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  1. Fulltext Exploring community behaviours and stakeholder challenges in engaging communities with dengue prevention behaviour in Malaysia: implementation research for a qualitative study with a community-based participatory research design
    Samsudin NA, Karim N, Othman H, Naserrudin NA, Sahani M, Hod R, et al.
    BMJ Open, 2024 Mar 12;14(3):e074222.
    PMID: 38479731 DOI: 10.1136/bmjopen-2023-074222
    OBJECTIVES: To use a community-based participatory research (CBPR) design to explore local community behaviours and stakeholders' challenges in engaging communities in dengue prevention behaviours in Hulu Langat, Selangor, Malaysia.

    DESIGN: This CBPR design in implementation comprised in-depth interviews (IDIs) and focus group discussions (FGDs). Themes were identified from the data with inductive and deductive thematic analysis.

    SETTING: FGDs were conducted in local community areas and IDIs were conducted in the local authority (LA) office and the Hulu Langat district health office.

    PARTICIPANTS: All FGD and IDI participants consented to the study, and included health authorities (n=4), LAs (n=7), community leader (n=1), faith leader (n=1), patients diagnosed with dengue (IDIs, n=2) and permanent residents of Hulu Langat who had been exposed to dengue infectious disease (FGDs, n=27).

    RESULTS: The main themes were categorised into community behaviour and stakeholder challenges. The community behaviour-related themes were awareness of dengue disease and Aedes mosquitoes, perception of risk and severity, and involvement of authorities. The themes related to stakeholder challenges were resource constraints and capacity issues, jurisdictional constraints and coordination, and educational dissemination and vandalism.

    CONCLUSIONS: The actions of the authorities shape community and stakeholder behaviours. Effective communication, including clear and aesthetically pleasing messages, motivates individuals to take appropriate actions. It is crucial for the authorities to engage in inclusive communication and consider diverse perspectives, such as those of residents and individuals exposed to dengue infection. Authorities that provide accurate and unbiased information foster transparency and enable informed decision-making by all stakeholders.

  2. Fulltext Impacts of climate change and environmental degradation on children in Malaysia
    Sahani M, Othman H, Kwan SC, Juneng L, Ibrahim MF, Hod R, et al.
    Front Public Health, 2022;10:909779.
    PMID: 36311578 DOI: 10.3389/fpubh.2022.909779
    The impacts of climate change and degradation are increasingly felt in Malaysia. While everyone is vulnerable to these impacts, the health and wellbeing of children are disproportionately affected. We carried out a study composed of two major components. The first component is an environmental epidemiology study comprised of three sub-studies: (i) a global climate model (GCM) simulating specific health-sector climate indices; (ii) a time-series study to estimate the risk of childhood respiratory disease attributable to ambient air pollution; and (iii) a case-crossover study to identify the association between haze and under-five mortality in Malaysia. The GCM found that Malaysia has been experiencing increasing rainfall intensity over the years, leading to increased incidences of other weather-related events. The time-series study revealed that air quality has worsened, while air pollution and haze have been linked to an increased risk of hospitalization for respiratory diseases among children. Although no clear association between haze and under-five mortality was found in the case-crossover study, the lag patterns suggested that health effects could be more acute if haze occurred over a longer duration and at a higher intensity. The second component consists of three community surveys on marginalized children conducted (i) among the island community of Pulau Gaya, Sabah; (ii) among the indigenous Temiar tribe in Pos Kuala Mu, Perak; and (iii) among an urban poor community (B40) in PPR Sg. Bonus, Kuala Lumpur. The community surveys are cross-sectional studies employing a socio-ecological approach using a standardized questionnaire. The community surveys revealed how children adapt to climate change and environmental degradation. An integrated model was established that consolidates our overall research processes and demonstrates the crucial interconnections between environmental challenges exacerbated by climate change. It is recommended that Malaysian schools adopt a climate-smart approach to education to instill awareness of the impending climate change and its cascading impact on children's health from early school age.
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