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A supply model for nurse workforce projection in Malaysia

Abas ZA, Ramli MR, Desa MI, Saleh N, Hanafiah AN, Aziz N, et al.

Health Care Manag Sci, 2018 Dec;21(4):573-586.
PMID: 28822005 DOI: 10.1007/s10729-017-9413-7

The paper aims to provide an insight into the significance of having a simulation model to forecast the supply of registered nurses for health workforce planning policy using System Dynamics. A model is highly in demand to predict the workforce demand for nurses in the future, which it supports for complete development of a needs-based nurse workforce projection using Malaysia as a case study. The supply model consists of three sub-models to forecast the number of registered nurses for the next 15 years: training model, population model and Full Time Equivalent (FTE) model. In fact, the training model is for predicting the number of newly registered nurses after training is completed. Furthermore, the population model is for indicating the number of registered nurses in the nation and the FTE model is useful for counting the number of registered nurses with direct patient care. Each model is described in detail with the logical connection and mathematical governing equation for accurate forecasting. The supply model is validated using error analysis approach in terms of the root mean square percent error and the Theil inequality statistics, which is mportant for evaluating the simulation results. Moreover, the output of simulation results provides a useful insight for policy makers as a what-if analysis is conducted. Some recommendations are proposed in order to deal with the nursing deficit. It must be noted that the results from the simulation model will be used for the next stage of the Needs-Based Nurse Workforce projection project. The impact of this study is that it provides the ability for greater planning and policy making with better predictions.

Matched MeSH terms: Health Manpower/statistics & numerical data*
Malaysian pharmacy students' intention to provide smoking cessation counseling

Simansalam S, Hadijah Shamsudin S, Mohamed MHN

Curr Pharm Teach Learn, 2017 Sep;9(5):918-924.
PMID: 29233325 DOI: 10.1016/j.cptl.2017.05.022

BACKGROUND AND PURPOSE: Malaysian National Quit Smoking Program had proposed to integrate smoking cessation counseling skills into all relevant healthcare curricula as one of its strategies to increase the number of Malaysians giving up smoking. More effective implementation of the curricula can be facilitated by further understanding the factors influencing students' intention in terms of providing smoking cessation counseling. This study, guided by Integrated Behavior Model (IBM), aimed to explore the factors which influenced pharmacy undergraduates in providing smoking cessation counseling.
EDUCATIONAL ACTIVITY AND SETTING: Following the elicitation study, the IBM-guided questionnaire was developed and distributed to students from two pharmacy schools which agreed to participate, each representing public and private institutions.
FINDINGS: A total of 387 pharmacy students participated yielding a 83% response rate. Multiple regression analysis revealed that all three, namely, attitude (23%), perceived norm (16%), and personal agency (16%) were significant predictors of students' intention. Further analysis revealed 'experiential attitude', a component of attitude as the strongest predictor. In other words, students who felt more comfortable had higher intention to provide smoking cessation counseling.
SUMMARY: An implication of this study is that tobacco-related curricula with an emphasis to enhance students' comfort level in providing counseling would be of value for these future pharmacists in terms of their intention as well as actual provision of smoking cessation counseling through the mediation of "experiential attitude" and personal agency.

Matched MeSH terms: Counseling/manpower*
Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions

Sayed S, Cherniak W, Lawler M, Tan SY, El Sadr W, Wolf N, et al.

Lancet, 2018 05 12;391(10133):1939-1952.
PMID: 29550027 DOI: 10.1016/S0140-6736(18)30459-8

Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs). Increasing and retaining a quality PALM workforce requires access to mentorship and continuing professional development, task sharing, and the development of short-term visitor programmes. Opportunities to enhance the training of pathologists and allied PALM personnel by increasing and improving education provision must be explored and implemented. PALM infrastructure must be strengthened by addressing supply chain barriers, and ensuring laboratory information systems are in place. New technologies, including telepathology and point-of-care testing, can have a substantial role in PALM service delivery, if used appropriately. We emphasise the crucial importance of maintaining PALM quality and posit that all laboratories in LMICs should participate in quality assurance and accreditation programmes. A potential role for public-private partnerships in filling PALM services gaps should also be investigated. Finally, to deliver these solutions and ensure equitable access to essential services in LMICs, we propose a PALM package focused on these countries, integrated within a nationally tiered laboratory system, as part of an overarching national laboratory strategic plan.

Matched MeSH terms: Clinical Laboratory Services/manpower*
Using overseas registered nurses to fill employment gaps in rural health services: quick fix or sustainable strategy?

Francis K, Chapman Y, Doolan G, Sellick K, Barnett T

Aust J Rural Health, 2008 Jun;16(3):164-9.
PMID: 18471187 DOI: 10.1111/j.1440-1584.2008.00967.x

OBJECTIVE:This study sought to identify and evaluate approaches used to attract internationally trained nurses from traditional and non-traditional countries and incentives employed to retain them in small rural hospitals in Gippsland, Victoria.
DESIGN: An exploratory descriptive design.
SETTING: Small rural hospitals in Gippsland, Victoria.
PARTICIPANTS: Hospital staff responsible for recruitment of nurses and overseas trained nurses from traditional and non-traditional sources (e.g. England, Scotland, India, Zimbabwe, Holland, Singapore, Malaysia).
RESULTS AND CONCLUSION: Recruitment of married overseas trained nurses is more sustainable than that of single registered nurses, however, the process of recruitment for the hospital and potential employees is costly. Rural hospitality diffuses some of these expenses by the employing hospitals providing emergency accommodation and necessary furnishings. Cultural differences and dissonance regarding practice create barriers for some of the overseas trained nurses to move towards a more sanguine position. On the positive side, single overseas registered nurses use the opportunity to work in rural Australian hospitals as an effective working holiday that promotes employment in larger, more specialized hospitals. Overall both the registered nurses and the employees believe the experience to be beneficial rather than detrimental.

Matched MeSH terms: Hospitals, Rural/manpower; Rural Health Services/manpower*
Growing wealth and growing pains: child and adolescent psychiatry in Hong Kong, Malaysia and Singapore

Tan S, Fung D, Hung SF, Rey J

Australas Psychiatry, 2008 Jun;16(3):204-9.
PMID: 18568628 DOI: 10.1080/10398560701874283

Several Asian regions have undergone a dramatic transformation, some becoming very affluent. This paper aims to ascertain how countries that are becoming wealthy have dealt with child and adolescent mental health issues.

Matched MeSH terms: Adolescent Psychiatry/manpower; Child Psychiatry/manpower
Fulltext Pre-employment medical examination of Indonesian domestic helpers in a private clinic in Johor Bahru--an eight year review

Leong CC

Med J Malaysia, 2006 Dec;61(5):592-8.
PMID: 17623961

On review of 3117 patients' records (all were female Indonesian foreign workers over the span of eight years (1997 to 2004 in a private clinic in Johor Bahru, 223 cases (7.2%) were found to have various medical problems. These 3117 foreigners were to be employed as domestic helpers in Malaysia. They were examined upon arrival in Johor Bahru even though our government did not require this pre-requisite (before 1st August 2005) as they were examined and certified fit in their country of origin before embarking to Malaysia. The proportion of female Indonesian foreign workers who were afflicted with category 1 conditions was 55.6% (which rendered them unfit for employment) and category 2 conditions was 44.4%. The medical problem detected most frequently was hypertension. Sixty-one (80.3%) out of 76 workers had stage 2 hypertension (JNC 7 report). Pulmonary tuberculosis ranked second in this review and is a category 1 condition. This paper supports the recent move by the Malaysian Ministry of Health to implement mandatory medical examinations for all foreign workers arriving in Malaysia within one month of arrival regardless of whether or not they are certified fit in their countries of origin.

Matched MeSH terms: Homemaker Services/manpower; Housekeeping/manpower
Impact of 24 hour critical care physician staffing on case-mix adjusted mortality in paediatric intensive care

Goh AY, Lum LC, Abdel-Latif ME

Lancet, 2001 Feb 10;357(9254):445-6.
PMID: 11273070

The 24 h availability of intensive care consultants (intensivists) has been shown to improve outcomes in adult intensive care units (ICU) in the UK. We tested whether such availability would improve standardised mortality ratios when compared to out-of-hours cover by general paediatricians in the paediatric ICU setting of a medium-income developing country. The standardised mortality ratio (SMR) improved significantly from 1.57 (95%CI 1.25-1.95) with non-specialist care to 0.88 (95%CI 0.63-1.19) with intensivist care (rate ratio 0.56, 95% CI 0.47-0.67). Mortality odds ratio decreased by 0.234, 0.246 and 0.266 in the low, moderate and high-risk patients. 24 h availability of intensivists was associated with improved outcomes and use of resources in paediatric intensive care in a developing country.

Matched MeSH terms: Pediatrics/manpower*; Intensive Care Units, Pediatric/manpower*
Maternity services and the role of the traditional birth attendant, bidan kampung, in rural Malaysia

Ali A, Howden-Chapman P

J Public Health Manag Pract, 2007 May-Jun;13(3):278-86.
PMID: 17435495 DOI: 10.1097/01.PHH.0000267686.08282.3c

This study was undertaken to explore the roles played by bidan kampungs and understand their contribution to rural Malay women during pregnancy and childbirth hundred sixteen pregnant women, 13 Western midwives, and 12 bidan kampungs were recruited using convenience and snowball sampling. Data were collected from focus groups, in-depth interviews, field notes, and observations. The findings indicated that although the women were happy to have Western maternity care, they valued the social and spiritual support received from bidan kampungs during pregnancy and postnatal care. Western care was considered useful for "modern" illnesses. The traditional maternity care that women received included pantang or ritual prohibitions that helped them through pregnancy and helped them achieve better postnatal recovery. The study indicates that there is a need to combine Western and traditional care for the benefit of the pregnant women and their infants' health.

Matched MeSH terms: Maternal Health Services/manpower*; Rural Health Services/manpower*
Indonesian immigrant settlements in peninsular Malaysia

Azizah Kassim

Sojourn, 2000 Apr;15(1):100-22.
PMID: 12349650

For over 2 decades, until the economic crisis in mid-1997, Malaysia's rapid economic growth attracted an influx of foreign labor, mostly from Indonesia, Bangladesh, and the Philippines. In 1997 the number of registered workers was estimated at 1.2 million and undocumented ones at approximately 800,000. The influx created various problems, of which housing is one of the most serious, especially in the Kelang Valley. This paper examines the ways and means by which Indonesian workers, the largest group among foreigners, overcame their accommodation problem. Two types of settlements are identified, that is, illegal ones in the squatter areas and legal ones, which are largely in Malay Reservation Areas. The settlements, which signify Indonesians' success in finding a foothold in Malaysia, today have become a base for more in-migration.

Matched MeSH terms: Health Manpower
Women's labour force participation and socioeconomic development: the case of Peninsular Malaysia, 1957-1970

Hirschman C, Aghajanian A

J Southeast Asian Stud, 1980 Mar;11(1):30-49.
PMID: 12336488
Matched MeSH terms: Health Manpower
Migrant workers in ASEAN: a review of issues and implications for government policies

Lim Lin Lean, Chan PT

Int Migr, 1983;21(2):277-87.
PMID: 12266834
Matched MeSH terms: Health Manpower
Environmental sanitation and pollution in Malaysia

Sekaran AS

Med J Malaysia, 1974 Dec;29(2):97-102.
PMID: 4282408
Matched MeSH terms: Health Manpower
Non-front-fanged colubroid ("colubrid") snakebites: three cases of local envenoming by the mangrove or ringed cat-eyed snake (Boiga dendrophila; Colubridae, Colubrinae), the Western beaked snake (Rhamphiophis oxyrhynchus; Lamprophiidae, Psammophinae) and the rain forest cat-eyed snake (Leptodeira frenata; Dipsadidae)

Weinstein SA, Griffin R, Ismail AK

Clin Toxicol (Phila), 2014 Apr;52(4):277-82.
PMID: 24645905 DOI: 10.3109/15563650.2014.897352

Non-front-fanged colubroid snakes (NFFC; formerly and artificially taxonomically assembled as "colubrids") comprise the majority of extant ophidian species. Although the medical risks of bites by a handful of species have been documented, the majority of these snakes have oral products (Duvernoy's secretions, or venoms) with unknown biomedical properties/unverified functions and their potential for causing harm in humans is unknown.

Matched MeSH terms: Animal Husbandry/manpower
Fulltext Emotional burnout, perceived sources of job stress, professional fulfillment, and engagement among medical residents in Malaysia

Al-Dubai SA, Ganasegeran K, Perianayagam W, Rampal KG

ScientificWorldJournal, 2013;2013:137620.
PMID: 24367238 DOI: 10.1155/2013/137620

This study was the first to explore factors associated with emotional burnout (EB) among medical residents in Malaysia. A cross-sectional study was conducted in a universal sample of 205 medical residents in a Malaysian general hospital. The self-administered questionnaire used consisted of questions on sociodemographics and work characteristics, sources of job stress, professional fulfillment, engagement, and EB. EB was measured using the emotional exhaustion subscale, the Maslach Burnout Inventory (MBI). Mean (±SD) age of the respondents was 26.5 (±1.6). The most common source of job stress was "fear of making mistakes." Most of the participants were dissatisfied with the increase of residentship period from one year to two years. A high level of EB was reported by 36.6% of the respondents. In multivariate analysis, the most important correlates of EB were sources of job stress, professional fulfillment, and engagement. A high prevalence of EB was found among medical residents. Sociodemographic characteristics, performance pressure, and satisfaction with policies were significantly associated with EB. Although this study was limited by its cross-sectional design, its findings posit a sufficient foundation to relevant authorities to construct, amend, and amalgamate existing and future policies. Nothing will sustain you more potently than the power to recognize in your humdrum routine, as perhaps it may be thought, the true poetry of life-the poetry of the common place, of the common man, of the plain, toil-worn woman, with their loves and their joys, their sorrows and their grief.SirWilliam Osler, Aphorisms from the Student Life (Aequanimitas, 1952).

Matched MeSH terms: Internship and Residency/manpower*
Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services

Kanchanachitra C, Lindelow M, Johnston T, Hanvoravongchai P, Lorenzo FM, Huong NL, et al.

Lancet, 2011 Feb 26;377(9767):769-81.
PMID: 21269674 DOI: 10.1016/S0140-6736(10)62035-1

In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues.

Matched MeSH terms: Health Manpower/statistics & numerical data*
Perceived safety management practices in the logistics sector

Auyong HN, Zailani S, Surienty L

Work, 2016 Mar 09;53(4):729-35.
PMID: 26967037 DOI: 10.3233/WOR-162272

BACKGROUND: Malaysia's progress on logistics has been slowed to keep pace with its growth in trade. The Government has been pressing companies to improve the safety of their activities in order to reduce society's loss due to occupational accidents and illnesses. Occupational safety and health is a crucial part of a workplace because every worker has to take care of his/her own safety and health. The main occupational safety and health (OSH) national policy in Malaysia is the enactment of the Occupational Safety and Health Act (OSHA) 1994. Only those companies which have excellent health and safety care have good quality and productive employees. This study investigated safety management practices in the logistics sector.
OBJECTIVES: The present study is concerned with the human factors to safety in the logistics industry. The authors examined the perceived safety management practices of workers in the logistics sector. The purpose was to identify the perception of safety management practices of Malaysian logistics personnel.
METHODS: Survey questionnaires were distributed to assess logistics personnel about management commitment. The quantitative method using the availability sampling method was applied. The data gathered from the survey were analysed using SPSS software. The responses to the survey were rated according to the Likert scale type, with '1' indicating strongly disagree and '5' indicating strongly agree. One hundred and three employees of logistics functions completed the survey.
RESULTS: The highest mean scores were found for fire apparatus, prioritisation of safety, and safety policy.
CONCLUSIONS: The results from this study also emphasise the importance of the management's commitment in enhancing workplace safety. Specifically, companies should maintain good relations between the employer and the employee to help reduce workplace injuries.

Matched MeSH terms: Occupational Health/manpower
Fulltext Job satisfaction and turnover intention among Iraqi doctors--a descriptive cross-sectional multicentre study

Ali Jadoo SA, Aljunid SM, Dastan I, Tawfeeq RS, Mustafa MA, Ganasegeran K, et al.

Hum Resour Health, 2015;13:21.
PMID: 25903757 DOI: 10.1186/s12960-015-0014-6

BACKGROUND: During the last two decades, the Iraqi human resources for health was exposed to an unprecedented turnover of trained and experienced medical professionals. This study aimed to explore prominent factors affecting turnover intentions among Iraqi doctors.
METHODS: A descriptive cross-sectional multicentre study was carried out among 576 doctors across 20 hospitals in Iraq using multistage sampling technique. Participants completed a self-administered questionnaire, which included socio-demographic information, work characteristics, the 10-item Warr-Cook-Wall job satisfaction scale, and one question on turnover intention. Descriptive and bivariate and multiple logistic regression analyses were conducted to identify significant factors affecting turnover intentions.
RESULTS: More than one half of Iraqi doctors (55.2%) were actively seeking alternative employment. Factors associated with turnover intentions among doctors were low job satisfaction score (odds ratio (OR) = 0.97; 95% confidence interval (CI): 0.95, 0.99), aged 40 years old or less (OR = 2.9; 95% CI: 1.74, 4.75), being male (OR = 4.2; 95% CI: 2.54, 7.03), being single (OR = 5.0; 95% CI: 2.61, 9.75), being threatened (OR = 3.5; 95% CI: 1.80, 6.69), internally displaced (OR = 3.1; 95% CI: 1.43, 6.57), having a perception of unsafe medical practice (OR = 4.1; 95% CI: 1.86, 9.21), working more than 40 h per week, (OR = 2.3; 95% CI: 1.27, 4.03), disagreement with the way manager handles staff (OR = 2.2; 95% CI: 1.19, 4.03), being non-specialist, (OR = 3.9, 95% CI: 2.08, 7.13), and being employed in the government sector only (OR = 2.0; 95% CI: 1.09, 3.82).
CONCLUSION: The high-turnover intention among Iraqi doctors is significantly associated with working and security conditions. An urgent and effective strategy is required to prevent doctors' exodus.

Matched MeSH terms: Delivery of Health Care/manpower*
Work and lifestyle factors associated with morbidity of electronic women workers in Selangor, Malaysia

Hwei-Mian Lim, Heng-Leng Chee, Mirnalini Kandiah, Sharifah Zainiyah Syed Yahya, Rashidah Shuib

Asia Pac J Public Health, 2002;14(2):75-84.
PMID: 12862411

The objective of this study was to identify sociodemographic, work, living arrangement and lifestyle factors associated with morbidity of electronics women workers in selected factories in Selangor, Malaysia. The research design was a cross-sectional questionnaire-based survey. Most of the 401 respondents were young single Malay women. Morbidity was high as 85.5% of the women reported experiencing at least one chronic health problem, and 25.7% said that an illness or injury prevented them from carrying out normal activities within the last two weeks. Major acute illness symptoms were the common cold, backache, and diarrhoea while chronic health problems such as persistent headache, eye problems, menstrual problems, and persistent backache were also reported. After logistic regression, chronic health problems was significantly associated with room sharing; while illness that prevented normal activities within the last two weeks was significantly associated with overtime work and exercise. Further research is recommended to understand the complex inter-relationship between morbidity and working and living conditions.

Matched MeSH terms: Electronics/manpower*
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: Health Manpower*
Job transfers: a neglected aspect of migration in Malaysia

Menon R

Int Migr Rev, 1987;21(1):86-95.
PMID: 12314668

"This article examines the incidence of [job-related] transfers in Malaysia. The retrospective migration data from the Malaysia Family Life Survey [conducted in 1976-1977] are used to demonstrate that transfers comprise 18 percent of all migration in the country and that there has been a rise in the incidence of transfers over a 35 year period. Factors underlying this trend are outlined. Furthermore, significant differences in age, educational attainment and other characteristics between transferees and other types of migrants are identified and their implications discussed."

Matched MeSH terms: Health Manpower*

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