Introduction: Methadone Maintenance Treatment (MMT) is the commonly used intervention for opioid dependents among Malays in FELDA settlements. However, relapse is common. Since majority of Malays are Muslims, Islamic Rehabilitation Intervention Module (ISRIM) using Health Belief Model (HBM) can be implemented as an intervention for reduction of relapse among opioid dependents in FELDA community. The objective of this study were to develop, implement and evaluate the effectiveness of ISRIM in the reduction of relapse among opioids dependent Malay males in FELDA communities in Jengka, Pahang. Methods: A single blind, cluster randomized controlled trial utilizing simple randomization was conducted, involving 10 MMT clinics. Intervention group received ISRIM for one session per week for four consecutive weeks, while control group were put on wait-list. Outcome was relapse, measured monthly for 6 months follow-up by the positive urine for drugs rapid test. Generalized Estimating Equations (GEE) was used as the main effectiveness analysis. Intention-to-treat (ITT), per protocol (PP) analysis, interaction terms, construct terms and key assumption terms were utilized. Results: Individual participation rate was 88.3%. All group comparisons at baseline were not significant (p>0.05). Cumulative relapse after 6-months follow-up for intervention and control group was 13.8% and 31.2%. There was significant difference in relapse between baseline, post-inter-vention and 6-months follow-up within intervention and control group (Q=29.06 vs 61.39,p
A strong and robust Primary Health Care system is essential to achieving universal health
coverage and to save lives. The Global Conference on Primary Health Care 2018: from Alma-Ata towards achieving Universal Health Coverage and the Sustainable Development Goals at
Astana, Kazakhstan provided a platform for low‐ and middle‐ income countries to join the
Primary Health Care Performance Initiative (PHCPI). At this Global Conference, Malaysia has
declared to become a Trailblazer Country in the PHCPI and pledged to monitor her Vital Signs
Profiles (VSP). However, the VSP project requires an honest and transparent data collection
and monitoring of the Primary Health Care system, so as to identify gaps and guide policy in
support of Primary Health Care reform. This is a huge commitment and can only be materialised
if there is a collaborative partnership between Primary Care and Public Health providers.
Fundamental to all of these, is the controversy concerning whether or not ‘Primary Care’ and
‘Primary Health Care’ represent the same entity. Confusion also occurs with regards to the role
of ‘Primary Care’ and ‘Public Health’ providers in the Malaysian Primary Health Care system.
This review aims to differentiate between Primary Care, Primary Health Care and Public Health,
describe the relationships between the three entities and redefine the role of Primary Care and
Public Health in the PHCPI-VSP in order to transform the Malaysian Primary Health Care
system.
Introduction: Congenital malformations (CM) comprise a wide range of abnormalities of body structure or function that are present at birth and are of prenatal origin. It has contributed to a significant proportion of infant morbidity and mortality. The aims of this study were to determine the extent and investigate the relationship between CM and its associated demographic variables.
Methods: Data was extracted from Ministry of Health (MOH) database compiled from the reports on Stillbirth & Under 5 Mortality from year 2013 to 2014.
Results Out of 9,827 child death, 2,840 (28.9%) were classified under CM as defined under ICD-10 classification. Majority of those with CMs died at neonatal stage (62.7%) and among mothers aged between 20 to 35 years old (67.3%). The mean age of mothers among CM children was 30.8±6.5 years old. Approximately 5.8%, 6.7% and 3.3 % of total CM were neural tube defects, heart defects and hydrops fetalis respectively. The prevalence of CM in males was 15% higher than females. The difference were evident between CM and age of death of children under 5 years old (p<0.001) as well as between CM and maternal age groups (p<0.001).
Conclusions: CM is responsible for 28.9% of total causes of child death with higher occurrence of malformation in males. A significantly higher risk of CMs among mother aged between 20 to 35 years old was observed. This emphasises the importance of raising awareness and the need to strengthen appropriate response for surveillance and prevention program of common CM in Malaysia.
Keywords: Congenital malformations - Child death - Neonatal - Neural tube defects - ICD-10.
Methadone Maintenance Therapy (MMT) for opiate dependence was first started in Malaysia in 2005. The service was initially provided by psychiatric clinics in hospitals and primary care clinics. Handling patients with opiate dependency especially in a primary care clinic is very challenging due to various constraints hence the success is doubtful. 143 patients from Tampin Health Clinic were recruited from November 2006 until March 2009. Retention rate in the program was high. Significant improvement was seen in the World Health Organization Quality Of Life score (WHOQOL-BREF) in all 4 domains done at baseline, 1st year and 2nd year in the program. After joining the program, there were no new blood borne virus infection for HIV and Hepatitis B and only 1 had Hepatitis C. Minimal number of patients were involved in new drug related offences while in the MMT program. Existing primary care clinics can be empowered to scale up this service in Malaysia.