In Indonesia, Family Medicine as a discipline is being developed through short courses since 12 years ago. A conversion program to become Family Physicians has been introduced recently. Among the 70,000 primary care physicians there are variety of practitioners, from new interns who start general practice to senior general practitioners. This study aims to describe the current Indonesian Primary Care Physicians (PCPs) profile which includes services provided and facilities as well as comparing the profile according to participation in the conversion program and practice hours.
Introduction: Hypertension (HPT) is the most common co-morbidity among type-2 diabetes mellitus (T2DM) patients which ominously increased their morbidity and mortality from cardiovascular diseases (CVD). We aimed to determine the prevalence and control status of HPT, and also the glycemic control among T2DM patients in a primary care clinic in Kuantan, Pahang. Methods: It was a retrospective study of 154 T2DM patients’ records, aged ≥18 years selected by random sampling. The statistical analysis is done by using Chisquare test, paired sample “t” test and ANOVA “F” test. Results: Among T2DM patients; 47% were Malay, 45% Chinese and 9% Indian. The prevalence of HPT was 72.1% and majority of T2DM patients were women (60%). Out of 82 T2DM aged >60 years, 80.5% were hypertensive. 67.2% of T2DM patients between the age of 40-60 years and 25% age <40 years were also hypertensive (p= 0.003). BP-controlled status were classified into controlled, uncontrolled, systolic and diastolic HPT. All patients were compared between the last visit and one year before, which reported 55.8% versus 33.1%, 14.9% versus 51.9%, 20.1% versus 10.4% and 9.1% versus 4.5% respectively. There were significant rises in percentage of systolic BP (by 9.7%) and diastolic HPT (by 4.6%) p<0.0001, from the first visit. BP controlled status for aged group >60 years showed increments in systolic HPT and diastolic HPT which were significant (p<0.0001). Regarding glycemic parameters, 71.4% T2DM patients had poor controlled level of Hb1Ac (≥6.5) and only 20.1% remained controlled after one year (p<0.0001). Conclusions: This pilot study found high prevalence of HPT, increasing prevalence of systolic HPT and diastolic HPT in older age group as well as poor glycemic control among T2DM patients.
Introduction: This study aimed to assess the nutritional status of children below 24 months in the district of Pekan, Pahang, and identify the contributing factors. Methods: Using a cross-sectional methodology, a total of 910 children was selected by random sampling from four public health clinics. Anthropometric measurements were taken and weight-for-age, height-for-age, and weight-for- height were calculated in Z scores. Immediate caregivers of children were interviewed by using a pretested validated questionnaire to assess their socio- economic, demographic, educational and occupational status. Results: Of the 910 children who participated in the study, the majority were Malay (70.1%), while the remaining comprised indigenous or Orang-Asli (OA) children. Prevalence of wasting, stunting and underweight were 28.7 %, 15.6 % and 19.0% respectively. There were more underweight males than females. Wasting was most common among children aged below 6 months. Stunting was more prevalent in children between 12 to 24 months. Obesity was seen in 7.3% of the sample. Maternal education, employment and socio-economic status had a significant influence on wasting and underweight. Children were vulnerable to stunting as age advanced, whereas prevalence of wasting tended to decrease. Conclusion: Malnutrition exists in significant proportions among children below 24 months in the Pekan district. This study identified low birth weight along with age, race, gender, large family size and socio-economic status as important risk factors of malnutrition.
Primary health care is essential for equitable, cost-effective and sustainable health care. It is the cornerstone to achieving universal health coverage against a backdrop of rising health expenditure and aging populations. Implementing strong primary health care requires grassroots understanding of health system performance. Comparing successes and barriers between countries may help identify mutual challenges and possible solutions. This paper compares and analyses primary health care policy in Australia, Malaysia, Mongolia, Myanmar, Thailand and Vietnam. Data were collected at the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) Asia-Pacific regional conference in November 2017 using a predetermined framework. The six countries varied in maturity of their primary health care systems, including the extent to which family doctors contribute to care delivery. Challenges included an insufficient trained and competent workforce, particularly in rural and remote communities, and deficits in coordination within primary health care, as well as between primary and secondary care. Asia-Pacific regional policy needs to: (1) focus on better collaboration between public and private sectors; (2) take a structured approach to information sharing by bridging gaps in technology, health literacy and interprofessional working; (3) build systems that can evaluate and improve quality of care; and (4) promote community-based, high-quality training programs.