Index
bold locators are tables and italics are figures.
accountability,
age distribution, 61
Alliance for Health Policy and Systems Research, 17
ambulatory health service, 73
analysis of health systems, 4
antibiotic-resistant bacteria
causal loop diagram, 22
antiretroviral (ARV) drugs, 388
ASEAN Risk Assessment Centre for Food Safety (ARAC), 414
Asian financial crisis, 76
BAKAS approach/programme, 224,
Bangi, 370
BCG vaccination programme, 183
behavioural change, feedback loops in, 196
Beluran, 139
British National Health Service, 306
cancer, 130, 396
breast cancer screening programme, 79
disease burden, 186
drug for, 387
liver, 431
lung, 48
capacity planning, lack of, 297
case studies
adoption of harm reduction strategies,
clinical waste management,
dialysis services,
macro-level model interpretations,
Malaysian health system,
managed care organisations (MCOs),
REAP-WISE,
rural water supply and sanitation,
treatment of Hepatitis C in Malaysia,
catastrophic health expenditure (CHE), 459
causal loop diagram (CLD), 22
circulatory diseases, 48
clinical waste management, 227, 242, 243
benefits from privatization,
case study,
challenges of privatization,
comparison before and after privatization,
Clinical Waste Management System (CWMS)
creation of, 245
financing and development of, 245
non-monopoly package, 246
project viability and sustainability, 246
cluster hospital concept, 353
communicable diseases (CDs), 123, 172, 307, 373, 414, See also re-emerging communicable diseases
control, 173
feedback loops, 185
Malaysia,
rate, 173
responses to emerging, 195
contexts of health systems,
Control of Drugs and Cosmetics Regulations (CDCR), 374
cross-boundary problems, 224
culture-nature systems, 18
data collection, 350
deaths, 42
Declaration of Alma Ata, 65, 72, 90, 116, 415
International Conference, 66
Rural Health Services (RHS) and, 68
delivery of care,
dependency rates, Malaysia, 62
development, human and health,
diabetes mellitus, 48, 78, 194
control of, 417
disease burden, 186
management of, 91
prevalence of in Malaysia, 164
diagnostic services,
dialysis services, 130, 144, 167,
expansion of private, 168
financing by sector, 169
price pre-treatment, 169
public funding of private delivery,
disease control programmes, , 204–339, 451, 455, 456
communicable diseases, 173
service delivery and,
socio-economic development, 176
types, 172
doctors
career path in Malaysia,
disparity in availability, 266
housemanship requirement and, 294
increased training for specialists, 304
other professional staff and, 268
post-graduate training and, 294
public and private sectors, 265
drug abuse,
drug development and public good, 389
elderly health, 351
emerging diseases, 188
Employees’ Provident Fund (EPF), 312
employment, 3, 35, 38, 51, 72, 181, 213, 257, 259, 286, , 312, 341, 423, 460, 467
benefit packages and, 321
decline in, 37
formal, 316
health systems and, 6
increasing, 43
industries and, 59
internal migration and, 41
patterns of, 46
environment, protection and management, 221
environmental health programs
factors contributing the success,
environmental health service (EHS), 180, 221, 455, 468
examples of in Malaysia,
factors contributing to the success,
Malaysia, , 232
equitable distribution of health workforce,
equity
access to health information, 349
access to information, 355
distribution and access to health services, 342
ethnic composition, 65
evaluation, governance and,
family planning programmes, 451
feedback loops, 12, 13, 19, 22, 350, 481, 490
case studies, 488
in behavioural change, 196
influence diagram and, 24
system dynamics and, 22
systems thinking, xxxii
through communicable diseases, 185
types used in the case studies,
feedback structure, 23
financing and health care systems,
delivery systems, 325
Food Basket Programme, 78
forced migration, 463
generic drug industry, 373
haemodialysis, 166
harm reduction strategies, 211, 212, 215, 217
examples, 211
lessons learnt,
Malaysian AIDS Council (MAC) involvement, 214
new challenges, 216
pilot programmes,
successes,
health and safety regulations,
health care access,
health care delivery service, , 196, 197, 407
community education and mobilisation, 182
human resources, 180
impact of MCO’s practices on, 110
international movements, 190
reorientation of policies,
surveillance systems, 181
vaccines production and diagnostic services,
health care financing/finance, , 332,
expansion of private health sector and,
fund pooling features in,
health expenditure, 353
information, 353
Malaysia,
pre-payment and,
sources of,
trends in,
health development, socio-economic framework of, 51
health engineers, public, 239
health impact assessment (HIA), 223
health information/systems, 8, 82, 87, 130, 146, 190, , 342, 350
2000s,
building blocks, 484
effectiveness, 342
evaluation study and, 339
health facilities and services,
Malaysian experience,
managerial decision-making and, 345
people and their health,
population,
single- and double-loop learning, 351
transition and, 343
health legislation, 412
health outcomes, ,
health risks, 48
Health Services Financing Study (HSFS), 309
health systems
as social institutions, 10
contestation within,
contexts of,
development, 402
enabling factors,
evaluation of interventions, , 17
evolution of Malaysia’s,
frameworks and typologies,
functions of, 325
governance, 420
information gap, 304
international collaboration,
limiting factors, 79
macro-level feedback loops, 482
macro-level model of,
Malaysia’s experience, , 52,
open and contextual nature of,
other,
overview of, 3
programming, 417
public–private mix in Malaysia,
role of NGOs in,
social and cultural institutions, 3
societal functions of,
socio-economic framework and,
systems thinking principles for improvement, 25
health systems research (HSR), 12, 131, 338, 344, 356, 414, 468
information for managerial decision-making, 345
health workforce, 254, 255, , 260, , 340, 344,
competence,
composition, 258
development in Malaysia,
equitable distribution,
evolution of,
implementation of programmes,
Malaysian experiences in training,
post-independence development,
second phase of development,
staff competencies,
third phase of development,
training programs, 264
utilization,
health, National Health and Morbidity Survey (NHMS), 186
healthcare expenditure, 7
healthcare systems
Malaysia’s experience,
hepatitis C, 431
conflict of interest and medication costs, 432
medication,
treatment in Malaysia case study,
HIV/AIDS, 47, 50, 186, 270, 407, 464
cases from injecting drugs use, 209
epidemic and drug abuse,
injecting drug use, 218
hospitals/hospital services, 333, 404
bed occupancy rates, 137
client satisfaction, 144
imaging technology in, 128
medical technology, 144
primary health care and,
private, 127–
types, 120
utilisation of, 122
housemanship, 294
How Public And Private Reforms Dramatically Improved Access To Dialysis Therapy In Malaysia’, 164
HPV immunisation, 418
human resources, xxxii, xxxv, 39, 70, 82, 100, 103, 481
competency in, 194
constraints, 78
delivery of health care, 180
development, 106
efficiency, 105
healthcare, 47
importance of training in EHS, 222
inequitable distribution of, 269
limits in, 129
MOH and challenges of, 423
pharmacists and,
PHC, 82
planning, 277
transfer of, 137
wastage of, 196
income per capita, 33
Institute of Medical Research (IMR)
role of in vaccines production and diagnostic services,
institutional deliveries and immunisation coverage, 73
insurance markets, regulation of, 7
integrated primary health care services
system analysis case study,
integration of disease prevention and control activities
examples of,
inter-ministerial leadership/partnership,
international negotiation,
Johor, 50
KOSPEN, 489
Lam Wah Ee Hospital (Penang), 396
leadership, 190, , 417,
and governance,
and governance for health, 405
characteristics and outcomes,
Malaysia’s health sector,
public health sector, 415
state public health engineers, 239
leadership and governance, 483, 488
building blocks, 484
in public health system, 415
service delivery and, 481
leadership development,
macro-level feedback loops
health systems, 482
Malacca, 323
Malaysia
age distribution in the population, 61
career pathway for doctors in,
communicable diseases,
environmental health service, 232
evolution of environmental health service,
evolution of health system,
examples of environmental health service,
financing and health care delivery systems, 325
funding sources, 145
health development, 337,
health financing,
health information system,
health system as a case study,
health systems transition,
health workforce development,
healthcare delivery, 407
HIV epidemic and drug abuse,
human development in, 34
lessons learnt, 364
pharmaceutical trade sector in,
poverty levels, 355
primary health care strategies,
second phase of health workforce development,
secondary health care, 122
socio-demographic and political forces, 118
traditional medicines, 367
urban population, 62
use of regulation, 410
Malaysia National Health Accounts (MNHA),
sources of health care financing,
Malaysian district hospitals, 118
Malaysian Health Data Warehouse (MyHDW), 354
Malaysian National Medicine Policy (NMP), 382
managed care organisations (MCOs)
caps on visits, 110
governance of,
impact on health care delivery, 110
problems encountered with, 111
provision of healthcare by GPs,
maternal and child health, 351
medical education, 296
medical personnel, regulation of, 409
medical products, 367
availability, 182
expenditure on medical products in the private sector,
import, production and purchase of, 369
Malaysia’s experience,
market-driven development of, 435
monitoring,
public sector,
purchase of, 376
regulation of, 353
technology and, 79
medical schools, increase in, 296
medical technology, 144
Medicine Advertisements Board (MAB), 379
medicines
management of flow of,
quality and safety,
mental health, 50
Ministry of Defence, 338
Ministry of Health
context and structure,
harm reduction strategies and, 212
inter-ministerial leadership,
intersectoral leader, 405
national governance context,
organisational structure,
Ministry of Information, 194
Multimedia Super Corridor programme, 361
National Drinking Water Quality Monitoring and Surveillance Programme (NDWQSP), , 410
National Environmental Health Action Plan (NEHAP),
National Health Accounts (NHA) programme, 349
National Pharmaceutical Regulatory Agency (NPRA), 377
National Quality Assurance Programme (QAP), 128
National Solid Waste Management Strategy, 223
Negeri Sembilan, 171
neonatal tetanus, 173
out-of-pocket payments (OOPPs), 7, 10, 110, 306, 309, 319, 326, 346
direct, 10
private financing and, 458
outpatient prescriptions, 385
outpatient services/visits (OPDs), 43, 48, 77, 87, 105, 118, 341, 346, 459 See
per capita, 283
utilisation patterns of, 81
overweight management, 78
pap smear slides, 79
Peninsular Malaysia, 454
deaths in, 42
environmental survey of, 223
health facilities in rural, 70
hospital utilisation in, 122
infant mortality rate in, 44
malaria cases in, 174
people, number of per doctors and nurses, 267
Perlis, 171
pharmaceutical products, 390
evolution of,
import and export value, 391
pharmaceutical pricing,
prescription, dispensing and human resources, 377
purchase of, 376
pharmaceutical regulatory system, 368
pharmaceutical trade (Pharmaceutical Services Programme (2013),
pharmaceutical trade sector
in Malaysia,
pharmacists,
per population, 381
plague, 173
political norms, 10
Port Klang, 370
pregnant women, nutritional surveillance of, 78
preventive primary health care (PHC) services,
primary health care (PHC), 456
clinics, 101
community organisations and, 182
first phase of development,
hospital services,
integration of, 82
Malaysia’s experience,
Malaysian experience,
other health systems components,
preventive,
private sector,
public sector, 77
second phase,
space and scheduling,
strategies for in Malaysia,
urban areas,
private funding sources
and out-of-pocket payments (OOPPs), 306
private household out-of-pocket payments,
private sector
primary health care in the,
secondary and tertiary care,
system analysis,
private sector employees
medical care for,
provision of healthcare by GPs to,
private voluntary health insurance (PVHI), 471
programme setting, 415
public and private health expenditures,
public and private health financing sources, 310
public and private sectors,
Quality and Costs of Primary Care (QUALICOPC) study, 87
right to government use, 388
Rural Environmental Sanitation Programme (RESP), 221,
Rural Health Services (RHS), 67, 68, 69, 118, 287, 456
Alma Ata Declaration and, 68
coverage to urban areas, 78
RESP and, 221
rural water and sanitation case study
MoH involvement in, 240
rural water supply and sanitation case study,
safe water, 37
sanitation programmes
National Drinking Water Quality Monitoring and Surveillance Programme (NDWQSP), , 410
National Environment Health programme, 223
National Environmental Health Action Plan (NEHAP),
Rural Environmental Sanitation Programme (RESP), 221,
sanitation, investment in, 237
SARS (severe acute respiratory syndrome), 464
secondary and tertiary care (STC), , 121–122, 151, 155
better-quality access, 123
demand, 121
growth, 123
Malaysia’s experience,
primary health care and,
quality assurance programmes, 131
systems thinking analysis,
secondary care services
early phase,
smallpox, 173
Social Security Organisation (SOCSO), 312
societal functions of a health system,
societal norms and values
health systems as, 3
socio-cultural norms, 467
specialist bottleneck, 300
specialist care, 125
specialist clinicians, 125
specialist doctors, 304
state public health engineers, 239
Sungai Petani, 370
surveillance systems
delivery of health care, 181
susceptible–infected–recovered (SIR) system, 21
system analysis case study
adoption of harm reduction strategies,
challenges in introducing telehealth,
challenges regulating traditional medical products,
clinical waste management,
expanded access to dialysis services,
managed care organisations (MCOs),
new medical graduates: Unexpected Influx of New Medical Graduates,
REAP-WISE,
rural water supply and sanitation,
treatment of hepatitis C in Malaysia,
systems analysis, 13, , 88, 106, 114, 218, , 261, 334, 365, 383, 389, 423, 424
clinical waste management, 252
communicable diseases, 185
health, 25
health care financing, 325
health system regulations, 399
human responses in health systems, 305
outsourcing of, 490
private sector,
problem definition and, 490
systems dynamics
approach used,
concepts and tools,
Telehealth Pilot Project, 347
tertiary health care services,
in the public sector, 131
tetanus, 174
total expenditures on health, 311
trade of medicines, 433
traditional medical products
challenges regulating,
training, 222, 227, 228, 236, 287, , 395, 406, 410, 414, 461
allied health professional and, 275
assistant nurses and, 282
environment, 299
facilities, 295
health personnel,
health workforce and, 264
house officers,
investment in, 136
military-style physical, 209
nurses and midwives, 259
process, 485
water operators, 225
transition,
primary health care (PHC), 106
tuberculosis, 118, 173, 174, 185, 194, 254, 339, 340, 354
contact tracing of, xxxii
referral systems for, 72
treatment rates, 452
Tung Shin Hospital (Kuala Lumpur), 396
workforce performance,
yaws, 174
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