Primary health care is key to solving the health challenges facing Malaysia, according to the Ministry of Health in Malaysia and the World Health Organisation (WHO).
On World Health Day 2019, Malaysia will present its vision on primary healthcare in the 21st century. Primary health care is the smartest first step towards universal health coverage, also known as ‘health for all’ for everyone and everywhere.
Malaysia has the highest rate of obesity and overweight among Asian countries with 64 percent of male and 65 percent of female population being either obese or overweight. One of the consequences is that the prevalence of diabetes among adults aged 18 years and above has increased from 11.6 percent to 17.5 percent over a period of 9 years from 2006 to 2015. Moreover, the prevalence of hypertension remains high at around 30 percent. More than 50 percent of diabetes or hypertension are undiagnosed.
Primary health care: the path to health for all
The Malaysia “Enhanced Primary Health Care” or EnPHC demonstration project has been implemented in 20 health clinics in Johor and Selangor since July 2017. The purpose of the project was to increase detection of chronic disease such as diabetes, hypertension and high cholesterol.
EnPHC ensures that every resident in the operational area will be registered. The population database is being developed, the risk profile is implemented and the population at risk is given early intervention according to their level of risk. The Enhanced Primary Health Care uses a proactive approach and emphasizes on the importance of early prevention of disease.
The percentage of the population enrolled after a year under this initiative was 309,472 (82 percent of the overall population in the operating areas of the 20 health clinics in Selangor and Johor) and 24.4 percent (92,209 people) of those enrolled have been screened for NCD risks. Through this initiative, positive outcomes were observed namely a 29 percent increase in diabetes tests done (HbA1c), and an improvement in control of cholesterol level among diabetic patients.
“More conclusive results of this study are expected by September 2019. We are already expanding the initiative to 20 more clinics in 2019 and more clinics in the future”, said Datuk Seri Dr Dzulkefly Ahmad, Minister of Health, Malaysia.
“Primary health care offers a comprehensive, coordinated, continuous range of services to people throughout their lives. It looks at patients’ health and well-being,” he added.
Through PekaB40, poor citizen will get access to private general practitioners. This will open better access for all Malaysians to good healthcare services and promote preventive care which saves both suffering and public funds.
“This is an efficient, acceptable, affordable way of providing health care. It is the first step on the road towards universal health coverage—a vision where all people get quality health services”, said Dr Ying-Ru Jacqueline Lo, WHO Representative to Malaysia, Brunei Darussalam and Singapore.
Strong primary health care systems needed to address diabetes, heart disease, cancer
The noncommunicable disease (NCD) crisis is growing. NCDs such as diabetes, heart disease and cancer are responsible for more than 70 percent of all early deaths in Malaysia. With an enhanced primary health care system people can come to their local primary health clinic for screening and routine visits that identify and manage health problems early, so they can avoid expensive hospital visits and diseases that can lead to years of costly care, or even premature death. Through the expansion of family doctor concept and person-centered care, patient compliance to treatment will be improved.