Malaysian Health SystemCountry Presentations on UHC:

Sharing of best practices

MALAYSIA

Commonwealth Health Ministers Meeting “Universal Health Coverage, with an emphasis on ageing and good

health” Geneva, Switzerland, 17th May 2015

Universal Health Coverage in Malaysia

• The extent and success of the Malaysian health care has been due to careful and systematic planning of development

– long term planning horizons, e.g. Vision 2020

– short term development plans, e.g. 10th Malaysia Plan (2011-2015) and 11th Malaysia Plan (2016-2020)

• Equitable distribution of wealth and social services, and the alleviation of poverty are central priorities to the Government of Malaysia

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• Malaysia now has a fairly developed healthcare system. This, coupled with the general tax funding for health, has provided Malaysia with an equitable public health care delivery system.

• The country had achieved universal health coverage around the 1980’s. (Savadoff & Smith, Dec 2011)

• World Bank has also acknowledged that Malaysia has achieved UHC to a large extent with more than 90% coverage. (Aparnaa Somanathan, World Bank Forum on Building Systems for UHC: South-South Knowledge Exchange with Korea. December 2014)

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Socio-Demographics

• 2014 Total Population: 30,261,700

– Age 0-14 years: 25.6%

– Age 15-59 years: 65.5%

– Age ≥ 60 years : 8.9%

• Population is multi-ethnic, multi-cultural & multi-religion

• Life expectancy at birth (2013) – Health Facts 2014

– Male: 72.5 years

– Female: 77.2 years

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• The Malaysian’s population will become an aged nation within 15 years’ time, where our elderly population aged 60 and above will make up about 15% of our total population

• The medical and social impact of ageing can burden a country especially when the elderly population are unhealthy. This is of concern to Malaysia given the heavy burden of NCDs and unhealthy lifestyle conditions that Malaysian’s have today

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Evidence From Local Research

• The National Health and Morbidity Survey – NHMS, 2011 - indicated that about 24% of Malaysia households will have at least one (1) elderly

• The Malaysia Health Care Demand Analysis – HCDA, 2012 shows that:

– 46.8% of elderly fall within the bottom 40% of households

– The elderly makes hospital admissions - 157 admissions per 1000 compared to 86 admissions per 1000 average population

– Outpatient 5.92 visits per year (4.44 visits per year)

– Elderly use the public sector much more than private health care services

– 83% of admissions in public hospitals (total population - 74%)

– Outpatient visits - 67% in public facilities (total population - 48%)6

• To alleviate financial burden of seeking care, the government of Malaysia has exempts charges for outpatient and inpatient treatment for the elderly to encourage appropriate access and utilization of healthcare services

• When seeking care, the elderly enjoy preferential treatment at public facilities counters that shortens their waiting time substantially

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Services Already in Place

National Policy for Older Persons in 1995 (revised in 2010) (MWFCD 2010)

• unified holistic national and inter-sectoral policy

• ensure that the elderly are independent, have dignity and are respected

• by optimising their own potential through healthy ageing, being positive, active and productive and thus can still contribute to the country’s development and wellbeing

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National Health Policy for Older Persons (MOH 2008)

• This policy emphasises on ensuring a healthy, active and productive ageing by empowering the older persons, family and community with knowledge, skills, an enabling environment as well as the provision of optimal healthcare services at all levels and by all sectors

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• Ministry of Health Malaysia provides comprehensive health care services to the elderly which includes:

– health education & promotion

– health screening & assessment

– medical examination

– consultation

– home visit and homecare nursing

– rehabilitation

– social

– recreation

– welfare activities

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• Till December 2014, almost about 75% (about 1.9 million) of our elderly had registered with our public primary healthcare facilities and had undergone health screening and intervention for physical health, cognitive function as well as others mental health conditions

• There are various inter-ministerial and inter-agency collaboration which also involves the private sector and NGOs working together to provide health, financial and social support for the elderly population in Malaysia

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31

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2 Interagency meeting national level 31 July

MWFCD

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12 Mapping of clients

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Community collaboration

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Target all clients identified to be provided with holistic support

NBOS 7 initiatives: 1MALAYSIA FAMILY CARE

• Launched by Malaysian's Prime Minister in 2012• This initiative delivered an outreach activity to

provide a holistic and inter-sectorial services for persons with disabilities, elderly and single mothers

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Regulating Private Institutions

• Acts to govern institutional care of the older persons:i. Care Center Act, under Department of Social

Welfare (governs old folk homes)

ii. Private Healthcare Facilities and Services Act, under Ministry of Health (governs nursing homes)

• The Malaysian government is in the midst of developing a regulatory law to further facilitate care for the elderly– This law will ensure the minimum provision of

quality care for the elderly in an accessible, affordable and sustainable manner

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Specific Challenges

1. Social: Changing family structure

2. Economy: Inadequate savings for the elderly

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Changing family structure

• In developing countries and less developed nations people are moving away from traditional extended family structures towards smaller families with fewer children– Over the past five decades in Malaysia since

independence, economic development, modernisation, and rural-urban migration together altered family ties and attributed to more fragmented family structures

• Previously social support for the elderly came from the extended family. This change is occurring at a much faster rate than what we (i.e. government) are able to create alternate systems

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Inadequate savings for the elderly

• Increasing life expectancy, but retirement age is from 55 – 60 years

• Inadequate savings due to shorter period of saving and longer period of spending

• The question is how to maintain productivity in the elderly?

– Extending working age

– Policies to encourage companies to bring retirees back into the workforce

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THANK YOU

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References• Ministry of Health Malaysia (MOH), Family Health Development

Division• Department of Statistics (DOS) of Malaysia• National Health and Morbidity Survey 2011 • Institute for Health System Research (IHSR) and Health Policy

Research Associates (HPRA) 2012: Malaysia Health Care Demand Analysis (HCDA) , IHSR and HPRA 2012.

• Ministry of Health Malaysia (MOH) 2012 :Circular of Finance Division

• Ministry of Women, Family and Community Development (MWFCD) 2010 : National Policy for Older Persons

• Ministry of Health Malaysia 2008: National Health Policy for Older Persons

• Social Welfare Department (SWD) http: //www.jkm.gov.my• Ministry of Health Malaysia (MOH), Medical Practice Division 2013.

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