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Estimating impact of Malaysian family planning programme on births: a comparison of matched acceptor and non-acceptor birth rates

Tan Boon Ann, Tey Nai Peng

Malays J Reprod Health, 1984 Dec;2(2):111-8.
PMID: 12280341
An overview of the population dynamics in Malaysia

Arshat H, Tey Nai Peng

Malays J Reprod Health, 1988 Jun;6(1):23-46.
PMID: 12281592
Multivariate areal analyses of neo-natal mortality in peninsular Malaysia

Tey Nai Peng, Tan Boon Ann, Arshat H

Malays J Reprod Health, 1985 Jun;3(1):46-58.
PMID: 12314427
Voluntary sterilization: an analysis based on service statistics of the national program

Tey Nai Peng, Tan Boon Ann, Arshat H

Malays J Reprod Health, 1985 Dec;3(2):160-6.
PMID: 12314741
The effects of life cycle and family formation variables on pregnancy outcome

Arshat H, Tan Boon Ann, Tey Nai Peng

Malays J Reprod Health, 1985 Dec;3(2):115-25.
PMID: 12314738
Fulltext Correlates of and barriers to the utilization of health services for delivery in South Asia and Sub-Saharan Africa

Tey NP, Lai SL

ScientificWorldJournal, 2013;2013:423403.
PMID: 24288482 DOI: 10.1155/2013/423403

The high maternal and neonatal mortality rates in South Asia and Sub-Saharan Africa can be attributed to the lack of access and utilization of health services for delivery. Data from the Demographic and Health Surveys conducted in Bangladesh, India, Pakistan, Kenya, Nigeria, and Tanzania show that more than half of the births in these countries were delivered outside a health facility. Institutional delivery was closely associated with educational level, family wealth, place of residence, and women's media exposure status, but it was not influenced by women's work status and their roles in decision-making (with the exception of Nigeria). Controlling for other variables, higher parity and younger women were less likely to use a health facility for delivery. Within each country, the poorer, less educated and rural women had higher unmet need for maternal care services. Service related factors (accessibility in terms of cost and distance) and sociocultural factors (e.g., did not perceive the need for the services and objections from husband and family) also posed as barriers to institutional delivery. The paper concludes with some suggestions to increase institutional delivery.
Fulltext Socio-economic development and mortality patterns and trends in Malaysia

Tan Poo Chang, Kwok Kwan Kit, Tan Boon Ann, Shyamala Nagaraj, Tey Nai Peng, Siti Norazah Zulkifli

Asia Pac Popul J, 1987 Mar;2(1):3-20.
PMID: 12341034

PIP: Morality in Peninsular Malaysia has reached a level that is quite similar to that prevailing in the low mortality countries. This article systematically documents changes in mortality levels and differentials in Malaysia over time and relates these to changes in development indicators and health-related policies. Remedial measures undertaken by the authorities including the expansion of hospital and health services into the estates, together with a comprehensive malaria-eradication program, improvements in sanitation laws, and increased provision of public utilities and education, resulted in beriberi being eliminated and the incidence of malaria, typhus, and smallpox being greatly reduced by the time of World War II. The gain in life expectancy over the period of 1957-1979 was greatest for the Malay, the most significant period being 1957-1967, which saw the introduction of rural health programs. The infant mortality rate and the neonatal and post-neonatal rates declined substantially for all ethnic groups in Peninsular Malaysia for the same time period. Although the lower infant mortality of the Chinese can be explained by their advantageous socioeconomic position the same reason cannot explain the lower decline in infant mortality levels of the Indians. Much still needs to be done to narrow, if not to eliminate, the existing mortality differentials of different groups in the country. Overall, the quality of life of the general population can be further enhanced by reducing the high mortality level of disadvantaged groups.
Contraceptive use in Cambodia: does household decision-making power matter?

Lai SL, Tey NP

Cult Health Sex, 2020 07;22(7):778-793.
PMID: 32037969 DOI: 10.1080/13691058.2019.1685683

In Cambodia, the growth of family planning services and socio-economic development have resulted in a spectacular rise in contraceptive prevalence rate and an equally remarkable reduction in contraceptive use differentials. With rising educational levels and increased participation in the modern labour market, Cambodian women are playing an increasingly pivotal role in household decision-making. This study used data from three rounds of Cambodia Demographic and Health Surveys to elucidate trends and patterns of contraceptive use. It then examined the determinants of contraceptive use through the use of logistic regression. The central hypothesis to be tested was whether or not women's involvement in household decision-making affected contraceptive use. Multivariate analysis showed that apart from the number of living children, women's work status and education of both men and women had a more significant impact on contraceptive use, as compared to women's power in household decision-making. More effort is needed to empower women in all aspects in order to reduce the socio-economic differentials in contraceptive use and improve their reproductive health, in line with the goal of the global agenda of the sustainable development goals (SDGs) to leave no one behind.
Midwives as Drivers of Contraceptive Uptake: Evidence From Indonesia Demographic and Health Surveys

Lai SL, Tey NP

Asia Pac J Public Health, 2021 Nov 15.
PMID: 34775805 DOI: 10.1177/10105395211058810

The midwives play an important role in maternal and child health in developing countries, but they are rarely involved in providing family planning services, except in Indonesia. This article underscores the midwives' crucial role in supplying modern contraceptive methods in Indonesia. Data for this analysis came from 8 waves of the Indonesia Demographic and Health Survey (IDHS). The main analysis was confined to 17 216 current users of modern methods from the 2017 IDHS. The midwives delivered contraceptives to 53% of the modern-method users in Indonesia. Multinomial logistic regression shows that the odds of users obtaining their contraceptive supplies from the midwives was significantly associated with age, parity, urban-rural location, region, education, wealth, exposure to family planning, and method type. The midwives help to reduce the doctors' workload for them to focus on specialized services. Developing countries can learn from the Indonesian experience to ensure equitable access to family planning services.
Fulltext Effects of selected leisure activities on preventing loneliness among older Chinese

Teh JKL, Tey NP

SSM Popul Health, 2019 Dec;9:100479.
PMID: 31646167 DOI: 10.1016/j.ssmph.2019.100479

This study examined three types of leisure activities (playing cards/mahjong, watching TV/listening to the radio, and participation in social activities) among the older segment of the Chinese population, and the effects of these activities in preventing the feelings of loneliness. Data came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), conducted in 2005, 2008, and 2011. The males, those who were educated, the young-old (aged between 65 and 74 years), urban dwellers, and living in institutions were more likely to participate in all three activities frequently. Frequent or occasional participation in these three activities was negatively associated with feelings of loneliness. The longitudinal study from 2005 to 2011 showed that respondents who frequently played cards/mahjong at baseline were less likely to feel persistent loneliness at the end of the 2011 wave. Instead, frequently watching TV/listening to the radio in 2008 was associated with lower odds in feeling persistent loneliness at the end of 2011. Hence, active participation in playing cards/mahjong and TV/radio entertainment can be effective treatment intervention against persistent loneliness among older Chinese. For the Chinese, a leisure activity steeped in a nation's culture and heritage, such as playing mahjong, may be used as an intervention strategy to prevent and alleviate chronic loneliness among older adults.
Proximate determinants of fertility in peninsular Malaysia

Tey NP, Ng ST, Yew SY

Asia Pac J Public Health, 2012 May;24(3):495-505.
PMID: 21490114 DOI: 10.1177/1010539511401374

The continuing decline in fertility despite a contraction in contraceptive use in Peninsular Malaysia since the mid-1980s has triggered considerable interest in the reasons behind this phenomenon, such as increase in abortion, sterility, and out-of-wedlock pregnancy. Fertility decline has been attributed to rapid socioeconomic development, which can only influence fertility through the intermediate variables. Application of vital statistics, population census, and survey data of Peninsular Malaysia on Bongaarts's model vindicates that marriage postponement and contraceptive use are the 2 most important proximate determinants of fertility, but the effects are not uniform across the ethnic groups. For instance, the predicted total fertility rate for Chinese and Malays are 2.9 and 1.6, respectively, compared with the observed level of 3.0 and 1.9. Postpartum infecundability and abortion also play a part in explaining ethnic fertility differentials. The fertility inhibiting effects of these proximate determinants have significant implications on reproductive health and future population growth.
Perceived health status and daily activity participation of older Malaysians

Ng ST, Tengku-Aizan H, Tey NP

Asia Pac J Public Health, 2011 Jul;23(4):470-84.
PMID: 20685663 DOI: 10.1177/1010539510374751

This article investigates the influence of perceived health status on the daily activity participation of older Malaysians. Data from the Survey on Perceptions of Needs and Problems of the Elderly, which was conducted in 1999, were used. The negative binomial regression results show that older persons with good perceived health status reported more varieties of daily activity participation, especially among the uneducated and those with below-average self-esteem. The multinomial logistic regression model suggests that older persons with good perceived health status tended to engage daily in paid work only or with leisure activities, whereas those perceived to have poor health were more likely to engage in leisure activities only or leisure and family role activities. Promotion of a healthy lifestyle at a younger age encourages every person to monitor and take responsibility for their own health, which is a necessary strategy to ensure active participation at an older age, and thus improve their well-being.
Fulltext What matters for life satisfaction among the oldest-old? Evidence from China

Ng ST, Tey NP, Asadullah MN

PLoS One, 2017;12(2):e0171799.
PMID: 28187153 DOI: 10.1371/journal.pone.0171799

OBJECTIVE: The world population is aging rapidly and the well-being of older people is of great interest. Therefore, this study investigates the determinants of life satisfaction among the oldest-old (i.e. individuals aged 80 or over) in China.
MATERIALS AND METHODS: We use the 2011/2012 Chinese Longitudinal Healthy Longevity Survey data (n = 6530) for this paper. Logistic regression is used to analyse the effects of socio-demographic, economic, health, instrumental activities of daily living, family and community factors on life satisfaction and depression among the oldest-old in China.
RESULTS: Our analysis confirms the significance of many factors affecting life satisfaction among the oldest-old in China. Factors that are correlated with life satisfaction include respondent's sex, education, place of residence, self-rated health status, cognitive ability (using mini mental state examination), regular physical examination, perceived relative economic status, access to social security provisions, commercialized insurances, living arrangements, and number of social services available in the community (p<0.05 for all these variables). Although life satisfaction is negatively associated with instrumental activities of daily living (β = -0.068, 95%CI = -.093-.043), and depression (β = -0.463, 95%CI = -.644-.282), the overall effect of self-rated health status is positive (p<0.001). This confirms the primacy of health as the determinant of well-being among the oldest-old.
CONCLUSIONS: Majority of the oldest-old in China rated their life satisfaction as good or very good. Our findings show that health and economic status are by far the most significant predictors of life satisfaction. Our finding on the primacy of health and relative income as determinants of well-being among the oldest-old, and the greater influence of self-rated health status over objective health measures is consistent with the findings of many past studies. Our results suggest that efforts should be directed at enhancing family support as well as health and social service provisions in the community to improve life satisfaction of older people.
Differential utilisation of health facilities and services for childbirth in Peninsula Malaysia--the ethnic factor

Arhsat H, Tan BA, Tey NP

Malays J Reprod Health, 1985 Dec;3(2):105-14.
PMID: 12314737
AGE AT MENARCHE AND SEXUAL DEBUT AMONG YOUNG FILIPINO WOMEN

Tey NP, Lai SL, Ng ST

J Biosoc Sci, 2019 01;51(1):77-94.
PMID: 29352813 DOI: 10.1017/S0021932017000682

There has been a secular decline in age at menarche since the 19th century. Early-maturing women are more likely to have their sexual debut at a younger age, which in turn gives rise to a host of reproductive health and social problems. This study used data from five waves of National Demographic and Health Surveys conducted in the Philippines between 1993 and 2013 to examine the trends and socioeconomic differentials in age at menarche and sexual debut. The changing trend in age at menarche and sexual debut was examined across birth cohorts, and logistic regressions were used to identify the determinants of early sexual debut. In the Philippines, the mean and median ages at menarche declined from 13.2 years and 12.6 years, respectively, among young women born in 1973-1977, to 12.9 years and 12.3 years, respectively, among those born in 1993-1997. The proportion who had their sexual debut by age 20 increased from 41.2% for the 1968-1972 birth cohort to 53.4% for the 1988-1992 birth cohort. Filipino women with low education, from poor families and living in rural areas were more likely to have earlier sexual debut despite attaining menarche at a later age as compared with their higher educated counterparts, and those from wealthier families and urban areas. Logistic regression analysis showed that, besides marital status, women's education and age at menarche were important determinants of early sexual debut. However, ethnicity, place of residence and family wealth had no significant effects on age at menarche. An increasing proportion of young women were found to be having unprotected sexual debut and at a younger age, with health and social ramifications. Hence, apart from increasing the enrolment of girls in schools and discouraging teenage marriage, there is a need for social and health agencies to implement appropriate adolescent sexual and reproductive health programmes such as counselling and educational campaigns, as well as support services, to address sexual problems among the youth.
Unraveling the Impact of Widowhood Duration on Depression: Does Time Heal All Wounds?

Huang X, Tey NP, Lai SL

Asia Pac J Public Health, 2024 May;36(4):352-357.
PMID: 38590147 DOI: 10.1177/10105395241244960

China's aging population has witnessed a surge in widowed older adults, raising concerns about their mental health. Losing a spouse is a profoundly distressing experience with enduring effects on well-being. Despite the proverbial belief in time's healing power, existing studies often neglect the potential decline in depressive symptoms during widowhood. Drawing data from the 2015 and 2018 China Health and Retirement Longitudinal Study, this study delved into the impact of widowhood duration on depression among 8370 older adults and uncovered significantly higher depression scores among widowed individuals, particularly in the initial three years. This study revealed that widowhood contributes to heightened depression levels even after accounting for sociodemographic factors. Although the depressive impact lessens over time, it persists beyond three years, underscoring the need for heightened awareness and support for this vulnerable population.
Fulltext Family support and loneliness among older persons in multiethnic Malaysia

Teh JK, Tey NP, Ng ST

ScientificWorldJournal, 2014;2014:654382.
PMID: 25383374 DOI: 10.1155/2014/654382

This study investigates factors affecting older persons' state of loneliness in multiethnic Malaysia using data from the 2004 Malaysian Population and Family Survey, the first nationally representative sample in Malaysia. The study sample was extracted to include Malays, Chinese, Indians and other Indigenous groups aged 60 and above, and who had children (n = 1791). Cross tabulations and ordinal logistic regression methods were used in the analysis. Among the ethnic groups, older Malays were more likely than their Chinese and Indian counterparts to experience loneliness. Loneliness was found to be associated with age, marital status, education level, sources of income, health status, and physical limitations. Among older people, feelings of loneliness were inversely related with coresidence with adult children and participation in religious activities. Sociodemographic changes have eroded the traditional family support system for the elderly, while social security remains inadequate. This study shows the important role of family in alleviating loneliness among older people. Hence the need to promote and facilitate coresidence, as well as participation in religious activities, and a healthy lifestyle as a priority strategy is in line with the objectives of the National Policy for the Older People.
Fulltext Ethnic and gender differentials in non-communicable diseases and self-rated health in Malaysia

Teh JK, Tey NP, Ng ST

PLoS One, 2014;9(3):e91328.
PMID: 24603609 DOI: 10.1371/journal.pone.0091328

OBJECTIVES: This paper examines the ethnic and gender differentials in high blood pressure (HBP), diabetes, coronary heart disease (CHD), arthritis and asthma among older people in Malaysia, and how these diseases along with other factors affect self-rated health. Differentials in the prevalence of non-communicable diseases among older people are examined in the context of socio-cultural perspectives in multi-ethnic Malaysia.

METHODS: Data for this paper are obtained from the 2004 Malaysian Population and Family Survey. The survey covered a nationally representative sample of 3,406 persons aged 50 and over, comprising three main ethnic groups (Malays, Chinese and Indians) and all other indigenous groups. Bivariate analyses and hierarchical logistic regression were used in the analyses.

RESULTS: Arthritis was the most common non-communicable disease (NCD), followed by HBP, diabetes, asthma and CHD. Older females were more likely than males to have arthritis and HBP, but males were more likely to have asthma. Diabetes and CHD were most prevalent among Indians, while arthritis and HBP were most prevalent among the Indigenous groups. Older people were more likely to report poor health if they suffered from NCD, especially CHD. Controlling for socio-economic, health and lifestyle factors, Chinese were least likely to report poor health, whereas Indians and Indigenous people were more likely to do so. Chinese that had HBP were more likely to report poor health compared to other ethnic groups with the same disease. Among those with arthritis, Indians were more likely to report poor health.

CONCLUSION: Perceived health status and prevalence of arthritis, HBP, diabetes, asthma and CHD varied widely across ethnic groups. Promotion of healthy lifestyle, early detection and timely intervention of NCDs affecting different ethnic groups and gender with socio-cultural orientations would go a long way in alleviating the debilitating effects of the common NCDs among older people.
Fulltext Teacher Reporting Attitudes Scale (TRAS): confirmatory and exploratory factor analyses with a Malaysian sample

Choo WY, Walsh K, Chinna K, Tey NP

J Interpers Violence, 2013 Jan;28(2):231-53.
PMID: 22902514 DOI: 10.1177/0886260512454720

The Teacher Reporting Attitude Scale (TRAS) is a newly developed tool to assess teachers' attitudes toward reporting child abuse and neglect. This article reports on an investigation of the factor structure and psychometric properties of the short form Malay version of the TRAS. A self-report cross-sectional survey was conducted with 667 teachers in 14 randomly selected schools in Selangor state, Malaysia. Analyses were conducted in a 3-stage process using both confirmatory (stages 1 and 3) and exploratory factor analyses (stage 2) to test, modify, and confirm the underlying factor structure of the TRAS in a non-Western teacher sample. Confirmatory factor analysis did not support a 3-factor model previously reported in the original TRAS study. Exploratory factor analysis revealed an 8-item, 4-factor structure. Further confirmatory factor analysis demonstrated appropriateness of the 4-factor structure. Reliability estimates for the four factors-commitment, value, concern, and confidence-were moderate. The modified short form TRAS (Malay version) has potential to be used as a simple tool for relatively quick assessment of teachers' attitudes toward reporting child abuse and neglect. Cross-cultural differences in attitudes toward reporting may exist and the transferability of newly developed instruments to other populations should be evaluated.
Utilization of Private Sector Family Planning Services in Malaysia

Lai SL, Tey NP, Mahmud A, Ismail N

Int Q Community Health Educ, 2021 Jul;41(4):395-403.
PMID: 33167794 DOI: 10.1177/0272684X20972864

BACKGROUND: The private sector is playing an increasingly important role in family planning services globally. The active participation of private providers is associated with a higher contraceptive prevalence rate.
OBJECTIVES: To examine the differentials and determinants of the utilization of private providers for family planning services.
METHOD: This study used the 2014 Malaysian Population and Family Survey data. Cross-tabulations and logistic regression were performed on 1,817 current users of modern methods.
RESULTS: Overall, 26% of modern method users obtained their supplies from private clinics/pharmacies and 15.2% from other sources, such as drug stores and sundry shops. The odds of utilizing the private sector for family planning services differ significantly across regions and socio-economic groups. The odds of obtaining supply from the private clinics/pharmacies were higher among the Chinese and urban women (AOR > 1), and it was lower among those from the eastern region (AOR = 0.47, 95% CI = 0.30-0.73). Non-Bumiputera, urban, higher educated, and working women, and those whose husbands decided on family planning had higher odds of obtaining the supply from the other sources (AOR > 1).
CONCLUSION: The private sector complements and supplements the public sector in providing family planning services to the public.

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