DENTAL TECHNOLOGY Introduction provide mobile dental clinic services to rural
communities without access to dental clinics. The
A dental technologist (dental laboratory Mobile Dental Laboratory services have been
technician) is a member of the dental supporting available in Negeri Sembilan, Perak, and Kelantan
team involved in designing, constructing, and since 2015.
fabricating dental restorative devices and Since the post basic graduate training in
appliances based on a prescription from a dental orthodontic specialty and maxillofacial specialty
practitioners and specialist. Dental technologists began in 1998, the scope of dental technology
work in dental laboratories, which provides programmes has been expanded to support
services to general dentistry, oral and maxillofacial dental services in hospitals and health clinics.
surgery, orthodontics, paediatric dentistry, Workload/ Census
periodontics, restorative dentistry, pathology and The number of services done by dental
oral medicine, forensic dentistry and public dental technologists for the past three (3) years is as
health. stated in the table below (Table 9):
Research/ Innovation/ Publication/ Presentation
Functions Participation of dental technologists in national
and international conferences via Malaysia Dental
Dental technologists play an essential role in Technologist Association includes:
preparing dental dentures, orthodontic
appliances, dental restoration including bridges, Study to Access the Knowledge and Impact of
crowns, dental braces, dental implants appliances Psychosocial Hazard among Dental Technologist in
and make various dental appliances. This service Penang Government Hospital and Clinic at 10th
aims to ensure the community has optimal oral Allied Health Scientific Conference Malaysia 2014
health and improve oral function, phonetic and by Kanan Arumugam.
aesthetic aspects. In MOH, dental technologists Training
are expected to function in the dental laboratory Currently, there are several training centres in the
and engage in biomedical engineering aspects in government sector, such as the Ministry of Health
dental equipment management. Malaysia Training Institution (Institut Latihan
Dental technologists also support physicians in Kementerian Kesihatan Malaysia, ILKKM) and
preparing the prosthesis such as maxillofacial, Armed Forces Training Institution (Institut Latihan
ocular, and auricular in obstetrics and Kesihatan Angkatan Tentera, INSAN). While in the
gynaecology, ear, nose and throat, ophthalmology, private sector, AIMST University provides
and others. bachelor’s degree courses, and MAHSA
University provides diplomas. It is hoped that the
Performance and Achievements dental technology profession will expand rapidly in
response to current needs, using the most
Enhancement of Service Delivery up-to-date technology.
Dental technology services are available in MOH
dental clinics, specialist dental clinics in major
specialist hospitals, and MOH health clinics.
However, with the 9th Malaysia Plan (9MP), the
Mobile Dental Laboratory was developed to
Table 9 : The Number of Services done by Dental Technologist in the Year 2017 - 2019
Type Appliances 2017 2018 2019
Dentures 159,992 100,169 125,678
Orthodontics 16,814 11,931 11,345
Crown/ Bridges/ Splint/ Prosthesis/ Mouth 5,997 33,755 40,785
guard/ Others
Study Model 41,608 25,173 26,754
Repair Appliances 39,543 29,402 26,677
84 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
ILKKM and INSAN produce a maximum of 60 and forward in the growth of dental technologists’
15 diploma candidates per year, respectively. On education and training.
the other hand, MAHSA trains a maximum of 30 Recognition/ Achievements
candidates, whereas AIMST trains a maximum of The establishment of Mobile Dental Laboratories
15 students per year. in providing services to the rural community in
Continuous and advanced training among dental three (3) different states: Negeri Sembilan, Perak
technologists is vital to enhance competency and and Kelantan, was a huge accomplishment for
support the quality assurance system. Advance dental technologists.
training in a specific field of specialisation will
produce highly skilled, competent, and Issues and Challenges
accountable dental technologists. A competent
dental technologist will contribute towards the Human Resource Capability and Competency
expansion and improvement of dental services
quality. Therefore, Bachelor of Dental Technology, According to Human Resource for Health Country DENTAL TECHNOLOGY
Advanced Diploma or Post Basic Courses in Profiles: Malaysia by the World Health
Maxillofacial, Orthodontic, Restorative or Dental Organization (2014), the ratio of dental
Material etc., are recommended to support practitioners to dental technologists is 2:1 in 2011.
evolving dental technology. However, the dental technologist position
There are only two (2) types of specialisations or requirements in all facilities have been enforced
post basic training, as shown in Table 10. and subjected to the Establishment Norms -
Clinicians in restorative dentistry remain Departmental Policy of Dental Technologist
dependent on dental technicians to complete Services in MOH, as shown in Table 11. This ratio
laboratory procedures efficiently. Although acts as a reference and guide in the Dental
dentists are educated in the basics of dental Service appointment norms.
technology, they rarely master the skills required.
However, no post basic restorative dentistry The Oral Health Programme (2018) Annual Report
courses or dental technologists have been sent for also stated that the workforce projection based on
advanced training to provide specialised dental the service targets method showed that the
laboratory services for these specialities in MOH. requirement for dentists approximates the
As of 2019, there are 232 dental specialist projected current stock while the health needs
facilities within MOH. There are 77 oral and method indicated the possibility of oversupply of
maxillofacial surgeons, 69 orthodontists and 31 dentists and dental therapists by the year 2020. As
restorative dentistry specialists in those facilities. of 2018, there are 3,095 dental officers, 284
In comparison, the number of dental technologists clinical dental specialists and 920 dental
who have attended the post basic course remains technologists working in MOH facilities. In
insufficient to accommodate the dental laboratory addition, Human Resource for Health (HRH)
services in specialist facilities. Thus, actions need Country Profile data showed that the ratio of
to be taken to plan and map appropriate training to dental technologists to the population in Malaysia
support the services. To gain additional is 1:35,049 in 2018. Since nearly 1,000 dentists
experience and keep up with the growing demand, and 60 dental technologists graduate each year,
dental technologists should be offered post basic the ratio will be one (1) dental technologist to six
training in specialist facilities on a regular basis. (6) dentists.
There are few challenges in producing expertise in
dental technology. However, limited allocations of Table 10: Types of Specialisations or Post Basic
scholarships as well as inadequate local training Training Attended by Dental Technologists
centres are among the issues. A survey on dental
technologist education and training conducted in Year Post Basic Number of
the UK and New Zealand revealed the lack of a Participants
national training strategy, inadequate funding for
training, and a limited number of training places 2000 Oral & Maxillofacial Surgery 19
for dental technicians, the number of training 2001 Orthodontic 22
centres and uneven geographical distribution of 2005 Orthodontic 18
training centres. 2007 Oral & Maxillofacial Surgery 18
Collaboration between employers, manufacturers, 2011 Orthodontic 24
professional bodies, dental hospitals and institutes 2014 Oral & Maxillofacial Surgery 16
of higher learning has been proposed as a way 2018 Orthodontic 25
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 85
Table 11 : Norms Ratio of Dental Technologist to Dentist and Dental Specialist (MOH)
No. Categories of Lab Personnel Specific Ratios of Dental Technologist/ Dentist
1. Dental laboratory technologist 1 dental technologist : 2 dentist
1 dental technologist : 1 dental specialist
4 dental technologist : Headquarter
2. Technical management 1 dental technologist : State level
1 dental technologist : District level
DENTAL TECHNOLOGY Technology Transfer training, it is the right time for MOH to consider
To transfer dental technology from conventional to upgrading the current existing grade scheme for
3D technology for dental providers through short dental technologists.
training and conferences is challenging. As an initiative to inspire new dental technologists
Adequacy and Optimisation Technique, to pursue a dental technology graduate
Equipment and Material programme, the authority of MOH or OHD should
The equipment used in the facilities in MOH are consider upgrading the dental technologist scheme
outdated and are of old techniques. Oral health to a degree.
should upgrade dental laboratories with new
up-to-date technology equipment and materials Limited Training Opportunity
needed to speed up the work process and reduce A limited quota was offered for Advanced Diploma
waiting time for patients to obtain dental or Post Basic programme (maxillofacial/
appliances. orthodontic/ restorative/ dental material/ dental
Examples of the latest equipment are: forensic). To meet the needs of the rapidly evolving
dental industry, advanced diploma, post basic, and
3D photocopy/ mailing denture/ CAD-CAMMS. postgraduate training programmes for all
Flexible denture, which sets material faster than specialities should be offered annually, with
older technique. alternative courses for dental technologists.
Some dental laboratories have yet to comply with
the standards specified in the occupational health Way Forward
and safety manuals for Dental Laboratory.
Strengthen/ Enhance Career Pathway To remain competitive with developed countries,
In MOH, the dental technologist scheme was dental technologists in the MOH needs to be
established with five (5) grade schemes ranging upgraded into a degree programme.
from U29 to U40. At present, the officer entitled to Simultaneously, the dental laboratory must be
the highest grade (U40) in MOH has a greater brought up to date with current technologies.
responsibility to supervise in ensuring a smooth The dental profession also plans to acquire
working process. With the increasing number technology and programmes to help people who
of dental technologists with postgraduate cannot access dental equipment and facilities due
to distance or other limitations. Finally, the UHC is
envisaged to be attained in terms of high-quality
dental appliances.
Conclusion : The dental technologist embraces the MOH vision and is
dedicated to assisting the Oral Health Division and the Allied Health Sciences
Division in providing patients with high-quality dental appliances. This is in line
with SDG 3, which aims to ensure healthy lives and promote wellbeing for
people of all ages. Dental technology prioritises resource management reform,
including human resource and facility optimisation, to achieve the above
objectives.
86 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Detailed Implementation Plan for Dental Technology
The allied health profession’s Detailed Implementation Plan (DIP) outlined in this Strategic Plan is divided into three (3) tiers
which are:
(A) Strategic Framework - Medical Programme
The activities/ indicators/ achievements will directly be monitored under the Head of Services, and the allied health
profession involved will report to their respective service in the Medical Programme/ Public Health Programme or other
relevant departments.
(B) Medical Framework - Allied Health Sciences Division
The activities/ indicators/ achievements will be monitored by AHSD, and then will report to the Medical Programme/
Public Health Programme or other relevant departments.
(C) Allied Health Sciences Division - Profession
The activites/ indicators/ achievements will be monitored by AHSD for internal report and discussion between AHSD and
allied health professions.
(A) Strategic Framework - Medical Programme DENTAL TECHNOLOGY
No Profession Strategy
(B) Medical Framework - Allied Health Sciences Division
Strategy 3: Enhance Capacity and capability of human resource for health
Main Implementation Plan No. 28: To ensure adequate supply of in-service competent medical personnel
Profession Activity Indicator Target
Implementation Plan
1. Ensure optimum number of dental Employment of new staff according Percentage increment of total numbers of 5% increment of total
to dental officer/ specialist dental technologists numbers of dental
technologists technologists per year
Main Implementation Plan No. 30: To advance clinical competencies of in-service medical personnel
Profession Activity Indicator Target
Implementation Plan
2. Enhance and strengthen Number of dental technologists undergone 25 persons per year
training in orthodontic/ maxillofacial field
competency and skills of
dental technologists To provide advanced diploma/ Number of dental technologists undergone
postal training Advanced Diploma in Maxillofacial Basics/
Orthodontic Basics/ Restorative Basics
25 persons per year
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 87
(C) Allied Health Sciences Division - Profession Dental Technology
Profession Activity Indicator Target
Implementation Plan
19 persons by 2025
1. Strengthening profession of Identify qualified personnel to Number of dental technologists 20 laboratories per year
dental technologists be appointed to position of U41/ approved 60% of dental
U42 dental technologists laboratories upgraded
by 2025
2. Upgrade latest equipment Procurement of the latest Number of dental laboratories with Management and
in dental laboratories equipment the latest equipment Professional Scheme for
dental technologists
3. Strengthen technical quality To upgrade the dental Percentage of dental laboratories endorsed by JPA by 2023
in dental laboratory laboratory in accordance with upgraded
the Safety and Health
Guidelines in the dental
laboratory
DENTAL TECHNOLOGY 4. Improve career pathway for To develop proposal paper to Submission of proposal paper to
dental personnel create scheme under Human Resources Division, MOH
management and professional and JPA
for dental technologists
88 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
DENTAL TECHNOLOGY
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 89
90 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
DIAGNOSTIC
RADIOGRAPHY
DIAGNOSTIC RADIOGRAPHY
92 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce
Radiology service was first introduced in Malaysia Year
shortly after discovering X-ray in February 1897,
with the first commissioning of X-ray machines in 2020
Taiping, Perak. Hospital Kuala Lumpur (HKL)
received X-ray machines on 15 Feb 1910, HOSPITAL 2,242
followed by Hospital Pulau Pinang. In 1947, a
British radiologist, Dr C. T. MacArthy, began the 125INSTITUTION
first formal training programme of the X-ray
Department at HKL. Six (6) dressers (now known 457HEALTH CLINIC
as a medical assistants) were selected from all
over Malaya to attend a training programme at the 14MOH
X-ray Department, HKL. In that programme, the
Technical College of Kuala Lumpur (now known as HEADQUARTER
Universiti Teknologi Malaysia, Kuala Lumpur)
taught physics and mathematics subjects. A Year MOH 5
British radiographer taught the radiographic COLLEGE 1
subject at the X-ray Department, HKL. 1963 CADRE POST
15HOSPITAL
Total : 15 Total : 2,844
The clinical training was conducted between DIAGNOSTIC RADIOGRAPHY
lecturers under the supervision of the British
radiographer. The candidates who completed the
training were then appointed as ‘X-ray assistants’.
They were awarded a certificate, issued jointly by
the Technical College of Kuala Lumpur and the
X-ray Department, HKL. Later, ‘X-ray assistants’
were sent to the United Kingdom, Australia, and
New Zealand to be trained as radiographers. On 8
Mar 1963, Radiographic Training School, HKL,
was established. Mr E.J.W. Quick, a Colombo
Programme Advisor was assigned to assist in
implementing this training programme. The first
intake of trainees for diagnostic radiography
consisted of 14 medical assistants and one (1)
trained nurse. This training programme lasted for
two (2) years, and it was based on the syllabus of
the Society of Radiographers, United Kingdom.
Successful trainees in this course were awarded
the Diploma of Society of Radiographers (DSR),
United Kingdom, which was subsequently
renamed as Diploma College of Radiographers
(DCR), United Kingdom. This training school was
later renamed the School of Radiography and
Radiotherapy, HKL. The training was based on the
local curriculum, which started in the late 70’s.
Successful trainees were awarded a Diploma in
Radiography. The diploma obtained is equivalent
to a diploma from the Institut Teknologi Mara,
known as UiTM today.
Currently, some public and private institutions of higher education provide radiography programmes at
degree and diploma levels. The Diagnostic Radiography Services Scheme was in category B, with
appointment grade at B9 and senior grade at B3. In 1991, under the New Remuneration System (Sistem
Saraan Baru, SSB), a new appointment grade was changed to U8. Later on, under the Malaysian
Remuneration System (Sistem Saraan Malaysia, SSM) in 2002, the new appointment grade changed to
U29. In 2005, the radiographer scheme was governed under Integrated Services Scheme (Skim
Perkhidmatan Bersepadu, SPB). After that, in addition to diploma qualifications; bachelor's degrees with
honours are also accepted into public services. Those with degrees are mainly placed in specialty areas
in clinical settings.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 93
Introduction result, diagnostic radiographers are facing
drastic revolution from basic conventional
Radiology services are an essential support radiography to modern, sophisticated
service to determine the patient’s diagnosis radiological equipment and applications such
and guide intervention procedures. Radiology as computed radiography (CR), digital
services also provide therapeutic procedures. radiography (DR), C-Arm Image Intensifier,
Radiography is the professional practice of Cone beam CT/ orthopantomography (OPG),
providing a range of diagnostic imaging Computerised Tomography (CT) Scan, Mobile
procedures using ionising and non-ionising CT, Mammography, Magnetic Resonance
radiation. A registered diagnostic radiographer Imaging (MRI), Ultrasonography, Vascular
is a healthcare professional who offers good Angiography, Bone Densitometry, Gamma
patient care and produces high-quality images Camera, Positron Emission Tomography –
using different imaging modalities and techniques Computed Tomography (PET-CT), Single-Photon
that play a vital role in patient diagnosis and Emission Computed Tomography (SPECT-CT),
treatment. and Extracorporeal Shock Wave Lithotripsy
(ESWL).
Functions This revolution has transformed diagnostic
radiographers into multi-skilled and vast
The main functions of a diagnostic technology-oriented practitioners in healthcare
radiographer are to perform multi-modality facilities. Apart from general radiography,
diagnostic imaging procedures focusing on diagnostic radiographers also provide mobile
positioning techniques, determining the ideal radiography services as bedside services for
exposure factors and applying principles of critically ill and non-ambulatory patients without
radiation protection and patient safety. A mobilising the patient to the radiology
diagnostic radiographer evaluates and department. Diagnostic radiographers play a
determines the diagnostic quality of images crucial role in delivering emergency radiology
produced to confirm or exclude a clinical services 24 hours a day in all MOH hospitals. The
diagnosis, assist, monitor and manage treatment service now has advanced into the therapeutic
processes, screening programmes and research. realm with the evolution of interventional
Diagnostic radiographers analyse and correlate radiology.
procedure requests and clinical information Modern medicine in the 21st century has
provided by a physician or patient, or both, for recognised the value of diagnostic radiographers.
DIAGNOSTIC RADIOGRAPHY pre-procedure determination of the appropriate Their involvement is now extended into forensic
examination, its extent, and its scope. The radiology, where vigorous research is ongoing
diagnostic radiographer is responsible for worldwide to assess its role in converting open
obtaining informed consent from patients by autopsy to virtual autopsy.
providing detailed explanations and instructions. As the service continues to progress in this
They also select, prepare, and operate medical era of disruptive technology, diagnostic
imaging equipment and accessories to conduct radiographer’s focus must pivot on patient care.
the examinations and procedures. The patient and The precedence of quality patient care in the
the examination/ procedure are also evaluated to service means providing high quality and
see if any discrepancies impact the expected time-efficient patient imaging while ensuring the
result. medical personnel and patients’ safety during the
radiological procedure.
Performance and Achievements As the radiological fraternity is on the verge of a
major revolution in medicine with the advent of
Enhancement of Service Delivery artificial intelligence (AI), diagnostic radiographers
should be actively involved in shaping the future
Diagnostic radiographers provide services for and warrant that the fittest survive natural
in-patients and outpatients in state, major and selection. Diagnostic radiographers need to
minor specialist hospitals, non-specialist expand their role and remain relevant in clinical
hospitals, selected special institutions and practice in the era of AI.
health clinics, and visiting services to other Workload/ Census
peripheral MOH facilities. The number of patients attended has grown
In recent years, the scope of service has expanded since the service was first offered. The number
tremendously throughout the country with new of patients attended by diagnostic radiographers
hospitals, health clinics and enhanced radiology, for the last three (3) years is shown in Table 12.
cardiology, and nuclear medicine services. As a
94 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Table 12: The Number of Patients Attended by Diagnostic Radiographers in the Year 2017 - 2019
Year 2017 2018 2019
Number of patients attended 7,951,489 8,348,644 8,751,739
by diagnostic radiographers
Table 13: The Innovations Programme Involved by Diagnostic Radiographers in the Year 2019/2020
No. Name of Hospital KIK or Innovation
1. Hospital Pulau Pinang BB Care Ray
2. National Cancer Institute Adjustable Anatomical Marker
3. Hospital Putrajaya Scar Marker for Mammography
4. Cut Image Barrier
5. HSNZ Terengganu Gown Designed for Mammogram patients
Research/ Innovation/ Publication/ Presentation Training DIAGNOSTIC RADIOGRAPHY
Malaysia Diagnostic Radiographer Conference Post basic CT Scan course for radiographers was
Diagnostic Radiographers Professional first introduced in 1996 at Allied Health Science
Technical Committee has successfully College, and 219 radiographers have been trained
organised the first Malaysian Diagnostic from 1996 until 2011. The advanced diploma
Radiographers Conference in 2019, with courses have been taught starting with
many research papers presented orally and Advanced Diploma in Breast Imaging since July
in poster format. This conference was 2011, where 82 female radiographers have been
attended by 252 participants mainly, trained since then. The curriculum of the post basic
diagnostic radiographers from the public, pilot course for Trauma Imaging in 2007 has
private and academic sectors. been reviewed with additional modules and
Innovation and Creative Group upgraded to Advanced Diploma in Emergency
Diagnostic radiographers have been actively and Trauma Imaging and is awaiting approval
involved in the Kumpulan Inovatif dan Kreatif from the MOH Education Board.
(KIK) or innovation programme at hospitals Currently, there are three (3) types of advanced
and state health departments, with over 20 diploma in radiology services offered to
innovations over the past five (5) years indirectly diagnostic radiographers under MOH, i.e.,
contributed to cost saving in the provision of Advanced Diploma in CT Scan (ADCT),
radiological services. Some innovations have Advanced Diploma in Breast Imaging (ADBI) and
even entered the market at the national level. Advanced Diploma in Cardiovascular (ADCV).
Table 13 shows some examples of innovations A total of 384 radiographers have been
for year 2019/2020. qualified in post basic and advanced diploma
programmes, accounting for 10% of all
Standard Operating Procedure (SOP) government radiographers.
There are six (6) Standard Operating After introducing the integrated service scheme
Procedures (SOPs) published in 2019 to in 2005, diagnostic radiographers have been
standardise the practice of diagnostic working to improve their careers. There are
radiographer services in MOH. The SOPs currently 144 diagnostic radiographers with an
are the Operational Management Plan for entry-level diploma qualification who graduated
Radiology Service by Diagnostic Radiographer, from local public and private universities. With a
General Radiography, Computed Tomography, bachelor’s degree as an entry-level qualification,
Mammography, Magnetic Resonance Imaging 45 diagnostic radiographers are working. To date,
and Fluoroscopy, Angiography, and Intervention there are 12 diagnostic radiographers with
Radiology. postgraduate or master’s qualifications.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 95
DIAGNOSTIC RADIOGRAPHY Recognition/ Achievements - Hospital Sultanah Nur Zahirah, Kuala
Subject Matter Expert (SME) Terengganu. Assessment of the necessity
to combine head and cervical spine
The Public Service Department (Jabatan computed tomography (CT) for patient with
Perkhidmatan Awam, JPA) has approved CT blunt trauma injury in Hospital Sultanah
Scan Imaging, Cardiovascular Imaging and Nur Zahirah (HSNZ) - Certificate of Merit
Breast Imaging as SME fields for the for Excellent Oral Presentation.
diagnostic radiographers in March 2018. Universiti Teknologi MARA Puncak Alam.
Effect of Breast Density and Compressed
Achievements of Malaysian Diagnostic Breast Thickness on Average Glandular Dose
Radiographers in International Conventions during Screening Mammography using Full
2019 Field Digital Mammography (FFDM).
> 54th KRTA Annual Conference & 26 Certificate of Merit for Excellent Oral
Presentation.
EACRT 2019 at Suwon Convention Center
on 25 - 26 Oct 2019 Hospital Wanita & Kanak-Kanak Sabah,
Kota Kinabalu, Sabah. Change in health
Hospital Umum Sarawak - Effective dose behaviours among cancer surviving
assessments of adult patient undergo CT individuals in follow up mammogram.
Thorax Abdomen Pelvis (TAP) using CT Certificate of Merit for Excellent Oral
EXPO version 2.2. Presentation.
Hospital Kuala Lumpur - The correlation of
the measurements of liver standardised Issues and Challenges
uptake value (SUV) and SUV normalised
by lean body mass (SUL) in contrast and Strengthen/ Enhance Service Provision
non-contrast enhanced PET/CT 18F - Retaining Specially Trained Diagnostic
FDG studies - Certificate of Merit for Radiographers in their Area of Interest or
Excellent Oral Presentation. Expertise
Universiti Kebangsaan Malaysia - Gender When any radiographer gets promoted, there
Differences in Response Inhibition: A is a problem retaining knowledgeable and
functional MRI (fMRI) Study of Internet skilful radiographers. Thus the flexi post
Addiction - Certificate of Merit for needs to be extent to different grades, such
Excellent Oral Presentation. as U32/U36 and U48/U52 in the facility required
> 19th Annual Meeting & 2019 Taiwan most.
Association of Medical Radiation
Technologists (TAMRT) International Forum Human Resource Capability and Competency
on 2 - 3 Nov 2019 Development in Information Technology in
- Hospital Pulau Pinang - Radiation dose Medical Field
between dual X-ray absorptiometry Not all radiographers are well trained and keep
(DXA) and quantitative computerised abreast with the development in technology in
tomography (QCT) scanning in the radiology field like Radiology Information
osteoporosis: A phantom study. System (RIS) and Picture Archiving and
- Hospital Tunku Azizah - The efficiency Communication System (PACS).
of sclerotherapy in the treatment of To keep abreast of technological advances,
craniofacial vascular malformations for radiographers should be well trained to produce
paediatric patients - Excellent Paper the optimal quality of radiological examination.
Award of International Oral Presentation. No accredited training is designed in Magnetic
Resonance Imaging (MRI), even though MRI is
Universiti Teknologi MARA Puncak Alam - a special field in radiology. MRI
Diagnostic performance of triple-phase radiographers gain expertise through informal
computed tomography in the evaluation of training without any credentialing. Recognised
hepatocellular carcinoma - Excellent advanced diploma courses should be
Paper Award of International Oral developed for MRI radiographers.
Presentation.
> 8th Myanmar Medical Radiation
Technologists (MMRT) Conference on 9 - 10
Nov 2019
96 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Human Resource, Equipment and Competency Limited Training Oppurtunity DIAGNOSTIC RADIOGRAPHY
The efforts to maintain professionalism and Radiography has continued to expand since the
expertise in radiographers keep the profession discovery of X-rays with newer technologies and
relevant to the current situation and technology. responsibilities for diagnostic radiographers.
Radiographers with a diploma as an entry- level Consequently, diagnostic radiographers need to
are encouraged to pursue a degree to meet the learn new skills to remain relevant in healthcare.
SME requirement. Meanwhile, grade U44 Unfortunately, while diagnostic radiographers who
radiographers are encouraged to engage engage in research and develop the profession
infull clinical work and become experts in through evidence-based are in high demand, only
certain image modalities. a small percentage of radiographers pursue
Currently, newly appointed radiographers postgraduate studies.
need to complete the competency logbook Firstly, it is due to the constraint of
before working in other health facilities such as postgraduate courses in local settings. MOH
health clinics. To enhance the capacity and has only advanced diploma courses for
capability of newly appointed radiographers, a diagnostic radiographers in breast imaging,
new compulsory placement programme for U29 cardiovascular imaging, and CT scan. Apart
and U41 at the state or major specialist hospital from that, postgraduate studies in medical
for a year to be developed. imaging or diagnostic radiography are limited to
Improve Quality Service - to Increase Advanced private higher education institutes. The
Diploma Courses education fees in those institutes are high and
Ensuring personal commitment to enhance not affordable to most diagnostic radiographers
the experience and knowledge in medical in the public sector. Hence, more government
imaging is in line with current technological scholarships for diagnostic radiographers for
advancement and environmental demands. furthering studies are needed.
Adequacy and Optimisation of Health Increasing Disease Burden and Change of
Resources Demography
Imaging is essential for the initial diagnosis and
Deployment and Integration of Human monitoring of the novel Coronavirus and other
Resource infectious diseases. Hence, diagnostic
Disease Control Unit in Sabah State Health radiographers are the frontliners providing
Department and Sarawak State Health diagnostic valued radiographic images to enable
Department has one (1) unit mobile X-ray clinicians to detect pathologies and diseases.
vehicle each. However, a dedicated As diagnostic radiographers work on the
radiographer is not allocated for this purpose. frontline, they should be aware of the potential
Radiographers from health clinics or risks associated with COVID-19 and other
hospitals, who are already busy and occupied emerging diseases. Consequently, diagnostic
with their existing workload, are expected to radiographers must follow protocols for protecting
support the service at the state health themselves from COVID-19 and other infectious
department. diseases. Diagnostic radiographers must be
The lack of integration between hospital and appropriately educated on coping with an
health clinic impedes the interchange of infectious disease outbreak considering the
radiology services in both settings. current situation. More thorough protocols for
ensuring the safety of diagnostic radiography, on
Strengthen/ Enhance Career Pathway the other hand, should be developed.
The highest grade of radiographers in health
clinics is U32. Radiographers in health clinics play
an essential role as head unit or state/ district
coordinator for radiology services in health
clinics. Therefore, radiographers with a higher
grade are needed to manage both clinical work
and administrative tasks.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 97
Way Forward > New Issues - New Strategies
To extend the flexi post to different grades
Philosophy such as U32/U36 and U48/U52.
The radiographer profession aims to provide
the best quality radiology services in line with To create new radiographer positions.
Universal Health Coverage (UHC). The Health To create higher radiographer positions in
Minister always emphasises welfare and workload Public Health Programme.
issues among healthcare providers. As per To create more advanced diploma courses.
Astana Declaration, primary healthcare success To encourage U41, U42, U44 radiographers
depends on its human resource. In that regard, the to involve fully in clinical work and strive to
diagnostic radiographer profession plans for better be experts in certain imaging modalities.
career and professional development, especially To create a new one-year compulsory
in public health. placement programme for U29 and U41 at
Principles the state or major specialist hospital.
> Current Achievements - Sustain/ Maintain To increase the number of radiographers
with an advanced diploma.
To maintain SME for radiographers in three To implement joint programmes at MOH
(3) fields: CT Scan Imaging, Cardiovascular facilities, including hospitals and health
Imaging and Breast Imaging. clinics within the same district.
To organise the Malaysian diagnostic
DIAGNOSTIC RADIOGRAPHY radiographer conference every year.
> Existing Issues That Have Not Been Solved -
Reform
Lack of diagnostic radiographers to handle
radiology services:
To propose critical service allowances for
diagnostic radiographers as a reward or
incentive to boost morale.
To propose recruitment of contract diagnostic
radiographers.
To propose outsourcing services in a hospital/
health clinic that has insufficient
radiographers.
Conclusion : The Strategic Plan for diagnostic radiographers acts as a tool to
prepare and overcome current and future challenges. Radiographers should be
aware of their essential role in ensuring professional continuity. This plan can
guide radiographers to maintain good work and upgrade services in quality
image production and patient care enhancement.
98 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Detailed Implementation Plan for Diagnostic Radiography
The allied health profession’s Detailed Implementation Plan (DIP) outlined in this Strategic Plan is divided into three (3) tiers
which are:
(A) Strategic Framework - Medical Programme
The activities/ indicators/ achievements will directly be monitored under the Head of Services, and the allied health
profession involved will report to their respective service in the Medical Programme/ Public Health Programme or other
relevant departments.
(B) Medical Framework - Allied Health Sciences Division
The activities/ indicators/ achievements will be monitored by AHSD, and then will report to the Medical Programme/
Public Health Programme or other relevant departments.
(C) Allied Health Sciences Division - Profession
The activites/ indicators/ achievements will be monitored by AHSD for internal report and discussion between AHSD and
allied health professions.
(A) Strategic Framework - Medical Programme
No Profession Strategy
(B) Medical Framework - Allied Health Sciences Division
Strategy 3: Enhance Capacity and capability of human resource for health
Main Implementation Plan No. 28: To ensure adequate supply of in-service competent medical personnel
Profession Activity Indicator Target
Implementation Plan
To apply for new post for Increment of diagnostic 150 diagnostic DIAGNOSTIC RADIOGRAPHY
1. Ensure adequacy of diagnostic radiographer in radiographers posts every radiographers per year
diagnostic radiographers in each MOH facilities year align with workload increment
MOH facilities To propose extension of the
flexi post to different grade
category such as U32/U36 Number of extended flexi posts 300 flexi posts by 2025
and U48/U52
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 99
Main Implementation Plan No. 30: To advance clinical competencies of in-service medical personnel
Profession Activity Indicator Target
Implementation Plan
2. Strengthen competency To increase number of Number of diagnostic radiographers 500 diagnostic
through advanced diploma/ diagnostic radiographers who attain advanced diploma/ degree radiographers by 2025
degree attain advanced diploma/
degree
3. Enhance capacity of sub field To attach in advanced Number of diagnostic radiographers 50 diagnostic
expertise among diagnostic structured programme with paediatric/ geriatric attachment radiographers by 2025
radiographers (paediatric imaging/ geriatric
imaging) in 2 phases Number of diagnostic radiographers 30 diagnostic
To train diagnostic with advanced diploma course in MRI radiographers by 2025
radiographers in MRI
advanced diploma course
4. Enhance capacity and To implement a one-year Percentage of diagnostic 100% new diagnostic
capability of newly compulsory placement for radiographers completed the one- radiographers by 2025
appointed radiographers newly appointed U29 and U41 year compulsory placement
at state or major specialist
hospital
Main Implementation Plan No. 33: To improve career pathway for medical personnel
Profession Activity Indicator Target
Implementation Plan
DIAGNOSTIC RADIOGRAPHY 5. Establish career pathway To recognise diagnostic Numbers of diagnostic radiographers 5 diagnostic
framework for diagnostic radiographers in specialised appointed as SME radiographers by 2025
radiographers field
100 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
(C) Allied Health Sciences Division - Profession Diagnostic Radiography
Profession Activity Indicator Target
Implementation Plan
1. Strengthen governance of To create diagnostic Number of diagnostic radiographer Minimum 1 post per state
diagnostic radiography radiographer management and posts for each state health health department by
services in every state professional posts in each state department 2025
health department to supervise
diagnostic radiography services
in state healthcare facilities
including hospitals, institutes
and health clinics
2. Enhance mobile X-ray To create diagnostic Number of diagnostic radiographer Minimum 3 diagnostic
vehicle services under radiographer post for mobile posts at Disease Control Unit, State radiographers per
Disease Control Unit, State X-ray vehicle services in Sabah Health Department of Sabah and machine by 2025
Health Department of Sabah and Sarawak Sarawak
and Sarawak
DIAGNOSTIC RADIOGRAPHY
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 101
102 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
DIETETICS
DIETETICS
104 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce
Dietetic services at MOH have been available 19Ye5ar 3 20Ye2ar 0
since 1953. The first dietitian with a postgraduate 1HOSPITAL
diploma was appointed at Hospital Kuala Lumpur Total : 1 HOSPITAL 333
as Penyelia Jenis Makanan (PJM). In 1980, the 42INSTITUTION
PJM post was upgraded to a bachelor’s degree,
elevated to the Management and Professional 4MOH
(Grade A22) level and dietitians trained from
abroad was hired. The post was initially HEADQUARTER
designated as the Science Service (Grade C3)
scheme in January 1992 and later changed to the HEALTH 93
Medical and Health (Grade U) scheme in 2005, CLINIC
representing the dietitian’s fundamental role in
clinical patient care. Total : 472
Subsequently, for the first time in 1982, the
Institute of Public Health (Institut Kesihatan DIETETICS
Umum, IKU) employed a dietitian to educate
community nursing trainers and health inspectors
on diet and nutrition. After that, it expanded the
dietitian’s job scope into research aspect, which is
considered essential to support the
comprehensive role of the dietetic profession.
Furthermore, a dietitian should constantly
substantiate the effectiveness of dietary
interventions provided to patients. Thus, there is a
need to integrate research findings into the routine
clinical nutrition care of patients.
In 1988, Universiti Kebangsaan Malaysia (UKM)
produced the first 10 local dietetic graduates, of
which MOH appointed seven (7) of them in various
hospitals. Later, the dietetic services have
expanded into sports nutrition in the late 90s.
Some dietitians were established at the National
Sports Council (Majlis Sukan Negara, MSN) and
the National Institute of Sports (Institut Sukan
Negara, ISN). In 2004, sports nutrition services
were further broadened with MOH cadre dietitian
appointment at Bukit Jalil Sports School, followed
by other sports schools in the country.
Dietetic services at the MOH made history in 2010
when MOH created 10 new dietitian positions at
health clinics in public health. In the same year, the
Disease Control Division (Bahagian Kawalan
Penyakit) began a dietitian position responsible for
developing non-communicable disease policies
and programmes. Parallelly, dietitian
appointments started in the Family Health
Development Division in 2014. Additionally, two (2)
MOH cadre dietitian positions have recently been
assigned to the military hospital.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 105
DIETETICS Introduction Several ongoing initiatives ensure that MOH
dietitians are knowledgeable, skilled, competitive,
Dietetics is defined as the application of the innovative, have integrity, and embrace the rapid
science of diet and nutrition to the human being in advancement of therapies, information, and
health and disease. Dietetics is a field that technology. The National Dietetic Technical
combines principles of dietetic, medicine, and Committee collaborates with the Allied Health
health science, psychology, and human nutrition to Sciences Division, professional associations, and
manage disease conditions. The involvement of a universities to develop and establish regular
dietitian is not only in the aspect of curative, but it structured training programmes to support
also includes the aspects of disease prevention, services and promote individual career
health promotion, rehabilitation, and palliative advancement. Orientation programme for newly
care. Dietitian is now accepted as the expert in the recruited dietitians, training in various clinical
planning and evaluating nutritional care for dietetics fields, postgraduate training,
patients requiring therapeutic dietary regimens attachments abroad, and leadership and
and the population in general. Bachelor of Science management courses are among the courses
in Dietetics with honours is the basic qualification planned.
required for employment at the MOH.
Workload/ Census
Functions Many patients are provided with MNT services at
hospitals and health clinics as dietitians’ roles are
Dietitians at MOH provide medical nutrition expanding due to the growing need for dietetic
therapy (MNT) services at hospitals and health services in various speciality areas. As shown in
clinics and deliver dietetic services to the Table 14, the number of cases indicates the
community and public. Dietitians also manage workload of dietitians for 2017 to 2019.
therapeutic dietary services at hospitals and Research/ Innovation/ Publication/ Presentation
actively conduct clinical and epidemiological
dietetic research. Research
In performing health-related research,
Performance and Achievements adherence to the standard of ethics outlined in
the basic Good Clinical Practice (GCP) is
Enhancement of Service Delivery critical. As a response, a significant number of
The current role of dietitians covers clinical dietetic dietitians have undergone Certification of Good
services, public health, epidemiological dietetics Clinical Practice (GCP), with 47 dietitians
research and therapeutic diet management. accredited as of 2019. In addition, numerous
Dietitians provide MNT to in-patients and studies have been completed and published by
outpatients in the area of clinical dietetics. On the dietitians in MOH.
other hand, community and public health dietetic Innovations
services are aimed at individuals and groups at Dietitians at MOH are actively involved in
risk for chronic or non-communicable disease. introducing service-related innovations, which
Dietitians are also involved in research and play an essential role in enhancing services.
research programmes involving epidemiological Among the awards and achievements of
dietetics, where these studies are crucial to assist innovation are:
in developing health policy in Malaysia. In
addition, dietitians manage therapeutic diets for Champion, 2018 in Innovative and Creative
patients in hospitals, where proper diet Convention MOH for the Hybrid
prescription is vital in improving patients’ dietary Improvements Category, titled Sodium
status and an essential element of a complete Counting – Novel Strategy to Combat
treatment process. Non-Communicable Disease (NCD).
Dietetic services are provided at 145 hospitals, Champion, 2019 in Quality Convention MOH
1,015 health clinics, five (5) Malaysia Sports for the Quality Assurance Category (Oral),
Schools, and two (2) Army Hospitals throughout titled Improving Percentage of Patients
Malaysia. In addition, in some health clinics Receiving Enteral Nutrition Product (ENP)
without dietitians, visiting dietitians from nearby within 24 hours of Dietitian’s Prescription in
hospitals or health clinics render dietetic services Selected Wards.
periodically.
106 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Table 14: The Workload of Dietitians in the Year 2017 - 2019
Workload 2017 2018 2019
261,629 cases
In-patients 241,278 cases 247,397 cases
Outpatients (hospital + health clinics) 83,930 + 104,467 = 85,290 + 109,729 = 94,913 + 148,180 =
188,397 cases 195,019 cases 243,093 cases
Finalist in Design Thinking Association of Human Resource Capability and Competency DIETETICS
Malaysia (DTAM) Award 2019 for the Lack of/ inadequate existing workforce (even
Innovation of People-Centric Category minimum numbers are not achieved) relative to
Award, titled Smart Na+. the workload for enhancement and expansion of
Training service scope.
As of 2019, 56 dietitians have completed master’s Limited competency and value-added approach
degrees, and five (5) have completed PhD skills to complement the development of medical
postgraduate studies in various nutrition and care.
dietetic fields.
Dietitians in MOH have also had the opportunity Adequacy and Optimisation of Health
for attachment training in foreign institutions. For Resources
example, in 2017, two (2) dietitians were offered to
study Public Health at the JICA Kyushu Centre in Unequal distribution of workforce which is not
Japan. In 2019, one (1) dietitian completed clinical based on workload and needs. Enhancement
attachment in the Rehabilitation field at Changi and expansion of service scope (number of staff
General Hospital in Singapore, and MOH sent two is not parallel with the workload) is not
(2) dietitians to Germany for Leadership and supported with adequate human resource.
Executive Management courses. Dietetics service fee is not fully implementing in
MOH.
Recognition/ Achievements Lack of integration and comprehensiveness in
Subject Matter Expert (SME) existing EMR system.
Recognition of competencies and expertise is The equipment used in the dietary service is not
seen through the implementation of credentialing up to date with the latest technology
and appointment of Subject Matter Experts developments.
(SME). As for 2019, two (2) dietitians were Limited clinic space for dietetic services.
appointed as SMEs in Oncology Dietetics.
Credentialing Strengthen/ Enhance Career Pathway
A total of 262 dietitians have been credentialed for Competency and value-added approaches are
advanced, specialised, and optional procedures needed in line with the development of medical
in various procedures. care. Credentialing and specialist certification
are required to recognise dietitians in speciality
Issues and Challenges areas.
Postgraduate qualifications should be
Strengthen/ Enhance Service Provision recognised as a speciality, and human resource
Limited access to dietetics services due to deployment mapping should be carried out
logistics and resource constraints. according to the demand of care.
The involvement of a dietitian in the Create a dynamic international image by
management of the geriatric population is not sharing national and international expertise
comprehensive. through the SME field.
Insufficient facilities to carry out MNT
procedures.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 107
Limited Training Opportunity In addition, the introduction of on-call or
No structured programme for specialisation after-hours duty illustrates the importance of
training. dietetic services in in-patient care.
Lack of Collaboration Intra/ Interagency/ To ensure life-saving and foster wellbeing for all
Community ages, the Sustainable Development Goals (SDG)
MNT is not covered by a medical insurance policy, prioritise good health and wellbeing as the top
making it difficult for clients to access dietetics three (3) priorities, including combating NCDs,
services outside the MOH facility. mental health, and environmental. Therefore, it
should also be our top priority to comprehensively
Increasing Disease Burden and Change of expand the scope of dietetic services to combat
Demography NCD. Rebranding existing group counselling as a
formal focus group for NCD may increase public
The involvement of a dietitian in managing the access to dietetic services and expand interaction
geriatrics population is not comprehensive with the general population. The restructuring of
enough to face the challenges of Malaysia as an traditional MNT approaches is vital for better
ageing country. accessibility and efficient dietetic care. The
Lack of self-care awareness and National Indicator Approach (NIA) or National
self-empowerment among patients/ clients. Health Care Quality Indicator (NHCQI) in NCD can
be adapted for performance benchmark for
Way Forward dietetic services in combating NCD and reassess
dietitian competency in delivering MNT and
Philosophy patients’ comprehension towards the dietary
Dietetic services in the MOH have been improving counselling given to them. Due to the COVID-19
and enhancing their functions to provide the pandemic and social distancing becoming a part
Malaysian population with up to date MNT in of the new working norms, new approaches are
dietetic services. Dietetic services are aligned to needed to provide MNT through the Internet of
the needs of Malaysians’ healthcare process and Things (IoT) or the Fourth Industrial Revolution (IR
system. The development and provision of MNT 4.0), which will soon become necessary.
for non-communicable diseases (NCD) to critically
ill patients, SME recognition and the development
of dietetic standard operating procedures (SOP) in
mental health are some examples of the service
enhancement needs.
DIETETICS Conclusion : This Strategic Plan 2021 - 2025 for dietetics is planned based on
the Strategic Framework of the Medical Programme 2021 - 2025 and the
direction of the Public Health Programme. It is hoped that this strategic plan will
act as a roadmap for establishing initiatives and activities for the next five years
for the dietetic profession in MOH. The activities and initiatives proposed in this
strategic plan 2021 - 2025 will be the steppingstone for dietitians in MOH to
invigorate the dietitian’s role in combating NCD in Malaysia and enhance
dietetic services in the new norms. In addition, there is a need for the service to
be more innovative, constructive, and proficient in embracing and using
Artificial Intelligence and the Internet of Things as modern 21st-century
challenges.
108 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Detailed Implementation Plan for Dietetics
The allied health profession’s Detailed Implementation Plan (DIP) outlined in this Strategic Plan is divided into three (3) tiers
which are:
(A) Strategic Framework - Medical Programme
The activities/ indicators/ achievements will directly be monitored under the Head of Services, and the allied health
profession involved will report to their respective service in the Medical Programme/ Public Health Programme or other
relevant departments.
(B) Medical Framework - Allied Health Sciences Division
The activities/ indicators/ achievements will be monitored by AHSD, and then will report to the Medical Programme/
Public Health Programme or other relevant departments.
(C) Allied Health Sciences Division - Profession
The activites/ indicators/ achievements will be monitored by AHSD for internal report and discussion between AHSD and
allied health professions.
(A) Strategic Framework - Medical Programme
No Profession Strategy
(B) Medical Framework - Allied Health Sciences Division
Strategy 2: Optimise resource management including facility, equipment and financing
Main Implementation Plan No. 22 :
To optimise utilisation of existing underutilised/ unused facilities via Hospital Cluster platform
Profession Activity Indicator Target
Implementation Plan
To extend dietitian service to Number of additional hospitals 2 cluster per year
the hospital within cluster by involved
phases
1. Expand and strengthen To extend dietitian visits Percentage increase in health clinic 5% increase in health
access to MOH dietetic across districts and visits clinic visits yearly
services programmes Percentage increase in visits from 5% increase in health
To establish a dietetic hospital to health clinic clinic visits by dietitian
reference centre at a district from hospital yearly
health facility without dietitian
Number of established dietetic 1 reference centre per
reference centres in selected district district per year
Main Implementation Plan No. 26 : DIETETICS
To optimise healthcare resources through interagency collaboration in service delivery
Profession Activity Indicator Target
Implementation Plan
2. Strengthen dietetic service To refer patients to dietetic Number of external facilities involved 5 facilities by 2025
access through public-private clinics in public universities as in the collaboration/ partnership
collaboration/ partnership or government-to-government
inter/ multi-sectorial/ agency initiative
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 109
Strategy 3: Enhance capacity and capability of human resource for health
Main Implementation Plan No. 28: To ensure adequate supply of in-service competent medical personnel
Profession Activity Indicator Target
Implementation Plan
3. Ensure adequate supply of Employment of new staff at Percentage increment of total 5% increment of total
competent in-service hospital/ health clinic numbers of dietitians numbers of dietitians
dietitians for smooth service Employment of contract/ Number of posts approved per year
delivery sessional dietitians under Minimum 2 person per
hospital/ health clinic specialist hospital by
2025
Strategy 6: Leverage the use of information technology to improve efficiency
Main Implementation Plan No. 58: To improve/ enhance services delivery through use of technology
Profession Activity Indicator Target
Implementation Plan
To initiate virtual dietetic clinic Number of health clinics involved 20 health clinics per
4. Uberisation of dietetic in health clinics year
services
(C) Allied Health Sciences Division - Professions Dietetics
Profession Activity Indicator Target
Implementation Plan
1. Optimisation of dietetic To map and relocate dietitians Number of proposals submitted to 1 per year
human resources based on needs, workload and Human Resources Division, MOH 8 posts in 5 years
logistic
2. Enhancement of dietetic
services through To apply and relocate dietitian
restructuring of medical post from the training pooled Number of posts relocated
nutrition therapy (MNT) post (jawatan simpanan latihan)
delivery method
To establish Focus Group Diet Number of health facilities establish a 10 facilities per year
clinics for NCD (DM and Focus Group Diet clinic
Hypertension) in health
facilities by phases
DIETETICS 3. Providing MNT as a To introduce MNT into medical Number of companies that include 1 company per year
component of insurance officer’s treatment packages MNT in their health insurance policy
packages at private under the protection of health
institutions insurance policy
110 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
DIETETICS
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 111
112 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
EMBRYOLOGY
EMBRYOLOGY
114 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce EMBRYOLOGY
Assisted Reproductive Technology (ART) is a Year 20Ye2ar 0 4
rapidly growing medical field. It evolved from
simple in vitro fertilisation (IVF) using male and 2006 HOSPITAL
female gametes from natural cycles in the 1980s to 1HOSPITAL
intracytoplasmic sperm injection (ICSI) following 6INSTITUTION
stimulated cycles to achieve pregnancy. Total : 1
In this field, Malaysia still lags, with the service Total : 10
only available in the big cities. After 1995 however,
the Ministry of Health (MOH) has taken the Currently, four (4) hospitals provide ART services,
initiative to train more reproductive medicine namely Hospital Tunku Azizah, Hospital Sultanah
specialists. As a result, more fertility centres will be Bahiyah, Hospital Sultanah Nur Zahirah and
established inevitably in the future, in both the Women & Children Hospital, Likas, Sabah. To
government and private sectors. date, institutions other than MOH that provide
Reproductive medicine services under the Medical these services are the Hospital Canselor Tuanku
Programme, MOH have been in operation with two Muhriz (HCTM), Pusat Perubatan Universiti
(2) subunits: the Clinical Unit and Laboratory Unit Malaya (PPUM), Universiti Islam Antarabangsa
since 1997. Initially, the ART services under MOH Malaysia (UIAM) and LPPKN. Since 2006, the
offered only intrauterine insemination (IUI) care. Hospital Kuala Lumpur has been performing ART
Subsequently, they expanded in 2006 to provide procedures with rising cases year after year.
IVF, ICSI and frozen embryo transfer (FET) Hence, an embryologist was appointed to conduct
services for couples who wish to achieve ART-related operations. There are currently a total
pregnancy. Later, MOH also manages male fertility of 10 embryologists in MOH hospitals. An
problems such as those with azoospermia. Sperm embryologist’s placement in MOH hospital is
retrieval procedures include testicular epididymis contingent on the medical expertise and related
sperm aspiration (TESA), testicular epididymis facilities. There are five (5) C41 grade officers,
sperm extraction (TESE), and percutaneous four (4) C44 grade officers and one (1) C48 grade
epididymal sperm aspiration (PESA) are available. officer. They are trained in reproductive
Sperm and testicular freezing are also performed technology by attachment in several local or
for oncology and urology patients who need to international reproductive centres. As for centres
preserve their sperms for future use before with senior embryologists, they will prepare the
oncology treatment. junior officers ‘in house’ for at least three (3) to six
The history of ART or IVF or, in layman’s terms, the (6) months.
test-tube baby programme in Malaysia is quite old
and extensive and about 30 years in the making. A
year after Singapore had successfully obtained the
first ART/ IVF pregnancy in Asia, we commenced
artificial insemination of husband’s sperm (AIH) at
the quasi-government organisation: National
Population and Family Development Board
(Lembaga Penduduk dan Pembangunan Keluarga
Negara, LPPKN). LPPKN was one (1) of the
primary providers of contraceptive services in
Malaysia at that time. The objective of LPPKN in
initiating ART treatment services for childless
couples in Malaysia was basically in keeping with
the decree of World Health Organization (WHO)
that national contraceptive service providers need
to complement their services with infertility
treatment. Thus, historically Malaysia was one of
the early pioneers in ART, having commenced their
services some eight (8) years after the
announcement of the birth of the first IVF baby in
1978.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 115
EMBRYOLOGY Introduction Research/ Innovation/ Publication/ Presentation
The Standards for Assisted Reproductive
Embryology is the field that plays an essential role Technology (ART) Guidelines
in ART treatment. Embryology covers the early A publication that acts as the critical guidance for
stage of human life form, from insemination with all embryologists working at MOH. Developed by
IVF or ICSI, determination of fertilisation, embryo the ART Laboratories Working Committee,
development monitoring and selection of embryo Medical Development Division, MOH based on
for transfer or freezing for future use. Laboratory Accreditation Scheme of Malaysia
Embryologists are professional who is responsible (SAMM), STR 2.7 - Specific Technical
for providing clinical services involving the embryo Requirements for Accreditation of ART
and ART treatment. Laboratories. The guidelines will be revised and
continuously updated with the latest information/
Functions input based on embryology and reproductive
medicine advancement.
An embryologist is a qualified healthcare Contribution in MyHEALTH Portal Website
professional conducting a series of complex MyHEALTH Portal is a web-based health
procedures to help with fertility. These involve information service set up by MOH as a
performing various laboratory procedures with multimedia super corridor (MSC) Telehealth
ART such as semen analysis, sperm freezing, IVF, Flagship Application in 2005. A Malaysian
ICSI, IUI, embryo freezing, grading and government's national initiative to bring about
transplantation. significant change to the country through the
As part of the Department of Obstetrics and creative use of Information and Communication
Gynaecology, embryologists work closely with Technology (ICT).
other healthcare professionals in guiding patients MyHEALTH Portal contributes informative
through infertility treatment procedures. Besides, articles related to IVF treatment, fertility, and
embryologists conduct research, develop policies, embryology field in the MyHEALTH Portal for the
procedures, and standards for ART treatment to public to access and understand the basic
strengthen the profession’s services. knowledge of the area easily.
Performance and Achievements Training
As of 2020, one (1) embryologist has completed
Enhancement of Service Delivery master’s degree.
Implemented day five (5) embryo (blastocyst) In-house training is provided at all new centres
freezing and thawing as part of the standard for newly appointed embryologists, medical
procedure in the ART laboratory could increase laboratory technologists and medical assistants
success in infertility treatment shown in in ART techniques.
pregnancy rates.
Maintained fertilisation rate of about 70 per cent Issues and Challenges
annually at all ART centres in MOH health
facilities. Strengthen/ Enhance Service Provision
Workload/ Census Advanced Embryology Service
There is an increasing number of IVF/ ICSI cases Equipment (e.g., time-lapse monitoring system,
each year for all ART centres under MOH. For Preimplantation Genetic Diagnosis -
example, an increment of 410 cases (47.5%) is Preimplantation Genetic Screening (PGD-PGS)
observed from 2016 to 2019, as shown in Table system) required to set up advanced
15. embryology laboratory procedures are
expensive. The time-lapse monitoring system
Table 15: Number of IVF/ ICSI Cases from Year 2016 - 2019
Year 2016 2017 2018 2019
No. of cases 863 979 892 1,273
116 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
has been around in the field since 2010, with four (4) states. Despite increasing EMBRYOLOGY
new models and upgrades being introduced. understanding of fertility issues, such centres
Currently, MOH facilities are not offering these cover a wide geographic area and affordable
services. ART treatment is not available to middle- and
Adequacy and Optimisation of Health lower-income people. Only selected patients
Resources with strict criteria stated by MOH can receive
Disproportionate ART Professionals across fertility treatment from the available centres.
MOH Hospitals
The workforce ratio among medical Way Forward
professionals (reproductive medicine specialist
vs embryologist) and the number of functioning Philosophy
ART laboratories under MOH are
disproportionate. There are several MOH The MOH’s ART treatment programme in Malaysia
hospitals with practising reproductive medicine is an ongoing endeavour to provide the public with
specialists and no embryologist available. affordable and safe fertility screening and
Cost of Treatments treatment by integrating excellent working
The government subsidises 60 per cent to 70 conditions, career development and a high
per cent of the overall cost of ART treatment in success rate of fertilisation. ART services could
government hospitals; however, because ART provide Malaysians with fertility issues an
treatments are expensive, the number of opportunity to pursue personal happiness while
treatments that can be initiated is limited. also contributing to the community and national
Limited Training Opportunity peace and prosperity.
Advanced Embryology-related training for
competency & Subject Matter Expert (SME) Principles
Embryologists have little opportunity to undergo > Current achievement - Sustain/ Maintain
advanced training (e.g., embryo biopsy, in vitro
maturation, etc.). These training are primarily Achieve a considerable success rate (30%)
available abroad and expensive, hampering the with limited resources, equipment, and
development of expertise and career facilities; however, there is still room for
advancement. improvement by utilising new skills and
Increasing Disease Burden and Change of technology.
Demography > Existing Issues That Have Not Been Solved -
Reform
Regional Centres Limited financial budget.
There are currently four (4) government
hospitals with their own Andrology & Inadequate ART personnel (trained
Embryology laboratory for ART care, located in reproductive specialist, andrologist and
embryologist).
> New Issues - New Strategies
To maintain MOH’s ART treatment standard,
technology, and technique up to date, and all
services are consistent with global industry
standards.
Conclusion : The strategic plan ensures adequate competent medical personnel in
terms of knowledge and skills in each MOH ART’s facility. It is in the plan to establish
ART’s facilities in each region. ART’s facilities are available in four (4) regions and
two (2) more incoming centres in two (2) additional regions. Furthermore, more ART
activities are to be developed in Malaysia through outsourcing services, such as
establishing a simple andrology lab or simple ART treatment. Thus, the capabilities of
our embryologists will be more diversified, not just in their centres but also in new
clinical settings in the future. As this, embryologists get to play a role as a trainer and
consultant to provide high-quality services of ART. Hence, working towards better
development and advancement of the embryologist profession in the country.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 117
EMBRYOLOGY Detailed Implementation Plan for Embryology
The allied health profession’s Detailed Implementation Plan (DIP) outlined in this Strategic Plan is divided into three (3) tiers
which are:
(A) Strategic Framework - Medical Programme
The activities/ indicators/ achievements will directly be monitored under the Head of Services, and the allied health
profession involved will report to their respective service in the Medical Programme/ Public Health Programme or other
relevant departments.
(B) Medical Framework - Allied Health Sciences Division
The activities/ indicators/ achievements will be monitored by AHSD, and then will report to the Medical Programme/
Public Health Programme or other relevant departments.
(C) Allied Health Sciences Division - Profession
The activites/ indicators/ achievements will be monitored by AHSD for internal report and discussion between AHSD and
allied health professions.
(A) Strategic Framework - Medical Programme
No Profession Strategy
(B) Medical Framework - Allied Health Sciences Division
Strategy 2: Optimise resource management including facility, equipment and financing
Main Implementation Plan No. 26:
To optimise healthcare resources through interagency collaboration in service delivery
Profession Activity Indicator Target
Implementation Plan
To identify private centres that Number of collaborations with private At least 1 collaboration
can provide embryo and centres per year
genetics medical laboratories
1. Collaboration between MOH for PGD & PGS Number of cases referred Number of cases
and private facilities To collaborate with private referred per year
hospitals for follow up
treatment/ procedures for post
ART cycle initiation
To send blood samples for Number of samples sent Number of samples sent
blood investigations for per year
hormonal profile (Estradiol,
FSH BHCG and others) to
private laboratories like
Gribbles, PATH lab, BP lab etc.
118 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Strategy 3: Enhance capacity and capability of human resource for health EMBRYOLOGY
Main Implementation Plan No. 28: To ensure adequate supply of in-service competent medical personnel
Profession Activity Indicator Target
Implementation Plan
2. Ensure adequacy of To recruit sessional/ contract Number of sessional/ contract At least 1 embryologist
embryology science officers embryology science officers for embryology science officers for centre with less than
in MOH facilities new ART centres under MOH appointed at Hospital Raja 100 IVF cases per year.
Perempuan Bainun, Ipoh & Each additional 50 cases
Hospital Umum Sarawak will require another staff
To place senior officer with Number of facilities with senior officer 5 facilities by 2025
post-grad qualification at ART posted
centre
Main Implementation Plan No. 30: To advance clinical competencies of in-service medical personnel
Profession Activity Indicator Target
Implementation Plan
To provide advanced Number of officers done advanced At least 2 of embryology
attachment/ training for attachment/ training science officers per year
embryology science officers at
government-approved training
centre for at least 2 weeks
3. Strengthen competency of To further study under HLP Number of officers completed study At least 1 embryology
embryology science officers To attend ART related under HLP science officer per year
conferences locally/ Number of officers who attended the At least 1 officer from
internationally such as relevant conferences each centre to attend
European Society yearly
of Human Reproductive and
Embryology (ESHRE) and the
ASIA Pacific Initiative on
Reproductive (ASPIRE)
Main Implementation Plan No. 33: To improve career pathway for medical personnel
Profession Activity Indicator Target
Implementation Plan
To recognise embryology Number of embryology science At least 1 SME
4. Establish career pathway science officers in specialised officers appointed as SME recognised per year
framework for embryology field
science officers
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 119
EMBRYOLOGY (C) Allied Health Sciences Division - Profession Embryology
Profession Activity Indicator Target
Implementation Plan
Document of MBOR for andrology List of basic equipment
laboratory services developed and space endorsed by
technical committee by
1. Enhance andrology To establish andrology 2025
laboratory services laboratory services
Number of credentialed embryology 3 embryology science
science officers in andrology officers credentialed per
laboratory services year
120 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
EMBRYOLOGY
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 121
122 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
ENTOMOLOGY
ENTOMOLOGY
124 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce
In 1983, anti-malaria, dengue, and filarial control Year 6
programmes were incorporated into the Vector
Borne Disease Control Programme (VBDCP). 2020
VBDCP was formed to control and prevent other
vector-borne diseases such as plague, Japanese MOH
encephalitis, chikungunya, yellow fever, and HEADQUARTER
kala-azar. In line with the expansion of this activity,
the number of Ahli Kaji Serangga (AKS) positions INSTITUTION 5
has increased to 10 and is being deployed to all
states of Peninsular Malaysia (except Perlis and STATE HEALTH 52
Malacca), Sabah and Sarawak. In 1991, AKS was DEPARTMENT
known as Pegawai Sains (Ahli Kaji Serangga).
Then, as a Pegawai Sains (Kaji Serangga) DISTRICT 70 ENTOMOLOGY
[Science Officer (Entomology)] in 2000. HEALTH OFFICE
While entomologists are in the VBDCP, their main
role was to carry out activities in planning, Year PUBLIC HEALTH 2
monitoring, and implementing vector control LABORATORY
activities, including research and entomological 1956
studies, until 2014. Entomologists contributed a INSTITUTION 3 CADRE POST 3
great impact in the reduction of vector-borne Total : 3
diseases especially malaria. Total : 138
After the year 2014, entomologists have
broadened their scope and functions at par with
the Ministry of Health’s aspiration to optimise
professionals in giving full commitment to serve
the country. In line with that, the establishment of
UEP (Entomology and Pest Unit) headed by the
entomologists was proposed to solve and reduce
the arising problems in public health, especially in
entomology and pest. UEP was suggested to be
outside VBDC administration in order to deliver the
best and effective service nationwide.
With the establishment of UEP outside VBDC
administration, its expanded and extended scope
will allow the activities and services, especially
pest, to be offered to other agencies, for example,
universities, local authorities, and other
government institutions. UEP shall represent the
Government in ensuring the pest control operators
(PCO) services are safe and of the best quality
and abide by the regulations stated in the law.
To date, a total of 138 posts have been approved
throughout Malaysia. These positions are
distributed at the ministry level (6 posts), state
level (52 posts), Public Health Institute (5 posts),
National Public Health Laboratory (2 posts) and
district health offices (70 posts) throughout the
country. As UEP expands its services, the need to
increase resources and workforce need to be
addressed in line with its expanding scope and
functions.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 125
ENTOMOLOGY Introduction Status of academic achievement among
entomologists; there are 26 with master's
The first entomologist in Malaysia was a British degrees and two (2) with PhD.
named Pratt when the Malaria Entomology Entomologist professionals' competency
Division was established in 1903. J.A. Reid and strengthens through myCPD system.
R.H. Wharton were two (2) entomologists Malaria
recorded in 1950s, but they are work on behalf of Development of a standard and
United State Medical Research Unit (USMRU). comprehensive application procedure of
Entomologist was established in 1956 at the insecticide residual spray (IRS).
Institute for Medical Research. The scheme was Development and implementation of
known as Ahli Kaji Serangga (AKS). In 1961, three insecticide treated net (ITN) as the main
(3) more positions were created under the World component in malaria prevention and control
Health Organization (WHO). In 1978, one (1) strategy using the WHO guidelines.
position was created at the Public Health Institute Implement and strengthen integrated vector
to train malaria control personnel. In the same and pest management (IVPM) as an important
year, two (2) AKS positions were deployed in control strategy in Vector Borne Disease
Sabah and Sarawak to implement the Malaria Control Programme.
Eradication Programme in Malaysia. Establishment of malaria vector mapping by
localities and profiles using updated geospatial
Functions technology.
Development of entomology data management
Basic tasks include entomological and pest system (myEntopest).
surveillance, taxonomy, technological base Larval source management (LSM) strategy at
entomology for vector control equipment, pest the community level to eradicate mosquito
control, laboratory, and arthropods management. breeding sources.
They are specialised in specific fields, including Dengue
advanced statistics in entomology and pest,
geospatial analysis in entomology, molecular Interpretation of main entomological index to
entomology, pesticide toxicology, forensic suggest effective dengue control and
entomology, arthropod and pest colony prevention measures.
maintenance for laboratory and research purposes Improvement and innovation of entomological
and hygiene and structural pest. The main aim tools to reduce Aedes population such as
now is to enhance entomologists’ competency and lethal-ovitrap and sticky-trap-base.
skills and improve the quality of health services. ‘Community Entomological Programme’ to
Other functions include: empower the community in using
a) Entomological practice in arthropod borne sticky-trap-base for prevention and control of
Aedes spp. breeding.
diseases and pest of public health importance. Development and implementation of Wolbachia
b) Monitoring and evaluation of disease-bearing mosquito (Aedes aegypti) as an indoor
biological control agent for dengue.
insects, entomology and pest control activities. Implementation of insecticide-resistant
c) Insectarium and laboratory services. management (IRM) in insecticide resistance
d) Monitoring and coordinating the application of monitoring.
Establishment of dengue vector mapping and
equipment used for arthropod/ pest control and profile using current technology involving
judicious use of pesticide. hotspots and localities with high incident of
e) Forensic entomology practice. case nationwide.
f) Advocacy and communication in the field of
entomology and pest.
Performance and Achievements
Capacity Building
Currently, there are 138 entomologists
nationwide working at the ministry, state, and
district level.
126 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Development of guidelines to improve Issues and Challenges ENTOMOLOGY
effectiveness and efficiency of Aedes control
activities. Aedes mosquito abundance over space and time
Development of guidelines for insecticide An increase in Aedes breeding places
application and dosage in vector control contributing to a significant increase of dengue
activities. incidence nationwide. Recurrence of cases in
Filariasis the same localities. Cryptic breeding places of
Identifying the main breeding sites of Filariasis Aedes and possible behavioural changes of
vector (Eichhornia crassipes). Aedes.
Application of insecticide treated net (ITN) at Controlling Aedes indoor (houses) during the
high endemicity state in Malaysia. day due to residents not at home.
Implementation of translocation technique to
eradicate mosquito larva. Anopheles mosquitoes spreading human and
Pest simian malaria
Implementation of termites control technique
without disrupting existing building structure, Prevent importation of malaria cases and
especially in health facilities. sustaining the malaria elimination status.
Creation of a mechanism for Sarcophagidae Introduction and increase of simian malaria due
flies free at all health facilities. to deforestation.
Entry Point (Airport/ Seaport) Resistance
Establishment of proper monitoring of residual There are signs of resistance in mosquitos
disinsection activity in aircraft at the main towards public health pesticides or insecticides
international airport (Kuala Lumpur used in vector control activities.
International Airport). Pest
To strengthen fumigation activities that are in In health facilities, entry points (seaports,
line with entomology and pest technology. airports), and food premises, pests such as
To strengthen the intra-, inter-agency for mosquitoes, cockroaches, flies, and rodents
vector and pest control involvement through are nuisances.
IVPM concepts. Pest-free in strategic premises.
Laboratory and Insectarium
Development and expansion of entomology Way Forward
laboratory and insectarium at states and
districts level to perform mosquito’s Philosophy
colonization, Wolbachia, insecticide resistance The vision, mission and objectives the profession
testing and related entomology lab work. of entomology are as below:
Establishment and expansion of the Vision: To strive for an organisation of superior
Communicable Disease Centre (CDC) for a quality combating disease bearing insects and
Specialised Diagnostics Reference Laboratory pest of public health importance.
(SDRL) in the country and region (CDC
Malaysia) through National Public Health Lab. Mission: To strengthen services with enhance
Strengthen the monitoring and evaluation of expert and consultation of entomological and pest
active ingredients in pesticide used in public through integrated vector and pest management.
health.
Objectives:
To strengthen the activities of entomological
and pest surveillance systems to facilitate
evidence-based problem solving.
To ensure vector and pest control activities are
implemented effectively using scientific
methods and entomological perspectives.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 127
ENTOMOLOGY To ensure vector and pest control operations Monitoring and evaluation.
are carried out judiciously and in line with the Release and sustainability of Aedes infected
latest technology. Wolbachia in targeted localities.
To provide support services for various Entomological & pest surveillance.
researches or studies of field and laboratory Pest free in public interest places and priority
operations to add value to scientific expertise. areas.
To encourage innovation initiatives and added Intervention of pesticide resistance.
value to technology in the field of entomology. Competency and capacity and building.
Ensuring the continuation of the Integrated vector and pest management
implementation of Allied Health Professions (IVPM).
Act 2016 (Act 774). Vector mapping using geospatial technologies.
Principles
Implement integrated pest management (IPM) Monitoring and Evaluation
and integrated vector management (IVM)
concepts by offering professional consultation. Indicators (Qualitative/ Quantitative)
Use of latest technologies for pest-free public To collect all entomological and pest indicators,
interest places/ areas. such as mosquito larva stages and pupa index,
Application of advanced and novel of biting rates, survival (parous rates, age
entomological tools for insects or pest control grading, etc.) and density to help/ assist vector
in public health. and pest control activities to reduce
Strengthen monitoring and evaluation (M&E) transmission the lowest level (impact on
system with entomological and pest impact vectorial capacity).
indicators to reduce transmission to the lowest To always update thresholds and map the
level (impact on vectorial capacity) and receptivity level of malaria vectors in localities,
improve vector and pest control. posing a risk or crisis to plan for future control.
Macro Strategies
Sharing of SOP for Aedes control and To monitor the frequency of more than 60 per
resources within MOH, local authorities and cent Aedes infected Wolbachia in every locality
other relevant authorities. and buffer zone, especially in dengue outbreak
Outsourcing of services through privatisation to localities.
overcome Aedes problems through To ensure key performance indicator (KPI) of
evidence-based measures obtained in entomologist is monitored six (6) monthly and
operational researches for a more targeted reported yearly.
and effective control method. Criteria for Indicator
Release and sustainability of Aedes aegypti The entomological and pest indicators are specific,
with Wolbachia in the locality as a biological measurable, achievable, relevant and timely
agent to solve dengue indoor premises (SMART).
problems.
Strengthening of entomological surveillance Proxy Indicators
and forecasting of an arthropod-borne disease
population such as malaria and dengue The incidence rate of arthropod-borne and pest
vectors. disease in specific localities.
To refine and enhance the insecticide Complaints from the public of arthropods and
resistance surveillance system in districts. pests as a nuisance.
Plan of Action, Activities and Initiatives Target
Targeted and advanced operational research. To achieve key performance indices stated.
128 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Conclusion : ENTOMOLOGY
Entomological and pest indicators collected are evidence used to solve
problems through the concept of integrated vector and pest management.
Monitoring and evaluation system with entomological and pest indicators to
facilitate decision making and implement vector and pest control for the
best impact on public health.
Entomological and pest operational research on the latest technology, i.e.,
‘green technology’ as a strategy for vector and pest control, for example,
using Aedes infected Wolbachia to control the spread of dengue.
Continuous capacity building activities to strengthen entomology and pest
knowledge to produce more experts.
The need to strengthen services given by enhancing entomology and pest
consultancy expertise.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 129
ENTOMOLOGY Detailed Implementation Plan for Entomology
The allied health profession’s Detailed Implementation Plan (DIP) outlined in this Strategic Plan is divided into three (3) tiers
which are:
(A) Strategic Framework - Medical Programme
The activities/ indicators/ achievements will directly be monitored under the Head of Services, and the allied health
profession involved will report to their respective service in the Medical Programme/ Public Health Programme or other
relevant departments.
(B) Medical Framework - Allied Health Sciences Division
The activities/ indicators/ achievements will be monitored by AHSD, and then will report to the Medical Programme/
Public Health Programme or other relevant departments.
(C) Allied Health Sciences Division - Profession
The activites/ indicators/ achievements will be monitored by AHSD for internal report and discussion between AHSD and
allied health professions.
(A) Strategic Framework - Medical Programme
No Profession Strategy
(B) Medical Framework - Allied Health Sciences Division
No Profession Strategy
(C) Allied Health Sciences Division - Profession Entomology
Strategy: Strengthen safety and quality in delivery of healthcare system
Implementation Plan: To strengthen the infection prevention and control programmes
Profession Strategy Activity Indicator Target
1. Strengthen evidence-based To collaborate with agencies/ Number of entomology At least 5 of
entomology procedures for authorities/ communities (i.e., procedures for Aedes control entomological
Aedes control Ministry of Health & Ministry of updated procedures for Aedes
Housing and Local Number of collaboration control updated by 2025
Government) to implement the activities At least 3 collaboration
updated evidence-based with others agencies by
entomology procedures for 2025
Aedes control
130 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Profession Strategy Activity Indicator Target
To conduct self-assessment by Percentage of self-evaluation At least 10%
public and private programme done by public & implementation self-
entomologists private entomologists evaluation among public
sector entomologists by
2. Analysis on outsourced 2025 ENTOMOLOGY
services for Aedes prevention At least 5%
and control Percentage of evaluation on implementation self-
To conduct entomological outsourced companies using evaluation among private
monitoring and evaluation standardised M&E procedures sector entomologists and
(M&E) by entomologists at academicians by 2025
MOH level for effectiveness of 15% of evaluation on
control activity outsourced companies
under MOH by 2025
Pest Control Operator (service Number of training/ meeting for 3% of evaluation on
provider) training/ meeting by personnel from public and outsourced companies
MOH entomologists private control company under non-MOH by
2025
2 trainings/ meetings per
year
3. Strengthen and sustain green To conduct entomological Percentage of conducive At least 70% of localities
technology biological control assessment on effectiveness of localities released with sustainability with
using Aedes aegypti with biological control using Aedes Wolbachia infected mosquitoes Wolbachia by 2025
Wolbachia aegypti with Wolbachia to Percentage of localities completed
solve indoor problems assessment (6 monthly) of Wolbachia 80% of localities
To upgrade insectariums in in mosquitoes completed assessment
states, Malaysia Number of insectariums upgraded of Wolbachia in
mosquitoes
80% of insectariums
upgraded by 2025
To empower community to Percentage of communities using At least 20% community
participate in using entomological tools for to participates in using
entomological tools for sustainability of Wolbachia in entomological tools for
sustainability of Wolbachia localities with Wolbachia sustainability of
Wolbachia by 2025
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 131
Profession Strategy Activity Indicator Target
To improve and streamline Number of agencies involved in At least 3 agencies
entomology and pest pest surveillance system at the involved by 2025
surveillance system and its national level At least 25 health
control in health facilities, Number of facilities involved in facilities per year and all
airports, seaports, and food the programme Points of Entry (PoE)
premises by 2025
2022
ENTOMOLOGY To improve and streamline 30% district with
control procedure using presence entomologist
Entomology and Pest Percentage of district/ states used Entomology and
Indicators involved Pest Indicators
2023
4. Improving efficiency and 50% district/ states used
upgrade on surveillance Entomology and Pest
system to minimise pest Indicators
threat and termite infestation 2024
90% district/ states used
To develop and implement Percentage implementation of Entomology and Pest
work specification and close work specification and close Indicators
monitoring procedures monitoring procedures 2021
Proposal completed and
To obtain private sector service Number of states obtained approved
(outsourcing to pest control private sector services 2022
operator, PCO) in MOH 25% implementation at
district and state level
To implement technical audit Number of health facilities 2023
on PCO engaged by the health audited 35% implementation at
facilities district and state level
2024
50% implementation at
district and state level
2025
Review of performance
At least 5 states obtained
private sector services by
2025
At least 2 health facilities
audited per year
132 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Profession Strategy Activity Indicator Target
To upgrade and improvise Percentage of localities 2023
insecticide resistance evaluated 50% states/ district
surveillance system in evaluated
districts/ states 2024 ENTOMOLOGY
70% states/ district
evaluated
2025
90% states/ district
evaluated
To train on susceptibility tests Percentage of entomologists trained At least 85% of
methods in susceptibility tests government
entomologists trained by
2025
To produce standard Number of standard documentation A complete Insecticide
documentation or report or report generated Resistance Management
(IRM) system to be
documented by 2025
Number of localities with signs of Number of localities per
resistance applied with biopesticide year
5. Enhance evaluation activity 2021
of insecticide resistance at 30% of localities
districts identified with no
resistance after using Bti
To use biopesticide (such as Percentage of localities identified 2022
Bti to kill larval stage of Aedes) with no resistance after using Bti 50% of localities
as an alternative and identified with no
intervention for insecticide resistance after using Bti
resistance issues 2023
70% of localities
identified with no
resistance after using Bti
2024
85% of localities
identified with no
resistance after using Bti
2025
100% of localities
identified with no
resistance after using Bti
To perform tests and an Number of studies to be performed At least 1 study
operational study application completed by 2025
on new biopesticide
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 133
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