BACKGROUND: Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation.
METHODS: We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates.
RESULTS: Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71-0.96).
CONCLUSIONS: Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in countries with limited healthcare resources. Nonetheless, geographic expansion alone is inadequate to achieve effective coverage in a dichotomous primary care system, and the role of the private sector in primary care delivery should not be overlooked.
PIP: Many countries have a wealth of population data already available for utilization. In launching family planning population programs on a national scale every country must establish a long range of integrated programs of evaluation and data collection which will measure the past, current, and future trends in fertility, mortality, and migration patterns. These demographic features and poupulation profiles will assist in charting the strategies, objectives, targets, and survey components to be implemented for the successful launching of a country-wide program. In Malaysia the 10-year period population census, vital registration systems, sample houshold surveys, immigration, emigration, industrialization records, and KAP surveys serve as a source for obtaining population data and for charting population programs. Attention is directed to the census and to essential features of a census as well as to vital registration systems. The population census is a "total process of collecting, compiling and publishing demographic, economic and social data pertaining at a specific time or times to all persons in a country or delimited territory." A census is conducted on a national scale and enumeration is done individually. In Malaysia a De Jure and a De Facto Census are normally conducted. Enumeration is carried out by means of direct interviews or canvasser methods. Malaysia's last census was conducted between May and June 1980. The organization aspects of administering a nationwide census is a long process which may take a couple of years in the planning period. While the census provides a picture on the population at 1 point in time, the vital registration system monitors the continuous process of vital events and performs dual functions: to register vital events and obtain vital records which are legal documents; and to collect statistics about vital events. In Malaysia the registration of births and deaths and marriages is compulsory. Vital statistics may also be obtained from household surveys.
There have been an increasing number of studies conducted on community preparedness, particularly on changing individual health behaviors in ways that minimizes individual risk to cope with the stress of a natural disaster. A variety of behavioral change theories and models used by disaster academics scrutinize the manner in which individual behavior is sought and transformed into disaster preparedness. This reflects the lack of knowledge about how these models identify certain behaviors regarding natural disaster preparation. This article seeks to address this lack of knowledge. It presents a set of health behavioral change models that can be used by scholars to comprehend variation in the nature and extent of individual disaster preparedness. The purpose of this study is to provide a review of the existing models on the subject, and also to present a comparative analysis of the models that may contribute to ways of understanding the investigation on natural disaster preparedness behaviors.
Monitoring of land use change is crucial for sustainable resource management and development planning. Up-to-date land use change information is important to understand its pattern and identify the drivers. Remote sensing and geographic information system (GIS) have proven as a useful tool to measure and analyze land use changes. Recent advances in remote sensing technology with digital image processing provide unprecedented possibilities for detecting changes in land use over large areas, with less costs and processing time. Thus, the objective of this study was to assess the land use changes in upper Prek Thnot watershed in Cambodia from 2006 until 2018. Geospatial tools such as remote sensing and GIS were used to process and produce land use maps from Landsat 5 TM, Landsat 7 ETM+ and Landsat 8. The post-classification comparison was conducted for analysing the land use changes. Results show forest area was greatly decreased by 1,162.06 km2 (33.67%) which was converted to rubber plantation (10.55 km2 ), wood shrub (37.65 km2 ), agricultural land (1,099.71 km2 ), built-up area (17.76 km2 ), barren land (3.65 km2 ), and water body (14.69 km2 ). Agricultural land increased by 1,258.99 km2 (36.48%), while wood shrub declined by 161.88 km2 (4.69%). Rubber plantation, built-up area, barren land, and water bodies were increased by 10.55 km2 (0.31%), 33.64 km2 (0.97%), 4.87 km2 (0.14%) and 15.89 km2 (0.46%), respectively. The decrease of forest and wood shrub had resulted due to population growth (1.8% from 2008 to 2019) and land conversion for agricultural purposes. Hence, this study may provide vital information for wise sustainable watershed’s land management, especially for further study on the effect of land use change on runoff in this area.
This paper seeks to illustrate how empowerment theory can be applied as a critical approach which
could heighten power and capacity in community development. This is because empowerment is not
just viewed through theory or philosophy only, but as an active approach which could be applied to
enhance individual, oganizational or even communal prosperity. Many communal issues discussed by
scholars such as poverty, health, women, people with disability, single mothers, youth, leadership, organization and many others utilises the empowerment approach. This is because it is the most
effective approach in resolving issues by empowering individual or target group to take effective action
through ability and potential, which have been developed. Discussion will ensue with definition of
empowerment, which will be elucidated, with the concept of power. In the context of community
development, empowerment refers to a mechanism where individual, organization and community will
amass control on life and related issues affecting them such as economy, social, psychology and
politics. To understand this concept clearly, discussion of empowerment concept will be closely
examined to view the definition from two different dimensions, which is whether empowerment can be
ascertained as a process, benefit or outcome. By using the qualitative approach, which is through
analysing content, books, journals and other references, a few steps or process have been unearthed to
apply empowerment as an approach, which could be practiced in the context of community
development specifically in rural areas.
Malaysian economy relies on palm oil industries as a driver for rural development. However, palm oil mill effluent
(POME) that is generated from palm oil processing stages causes major environmental challenges. Before being
released to the environment, POME treatment is crucial to comply with standard discharge limit. Microalgae have
demonstrated excellent potential for phycoremediating POME and capturing CO2
. In this study, local microalgae isolate
such as Chlamydomonas sp. UKM 6 and Chlorella spp. UKM 8 were used for POME treatment in 21 days with different
inoculum sizes (5%, 10% and 15%). In addition, an integrated treatment process was performed by taking the treated
POME supernatant for cultivation of Chorella spp. UKM 2, Chorella sorokiniana UKM 3 and Chlorella vulgaris for CO2
sequestration study. Different CO2
concentrations (5%, 10% and 15%) were used and the experiments were carried
out in 10 days under continuous illumination. The results showed that among two species involves in POME treatment,
Chlamydomonas sp. UKM 6 showed a great potential to remove pollutant such as COD (56%), nitrogen (65%) and
phosphorus (34%). The biomass after POME treatment and CO2
biofixation content high lipid (90 mg lipid/g biomass)
which can be the potential source for biodiesel production. In CO2
sequestration study, C. sorokininana UKM3 able
to takes up to 15% CO2
with CO2
uptake rate of 273 mgL-1d-1. In this study, the integrated system of POME treatment
and CO2
sequestration were feasible using microalgae.
"This article provides some empirical information pertaining to the benefits and costs of foreign labor to Singapore and subjects to critical analysis some of Pang and Lim's hypotheses concerning the costs of labor importation presented in a previous article.... The article concludes with a discussion of the real cost to Malaysia of Singapore's labor importation policies and its potential for disruption of Malaysia's development plans."