 100,000 women per year; 95% CI 17.8, 38.7) than Malay females (20.6 per 100,000 women per year; 95%
CI 17.1, 24.2), while other ethnic groups in Brunei Darussalam had a significantly lower incidence (6.5 per 100,000 women per year; 95% CI 3.0, 10.0).
Conclusion The results suggest that Brunei Darussalam has a relatively higher incidence of cervical cancer compared to its neighbouring countries. The findings support the need for more comprehensive screening, public education programmes and vaccination against HPV in the country.

Matched MeSH terms: Health Policy
Fulltext Impact of Point-of-Sale Tobacco Display Bans in Thailand: Findings from the International Tobacco Control (ITC) Southeast Asia Survey

Li L, Borland R, Yong HH, Sirirassamee B, Hamann S, Omar M, et al.

Int J Environ Res Public Health, 2015 Aug;12(8):9508-22.
PMID: 26287219 DOI: 10.3390/ijerph120809508

In September 2005 Thailand became the first Asian country to implement a complete ban on the display of cigarettes and other tobacco products at point-of-sale (POS). This paper examined the impact of the POS tobacco display ban in Thailand, with Malaysia (which did not impose bans) serving as a comparison. The data came from the International Tobacco Control Southeast Asia Survey (2005-2011), a prospective cohort survey designed to evaluate the psychosocial and behavioral impacts of tobacco control policies. Main measures included smokers' reported awareness of tobacco displays and advertising at POS. At the first post-ban survey wave over 90% of smokers in Thailand were aware of the display ban policy and supported it, and about three quarters thought the ban was effective. Noticing tobacco displays in stores was lowest (16.9%) at the first post-ban survey wave, but increased at later survey waves; however, the levels were consistently lower than those in Malaysia. Similarly, exposure to POS tobacco advertising was lower in Thailand. The display ban has reduced exposure to tobacco marketing at POS. The trend toward increased noticing is likely at least in part due to some increase in violations of the display bans and/or strategies to circumvent them.

Matched MeSH terms: Health Policy*
Fulltext Healthcare is not universal if undocumented migrants are excluded

Legido-Quigley H, Pocock N, Tan ST, Pajin L, Suphanchaimat R, Wickramage K, et al.

BMJ, 2019 Sep 16;366:l4160.
PMID: 31527060 DOI: 10.1136/bmj.l4160
Matched MeSH terms: Health Policy*
Results from Malaysia's 2016 report card on physical activity for children and adolescents

Sharif R, Chong KH, Zakaria NH, Ong ML, Reilly JJ, Wong JE, et al.

J Phys Act Health, 2016 11;13(11 Suppl 2):S201-S205.
PMID: 27848721 DOI: 10.1123/jpah.2016-0404

BACKGROUND: The 2016 Malaysia Active Healthy Kids Report Card aims to collect, assess, and grade current and comprehensive data on physical activity (PA) and associated factors in Malaysian children and adolescents aged 5 to 17 years.
METHODS: This report card was developed following the Active Healthy Kids Canada Report Card protocol. The Research Working Group identified the core matrices, assessed the key data sources, and evaluated the evidence gathered for grade assignments. A grade was assigned to each indicator by comparing the best available evidence against relevant benchmark using a standardized grading scheme.
RESULTS: Overall Physical Activity, Active Transportation, and Sedentary Behavior were assigned the D grade. The lowest grade of F was assigned to Diet, while School and Government Strategies and Investments were graded higher with a B. Five indicators were assigned INC (incomplete) due to a lack of representative data.
CONCLUSIONS: The report card demonstrates that Malaysian children and adolescents are engaging in low levels of PA and active commuting, high levels of screen time, and have extremely low compliance with dietary recommendations. More efforts are needed to address the root causes of physical inactivity while increasing the opportunities for children and adolescents to be more physically active.
MESH: screen time

Matched MeSH terms: Health Policy
Health imperatives in foreign policy: the case of Malaysia

Barraclough S, Phua KL

Bull World Health Organ, 2007 Mar;85(3):225-9.
PMID: 17486215

Malaysia's global, regional and bilateral international health relations are surveyed against the historical backdrop of the country's foreign policy. Malaysia has always participated in multilateral agencies, most notably the World Health Organization, as such agencies are part of the longstanding fabric of "good international citizenship". The threats of infectious diseases to human health and economic activity have caused an intensification and an organizational formalization of Malaysian health diplomacy, both regionally and bilaterally. Such diplomacy has also established a basis for developing a wider set of cooperative relationships that go beyond responding to the threat of pandemics. As Malaysia approaches "developed" status, its health sector is becoming increasingly integrated into the global economy through joint research and development ventures and transnational investment. At the same time, it will have the technological, financial and human resources to play an expanded altruistic role in global and regional health.

Matched MeSH terms: Health Policy*
Redesigning healthcare systems to meet the health challenges associated with climate change in the twenty-first century

Phua KL

J Emerg Manag, 2015;13(3):255-63.
PMID: 26150369 DOI: 10.5055/jem.2015.0239

In the twenty-first century, climate change is emerging as a significant threat to the health and well-being of the public through links to the following: extreme weather events, sea level rise, temperature-related illnesses, air pollution patterns, water security, food security, vector-borne infectious diseases, and mental health effects (as a result of extreme weather events and climate change-induced population displacement). This article discusses how national healthcare systems can be redesigned through changes in its components such as human resources, facilities and technology, health information system, and health policy to meet these challenges.

Matched MeSH terms: Health Policy*
Fulltext Greying Malaysians: strategies for promoting and supporting healthy and productive ageing

Phua KL

Malaysian Journal of Community Health, 2007;13(1):16-21.
MyJurnal

Population ageing is inevitable in Malaysia as a result of declining fertility rates. Steps can be taken to face this challenge. These include ways to promote “healthy ageing” and “compression of morbidity” and ways to promote “productive ageing”, i.e., keeping the elderly economically and socially engaged. This article, based on a review of the literature, argues that it is illogical to force people into compulsory retirement at an arbitrary age when they can continue to contribute actively to society. Instead, ways can be devised to promote healthy ageing, prolonging independence and encouraging productive ageing through gradual economic and social disengagement of the individual depending on the individual’s physical health, mental health, contribution to society and personal inclination and preferences. Public policy in general and public health policy in particular can be designed or redesigned to help achieve this.

Matched MeSH terms: Health Policy
Fulltext Challenges in dental public health – an overview

Pau, Allan Kah-Heng

International e-Journal of Science, Medicine & Education, 2012;6(10):0-0.
MyJurnal

Oral health diseases are common in all regions of the world and their impact on anatomical
and social functioning is widely acknowledged.Their distributions are unequal between and within countries, with the greatest burden falling on disadvantaged and socially marginalized populations. The risk factors and social determinants for oral diseases have been comprehensively documented, and the evidence base for their prevention is growing. However, decisions on health care are still often made without a solid grounding in research evidence. Translation of research into policy and practice should be a priority for all. Both community and individual interventions need tailoring to achieve a more equal and person-centered preventive focus and reduce any social gradient in health. The major challenges of the future will be to translate knowledge and experiences in oral disease prevention
and health promotion into action programmes.The international oral health research community needs to engage further in research capacity building and in strengthening the work so that research is recognized as the foundation of oral health policy at global level.

Matched MeSH terms: Health Policy
Fulltext Investigating revisit intention of medical tourists in China through nutritional knowledge, perceived medical quality, and trust in the physiologist: A recommendation on health tourism policy measures

Fengmin Z, Baijun W, Jiangtao B, Li L, Patwary AK

Front Public Health, 2022;10:893497.
PMID: 36091519 DOI: 10.3389/fpubh.2022.893497

Good medical care has long been a top priority in health tourism to keep the flow of visitors coming for medical treatment. Medical tourism encompasses a range of treatments, from basic check-ups to surgical operations. For its friendly character and high quality of service, China has earned a reputation as one of Asia's top destinations for health tourism. Along with India and Taiwan, Japan, Thailand, and South Korea are China's top tourism destinations. Considering the above fact, this study aims to examine the influence of nutritional knowledge, perceived medical quality, and trust in physiologists on revisiting the intention of medical tourists in China. This study is cross-sectional and follows a quantitative approach. The researchers used questionnaires as a survey tool to obtain information from the respondents. The respondents of this chosen international tourists in China who come for medical treatment purposes. A systematic random sampling technique was used to select the respondents, and 315 usable responses were collected from the respondents and proceeded with further analysis. The study conducted structural equation modeling using Smart PLS version 3. The results found that nutritional knowledge, perceived medical quality, and trust in physiologists significantly influence the revisit intention of medical tourists in China.

Matched MeSH terms: Health Policy
Reducing maternal mortality: can we derive policy guidance from developing country experiences?

Liljestrand J, Pathmanathan I

J Public Health Policy, 2004;25(3-4):299-314.
PMID: 15683067 DOI: 10.1057/palgrave.jphp.3190030

Developing countries are floundering in their efforts to meet the Millennium Development Goal of reducing maternal mortality by 75% by 2015. Two issues are being debated. Is it doable within this time frame? And is it affordable? Malaysia and Sri Lanka have in the past 50 years repeatedly halved their maternal mortality ratio (MMR) every 7-10 years to reduce MMR from over 500 to below 50. Experience from four other developing countries--Bolivia, Yunan in China, Egypt, and Jamaica-confirms that each was able to halve MMR in less than 10 years beginning from levels of 200-300. Malaysia and Sri Lanka, invested modestly (but wisely)--less than 0.4% of GDP--on maternal health throughout the period of decline, although the large majority of women depended on publicly funded maternal health care. Analysis of their experience suggests that provision of access to and removal of barriers for the use of skilled birth attendance has been the key. This included professionalization of midwifery and phasing out of traditional birth attendants; monitoring births and maternal deaths and use of such information for high profile advocacy on the importance of reducing maternal death; and addressing critical gaps in the health system; and reducing disparities between different groups through special attention to the poor and disadvantaged populations.

Matched MeSH terms: Health Policy/legislation & jurisprudence*
Increased utilization of peritoneal dialysis to cope with mounting demand for renal replacement therapy--perspectives from Asian countries

Li PK, Lui SL, Leung CB, Yu AW, Lee E, Just PM, et al.

Perit Dial Int, 2007 Jun;27 Suppl 2:S59-61.
PMID: 17556331

With the number of end-stage renal disease (ESRD) patients growing, one of the crucial questions facing health care professionals and funding agencies in Asia is whether funding for dialysis will be sufficient to keep up with demand. During the ISPD's 2006 Congress, academic nephrologists and government officials from China, Hong Kong, India, Indonesia, Japan, Macau, Malaysia, Philippines, Singapore, Taiwan, Thailand, and Vietnam participated in a roundtable discussion on dialysis economics in Asia. The focus was policy and health care financing. The roundtable addressed ESRD growth in Asia and how to obtain enough funding to keep up with the growth in patient numbers. Various models were presented: the "peritoneal dialysis (PD) first" policy model, incentive programs, nongovernmental organizations providing PD, and PD reimbursement in a developing economy. This article summarizes the views of the participant nephrologists on how to increase the utilization of PD to improve on clinical and financial management of patients with ESRD.

Matched MeSH terms: Health Policy/economics
Malaysia mental health country profile

Parameshvara Deva M

Int Rev Psychiatry, 2014 Feb-May;16(1-2):167-76.
PMID: 15276949 DOI: 10.1080/09540260310001635203

Malaysia is a tropical country in the heart of south east Asia with a population of 24 million people of diverse ethnic, cultural and religious backgrounds living in harmony in 330,000 km(2) of land on the Asian mainland and Borneo. Malaysia, which lies on the crossroads of trade between east and west Asia, has an ancient history as a centre of trading attracting commerce between Europe, west Asia, India and China. It has had influences from major powers that dominated the region throughout its history. Today the country, after independence in 1957, has embarked on an ambitious development project to make it a developed country by 2020. In this effort the economy has changed from one producing raw material to one manufacturing consumer goods and services and the colonial health system has been overhauled and social systems strengthened to provide better services for its people. The per capita income, which was under 1,000 US dollars at independence, has now passed 4,000 US dollars and continues to grow, with the economy largely based on strong exports that amount to over 100 billion US dollars. The mental health system that was based on institutional care in four mental hospitals at independence from British colonial rule in 1957 with no Malaysian psychiatrists is today largely based on over 30 general hospital psychiatric units spread throughout the country. With three local postgraduate training programmes in psychiatry and 12 undergraduate departments of psychiatry in the country--all started after independence--there is now a healthy development of mental health services. This is being supplemented by a newly established primary care mental health service that covers community mental health by integrating mental health into primary health care. Mental health care at the level of psychiatrists rests with about 140 psychiatrists most of whom had undertaken a four-year masters course in postgraduate psychiatry in Malaysia since 1973. However, there continues to be severe shortages of other professionals such as clinical psychologists and social workers in mental health services. There are a few specialists, and specialized services in child, adolescent, forensic, rehabilitative, liaison or research fields of mental health. In the area of services for women and children, as well as the disabled in the community, there are strong efforts to improve the care and provide services that are in keeping with a caring society. New legislation on these are being passed every year and the setting up of a Ministry for Women's Affairs is one such move in recent years. Mental health in Malaysia has been slow in developing but has in the past decade seen important strides to bring it on par with other branches of medicine.

Matched MeSH terms: Health Policy/legislation & jurisprudence
EVIPNet: translating the spirit of Mexico

Hamid M, Bustamante-Manaog T, Truong VD, Akkhavong K, Fu H, Ma Y, et al.

Lancet, 2005 Nov 19;366(9499):1758-60.
PMID: 16298204 DOI: 10.1016/S0140-6736(05)67709-4
Matched MeSH terms: Health Policy*
Fulltext Comparing and assessing physical activity guidelines for children and adolescents: a systematic literature review and analysis

Parrish AM, Tremblay MS, Carson S, Veldman SLC, Cliff D, Vella S, et al.

Int J Behav Nutr Phys Act, 2020 02 10;17(1):16.
PMID: 32041635 DOI: 10.1186/s12966-020-0914-2

BACKGROUND: The impact of declining physical activity and increased sedentary behaviour in children and adolescents globally prompted the development of national and international physical activity guidelines. This research aims to systematically identify and compare national and international physical activity guidelines for children and adolescents and appraise the quality of the guidelines to promote best practice in guideline development.
METHODS: This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Only national, or international physical activity and/or sedentary behaviour guidelines were included in the review. Included guidelines targeted children and adolescents aged between 5 and 18 years. A grey literature search was undertaken incorporating electronic databases, custom Google search engines, targeted websites and international expert consultation. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II).
RESULTS: The search resulted in 50 national or international guidelines being identified. Twenty-five countries had a national guideline and there were three international guidelines (European Union, Nordic countries (used by Iceland, Norway and Sweden), World Health Organization (WHO)). Nineteen countries and the European Union adopted the WHO guidelines. Guidelines varied in relation to date of release (2008 to 2019), targeted age group, and guideline wording regarding: type, amount, duration, intensity, frequency and total amount of physical activity. Twenty-two countries included sedentary behaviour within the guidelines and three included sleep. Total scores for all domains of the AGREE II assessment for each guideline indicated considerable variability in guideline quality ranging from 25.8 to 95.3%, with similar variability in the six individual domains. Rigorous guideline development is essential to ensure appropriate guidance for population level initiatives.
CONCLUSIONS: This review revealed considerable variability between national/international physical activity guideline quality, development and recommendations, highlighting the need for rigorous and transparent guideline development methodologies to ensure appropriate guidance for population-based approaches. Where countries do not have the resources to ensure this level of quality, the adoption or adolopment (framework to review and update guidelines) of the WHO guidelines or guidelines of similar quality is recommended.
TRIAL REGISTRATION: Review registration: PROSPERO 2017 CRD42017072558.

Matched MeSH terms: Health Policy*
Policy implications of health changes in rapidly developing countries: the case of Malaysia

Harlan WR, Harlan LC, Oii WL

J Public Health Policy, 1984 Dec;5(4):563-72.
PMID: 6526940
Matched MeSH terms: Health Policy/trends*

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