In 2010, Klang Valley has only 17% trips each day were completed using public transport, with the rest of the 83% trips were made through private transport. The inclination towards private car usage will only get worse if the transport policy continues to be inefficient and ineffective. Under the National Key Economic Area, the priority aimed to stimulate the increase of modal share of public transport in the Klang Valley to 50% by 2020. In the 10th Malaysia Plan, the Klang Valley Mass Rapid Transit was proposed, equipped with 141 km of MRT system, and will integrate with the existing rail networks. Nevertheless, adding kilometers into the rail system will not help, if people do not make the shift from private into public transport. This research would like to assess the possible mode shift of travellers in the Klang Valley towards using public transport, based on the utility function of available transport modes. It intends to identify the criteria that will trigger their willingness to make changes in favour of public transport as targeted by the NKEA.
The Government's decision to drastically and speedily increase the number of doctors in the country needs to be reviewed. The standard and quality of health care does not depend on the number of doctors, but on the improvement of the health care infrastructure. Increasing the number of government medical schools and increasing the intake of students should be done on a need-to basis, with the above perspective in mind. The selection criteria of candidates must not be compromised and the teaching staff must be adequate and experienced. The number of doctors should be gradually increased over the years in tandem with the development of the health care infrastructure and the deployment of doctors must be directed at providing equitable care to the people at all economic levels and geographic locations. The strength of academic staff in existing government medical schools must be upgraded to provide high level of teaching and research, perhaps reinforced with the recruitment of suitably qualified and experienced foreign teachers. The infrastructure of existing government medical schools must be upgraded to cater for the gradual increasing demand for more doctors as the country develops. The selection of candidates for the government medical schools must be based on merit and without undue emphasis on ethnic considerations, for it is only in the arena of fair competitiveness that excellence can be born. The considerations of merit in selection must include assessment of attitude, self-development, moral ethics and reasoning. If the above perspectives are fully appreciated, then there is really no requirement for private medical colleges in Malaysia.
Issues related to the provision of private education are discussed in relation to the need, clinical teaching, professional standards and financial implications. The advantages and disadvantages are summarised.
The pursuit, initiation and establishment of multi-stakeholder partnerships, including with the private sector, is often a critical component of attaining and achieving the success and sustainability of many projects the world over. However, the soliciting and securing of socially, economically and environmentally constructive engagements between the private sector on the one hand, and the NGOs, CBOs and local communities on the other hand, is in reality much easier said than done. Notably, since most private sector corporations undoubtedly tend to leave behind various "ecological footprints", differing only in their size and depth, stemming from their respective forms and functions, and their ensuing impacts and implications. The interplay between the civil society and the private sector, especially for resource mobilization. (Copied from article).
Life-cycle assessment (LCA) is one of the most attractive tools employed nowadays by environmental policy-makers as well as business decision-makers to ensure environmentally sustainable production/consumption of various goods/services. LCA is a systematic, rigorous, and standardized approach aimed at quantifying resources consumed/depleted, pollutants released, and the related environmental and health impacts through the course of consumption and production of goods/service. Algal fuels are no exception and their environmental sustainability could be well scrutinized using the LCA methodology. In line with that, this chapter is devoted to present guidelines on the technical aspects of LCA application in algal fuels while elaborating on major standards used, i.e., ISO 14040 and 14044 standards. Overall, LCA practitioners as well as technical experts dealing with algal fuels in both the public and private sectors could be the main target audience for these guidelines.
Jaafar S, Mohd Noh K, Abdul Muttalib K, Othman NH, Healy J, Maskon K, et al.
Citation: Jaafar S, Mohd Noh K, Abdul Muttalib K, Othman NH, Healy J, Maskon K, et al. Malaysia Health System Review. Geneva: World Health Organization; 2013
Malaysia is a federation of 13 states and 2 territories in a parliamentary democracy, with the Prime Minister the head of government and a constitutional monarch elected by the Sultans. Malaysia is a multicultural society and a secular state with Sunni Islam as the official religion. Classified by the World Bank as an upper middle-income country, its society and economy were transformed by rapid economic growth in the latter half of the 20th century. Malaysia’s population (now numbering over 28 million with 70% living in urban areas) has benefited from a well developed health care system, good access to clean water and sanitation, and strong social and economic programmes. Life expectancy at birth is 73 years. Noncommunicable diseases now account for most mortality and morbidity but communicable diseases remain a concern. Section 2 describes the organization and governance of the health system. Health care services consist of tax-funded and governmentrun primary health care centres and hospitals, and fast-growing private services mainly located in physician clinics and hospitals in urban areas. Public sector health services are administered by the Ministry of Health through its central, state and district offices. The Ministry of Health regulates the private sector, pharmaceutical industry and food safety and plans and regulates its own health care services. Legislation governing health care professionals requires them to register with statutory professional bodies. Section 3 reports on health care financing. Malaysia’s public health system is financed mainly through general revenue and taxation collected by the federal government, while the private sector is funded principally through out-of-pocket payments from patients and some private health insurance. Spending on health reached 4.6% of GDP in 2009 with the majority from public spending, reaching 56% of total health expenditure (THE) in 2009. The main sources of THE in 2008 were the Ministry of Health (42%), followed by household out-of-pocket expenditure at nearly 34%. The Ministry of Health funds public facilities through line item budgets and patients pay private physicians and private hospitals on a fee-for-service basis. Physical and human resources are described in Section 4. The number of public primary care facilities (currently 802 centres and over 2000 small community clinics) and dental clinics were expanded steadily in earlier decades, particularly to reach people in under-served rural areas. Secondary care is offered in smaller public hospitals and more complex tertiary care, in regional and national hospitals (including university teaching hospitals run by the Ministry of Higher Education). Growth has slowed in recent years, however, and public services in urban areas have not kept pace with rapid urbanization, while the population ratio of hospital beds has declined slightly. Private clinics and hospitals in urban areas have grown rapidly over the last decade. The supply of health professionals remains seriously below the required number, although the government has increased the number of training places. Section 5 looks at provision of services. National health policies stress public health and health promotion, that is, ‘a wellness’ as well as a ‘disease’ perspective. The Ministry of Health has developed an extensive network of public primary care centres and also dental services especially for children, but these services are under strain and have staff shortages, so patients often encounter long waits. Primary care exerts only a limited gatekeeper function since people can bypass a referral from a general practitioner and for a small additional fee (if in the public sector) can go directly to specialists and hospitals. Government services increasingly serve the poor and private services the better-off people who live in urban areas. Hospital policy currently has three main thrusts: strengthening specialty care in large public hospitals; increasing the number of day surgery centres; and expanding top-end private hospital care to cater to the medical tourism market (with 35 participating hospitals in 2010). Malaysia has a large pharmaceutical manufacturing sector that exports to other countries and also supplies 30% of domestic demand. The principal health care reforms are discussed in Section 6. The government has stepped up its surveillance and early response to infectious disease outbreaks as a result of recent pandemics such as SARS and avian flu, which had a major impact on the country’s economy. The Ministry of Health has maintained its extensive vaccination programmes, has consolidated its primary health care clinics and upgraded its hospitals, and is slowly introducing information communication technology into its public facilities. The government has increased training places to counter shortages of health professionals, has strengthened food and drug safety regulation, is considering price xv regulation of pharmaceuticals, and is positioning the country as a medical tourism destination. Section 7 provides an assessment of the health system. Malaysia has a strong population health tradition and well-established and extensive health care services. Although total health expenditure at 4.6% of GDP in 2008 is in the range for middle-income countries, the government is concerned about future sustainable financing. Successive administrators have prioritized the provision of cost-effective, preventative and mainly free primary health care in public clinics. The rapid growth of private health care means that private spending has risen faster than public spending, including out-of-pocket payments by the public, with the government share (from general revenue) just above half (56%) of health expenditure in 2009. In conclusion, Malaysia has achieved impressive health gains for its population with a low-cost health care system funded through general revenue that provides universal and comprehensive services. Like many other countries in the region, Malaysia has struggled to produce an adequate supply of health professionals, and to integrate and regulate its rapidly growing private health sector. Public services have not kept pace with population growth in urban areas and those with higher purchasing power use private rather than public doctors and hospitals, which leaves the public sector with more poorer and sicker patients. The Malaysian Government recently revived the debate over options for a national social health insurance scheme. The financing challenge is to agree on a scheme for fair and sustainable funding and its respective contributions from general revenue and private payments. The regulatory challenge for the Malaysian Government is to strengthen its governance of both public and private health services in order to ensure high quality and safe services and fair charges. The structural challenge is to determine the balance between public and private sector delivery and to engage in a more productive partnership between public and private sectors. The administrative challenge is to consider whether the community would be better served by more decentralized and responsive services. As Malaysia seeks to attain high income country status, and as demographic and epidemiological transitions continue and new technology expands the possibilities for intervention, the demand for xvi health care by the population will continue to rise. The government will need to address growing concerns about equity, efficiency and budgetary constraints and balance conflicting policy principles. Pressures are building up for health system reform in Malaysia looking towards the year 2020 and beyond.
A total of 245 foreign workers was screened for various microbial and parasitic infections, as part of the pilot study on the health problems of foreign workers. The sample comprising of Indonesian and Bangladeshi workers, was selected on a non-probability basis from two sources, i.e. University Hospital and a private sector. This investigation revealed substantive number of workers with positive cases to some of the microbial and parasitic infections. KEYWORDS: Pilot study, infective agents, foreign workers
Governments in emerging markets face mounting challenges in managing health spending, building capability and capacity, modernizing ageing infrastructure, and investing in skills and resources. One path to overcoming these challenges is to establish new public-private models of health care development and delivery based on United States academic medical centers, whose missions are to advance medical education and clinical delivery. Johns Hopkins Medicine is a participant in the collaboration developing between the Perdana University Hospital and the Perdana University Graduate School of Medicine in Malaysia. These two organizations comprise an academic health science center based on the United States model. The Perdana project provides constructive insights into the opportunities and challenges that governments, universities, and the private sector face when introducing new models of patient care that are integrated with medical education, clinical training, and biomedical research.
Between 1990 and 2005, dialysis treatment rates in Malaysia increased more than eightfold. Dialysis treatment reached a level comparable to rates in developed countries. This remarkable transformation was brought about in large part by the Malaysian government's large-scale purchase of dialysis services from the highly competitive private sector. This paper traces a series of public- and private-sector reforms that dramatically increased access to dialysis for patients with kidney failure from 13 per million people in the population in 1990 to 119 per million in 2005. Not all developing countries have had uniformly positive experiences with private-sector participation in health care. However, our data suggest that strong participation by the private sector in Malaysia has helped make for a stronger health care system as well as healthier patients. Yet the policy decisions that enabled the private sector to participate fully in providing dialysis have not been repeated with other medical services.
Objectives: Occupational stress among healthcare workers is an important concern due to its crucial contribution in attaining maximum job output and optimal quality of working life. Our study aims to compare job stress levels of healthcare employees based on 1) sector, 2) category and 3) specialisation. Methods: Stress severity and frequency were evaluated using the 9-point scale Job Stress Survey (Job Stress, Job Pressure, Lack of Support). A crosssectional sample of 223 healthcare providers were enrolled from seven health institutions in Peninsular Malaysia (East Coast = 55%; mean age = 30 years; female = 78.9%; < 2 years experience = 35.9%; government-based = 48%; supportive = 62.8%). Results: No significant difference was found between government and private sector workers. Supportive staff reported significantly higher stress frequency in contrast to professionals who demonstrated significantly higher stress severity in all dimensions (p < .05). Within the supportive group, radiographers were the most stressed, followed by nurses and medical laboratory technologists (p > .05). Research-based professionals experienced significantly worse stress frequency in all components compared to professional practitioners (p < .05). Conclusion: Because stress levels are affected by job category and specialisation, flexible strategies to ensure employees’ job productivity, contentment and personal well-being should be implemented.
Since 1957, there has been major reorganization of health care services in Malaysia. This article assesses the changes and challenges in health care delivery in Malaysia and how the management in health care processes has evolved over the years including equitable health care and health care financing. The health care service in Malaysia is changing towards wellness service as opposed to illness service. The Malaysian Ministry of Health (MOH), being the main provider of health services, may need to manage and mobilize better health care services by providing better health care financing mechanisms. It is recommended that partnership between public and private sectors with the extension of traditional medicine complementing western medicine in medical therapy continues in the delivery of health care.
Health biotechnology has rapidly become vital in helping healthcare systems meet the needs of the poor in developing countries. This key industry also generates revenue and creates employment opportunities in these countries. To successfully develop biotechnology industries in developing nations, it is critical to understand and improve the system of health innovation, as well as the role of each innovative sector and the linkages between the sectors. Countries' science and technology capacities can be strengthened only if there are non-linear linkages and strong interrelations among players throughout the innovation process; these relationships generate and transfer knowledge related to commercialization of the innovative health products. The private sector is one of the main actors in healthcare innovation, contributing significantly to the development of health biotechnology via knowledge, expertise, resources and relationships to translate basic research and development into new commercial products and innovative processes. The role of the private sector has been increasingly recognized and emphasized by governments, agencies and international organizations. Many partnerships between the public and private sector have been established to leverage the potential of the private sector to produce more affordable healthcare products. Several developing countries that have been actively involved in health biotechnology are becoming the main players in this industry. The aim of this paper is to discuss the role of the private sector in health biotechnology development and to study its impact on health and economic growth through case studies in South Korea, India and Brazil. The paper also discussed the approaches by which the private sector can improve the health and economic status of the poor.
The provision of renal replacement therapy (RRT) in developing economies is limited by lack of financial and other resources. There are no national reimbursement policies for RRT in many countries in Asia. The Southeast Asia countries of Singapore, Malaysia, Thailand, and Indonesia have adopted a strategy of encouraging public-private partnerships to increase the RRT rates in their respective countries. The private organizations include both for-profit and philanthropic bodies. The latter raise funds from ordinary citizens, corporations, and faith-based groups, as well as receive subsidies from the government to support RRT for patients in need. The kidney foundations of these countries play a leadership role in this public-private partnership. Many of the private organizations that support RRT are providers of treatment in addition to offering financial assistance to patients, with hemodialysis being the most frequently supported modality. Public-private partnership in funding RRT is sustainable over the long term with proper organization and facilitated by support from the government.
The aim of the study was to assess the potential role of dentists as smoking cessation counsellors in their practice. The target group comprised of all public and private sector dentists in the Federal Territory of Kuala Lumpur (FTKL) and Selangor. Data were collected via a twenty-six item questionnaire which was mailed to 831 dentists. A response rate of 67.1% was obtained. Results revealed that the majority of the respondents (97.8%) perceived that in addition to providing oral care, dentists should also be interested in their patients’ general health. Generally, about two-thirds of dentists (69.1%) and especially those from the public sector (76.4%) considered that they have an important role to play as smoking cessation counsellors. However, less than half of the respondents (40.3%) perceived that patients do not expect smoking cessation advice from their dentists. Yet, more than half of the respondents (55.1%) provided advice or helpful hints in order to motivate their patients to quit smoking. About 65% of the overall respondents did explain to their patients regarding the health risk due to smoking and its detrimental effects. Perceived obstacles to smoking cessation include lack of information between dentistry and smoking cessation (86.1%) followed by lack of training and lack of time.