Displaying publications 101 - 120 of 229 in total

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  1. Fulltext Barriers in obtaining primary health care services from public clinics by non-citizen labors in Malaysia
    Maryam Sohrabi, Ahmad Farid Osman, Makmor Tumin
    Malaysian Journal of Medical Research, 2018;2(1):52-60.
    MyJurnal
    Non-citizen labors in the country have been found to face difficulties in accessing healthcare services. The study seeks to investigate the existence of barriers in accessing primary healthcare services by non-citizen labors in Malaysia. This study was conducted on 323 non-citizen labors residing in the urban areas of Malaysia, particularly of Johor Bahru and Klang Valley from May to September 2017. Relevant information regarding the personal barriers (language, preference for physician's gender, difficulty taking leave from work), structural barriers (availability of public clinic in residential area, travel time to the public clinic,physician's knowledge and skill) and financial barriers (insurance coverage, fear of losing daily income,transportation costs) on using primary healthcare services at public clinics were obtained. The result of the analysis revealed that the barriers cited by non-citizens to seek primary healthcare in Malaysia were lack of medical insurance protection (75.1%), non-availability of a public clinic in the residential area (38.7%), not receiving the needed or wanted services (21.3%), long travel time to the nearest public clinic (17.3%), language (10.2% of respondents), negative perception about the doctors' knowledge and skills (9.9%), difficulty taking leave (7.8%), fear of losing daily income (7.7%), high transportation cost (3.7%) and different doctor gender preference (2.5%). Therefore, barriers to access healthcare services among noncitizens exist in Malaysia.
    Matched MeSH terms: Health Services Accessibility
  2. Fulltext Management of advanced prostate cancer in a middle-income country: real-world consideration of the Advanced Prostate Cancer Consensus Conference 2017
    Saad M, Alip A, Lim J, Abdullah MM, Chong FLT, Chua CB, et al.
    BJU Int, 2019 09;124(3):373-382.
    PMID: 31077523 DOI: 10.1111/bju.14807
    OBJECTIVE: To examine the results of the Malaysian Advanced Prostate Cancer Consensus Conference (MyAPCCC) 2018, held for assessing the generalizability of consensus reached at the Advanced Prostate Cancer Consensus Conference (APCCC 2017) to Malaysia, a middle-income country.

    METHODS: Six key sections were chosen: (1) high-risk localized and locally advanced prostate cancer, (2) oligometastatic prostate cancer, (3) castration-naïve prostate cancer, (4) castrate resistant prostate cancer, (5) use of osteoclast-targeted therapy and (6) global access to prostate cancer drugs. There were 101 consensus questions, consisting of 91 questions from APCCC 2017 and 10 new questions from MyAPCCC 2018, selected and modified by the steering committee; of which, 23 questions were assessed in both ideal world and real-world settings. A panel of 22 experts, comprising of 11 urologists and 11 oncologists, voted on 101 predefined questions anonymously. Final voting results were compared with the APCCC 2017 outcomes.

    RESULTS: Most voting results from the MyAPCCC 2018 were consistent with the APCCC 2017 outcomes. No consensus was achieved for controversial topics with little level I evidence, such as management of oligometastatic disease. No consensus was reached on using high-cost drugs in castration-naïve or castration-resistant metastatic prostate cancer in real-world settings. All panellists recommended using generic drugs when available.

    CONCLUSIONS: The MyAPCCC 2018 voting results reflect the management of advanced prostate cancer in a middle-income country in a real-world setting. These results may serve as a guide for local clinical practices and highlight the financial challenges in modern healthcare.

    Matched MeSH terms: Health Services Accessibility
  3. Fulltext Making Health Services Adolescent-Friendly in Northeastern Peninsular Malaysia: A Mixed-Methods Study
    Awang H, Ab Rahman A, Sukeri S, Hashim N, Nik Abdul Rashid NR
    Int J Environ Res Public Health, 2020 02 19;17(4).
    PMID: 32093018 DOI: 10.3390/ijerph17041341
    A mixed-methods study was conducted in a Malaysian state beginning with a cross-sectional quantitative study to determine the relationship between clinic characteristics and clinic score of adolescent-friendliness. Subsequently, perceptions of healthcare providers on the facilitating factors for the provision of adolescent-friendly health services were explored qualitatively to support the quantitative findings. Availability of trained healthcare providers, adequate privacy, dedicated adolescent health services team, and adolescent health promotional activities were the clinic characteristics that significantly (p < 0.05) related with clinics' scores of adolescent-friendliness. The facilitating factors required for adolescent-friendly health services were (1) healthcare providers' commitment and prioritization towards adolescent-friendly health services; (2) organizational supports; (3) appropriate clinic settings; and (4) external supports for adolescent health promotional activities. The qualitative findings reaffirmed those of the quantitative study on the significant clinic characteristics required for adolescent-friendly health services. This study provides valuable insight for the Ministry of Health to elicit the required facilitating factors to further improve the quality of adolescent health services in Malaysia.
    Matched MeSH terms: Health Services Accessibility
  4. Fulltext The Lancet Commission on diagnostics: transforming access to diagnostics
    Fleming KA, Horton S, Wilson ML, Atun R, DeStigter K, Flanigan J, et al.
    Lancet, 2021 Nov 27;398(10315):1997-2050.
    PMID: 34626542 DOI: 10.1016/S0140-6736(21)00673-5
    Matched MeSH terms: Health Services Accessibility
  5. Fulltext Perceptions of Good-Quality Antenatal Care and Birthing Services among Postpartum Women in Nepal
    Rajbanshi S, Norhayati MN, Nik Hazlina NH
    Int J Environ Res Public Health, 2021 Jun 26;18(13).
    PMID: 34206868 DOI: 10.3390/ijerph18136876
    Patient complaints and dissatisfaction should be taken seriously and used as an opportunity to provide acceptable services. Mounting evidence shows that the perception of the quality of healthcare services impacts health-seeking behaviors. This study explores the perceptions of good-quality antenatal and birthing services among postpartum women. A qualitative study using phenomenological inquiry was conducted in the Morang district, Nepal. The study participants were postpartum women with at least one high-risk factor who refused the referral hospital's birth advice. A total of 14 women were purposively selected and interviewed in-depth. NVivo 12 Plus software was used for systematic coding, and thematic analysis was performed manually. Three themes emerged: (i) women's opinions and satisfactory factors of health services, (ii) expectations of the health facility and staff, and (iii) a lack of suggestions to improve the quality of care. Women did not have many expectations from the healthcare facility or the healthcare providers and could not express what good quality of care meant for them. Women from low socioeconomic status and marginalized ethnicities lack knowledge of their basic reproductive rights. These women judge the quality of care in terms of staff interpersonal behavior and personal experiences. Women will not demand quality services if they lack an understanding of their basic health rights.
    Matched MeSH terms: Health Services Accessibility
  6. Fulltext The paediatric global musculoskeletal task force - 'towards better MSK health for all'
    Foster HE, Scott C, Tiderius CJ, Dobbs MB
    Pediatr Rheumatol Online J, 2020 Jul 14;18(1):60.
    PMID: 32664961 DOI: 10.1186/s12969-020-00451-8
    There is increasing concern about the emerging global non-communicable diseases (NCDs) burden. The focus has mainly been on NCDs in adults but it is important that MSK morbidity in both children and adults is included in strategic planning. There have been considerable advances in the understanding and treatment options for children and young people (CYP) and clinical outcomes are improving for those who can access such high quality care. However vast inequity exists and there are many CYP who live in areas of the world with high burden of health care challenges, compounded by paucity of specialist care and limited access to treatments. The Paediatric Global Musculoskeletal Task Force aims to raise awareness about unmet needs for CYP with MSK conditions, promotion of MSK health through lifestyle and the avoidance of injury. We aim to leverage change through 'working together better'.
    Matched MeSH terms: Health Services Accessibility
  7. Fulltext Closing the global cancer divide--performance of breast cancer care services in a middle income developing country
    Lim GC, Aina EN, Cheah SK, Ismail F, Ho GF, Tho LM, et al.
    BMC Cancer, 2014;14:212.
    PMID: 24650245 DOI: 10.1186/1471-2407-14-212
    BACKGROUND: Cancer is the leading cause of deaths in the world. A widening disparity in cancer burden has emerged between high income and low-middle income countries. Closing this cancer divide is an ethical imperative but there is a dearth of data on cancer services from developing countries.
    METHODS: This was a multi-center, retrospective observational cohort study which enrolled women with breast cancer (BC) attending 8 participating cancer centers in Malaysia in 2011. All patients were followed up for 12 months from diagnosis to determine their access to therapies. We assess care performance using measures developed by Quality Oncology Practice Initiative, American Society of Clinical Oncology/National Comprehensive Cancer Network, American College of Surgeons' National Accreditation Program for Breast Centers as well as our local guideline.
    RESULTS: Seven hundred and fifty seven patients were included in the study; they represent about 20% of incident BC in Malaysia. Performance results were mixed. Late presentation was 40%. Access to diagnostic and breast surgery services were timely; the interval from presentation to tissue diagnosis was short (median = 9 days), and all who needed surgery could receive it with only a short wait (median = 11 days). Performance of radiation, chemo and hormonal therapy services showed that about 75 to 80% of patients could access these treatments timely, and those who could not were because they sought alternative treatment or they refused treatment. Access to Trastuzumab was limited to only 19% of eligible patients.
    CONCLUSIONS: These performance results are probably acceptable for a middle income country though far below the 95% or higher adherence rates routinely reported by centres in developed countries. High cost trastuzumab was inaccessible to this population without public funding support.
    Matched MeSH terms: Health Services Accessibility/economics*
  8. Primary health care: hope and challenges for public health in Maldives
    Sulaiman AI, Abu Bakar SH, Wahab HA
    J Community Health, 2014 Jun;39(3):627-31.
    PMID: 24488646 DOI: 10.1007/s10900-013-9809-3
    The government of Maldives considers that the enjoyment of the highest attainable level of health is a basic right of every citizen. Thus it lays emphasis on the accessibility and affordability of health care services. In order to achieve these objectives, it is very important to expand curative services as well as preventive services in the country. The major hurdles faced by the country are result of the inherent structural problem faced by the county which leads to sever diseconomies of scale in the provision of healthcare services. Community and individual involvement and self-reliance are very important to achieve Health for All by the Year 200 AD. Community participation is one of the domains of community capacity building in a small island country. It is one of the mechanisms to empower people to take part in community development. In this paper, the nature, the dimensions of community participation, and its role and scope in implementation of different components of primary health care have been described. The health services in public and curative care have been briefed. Some of the achievements in health sector have also been briefly presented.
    Matched MeSH terms: Health Services Accessibility/trends*
  9. 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: Health Services Accessibility*
  10. Fulltext Malaysian primary care doctors' views on men's health: an unresolved jigsaw puzzle
    Tong SF, Low WY, Ismail SB, Trevena L, Willcock S
    BMC Fam Pract, 2011;12:29.
    PMID: 21569395 DOI: 10.1186/1471-2296-12-29
    BACKGROUND: Men have been noted to utilise health care services less readily then women. Primary care settings provide an opportunity to engage men in health care activities because of close proximity to the target group (men in the community). Understanding attitudes towards men's health among Malaysian primary care doctors is important for the effective delivery of health services to men. We aimed to explore the opinions and attitudes of primary care doctors (PCDs) relating to men's health and help-seeking behaviour.
    METHODS: A qualitative approach to explore the opinions of 52 PCDs was employed, using fourteen in-depth interviews and eight focus group discussions in public and private settings. Purposive sampling of PCDs was done to ensure maximum variation in the PCD sample. Interviews were recorded and transcribed verbatim for analysis. Open coding with thematic analysis was used to identify key issues raised in the interview.
    RESULTS: The understanding of the concept of men's health among PCDs was fragmented. Although many PCDs were already managing health conditions relevant and common to men, they were not viewed by PCDs as "men's health". Less attention was paid to men's help-seeking behaviour and their gender roles as a potential determinant of the poor health status of men. There were opposing views about whether men's health should focus on men's overall health or a more focused approach to sexual health. There was also disagreement about whether special attention was warranted for men's health services. Some doctors would prioritise more common conditions such as hypertension, diabetes and hypercholesterolaemia.
    CONCLUSIONS: The concept of men's health was new to PCDs in Malaysia. There was wide variation in understanding and opposing attitudes towards men's health among primary care doctors. Creating awareness and having a systematic approach would facilitate PCDs in delivering health service to men.
    Matched MeSH terms: Health Services Accessibility/organization & administration
  11. Fulltext Understanding the modifiable health systems barriers to hypertension management in Malaysia: a multi-method health systems appraisal approach
    Risso-Gill I, Balabanova D, Majid F, Ng KK, Yusoff K, Mustapha F, et al.
    BMC Health Serv Res, 2015;15:254.
    PMID: 26135302 DOI: 10.1186/s12913-015-0916-y
    The growing burden of non-communicable diseases in middle-income countries demands models of care that are appropriate to local contexts and acceptable to patients in order to be effective. We describe a multi-method health system appraisal to inform the design of an intervention that will be used in a cluster randomized controlled trial to improve hypertension control in Malaysia.
    Matched MeSH terms: Health Services Accessibility*
  12. Fulltext Factors affecting patient compliance with anti-tuberculosis chemotherapy using the directly observed treatment, short-course strategy (DOTS)
    O'Boyle SJ, Power JJ, Ibrahim MY, Watson JP
    Int J Tuberc Lung Dis, 2002 Apr;6(4):307-12.
    PMID: 11936739
    SETTING: Kota Kinabalu and surrounding communities in Sabah, Malaysia.
    OBJECTIVES: To establish factors affecting compliance of patients with anti-tuberculosis chemotherapy, their knowledge of the disease, and views on improving the DOTS strategy.
    DESIGN: Interviews with compliant patients attending clinics for DOTS treatment and with non-compliant patients in their homes, in August and September 2000.
    RESULTS: A total of 63 compliant and 23 non-compliant patients were interviewed. For non-compliant patients, reaching the treatment centre entailed greater cost (P < 0.005) and travel time (P < 0.005) compared to compliant patients. Cost of transport was the reason most frequently given for non-attendance. Non-compliant patients were more likely to have completed secondary education (P < 0.05), and to be working (P < 0.01). More non-compliant patients had family members who had had the disease (P < 0.01). There was no difference between the groups for overall tuberculosis knowledge scores; however, non-compliant patients were more likely to think that treatment could be stopped once they were symptom free (P < 0.01). Most patients (73%) felt that the DOTS system could be improved by provision of more information about tuberculosis.
    CONCLUSION: Compliance with DOTS in the Kota Kinabalu area is affected by travel expenses, time spent travelling to treatment centres, and having family members who have had the disease. Patients would like more information on tuberculosis.
    Study site: Tuberculosis clinics, Kota Kinabalu, Malaysia
    Matched MeSH terms: Health Services Accessibility/economics
  13. Available, accessible and affordable. Malaysia. The Hague Forum
    Ismail PZ
    Integration, 1999.
    PMID: 12322184
    Matched MeSH terms: Health Services Accessibility*
  14. Accessibility of breast and cervical cancer services in Malaysia
    Arrows Change, 1997 Dec;3(3):3.
    PMID: 12294552
    Matched MeSH terms: Health Services Accessibility*
  15. The health care seeking behavior of schizophrenic patients in 6 East Asian areas
    Rhi BY, Ha KS, Kim YS, Sasaki Y, Young D, Woon, et al.
    Int J Soc Psychiatry, 1995;41(3):190-209.
    PMID: 8847200
    The patterns of health care seeking behavior of 1061 schizophrenics and the factors that affect the determination of the patterns were studied in 6 areas of 5 nations in east Asia: Hunan and Sichuan Provinces in China, Japan, Korea, Malaysia and the Philippines. The information was gathered through a structured questionnaire developed by the authors. The subjects generally favored psychiatry-oriented health care, but with frequent interruptions or combination with other types of managements. Most Japanese subjects sought care in western medicine, while subjects from Hunan, Sichuan and Korea alternated between western medicine and magicoreligious therapies or traditional herbal medicine. In the Philippines and Malaysia, the majority of the subjects sought magicoreligious therapies first, then later sought western psychiatric care. The choice of western psychiatric care was mostly influenced by the decision maker's knowledge and interpretation of the patient's illness. In determining the choice of management among various types of non-psychiatric management, cost, location, and societal attitudes played substantial roles as well as knowledge and interpretation. Suggestions and opinions were discussed to improve health care services for schizophrenic patients in each community.
    Matched MeSH terms: Health Services Accessibility/statistics & numerical data
  16. Rights of patients: comparative perspectives from five countries
    Blum JD, Talib N, Carstens P, Nasser M, Tomkin D, McAuley A
    Med Law, 2003;22(3):451-71.
    PMID: 14626880
    Recognition and articulation of patient rights are core issues in the medical jurisprudence of most nations. While the nature of rights in medical care may vary from country to country, reflecting the idiosyncrasies of domestic law and health delivery, there are commonalities in this area of law that cut across borders. This paper presents five case studies in the patient rights area from Malaysia, Ireland, South Africa, Indonesia and the United States, respectively. The case discussions range from ongoing and fundamental concerns over broad patient rights issues, such as access to health care and informed consent, to rights concerns of those suffering from HIV/AIDS, to a novel consideration over ethical and legal issues concerning ownership of infant organs. It is the hope of the authors that individually, and collectively, the cases will provide helpful insights into this core area of medical law.
    Matched MeSH terms: Health Services Accessibility/legislation & jurisprudence*
  17. Strengthening acute coronary syndrome referral network: Insights from initiatives of Penang General Hospital cardiology centre
    Abdul Kader MAS
    Med J Malaysia, 2019 08;74(4):355-358.
    PMID: 31424052
    The importance of networking for the management of acute coronary syndrome (ACS) has been emphasised in the 2012 guidelines by the European Society of Cardiology (ESC) on ST-segment elevation myocardial infarction (STEMI). In Penang, the ACS referral network has the Penang General Hospital (PGH), a percutaneous coronary intervention (PCI)- capable hospital, with 14 other hospitals referring their patients for PCI to PGH on a daily basis. In one of its review regarding the referral methodology in the network, PGH's Cardiology centre observed gaps in the referral systems, which was leading to poor quality of referrals. To address these issues, the PGH Cardiology centre developed a standardised protocol and conducted a one-day workshop to educate medical officers about the standardised protocol. This commentary piece is a proof of this concept, and aims to share the experience and provide an overview on the initiatives by the PGH, which has resulted in improved quality of PCI referrals.
    Matched MeSH terms: Health Services Accessibility/organization & administration*
  18. Expanding Access: Cost-effectiveness of Cochlear Implantation and Deaf Education in Asia
    Emmett SD, Sudoko CK, Tucci DL, Gong W, Saunders JE, Global HEAR (Hearing Loss Evaluation, Advocacy, and Research) Collaborative:, et al.
    Otolaryngol Head Neck Surg, 2019 10;161(4):672-682.
    PMID: 31210566 DOI: 10.1177/0194599819849917
    OBJECTIVE: To determine the cost-effectiveness of cochlear implantation (CI) with mainstream education and deaf education with sign language for treatment of children with profound sensorineural hearing loss in low- and lower-middle income countries in Asia.

    STUDY DESIGN: Cost-effectiveness analysis.

    SETTING: Bangladesh, Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, and Sri Lanka participated in the study.

    SUBJECTS AND METHODS: Costs were obtained from experts in each country with known costs and published data, with estimation when necessary. A disability-adjusted life-years model was applied with 3% discounting and 10-year length of analysis. A sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost-effectiveness was determined with the World Health Organization standard of cost-effectiveness ratio per gross domestic product (CER/GDP) per capita <3.

    RESULTS: Deaf education was cost-effective in all countries except Nepal (CER/GDP, 3.59). CI was cost-effective in all countries except Nepal (CER/GDP, 6.38) and Pakistan (CER/GDP, 3.14)-the latter of which reached borderline cost-effectiveness in the sensitivity analysis (minimum, maximum: 2.94, 3.39).

    CONCLUSION: Deaf education and CI are largely cost-effective in participating Asian countries. Variation in CI maintenance and education-related costs may contribute to the range of cost-effectiveness ratios observed in this study.

    Matched MeSH terms: Health Services Accessibility/economics*
  19. Fulltext Perception of Health Conditions and Test Availability as Predictors of Adults' Mental Health during the COVID-19 Pandemic: A Survey Study of Adults in Malaysia
    Dai H, Zhang SX, Looi KH, Su R, Li J
    Int J Environ Res Public Health, 2020 07 30;17(15).
    PMID: 32751459 DOI: 10.3390/ijerph17155498
    Research identifying adults' mental health during the coronavirus disease 2019 (COVID-19) pandemic relies solely on demographic predictors without examining adults' health condition as a potential predictor. This study aims to examine individuals' perception of health conditions and test availability as potential predictors of mental health-insomnia, anxiety, depression, and distress-during the COVID-19 pandemic. An online survey of 669 adults in Malaysia was conducted during 2-8 May 2020, six weeks after the Movement Control Order (MCO) was issued. We found adults' perception of health conditions had curvilinear relationships (horizontally reversed J-shaped) with insomnia, anxiety, depression, and distress. Perceived test availability for COVID-19 also had curvilinear relationships (horizontally reversed J-shaped) with anxiety and depression. Younger adults reported worse mental health, but people from various religions and ethnic groups did not differ significantly in reported mental health. The results indicated that adults with worse health conditions had more mental health problems, and the worse degree deepened for unhealthy people. Perceived test availability negatively predicted anxiety and depression, especially for adults perceiving COVID-19 test unavailability. The significant predictions of perceived health condition and perceived COVID-19 test availability suggest a new direction for the literature to identify the psychiatric risk factors directly from health-related variables during a pandemic.
    Matched MeSH terms: Health Services Accessibility*
  20. Islam and harm reduction
    Kamarulzaman A, Saifuddeen SM
    Int J Drug Policy, 2010 Mar;21(2):115-8.
    PMID: 20006483 DOI: 10.1016/j.drugpo.2009.11.003
    Although drugs are haram and therefore prohibited in Islam, illicit drug use is widespread in many Islamic countries throughout the world. In the last several years increased prevalence of this problem has been observed in many of these countries which has in turn led to increasing injecting drug use driven HIV/AIDS epidemic across the Islamic world. Whilst some countries have recently responded to the threat through the implementation of harm reduction programmes, many others have been slow to respond. In Islam, The Quran and the Prophetic traditions or the Sunnah are the central sources of references for the laws and principles that guide the Muslims' way of life and by which policies and guidelines for responses including that of contemporary social and health problems can be derived. The preservation and protection of the dignity of man, and steering mankind away from harm and destruction are central to the teachings of Islam. When viewed through the Islamic principles of the preservation and protection of the faith, life, intellect, progeny and wealth, harm reduction programmes are permissible and in fact provide a practical solution to a problem that could result in far greater damage to the society at large if left unaddressed.
    Matched MeSH terms: Health Services Accessibility/trends
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