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.
The relationship between healthcare services and inequalities is more likely when a group that shares a salient identity faces severe inequalities of various kinds. Such inequalities may be catalyzed by economic, social, political or concern cultural status. The objectives of this review are to identify the issues and challenges involve in healthcare inequalities, to compare factors contributes to healthcare inequalities and to purpose suggestions and recommendations for improvement based on issues and challenges between United States and India. Comparing annual year healthcare report, documentation of healthcare institutional, Ministry of Health's report and circular, official institutional website, scientific healthcare journals, articles and reports published in 1994 until 2011 regarding healthcare inequalities between United States and India. Health inequalities in the healthcare system contributed by the different in socioeconomic status and accessibility to the healthcare facility due to high cost of treatment has been common risk 'Catastrophic' factors to the inequalities in both countries. Health financing system and resource allocation that benefit only the upper class social spectrum of the population. Disparities occur due to the imbalance in distribution of wealth, discrimination and change in the world economy. Adapting healthcare system that provides care to all classes of people need improvement as no healthcare system is perfect. This matter must be tackle urgently as it's a matter of national concern.
Globally, the health of the indigenous people is lagging behind as compared to the mainstream population in countries in which they live. Despite improved overall prosperity and population longevity, social and health inequalities seem to persist in this underprivileged community. Failure in delivering effective health promotion toward the indigenous community is determined by a range of factors. This includes the absence of culturally sensitive awareness among the healthcare workers, ineffective communication of the healthcare providers, poor access to health service, lack of culturally specific health promotional materials, lack of involvement by indigenous healthcare workers, lack of community based programs and inefficiency of indigenous health data collection. Effective interventions for indigenous health require a trans-disciplinary and holistic approach that incorporates indigenous health beliefs and engages with the social and cultural drivers of health.Such culturally congruent health promotion strategies are hoped to narrow down the existing wide gap of health outcomes that contribute to inequalities between indigenous communities and the mainstream population.
Men must be made to understand the value of family planning - particularly in societies where men hold the power of decision in the family. Dr. Kotha Pannikar, chairman of the Kedah Family Planning Association (FPA) in Malaysia, illustrated this point in discussion which followed the Consultation of Medical and Communication Fieldworkers conference in Kuala Lumpur in August, with a story about 1 of her own patients. When the girl, who had a rheumatic heart, was 16, Dr. Pannikar advised the parents that she needed cardiac surgery if she were to be a healthy wife and mother. But the parents lived some distance from Dr. Pannikar's surgery and did not heed the advice. The girl was married to a carpenter from a traditional Chinese family, in which "the man is lord and master." Her new home had no piped water, and in additional to normal domestic tasks she had to carry water from a source 1 1/2 miles agay. In the 7th month of her 1st pregnancy, she went into cardiac failure. After the 3rd pregnancy and a 3rd cardiac failure, Dr. Pannikar tried to arrange a sterilization "but we could not get consent - her husband refused to turn up at the hospital." When the girl was admitted to hospital 6 months into her 4th pregnancy, Dr. Pannikar got hold of her patient's mother-in-law. "I told her if she wanted a servant in the house, it was easy to get one. But no servant would look after her grandchildren the way their mother would. I told her if she wanted to save the girl's life she had better speak to her son." During the 4th delivery, the girl went into cardiac arrest and spent 2 weeks in intensive care. The mother-in-law prevailed upon her son to at least consent, and the girl was sterilized before she left hospital. But "it was a very near thing," Dr. Pannikar recalls "and it wouldn't have happened if the husband had felt he was responsible in parenthood." The Kedah FPA makes special efforts to reach men. Dr. Pannikar herself talks to men's organizations like the Lions and Rotary Clubs, and arranges education programs for trade unions and workers on the rubber estates. She thinks women need to be told repeatedly that they have a basic human right to choose whether they want to have a baby, and when. "Women feel," she says, "that their only function is to cook, wash clothes and feed the baby. We need to tell them they have a part to play in the society of today because their children will be the citizens of tomorrow."o
Universal health coverage is a key health target in the Sustainable Development Goals (SDGs) that has the means to link equitable social and economic development. As a concept firmly based on equity, it is widely accepted at international and national levels as important for populations to attain 'health for all' especially for marginalised groups. However, implementing universal coverage has been fraught with challenges and the increasing privatisation of health care provision adds to the challenge because it is being implemented in a health system that rests on a property regime that promotes inequality. This paper asks the question, 'What does an equitable health system look like?' rather than the usual 'How do you make the existing health system more equitable?' Using an ethnographic approach, the authors explored via interviews, focus group discussions and participant observation a health system that uses the commons approach such as which exists with indigenous peoples and found features that helped make the system intrinsically equitable. Based on these features, the paper proposes an alternative basis to organise universal health coverage that will better ensure equity in health systems and ultimately contribute to meeting the SDGs.
OBJECTIVE: The present study was aimed to evaluate the practices and attitudes of young Malaysian adults towards the use of antibiotics, and to determine the socioeconomic factors associated with the antibiotic use.
METHODS: A survey was carried in Cheras community by approaching a conveniently selected sample of 480 participants. A pre-tested questionnaire was used for data collection.
RESULT: Of 480 participants approached, 400 agreed to participate in this study, giving a response rate of 83.3%. The study results showed that 42.75% of the participants exhibited poor attitudes towards antibiotic usage. Chinese race and high income were significantly associated with the positive attitudes towards antibiotic usage. It is shown that the practice of the participants towards antibiotics was relatively poor. The majority of participants agreed that they do not consult a doctor for minor illnesses (64%). The main reason for not consulting a doctor was the high fees of consultation (34.25%) and the inconvenience of visit (29.25%). However, a large proportion of respondents (77.5%) agreed that there is a need to enhance antibiotic education among public.
CONCLUSION: The study results identified some crucial gaps in the attitudes and practices of Cheras community about the use of antibiotics. Thus, improving the public knowledge and changing their attitude towards antibiotic use along with proper interventions to regulate the ease of their availability would play a significant role for the effective use of antibiotics in the community.
Current worldwide projections of sea-level rise show a staggering increase in water level of up to 2 m by 2100 owing to global warming exacerbated by anthropogenically induced climate change. While amplified rates of sea-level rise is an immense hazard to coastal communities, storm surges are expected to increase in intensity and frequency making it an equally significant threat to coastal populations. In France, these hazards are not uncommon with records of extreme tempests every thousand years in the Holocene. Despite these recurring devastating events, in the Bay of Saint-Brieuc, Brittany, legislated laws for coastal management do not entirely focus on protecting littoral zones from such calamities. 130,739 people are concentrated in 21 municipalities with major cities located at close proximity to the shoreline with numerous socio-economic activities, which increases the vulnerability of the coastal population and infrastructures; thus, affirming the indispensable need of a thorough vulnerability assessment. Here, we conduct a mechanistic appraisal of the vulnerability of the bay considering thirteen parameters within three governing sub-systems that demonstrate the multidimensional dynamics in these municipalities. In the occasion of an extreme climatic event, our results of total vulnerability show risks in the sub-systems highlighting erosional processes due to augmented hydrodynamics, socio-economic and administrative vulnerabilities associated with anthropogenic development. Eight municipalities of the bay portray moderate to very high vulnerability and the remaining exhibits a lower risk; however, not devoid of high vulnerabilities for certain sub-systems. We posit that a more accurate fit for predicting the total vulnerability of the region can be achieved by exclusively integrating physical-natural and administrative sub-system vulnerabilities. We propose generic but requisite recommendations for Integrated Coastal Zone Management such as surveillance of urban development along the coast, implementation of coastal defense systems and appropriate industrial corridors to attenuate and dispose hazardous refuse.
Low socio-economic status (SES) is often associated with various health-related problems. Therefore, the present paper aims to review the available literature to identify the prevalence of malnutrition, prevalence of poor diet quality and its associated risk factors among older adults with low SES. A literature search was performed using four databases, namely PubMed, Google Scholar, Springer and Science Direct. The search terms used were 'diet quality', 'nutritional status', 'dietary intake', 'overweight', 'obesity', 'underweight', 'older people' and 'low socioeconomic status (SES)'. The overall prevalence of undernutrition among older adults with low SES worldwide was in the range of 28·9 to 48 %, while overnutrition was reported to be between 8·1 to 28·2 %. In Asia, the prevalence of undernourished older adults ranged from 3 to 64·9 %, while 2·5 to 32·8 % were overnourished. Most of the studies (60 %) included in the present review used BMI as the tool to identify malnutrition, but none of the nutritional screening tools were considered to be the 'gold standard'. For dietary assessment, FFQ and multiple 24 h dietary recall improved the estimation of individual dietary intake. Risk factors for poor diet quality included financial hardship, functional limitation, sex, place of residence, smoking and oral health. Poor nutritional status, especially lack of good-quality diet, and thinness are prevalent among older adults with low SES. Hence, it is important to establish nutrition-related programmes and intervention studies among this group of individuals for improving their health status and quality of life.
Orang Asli, the indigenous people of Peninsular Malaysia, is a minority population and placed behind in terms of socioeconomy, education and health. The Malaysian government has supported Orang Asli since the second Malaysia Plan in the 1970s, resulting in changes in their living standard, access to health, education and occupation. Hence, this review aims to assess the recent prevalence of diseases among Orang Asli in Peninsular Malaysia. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) review protocol guided this systematic review. The research question was formulated based on Population, Interest, Comparison and Outcome (PICO). The selected databases include Web of Science, Scopus, Ovid and EBSCOhost. The process of identification, screening and inclusion identified 33 articles. The mixed methods appraisal tool (MMAT) was then used to rank the quality of the articles. Selangor is the most frequent state involved in this review (12 studies), followed by Perak (10 studies), Pahang (10 studies) and Kedah (one study). We categorised into four categories of diseases, namely neglected tropical disease (n = 20), non-communicable disease (n = 6), nutritional status (n = 5), and hepatic disease (n = 2). The prevalence of diseases among Orang Asli is higher than in the general population, especially for soil-transmitted helminth (STH) and malnutrition. There is increasing research on non-communicable diseases due to an increasing trend in the socioeconomic status and lifestyle of the Orang Asli. Government agencies and private organisations must work together to empower Orang Asli with a healthy lifestyle, improve their socioeconomic status, and enhance food security, all of which will improve Orang Asli's health and reduce the prevalence of diseases.
The objective of this article is to examine the impact of coronavirus disease 2019 (COVID-19) upon university students' anxiety level and to find the factors associated with the anxiety level in Malaysia. We collected data from 958 students from 16 different universities using an originally designed questionnaire. The Generalized Anxiety Disorder Scale 7-item (GAD-7) was used to estimate the anxiety. Then we applied the ordered logit model to calculate the odds ratios (OR) and factors associated with the anxiety level. We find that 12.3% of students were normal, whereas 30.5% were experiencing mild anxiety, 31.1% moderate anxiety, and 26.1% severe anxiety. Surprisingly, only 37.2% of students were aware of mental health support that was provided by their universities. However, age above 20 years (OR = 1.30), ethnicity Chinese (OR = 1.72), having any other disease (OR = 2.0), decreased family income (OR = 1.71), more time spent on watching COVID-19-related news (OR = 1.52), and infected relative or friends (OR = 1.62) were risk factors for anxiety among students. We conclude that the government of Malaysia should monitor the mental health of the universities' students more closely and universities should open online mental health support clinics to avoid the adverse impacts of anxiety.
OBJECTIVES: The success of the Expanded Program on Immunization among children will greatly reduce the burden of illness and disability from vaccine preventable diseases. The aim of the study was to evaluate the complete immunization coverage and its determinants among children aged 12-23 months in Malaysia.
STUDY DESIGN: Cross-sectional study.
METHODS: Data on immunization were extracted from the 2016 National Health and Morbidity Survey. Complete immunization coverage was classified as received all recommended primary vaccine doses by the age of 12 months and verified by vaccination cards, and incompletely immunized if they received partially recommended vaccine dose or not received any recommended vaccine dose or had no vaccination card. The multiple logistic regression analyses were conducted to determine the sociodemographic factors associated with complete immunization coverage.
RESULTS: The overall complete immunization coverage among children (verified by cards) was 86.4% (n = 8920, 95% confidence interval: 85.4-87.4). Multivariable logistic regression analyses model revealed that factors significantly associated with complete immunization coverage were ethnicity, occupation of the mother, head of household's education level, and head of household's occupation. While sex, citizenship, household income, mother's age, and marital status were not significantly associated with complete immunization coverage.
CONCLUSIONS: According to the World Health Organization criteria, the present study demonstrated that the immunization coverage of 86.4% is still unsatisfactory. Thus, the current intervention program should be enhanced in order to achieve the 95% coverage for all antigens in the national vaccination program.
Study name: National Health and Morbidity Survey (NHMS-2016)
The Three Gorges Dam's construction and industrial transfer have resulted in a new air pollution pattern with the potential to threaten the reservoir eco-environment. To assess the impact of socioeconomic factors on the pattern of air quality vairation and economical risks, concentrations of SO2, NO2, and PM10, industry genres, and meteorological conditions were selected in the Three Gorges Reservoir of Chongqing (TGRC) during 2006-2015. Results showed that air quality had improved to some extent, but atmospheric NO2 showed an increased trend during 2011-2015. Spatially, higher atmospheric NO2 extended to the surrounding area. The primary industry, especially for agriculture, had shown to be responsible for the remarkable increase of atmospheric NO2 (p
Transboundary haze pollution caused by periodic forest fires has initiated a serious negative implication to the economy, tourism sectors and public health in Southeast Asia. Due to the raising concerns of health effects of haze towards the Malaysian population, the present study was conducted to investigate the degree of awareness towards haze and the number of safety measures adopted by the Malaysian population during the haze crisis based on demographic characteristics. A cross-sectional questionnaire-based study was conducted from 4 to 29 January 2016 on 387 subjects in Klang Valley, Malaysia. The results showed that more than 90% of the respondents were aware of the hazards of haze pollution. Respondents with higher education background with diploma, undergraduate and postgraduate degree possessed greater awareness on the hazards of haze (p RM 10,000/month) had higher awareness level on haze (p
Air pollution has massive impacts on human life and poor air quality results in three million deaths annually. Air pollution can result from natural causes, including volcanic eruptions and extreme droughts, or human activities, including motor vehicle emissions, industry, and the burning of farmland and forests. Emission sources emit multiple pollutant types with diverse characteristics and impacts. However, there has been little research on the risk of multiple air pollutants; thus, it is difficult to identify multi-pollutant mitigation processes, particularly in Southeast Asia, where air pollution moves dynamically across national borders. In this study, the main objective was to develop a multi-air pollution risk index product for CO, NO2, and SO2 based on Sentinel-5P remote sensing data from 2019 to 2020. The risk index was developed by integrating hazard, vulnerability, and exposure analyses. Hazard analysis considers air pollution data from remote sensing, vulnerability analysis considers the air pollution sources, and exposure analysis considers the population density. The novelty of this study lies in its development of a multi-risk model that considers the weights obtained from the relationship between the hazard and vulnerability parameters. The highest air pollution risk index values were observed in urban areas, with a high exposure index that originates from pollution caused by human activity. Multi-risk analysis of the three air pollutants revealed that Singapore, Vietnam, and the Philippines had the largest percentages of high-risk areas, while Indonesia had the largest total high-risk area (4361 km2). Using the findings of this study, the patterns and characteristics of the risk distribution of multiple air pollutants in Southeast Asia can be identified, which can be used to mitigate multi-pollutant sources, particularly with respect to supporting the clean air targets in the Sustainable Development Goals.