MALAYSIA has achieved universal health coverage. It has made remarkable progress in improving health outcomes over the past seven decades.
At the time of independence, the number of infant deaths was 75.5 per 1,000 live births.
This has fallen by more than 90 per cent to 6.7 deaths per 1,000 live births in 2016.
Maternal mortality, which refers to the death of a woman caused by her pregnancy as well as during and after delivery, has also decreased by 89 per cent between 1963 and 2013.
The country eradicated smallpox in 1978, a year ahead of the World Health Organisation (WHO) declaring the world smallpox-free.
In 2011, Malaysia achieved the WHO regional target on Hepatitis B control through its childhood vaccination programme. This achievement was six years ahead of the target date set to reduce the rate of Hepatitis B among 5 year olds to one per cent.
Malaysia has been acknowledged globally for a high-performing health system based on a well-trained workforce, excellent infrastructure and quality service delivery. It has a low incidence of catastrophic healthcare expenditure.
According to data, less than one per cent of the population spent more than 25 per cent of their household budget on health. However, it is noteworthy that with rising levels of non-communicable diseases, out-of-pocket spending has increased to 38 per cent of total health expenditure as of 2016.
Life expectancy in Malaysia has increased to 75 years.
Population projections suggest that in two years, seven per cent of the population will be 65 years and older.
About 70 per cent of deaths in the economically-productive age group are from consequences of non-communicable diseases. The onset of such diseases is often silent.
For example, about one-third of those with diabetes and high- blood pressure are unaware of the conditions.
The burden of non-communicable diseases requires a transformation in how health services are organised, financed and delivered.
The 11th Malaysia Plan aims to accelerate efforts to achieve universal access to quality healthcare by targeting under-served areas, increasing the capacity of healthcare facilities and personnel, and promoting community engagement.
Malaysia has made new commitments to sustain universal health coverage.
One such commitment is the Enhanced Primary Healthcare programme in 20 public clinics in Johor and Selangor.
This is showing promising results. This initiative aims to tackle diabetes, high-blood pressure and high cholesterol.
It encourages smokers to quit by empowering individuals with knowledge and strategies to achieve better health and wellbeing.
Through a system that registers residents in the vicinity of clinics, patients at risk are monitored and followed up by primary-care doctors.
Another commitment is community engagement.
A recent partnership — between a private university, the Segamat district in Johor and the state Health Department — is contributing to improving health outcomes.
Through direct engagement of some 40,000 residents in five sub-districts, research findings suggest that breast cancer and ageing are priority areas.
In response, a breast cancer service was established at Segamat Hospital and a system of home visits has been organised to monitor elderly patients living alone.
WHO and the United Nations University’s International Institute for Global Health are pleased to see the results from this community engagement initiative, which bears testimony to the fact that when communities are empowered, they can be more proactive in directing their health and healthcare needs.
Malaysia must build on its successes and reinforce its health services to cope with the challenges from its changing demographics and burden of non-communicable diseases.
Dr Lo Ying-Ru Jacqueline
Head of mission and WHO representative to Malaysia, Brunei Darussalam and Singapore
Professor Pascale A. Allotey, Director of United Nations University Institute for Global Health