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Strategy: Leverage the use of information of technology to improve efficiency
Implementation Plan: To improve / enhance services delivery through use of technology

Profession Strategy Activity Indicator Target

ENTOMOLOGY 6. Strengthen entomological To establish entomology Percentage of districts with 2023
surveillance team and data surveillance team (Norm: 2 entomology surveillance team 50% of districts
monitoring system sub-team per district with an established established entomology
existing entomologist) surveillance team
2024
75% of districts
established entomology
surveillance team
2025
100% of standard norm
completed by 2025

To develop data monitoring Percentage of data monitoring 100% completion on data
system (MyEntopest) system developed monitoring system by
2025

134 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

ENTOMOLOGY

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 135

136 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

ENVIRONMENTAL
HEALTH

ENVIRONMENTAL HEALTH

138 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Background Workforce

In Malaysia, sanitary inspectors, market inspectors Year 95
or food inspectors were established in 1921. The 3
graduated Diploma of the Royal Society for the 2020
Promotion of Health (London) from King Edward 89
VII of Medicine College, Singapore, was appointed HOSPITAL
for this post in Malaysia. However, all the position INSTITUTION 441
above were later re-named as a public health MOH
inspector certified with the Royal Society of Health HEADQUARTER
(London). STATE HEALTH
In 2005, Health Inspector Scheme was developed DEPARTMENT
into an integrated scheme that includes an
environmental health officer (EHO) and assistant Year DISTRICT 4,332
environmental health officer (AEHO). The HEALTH 25
integrated scheme was introduced in line with 1921 OFFICE
professional development in Malaysia and MOH
developed countries. It was approved by the Public Ministry of Health COLLEGE
Service Department (Jabatan Perkhidmatan
Awam, JPA) to condition the multitask concept Total : CADRE POST 23
EHO, and the AEHO job scope is maintained as No data recorded
outlined in Pekeliling Perkhidmatan Bilangan 11 Total : 5,008
Tahun 2015. With that, 41 EHO were appointed in
2008 in accordance to the scheme. ENVIRONMENTAL HEALTH
EHO must hold a bachelor’s degree in
environmental health or any related field from
public/ private universities accredited by Malaysian
Qualification Accreditation (MQA). Meanwhile, the
appointment as AEHO is a diploma in
environmental health from the Training College of
MOH or any other higher institution, either public or
private, accredited by MQA.
Generally, the profession plays an essential role in
environmental health. Its prominent is in the
prevention of environmental health risks,
promotion and protection of public health and the
environment in the areas of disease control,
hygiene and food safety, housing and
environmental health, vector control, drinking
water quality, water sanitation, emergency
preparedness and the enforcement of public
health law following the roles and functions
prescribed by the World Health Organization
(WHO) and the International Federation of
Environmental Health (IFEH).

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 139

ENVIRONMENTAL HEALTH Introduction persons who contravened the regulation such as
smoking in prohibited area as stipulated in
According to WHO Report 2003, ‘environmental Regulation.
health’ consists of human health aspects EHO and AEHO also were appointed as
determined by physical, chemical, biological, and authorised officers under Prevention and Control
social factors in the environment that may cause a of Infectious Disease Act 1988 (Act 342), Food Act
deleterious effect on his physical development, 1983 and its Regulations, and Destruction of
health or survival. Disease Bearing Insects Act 1975 (Act 154). They
In general, EHO and AEHO are responsible for the also conduct health risk assessment which include
control of the environmental health (EH) risks, of; assessment of food premises, sampling of food
promotion and protection of public health and the products, sampling of treated drinking water,
environment in the scopes of disease control, health risk assessment in order the premises to be
hygiene and safety of food, housing and closed for disinfection as required under Act 342,
environmental health, vector control, drinking and occupational and environmental risk
water quality, water sanitation, emergency assessment to ensure compliance with the
preparedness and enforcement of public health Occupational and Safety Health Act 1994.
legislation in line with the roles and functions as EHO and AEHO are involved in module
determined by the Expert Committee, the World development, consultation, and evaluation on
Health Organization No. 79 or its amendments. fumigation activities according to the Hydrogen
Cyanide Act 1953. At the same time, they also
Functions conduct all screening activities of travellers and
inspection of ships/ vessels to ensure compliance
IFEH 2004 was highlighted that EHO and AEHO with the International Health Regulation 2005. On
required operational skills for assessing, top of that, they are required to plan, implement,
correcting, and preventing impacts of biological, and evaluate projects of water supply facilities
physical, chemical, social, and psychosocial such as gravity feed system (GFS), system
stressors in environments. The highlighted connection to home well, rainwater catchment
functional skills as below: systems and Water Supply and Environmental
Sanitation (BAKAS). In addition, they must plan,
• Enforce • Assess implement, and evaluate the construction of
• Educate • Investigate toilets, sanitation, and sewage water in rural areas
• Advocate • Inspect to prevent and control the incidence of
• Evaluate • Consult water-borne diseases such as cholera, typhoid,
• Research • Advice and dysentery. They also conduct analysis and
evaluation on any activities, research, and
In general, EHO and AEHO are responsible in projects related to environmental health.
drafting policies including amendment of Acts and
Regulations related to public health, developing Performance and Achievements
Standard Operating Procedures (SOP) as well as
enforcement. In Malaysia, the Acts and Regulations Enhancement of Service Delivery
that involve EHO and AEHO are; Prevention and Quality Indicator
Control of Infectious Disease Act 1988 (Act 342) Operation activities for enforcement under Food
and its regulations, Destruction of Disease Bearing Act 1983, Destruction of Disease Bearing
Insects Act 1975 (Act 154) and its regulations, Food Insects Act 1975 (Act 154) and the Control of
Act 1983 and its regulations, the Control of Tobacco Tobacco Product Regulations 2004 (Target KPI:
Product Regulations 2004, Hydrogen Cyanide Act 100%)
1953, International Health Regulation 2005 and > 2017: 103.8%
Local Authority Act 1976. > 2018: 123.4%
EHO plays a vital role as a technical officer and > 2019: 100%
liaises directly with Attorney-General Chamber and High Impact Contributions on Control and
legal advisors in amendment of Acts and Prevention of Diseases/ Outbreak/ Public Health
Regulations related to public health and also Issues in Malaysia by EHO and AEHO
appointed as prosecution officers for the Control malaria outbreak from 1960 until 1980
prosecutions related to public health Act and through implementing the Malaria Eradication
Regulations. As an example, for enforcement of Programme (MEP).
Control of Tobacco Product Regulations 2004, EHO
and AEHO are responsible to compounds any

140 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Control of parasite infection, food- and − Contamination of 3MCPD in soy sauce and ENVIRONMENTAL HEALTH
water-borne diseases such as cholera, flavouring substances in 2000.
dysentery, typhoid fever in rural areas through
sanitary system, solid waste disposal system Workload/ Census
under the Rural Environmental Sanitation
Programme (RESP). The workload of EHO and AEHO has increased
Provided safe water supply for the rural consistently with rapid development and
community by implementing gravity feed urbanisation, increasing trend of infectious
system, sanitary well under Water Supply and diseases, contravention of public health acts and a
Environmental Sanitation (BAKAS). growing number of food premises.
Managed food crisis of imported foods such as:
− Radioactive contamination in food due to Infectious diseases that are significant and
contribute to high workloads are as in Table 16.
explosion of a nuclear plant in Chernobyl, Enforcement activities under public health Acts
Russia 1984; result in significant and high workloads to EHO
and AEHO are shown in Table 17.
− Contamination of meat by bovine Workloads for implementation of water supply
spongiform encephalopathy (mad cow systems in rural areas and sanitation systems,
disease) in 1997; as well as monitoring of treated drinking water in
the urban area, are as in Table 18.
− Meat, milk and egg products contaminated
by dioxin in 1992;

Table 16:
The Workload of Environmental Health Officer and Assistant Environmental Health Officer from Year 2017 - 2019

Infectious Diseases 2017 Number of Cases 2019
2018

Food Poisoning 13,686 15,023 16,584

Dengue 83,443 80,210 129,576

Hand Foot and Mouth Diseases (HFMD) 29,359 76,446 52,176
HIV 3,347 3,293 3,564

Leptospirosis 4,365 5,056 5,216

Tuberculosis 26,168 25,837 26,352

Table 17: Enforcement Activities Conducted under Public Health Acts from Year 2017 - 2019

2017 2018 2019

Disease Destruction Bearing Insects Acts (DDBIA) 1975

Number of premises inspected 4,623,927 4,688,302 4,877,369

Number of Compounds 24,450 21,370 24,869

Number of premises closed under DDBIA 1975 196 120 117

Number of investigation papers registered in 1,867 2,599 2,665
court

Control of Tobacco Product Regulation 2004

Number of Compounds 23,571 25,834 29,819

Food Act 1983 and its regulations

Number of premises inspected 131,404 126,896 130,894
Number of food samples 31,289 29,809 30,268
Number of premises closed under Food Act
1983 2,184 2,302 2,644

Number of Compounds 9,701 12,183 23,064

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 141

Table 18: Activities Related to Sanitation System, Water Supply and Water Treatment

Activities 2017 2018 2019

Water supply system in the rural area 941 128 255

Sanitation system (sanitary toilet, SPAL, 191 1,343 1,213
SPSP)

Water Samples (raw water & treated 189,342 190,981 195,320
water)

ENVIRONMENTAL HEALTH Research/ Innovation/ Publication/ Presentation > Sistem Mencuci Pinggan Mangkuk Premis
Development of Standard Operating Procedure Makanan Kerian (SIMPAK) won gold
(SOP) of Enforcement under Public Health Act medal in 1998 during International
and regulations in Malaysia Innovation Competition at Geneva.
EHO and AEHO successfully developed SOP
for enforcement under the public health act in Training
2007. There are 20 SOPs on the investigation, Master’s Degrees : 39 officers.
enforcement and prosecution procedures for the Post Basic Training: 160 officers.
Prevention and Control of Infectious Disease Act Trained and appointed by the Deputy Public
1988 (Act 342), the Destruction of Disease Prosecutor as prosecution officers for public
Bearing Insects Act 1975 (Act 154), and the health act in Malaysia: 246 officers
Control of Tobacco Product Regulations 2004. > Headquarters Putrajaya: 2 prosecution
Research: Career Satisfaction among EHO and officers.
AEHO at Ministry of Health (2015) > State health departments: 36 prosecution
The research was supported by a grant officers.
(RM10,000) under the National Institute of Health > District health offices: 208 prosecution officers.
(NIH). In conjunction with that, a document on job
scopes of EHO and AEHO at MOH was Competent personnel certified by Australia
endorsed by the Public Health Development Fumigation Accreditation Scheme (AFAS): four
Division, MOH, as a reference and guidance for (4) officers.
EHO and AEHO in Malaysia. Trained auditors for Fumigation Audit: 46
Development of Module to Evaluate the officers.
Competency of Audit Officers for Fumigation
Activities Recognition/ Achievements
A module to evaluate the competency of audit Development of International Federation of
officers for fumigation activities was developed Environmental Health (IFEH)
by EHO and AEHO profession. Currently, 46 EHO and AEHO in Malaysia, represented by the
EHO and AEHO appointed as competent Malaysia Association of Environmental Health
fumigation auditors as per the Australian (MAEH), collaborated with other environmental
Fumigation Accreditation Scheme (AFAS) and health organisations from other countries to
Hydrogen Cyanide (Fumigation) Act 1953 establish the International Federation of
requirements. Environmental Health (IFEH). IFEH is an
Innovation: Projects Won at International Level international professional body in environmental
> Sistem Perlimbahan Air Kerian (SPAK) won a health, membered by 45 countries. The meeting
silver medal in 1996 during International for the development of IFEH was held in Sydney,
Innovation Competition in Geneva. Australia, in 1982. Ex-President of MAEH, YM
> System Pelupusan Sampah Kerian (SPSK) Hj. Ungku Abu Bakar Bin Abdul Rahman was
won a silver medal in 1996 during selected to be the 4th president of IFEH during
International Innovation Competition in the World Congress of Environmental Health in
Geneva. 1994 at Putra World Trade Centre, Kuala
Lumpur.

142 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Commemoration of World Environmental Health been given authority to implement Act 342, ENVIRONMENTAL HEALTH
Day (WEHD) in Malaysia including police officers, RELA, JKR and other
In 2016, the Minister of Health, announced and agencies.
commemorated WEHD will be celebrated annually > Conduct investigation on COVID-19 positive
on 26 September in Malaysia to appreciate all EH
practitioners. cases and person under investigation (PUI).
Formulation of Standard for EH Programme – > Conduct contact tracing for positive patient
Malaysia Qualification Accreditation (MQA)
President of EHO and AEHO profession was cases.
appointed by MQA as one of the panels for > Conduct screening of travellers at entry
Reviewing the Standard Programme: Health
Science and Medical, subfield Environmental points.
Health in 2005. The standard programme > Serve quarantine order, monitoring and
includes both diploma and bachelor’s degree
levels in environmental health. surveillance of persons under quarantine.
Publication: Career of EHO and AEHO in > Supervise disinfection of premises.
Malaysia > Monitor and handle dead bodies of
A book guiding on career development for EHO
and AEHO was published in 2014. COVID-19 cases.
Others > Conduct mass sampling for COVID-19.
Involvement in Control of COVID-19 Outbreak in > Monitor and enforce Act 342 and the SOP of
Malaysia
EHO and AEHO play essential roles and Movement Control Orders (MCO).
contributed towards the control and prevention
of COVID-19 in Malaysia. EHO and AEHO not Issues and Challenges
only functioned as frontliners but are also
involved in the drafting of policies, amendment Human Resource Capability and Competency
of Prevention and Control of Infectious Disease Multitasking of Job Scopes for EHO and AEHO
Act 1988 (Act 342) and in developing related EHO and AEHO are involved in multidisciplinary
legislation as below: fields (as listed in the function) and require
> Prevention and Control of Infectious Diseases multitasking skills to ensure the officers are
competent in delivering service to the public. In
(Declaration of Infected Local Areas). addition, the nature of work of EHO and AEHO
> Regulations on Prevention and Control of is complex and requires specific technical skills
and exposure in the field.
Infectious Diseases (Measures within Competency of EHO and AEHO
Infected Local Areas). The officer's placement in a particular unit or
> Prevention and Control of Infectious Diseases department for an extended period may lead to
(Compounding of Offences). less exposure or experience in other fields or
> Prevention and Control of Infectious Diseases units. For example, suppose an officer works in
(Amendment of First Schedule) 2020. Disease Control Unit for too long without
rotation to any other unit. In that case, it may
The Head of EHO and AEHO Profession is also cause a lack of exposure in different fields such
actively involved in meetings and discussions as the Food and Safety Unit or Inspectorate &
with Majlis Keselamatan Negara, Legislation Unit.
Attorney-General Chamber, Legal Advisors, and Due to the needs of placement in various units
many other agencies on technical aspects or departments, officers with specific
regarding the enforcement of Act 342. Head of competency, qualification or post fundamental
Profession assists in advising the minister may not be placed following their expertise or
regarding requirements for the appointment of skill set. Consequently, their expertise is not
authorised officers to enforce Act 342. During applied to their daily work. Therefore, it is a
the COVID-19 outbreak, several agencies have wastage of knowledge for the government if it is
not fully utilised.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 143

ENVIRONMENTAL HEALTH Adequacy and Optimisation of Health Way Forward
Resources
The ‘10 Essential Public Health Services’,
Norm for EHO and AEHO vs Policy/ Workload Centre for Disease Control and Prevention
Currently, there is no specific norm to estimate One of the ‘10 Essential Public Health Services’
the required number of posts for EHO and frameworks under the Centre for Disease Control
AEHO in Malaysia. Therefore, it is not easy to and Prevention has highlighted enforcement of
evaluate and optimise the human resource for laws and regulations that protect health and safety.
EHO and AEHO in Malaysia. This strategic plan is developed to support the ‘10
Technology Usage for Work Procedures Essential Public Health Services’.
Some work procedures still use the manual National Community Policy, 2018
method, not the latest technology practices The implementation of the National Community
currently. For example, compound and notice Policy focuses on eight (8) primary areas or
are given manually during enforcement clusters. One of the areas or clusters is health,
activities, which is less efficient and may lead to environment, and cleanliness. Communities must
human error. prioritise healthcare, starting with themselves and
their families and the community at large. This
Strengthen/ Enhance Career Pathway includes ensuring that housing areas are clean
EH services in the private sector need to be and free from diseases and epidemic threats
introduced and enhanced. In the private sector, supported by this strategic plan.
EH related activities are being conducted by those WHO Framework Convention on Tobacco
in the occupational health and safety field. Control (WHO FCTC)
Lack of Collaboration Intra/ Interagency/ The strategic plan parallels with the WHO
Community Framework Convention on Tobacco Control (WHO
FCTC) strategy to protect everyone from tobacco
Roles of EHO and AEHO at other agencies smoke exposure. Therefore, each party shall
Currently, EHO and AEHO are allocated under adopt and implement in areas of existing national
the Ministry of Health and Ministry of Housing jurisdiction as determined by federal law. Besides,
and Local Authority (cadre post). However, actively promote the adoption and implementation
certain agencies require the technical skills and of effective legislative, executive, administrative,
input of EHO and AEHO in their work and other initiatives to protect the public from
procedures. Therefore, it is essential to create a tobacco smoke exposure in indoor workplaces,
post and expand the role, capacity, and public transportation, and other public places at
placement of EHO and AEHO to other agencies different jurisdictional levels. Thus, governments
requiring these technical skills. reduce the heavy burden of disease and death
attributable to tobacco use or exposure by
Increasing Disease Burden and Change of implementing this measure.
Demography
The increasing trend of infectious diseases, MPOWER 2008 WHO publication with six key
including the latest COVID-19 pandemic, affecting strategies on Tobacco Control
Malaysia and countries worldwide contributes to the The strategic plan encompasses protecting
high burden and workloads for EHO and AEHO. In people from tobacco smoke and enforcement on
addition, rapid urbanisation in Malaysia also posed a tobacco advertisement and packaging, parallel
significant challenge for environmental health with MPower 2008 WHO publication, with six (6)
services in Malaysia. According to the Department key strategies on Tobacco Control.
of Statistics Malaysia in 2019, 76.2 per cent of Philosophy
Malaysians live in urban areas. However, the EHO & AEHO focusses on these philosophies in
environmental health delivery system might not be future planning:
able to cope with the rate of urbanisation in
Malaysia. Specialty in the EH field by developing a Subject
Matter Expert (SME) on related areas.

144 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Strengthened human resources of EHO & Collaborated with MQA in advising and
AEHO reviewing Standard Programme for Health
Science and Medical, subfield Environmental
Produce norm/ standard of EHO and AEHO Health.
numbers with workloads or population in
Malaysia to estimate burden and workload. For > Existing Issues That Have Not Been Solved -
example, the International Federation of Reform
Environmental Health (IFEH) has proposed a Norm/ standard of EHO and AEHO numbers
norm; 1 officer to 3,000 population for EH with workloads or population in Malaysia to
services. Therefore, a norm/ standard need to estimate burden and plan human resources
be established in Malaysia for appropriate for EH.
planning of human resources. Speciality in EH - Subject Matter Expert
(SME).
Extend roles of EHO Lack of technology usage in daily work
procedures, such as issuing compound/
Strategic Planning of MOH for 12th Malaysia summon manually instead of using electronic ENVIRONMENTAL HEALTH
Plan emphasises networking outside MOH to devices that other agencies widely use.
increase access to quality healthcare services
by expanding the roles of EHO in other > New Issues - New Strategies
agencies and private sectors. Extend roles of EHO to other agencies and
Principles private sectors.
> Current Achievements - Sustain / Maintain

Specialised trained officers as: public
- Prosecution officers for the

health-related act.

- A competent person certified by Australia
Fumigation Accreditation Scheme
(AFAS).

- Trained auditors for fumigation audits.

Conclusion : In conclusion, the proposed strategies are essential in
developing the new high skilled AEHO and Subject Matter Experts among
EHO. It is also vital to ensure that the work procedures will be more efficient
with using the latest technology methods and extending the roles of EHO and
AEHO to other agencies.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 145

Detailed Implementation Plan for Environmental Health

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.

ENVIRONMENTAL HEALTH (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 conduct technical meetings Number of technical meetings 5 by 2025
with participation from inter and
intra-agency in developing
policies related to
environmental health

1. Strengthen inter and intra- To develop collaborative Number of programmes or activities 5 by 2025
agency collaboration in programmes and activities with
environmental health field other agencies, e.g.,
conference, CME, integrated
operation

To develop job descriptions for Number of agencies involved 5 by 2025
EHO in related agencies (State Secretary, Ministry
of Education,
Environmental
Department, Ministry of
Women, Family &
Community Development,
and Department of
Occupational Safety &
Health)

146 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
Main Implementation Plan No. 30: To advance clinical competencies of in-service medical personnel

Profession Activity Indicator Target
Implementation Plan

2. Produce highly skilled AEHO To provide training for AEHO in Percentage of AEHO trained in post 70% of AEHO U29/U32/
by establishment and highly skilled environmental basic in highly skilled field in U36 by 2025
empowerment of health field environmental health ACP for AEHO
competency training and To develop advanced ACP for AEHO developed developed by 2023
exposures in related areas competency programme Number of AEHO trained in ACP 12 AEHO by 2025
(ACP) for AEHO

Main Implementation Plan No. 33: To improve career pathway for medical personnel

Profession Activity Indicator Target
Implementation Plan
ENVIRONMENTAL HEALTH
To deploy EHO according to the Number of EHO deployed according
need of environmental health to the need of environmental health 25 by 2025
specialised fields specialised fields
3. Recognition of EHO in
environmental health To develop environmental Percentage of EHO appointed as At least 1 SME
specialised fields health specialised field for SME recognised per year
career pathway as Subject
Matter Expert (SME) for EHO

(C) Allied Health Sciences Division - Profession Environmental Health

Profession Activity Indicator Target
Implementation Plan
100% of officers (AEHO
1. Optimising resource To implement placement of Percentage of officers involved in U29 & U32) by 2025
management (human AEHO by rotation in different rotation 1 per year
resource) units for exposure of job 1 by 2025
scopes

2. Develop norm of workloads To Produce WISN report for Number of WISN report produced
for AEHO/ EHO in Malaysia AEHO/ EHO Number of research produced
To conduct research on
workload of AEHO/ EHO

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 147

148 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

FOODSERVICE
(HEALTHCARE)

FOODSERVICE (HEALTHCARE)

150 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Background Workforce

The appointment of the foodservice assistant Year Year
began when Ministry of Health (MOH) identified
the need for qualified and specialised staff to lead 1979 2020
the management of patients’ food services. Before HOSPITAL 350
the establishment of the profession of foodservice 11HOSPITAL / 27INSTITUTION
officers (healthcare) and foodservice assistant
(healthcare) in 1953, the foodservice in hospitals INSTITUTION Total : 377
was handled by medical assistant and
subsequently taken over by the hostel supervisor Total : 11
(Penyelia Asrama).
In May 1979, MOH established the role of FOODSERVICE (HEALTHCARE)
foodservice officer, looking at the relatively
technical aspects of the task, rules, and
guidelines. In the 1980s, MOH formed an
intelligent partnership with the Universiti Teknologi
MARA (UiTM). Graduates with Diploma in
Institutions and Catering Management are trained
to be the qualified human capital leading the
Foodservice Department in MOH hospitals.
Thirty years later, the foodservice officer
(healthcare) position with grades C41, C44, C48,
C52 and C54 were then created. The first food
service officer (healthcare) appointed was at
Hospital Kuala Lumpur in 2011, followed by
converting two (2) hostel managers from INTAN &
INSTUN to the same profession and posted in
MOH. Out of the remaining 18 positions filled in
September 2012, 11 staff members were
promoted by appointment (Kenaikan Pangkat
Secara Lantikan, KPSL), and seven (7) of them
are by the new appointment. Thus, 33 positions of
foodservice officer (healthcare) are allocated in all
major specialists and several minor specialist
hospitals in MOH.
Foodservice assistant (healthcare) was created
before the job of foodservice officer (healthcare).
In 1988, the first foodservice assistant (healthcare)
was allocated at the university hospital: Pusat
Perubatan Universiti Malaya (PPUM). A
foodservice assistant (healthcare) position began
as a hostel supervisor with diploma graduates
qualification. A total of 394 foodservice assistant
(healthcare) posts from various grades of C29,
C32, and C38 throughout the MOH hospitals have
been filled while C40 grade has yet to be formed.

In 1991, under the New Remuneration System (Sistem Saraan Baru, SSB), appointment grades were
changed to C5 and C6 with the title foodservice assistant. Later on, under the Malaysia Remuneration
System (Sistem Saraan Malaysia, SSM) in 2002, the appointment grades changed to C27, C32 and C38.
In 2009, Pekeliling Bilangan 8 Tahun 2009 was created for the post of foodservice officer (healthcare)
grade C41, C44, C48, C52 and C54. According to the Pekeliling Perkhidmatan Bilangan 1 2016, 376
qualified assistant cooks grade N19 with diploma qualification were upgraded to foodservice assistant
grade C29.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 151

Introduction Performance and Achievements

Foodservice management at the MOH hospitals is Enhancement of Service Delivery
operated either in-house or outsourced. The At present, only 12 hospitals (in Peninsular
service provides meals to all in-patients, day care Malaysia and Sarawak) outsourced the
patients, mother accompanying child (MAC) and foodservice, while the other hospitals are
other qualified healthcare staff based on the operated in-house (Table 19).
nutritional needs. Table 19: Number of Hospitals with
Foodservice officers and foodservice assistants In-House and Outsource Foodservice
ensure the food provided is balanced, healthy, and No. of Hospitals with No. of Hospitals with
palatable to support the recovery of the patients.
The meals served are according to medical In-House Food Service Outsource Food Service
conditions, age groups, religious and ethnic 133 12
needs.
Department Quality Performance (Foodservice
Functions Section) shows in Table 20.
Workload/ Census
Foodservice officers (healthcare) are responsible Total number of diets served to patients and
for managing and providing services according to healthcare providers in 144 hospitals/ institutions
customer needs and diet requirements in (132 in-house hospitals and 12 outsource
compliance with the principles of the Food Safety hospitals) as shown in Table 21 and Table 22.
and Quality Assurance Programme, including
ensuring that the optimisation of the use of budget
without compromising the dietary needs of
customers with the supervisory and monitoring
assistance from foodservice assistant
(healthcare).

Table 20 : Key Performance Indicator for Foodservice at In-House and Outsource Hospitals

No. Key Performance Indicator In-house Hospital Outsource Hospital
for Food Service
FOODSERVICE (HEALTHCARE) 2016 2017 2018 2016 2017 2018

Patient Satisfaction Level with 96.6 96.5 No. of Hospitals with
1. Quality of Foodservice Provided 96.8 Outso8u5r.c4e Food7S9e.9rvice 83.6

to Patients in MOH Hospital
(Std: ≥ 85%)

Physical Food Contamination 8 17 14 7 84
2. (Hazards) Served to Patient - - 97.2 - - 96.9

(Std: Sentinel Event)

3. Percentage of Accuracy of Meal
Served to Patients As Per Order
In Ward (Std: ≥ 85%)

Table 21: The Number of Diets Served at In-House Hospitals in Year 2016 - 2018

Types of Meal (In-House) 2016 2017 2018

Normal (K1, K2, K3) 8,291,029 7,251,996

Therapeutic 18,817,922 3,967,291 4,201,304
Nourishing Fluid NA 309,930

Medical Eligible Staff 1,412,365 1,426,068

Total 18,817,922 13,670,685 13,189,298

152 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Table 22: The Number of Diets Served at Outsource Hospitals in Year 2016 - 2018

Types of Meal (Outsource) 2016 2017 2018

Normal (K1, K2, K3) 6,787,724 3,890,478

Therapeutic 10,877,528 2,119,722 2,536,135
Nourishing Fluid 56,243 46,128

Medical Eligible Staff 622,044 582,152

Total 10,877,528 9,585,733 7,054,893

Research/ Innovation/ Publication/ Presentation Proses Pengendalian Sumber Sisa Buangan
Innovations Sayur Dan Buah Serta Sisa Makanan Dari Wad
Kepada Penyediaan Baja Organik di Hospital
Pertandingan Inovasi: Buku Pesanan Diet, Tuaran, Sabah (2019).
Hospital Balik Pulau (2018).
Training
Knowing Diet as Simple as ABC (2019). Table 23 shows the number of foodservice officers
and foodservice assistants with their educational
e-PaFs Diet (Maklumbalas Kepuasan background.
Pelanggan Terhadap Diet yang Disediakan) Recognition/ Achievements
(2018). Table 24 is the type of certification and number of
hospitals on Food Safety Management System
Improvement of diet order in Hospital Lahad (FSMS) recognition.
Datu (2019).

EASY-CO in Hospital Queen Elizabeth, Sabah
(2018).

Table 23: Education Background of Foodservice Officers and Foodservice Assistants

Designation and Grade PhD Master’s Bachelor’s Other Diploma FOODSERVICE (HEALTHCARE)
NA 8 Degree in Bachelor’s 29
Foodservice Officer NA Foodservice 380
(Healthcare) (Grade C41) Degree
Foodservice Assistants
(Healthcare) (Grade C29-C38) 33 NA

NA 59 11

Table 24: Recognition on Food Safety Issues and Challenges
Management System (FSMS)
Strengthen/ Enhance Service Provision
Certification Number of Hospitals The needs to increase supervisory staff for
monitoring activities.
GMP Certification 136 The needs to comply with Malaysian Standard
HACCP Certification 130 (MS1480:2019) Food Safety According to
55 Hazard Analysis and Critical Control Point
Halal Certification (HACCP) system (Second Revision).

The needs to implement standardised menu
and recipe within MOH cluster hospitals to avoid
food wastage.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 153

FOODSERVICE (HEALTHCARE) The needs to improve on online/ manual food Lack of Collaboration Intra/Interagency/
ordering system to reduce incorrect diet order Community
served and food wastage. Currently, there are only 33 posts for foodservice
The needs to implement centralised food contracts officers (healthcare) in MOH hospitals. In line with
among clusters hospital to reduce government the aspirations of the Medical Programme MOH,
expenditure. the management of Hospital Food Services will be
implemented according to the cluster system.
Adequacy and Optimisation of Health Resources Therefore, a sufficient number of officers are
Infrastructure, Equipment, and Kitchen Facility needed to ensure the administration and
> Limited budget to replace obsolete kitchen management of Food Service are implemented
equipment, buy new kitchen equipment and more smoothly and effectively to better patient
renovate old kitchen facility. care.
> Most of the kitchen equipment is outdated
and obsolete due to prolonged/ continual Way Forward
usage.
Procurement Philosophy
> Non-centralised of food supply contracts Strengthen and to further improve current food
within MOH facilities. services delivery in hospitals via optimisation of
> Food suppliers are unable to deliver food resources and outcome-informed evidence-based
items according to contract specifications and practice.
for outsourcing hospitals, foodservice The management of food service in hospitals
contract appointed suppliers are unable to adheres to the vision of MOH and is committed to
sustain their service performance. provide and deliver quality health service to the
> Service disruption is caused by the inability people. The planning and expansion of this
of the food supplier to supply raw material/ service are aligned to Sustainable Development
service per order. Goal 3, which ensures healthy lives and promotes
> Lack of competent food supplier company for well-being for all ages. The profession focuses on
hospital food service. reforming resource management, which involves
human resources and facilities to achieve the
Human Resource above objectives.
> Shortage of staff despite an increasing This profession also hopes to improve the food
service system and minimise government
number of workload and demand. spending while still providing the best available
> Imbalance distribution of staff in MOH service to the people.
Next, the profession aims to foster public-private
facilities. partnerships through collaboration with the
> Increased health problems due to workload community in health promotion, awareness, and
disease prevention.
and demands. Principles
Strengthen/ Enhance Career Pathway > Current Achievements – Sustain/ Maintain

Limited number of foodservice officers Quality Assurance System
specialise in specific areas of practice and yet to All hospitals in Malaysia have received
have Subject Matter Expert (SME) appointed. quality certification in certificates such as
Limited post of foodservice officer in MOH GMP, HACCP and Halal (Table 25). This
hospital. achievement demonstrates that the services
Limited Training Opportunity provided have met the standards set by the
Inadequate allocation for the training of staff. Department of Standards Malaysia (Standard
of Malaysia Act 1996 - Act 549) and SIRIM
Berhad.

154 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Table 25: The Number of Hospitals that have > New Issues – New Strategies through cluster
Received Quality Certification Strengthening services
hospital management
No. Quality Assurance In-house Outsource
System Hospital Hospital Implementation of food service
9 management within cluster hospitals.
Good Manufacturing 127 7
1. Practice (GMP) 123 0 Governance on food service department in
55 cluster hospital.
Hazard Analysis
2. Criticalof Control Expansion of MOH Hospital Food Service
outsourcing policy
Point (HACCP)
Expansion of outsourcing policies to new
3. Halal and existing hospitals that have been
upgraded regardless of the number of beds.
* Total In-house hospital : 133
Total Outsource hospital : 12

> Existing Issues That Have Not Been Solved - Improving the quality of food service through
Reform effective monitoring
Establish human resource mapping.
Establish standard contract documents for Developing Audit Guidelines on
food supply and service. Foodservice Management (Healthcare) in
Establish standard menu and recipe in MOH MOH facilities.
hospital.
Establish standard of food ordering (ICT)
systems.
Upgrade and maintain assets and kitchen
equipment.

Conclusion : The foodservice officers (healthcare) and foodservice assistants FOODSERVICE (HEALTHCARE)
(healthcare) strive to perform an efficient and effective foodservice delivery
system under the strategic service plan. Through this strategic plan and
stakeholders’ support, it is hoped that the service delivery and career
development for foodservice officers (healthcare) and foodservice assistants
(healthcare) can be enhanced and expanded.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 155

Detailed Implementation Plan for Foodservice (Healthcare)

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

FOODSERVICE (HEALTHCARE) 1. Optimising resources in To implement hospital food Number of clusters implemented 5 clusters by 2025
foodservice within cluster services management in food service management
hospitals clusters by phases

2. Enhancing food service To enhance online food Number of hospitals using bed 6 hospitals by 2025
ordering system ordering using bed watcher watcher system
system

To implement centralise food Number of cluster hospitals (in- 4 clusters (Selangor,
contract (tender/ quotation) for house foodservice) implementing Melaka, Pahang, Kedah)
in-house foodservice in cluster centralise food contract by 2025
hospitals 4 clusters (Selangor,
Number of cluster hospitals (in- Melaka, Pahang, Kedah)
3. Improving the governance of house foodservice) implementing by 2025
Foodservice Department in To implement uniform menu/ uniform menu/ recipe 10 outsource hospitals by
cluster hospital recipe Number of outsource foodservice 2025
hospitals implementing uniform 10% of posts remapped
To re-map the existing post menu/ recipe (in-house or outsource)
in cluster hospital by phase per year
Percentage of posts remapped in
4 clusters of MOH

156 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Profession Activity Indicator Target
Implementation Plan
To identify kitchen building and Number of upgraded hospital 2 hospital kitchens by
4. Optimisation of hospital infrastructure that need to be kitchen 2025 in Sabah State
kitchen facilities upgraded 2 hospital kitchens by
2025 in Sabah State
To conduct audit on building Number of hospitals audited Number of kitchen assets/
and infrastructure defect in equipment re-mapped per
MOH facilities year

To re-map kitchen assets and Number of kitchen assets/
equipment in cluster hospitals equipment re-mapped

FOODSERVICE (HEALTHCARE)

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 157

(C) Allied Health Sciences Division - Profession Foodservice (Healthcare)

Profession Activity Indicator Target
Implementation Plan

1. Improving service delivery To expand outsourcing policies Number of new/ existing hospitals with 12 hospitals by 2025
via outsourcing to new and existing hospitals outsource foodservice
that have been upgraded
regardless of the number of Audit Guidelines on Foodservice By 2021
beds Management (Healthcare) in MOH
To develop Audit Guidelines facilities developed
on Foodservice Management
(Healthcare) in MOH Facilities

2. Enhance quality and safety To conduct audit on Number of hospitals audited 4 hospitals per year
of foodservice in MOH Foodservice Management (in-house) 2 hospitals per year
facilities (Healthcare) at MOH in-house
food service facility

To audit specification and Number of hospitals audited
contract of food supply in (outsource)
hospitals as well as compliance
on Standard Operating
Procedure (SOP) at outsource
food service MOH facility

FOODSERVICE (HEALTHCARE)

158 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

FOODSERVICE (HEALTHCARE)

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 159

160 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

FORENSIC
SCIENCE

FORENSIC SCIENCE

162 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Background Workforce FORENSIC SCIENCE

Forensic science was founded in 2004 as part of Year 20Ye2ar 0 44
the Ministry of Health’s (MOH) services. This
profession is placed under the National Forensic 2004 HOSPITAL
Medicine Institute (Institut Perubatan Forensik 11HOSPITAL
Negara, IPFN). The first appointment consisted of 1MOH
11 pioneer graduates of the Universiti Sains
Malaysia (USM). Until now, 42 officers have been HEADQUARTER
appointed with grade C48 (two (2) officers), C44
(six (6) officers) and C41 (34 officers). Total : 11 Total : 45
Forensic scientists are responsible for developing
and expanding forensic medicine laboratory
services, assisting in handling medicolegal
specimens, assisting in forensic investigations at
crime scenes, and providing support for grave
(criminal/ welfare) cases. At present, forensic
medicine laboratory offers forensic histopathology,
anthropology, and toxicology analysis services.
Forensic histopathology services are offered at all
forensic medicine laboratories in Malaysia. It
began as early as 2007 to establish the first
Forensic Histopathology Laboratory at Hospital
Sultanah Bahiyah, Alor Setar. It is also becoming
the reference centre for forensic histopathological
analysis in Malaysia. Forensic scientists have
been the backbone of this service by undertaking
medicolegal autopsy specimen processing tasks
for analysis purposes and subsequently ensuring
that the slide quality meets specified standards.
Forensic scientists involved in forensic
anthropological analysis are responsible for bone
marrow processing obtained from the crime scene.
They also assist the autopsy and carry out the
bones’ biological profiling (gender, age, height,
and heredity). IPFN has been the referral centre of
Forensic Anthropological Services since 2002.
The only forensic toxicology laboratory services
operate in the Forensic Medicine Department, in
Hospital Sungai Buloh. Several qualitative and
quantitative analyses are offered, such as the
analysis of alcohol content and solvent in blood
and the analysis of the presence and
concentration of certain types of drugs in
post-mortem samples. Forensic Toxicology
Laboratory, Sungai Buloh is a pioneering project of
Forensic Toxicology Services, MOH. This lab has
been in operation since 2008 using a modified
autopsy room. However, this placement is
temporary until a laboratory equipped with the
requirements for forensic laboratory accreditation
is built.
Overall, the forensic medicine laboratory operated
by forensic scientists is a platform for research in
applied sciences to improve the delivery of
forensic medical services.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 163

FORENSIC SCIENCE Introduction Involve in the crime scene investigation (CSI)
Hospital team in an investigation and on-site
Forensic science is the application of scientific inspection.
knowledge and methodology to a legal and criminal Involve in the process of the grave excavation
investigation. Forensic science encompasses process if required.
many different fields of science, including Involve in the Disaster Victim Identification (DVI).
anthropology, toxicology, histology, biology,
chemistry, engineering, genetics, medicine, Performance and Achievement
pathology, and other science-related fields.
Enhancement of Service Delivery
This professional play an essential role in In the early 2000s, the forensic medicine service
laboratory operations and management. These mainly involves post-mortem examination.
include the retrieval, storage and analysis of However, with the appointment of the forensic
samples/ specimens received from the scientists in the MOH in September 2004, forensic
post-mortem examination. Forensic scientists medicine had expanded to laboratory services.
participate as the medical team to investigate the Workload/ Census
causes of death using multiple disciplines, Five (5) laboratories have been established as of
including toxicology, histopathology, entomology, 2018 to provide the following analysis services:
anthropology, and biology.
Forensic Toxicology and Histopathology
Functions Laboratory in Hospital Sungai Buloh.
Forensic Histopathology Laboratory in Hospital
Forensic scientists are responsible for : Sultanah Bahiyah, Alor Setar.
Receive and take control of the samples/ Forensic Entomology and Histopathology
specimens following the chain of custody’s Laboratory in Hospital Queen Elizabeth, Kota
procedure. Kinabalu.
Conduct screening analysis on samples/ Forensic Histopathology Laboratory in Hospital
specimens according to specified work Umum Sarawak, Kuching.
instructions. Forensic Anthropology and Biology Laboratory in
Conduct the routine or periodic operational and Hospital Tengku Ampuan Afzan, Kuantan.
calibration of the analytical equipment according
to the predefined schedule. Below (Table 26) is the workload managed by
Carry out laboratory internal or external quality forensic scientists for the last three (3) years.
evaluation activities to ensure the quality of the
resulting analysis results.
Issue result of analysis for submission to the
appropriate officer.
Receive, conduct tests and issue results for
clinical samples, if required.

Table 26: The Workload of Forensic Scientists at Five (5) Laboratories in the Year 2016 - 2018

Forensic Histopathology

No. Total slides 2016 2017 2018

1. Routine H&E staining 35,452 22,492 34,545

2. Special stain & immunology stain 1,147 166 3,339

Forensic Toxicology

No. Total slides 2016 2017 2018

1. Blood methanol/ ethanol 214 699 615

2. Urine for drug of abuse 140 637 422

Forensic Entomology

No. Total slides 2016 2017 2018

1. Entomology slides & Speciation Service has not been offered yet 3,344

Forensic Diatom Analysis

No. Total slides 2016 2017 2018

1. Diatom slides 26 54 48

164 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Mass Casualties Management Activities It can also be defined as an event resulting in a FORENSIC SCIENCE
Whenever a disaster involving mass casualties number of victims large enough to disrupt the
occurs, the Disaster Victim Identification (DVI) normal course of emergency and healthcare
team will be activated. The joint team is comprised services (PAHO/WHO 2001).
of forensic specialists, medical officers, forensic The following (Table 27) is a list of mass casualty
scientists, and other relevant personnel. A mass management activities.
casualty incident is defined as an event that
generates more patients at one time than locally Training
available resources can manage using routine The number of forensic scientists with
procedures. It requires exceptional emergency postgraduate programmes is listed below in Table
arrangements and additional or extraordinary 28.
assistance.

(Source: MASS CASUALTY MANAGEMENT SYSTEMS: Strategies and guidelines for
building health sector capacity; Health Action in Crises Injuries and Violence
Prevention 2007).

Table 27: List of Mass Casualty Management Activities

No. Tragedy Year Death
74 death
1. Military conflict & intrusion by the armed group @ Lahad Datu 2013 298 death
162 death
2. Ops DVI MH17 Crash @ The Netherlands 2014 165 death
18 death
3. Ops DVI AirAsia QZ 8501 Crash @ Surabaya, Indonesia 2015
3 remains
4. Ops DVI Wawasan Khas (Mass grave)@ Wang Kelian & Hospital 2015
Sultanah Bahiyah Alor Star, Kedah 32 death

5. Ranau Earthquake @ Sabah 2015 28 death

Ops Gangga: Excavation Team for United States Army Air Forces 2015
6. (USAAF) to search for human remains of the Servicemen of the

USAAF aircraft crash during World War II @ Hutan Simpan Kekal
Bubu, Beruas, Perak

Ops Reunites: Excavation and exhumation of Commonwealth War 2015
7. Graves @ Terendak Garrison, a military camp of the Malaysian 2018

Armed Forces, Melaka

Ops Te Auraki (Excavation and identification of human skeletal
remains of the New Zealand military and their dependants) @
8. Commonwealth War Grave Terendak, Melaka, Taiping, Perak &

Cheras, KL

Table 28 : The Postgraduate Programmes Attended by Forensic Scientists

No. Postgraduate for Forensic scientist Graduated On-going

1. Master of Science 5
− Forensic Science 2
− Chemical Instrumentation 7
− Analytical Chemistry & Instrumentation Analysis 1
− Medical Science 1
− Medical Entomology 1
− Criminal Justice System 1
− Health Science

2. PhD 1
− Science and Technology 1
− Policy & Disaster Management 1
− Anthropometry
− Entomology 1
− Health Science 1

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 165

FORENSIC SCIENCE Recognition/ Achievements Two (2) of the officers have been gazetted as
Letter of Appreciation/ Acknowledgment Chemist by Institut Kimia Malaysia
Op Te Auraki acknowledgement from New
Zealand Under Chemist Act, they are eligible to
Excavation works, forensic analysis, perform analytical chemistry related to
‘reconciliation process’ and ‘identification forensic fields such as toxicology. Although the
board’ in Terendak involved 112 officers from analyses can be performed by other forensic
Malaysian Army Force (ATM), 110 officers scientists as described in Warta Kerajaan
from government agencies and local ‘Akta A1457 Akta Dadah Berbahaya (Pindaan)
universities with 29 officers from New 2014’, the chemist has a good reputation in
Zealand. front of the judges when presenting the
Appreciation letter from Prime Minister after testimony in court.
the MH17 DVI operation Awards
The Malaysian DVI team in Hilversum is made Certificate of recognition awarded by the
up of officers and members of the MOH, Government of the Netherlands after the MH17
Ministry of Defense Malaysia, the Royal DVI Operation.
Malaysian Police and the Malaysian
Chemistry Department and are deployed Issues and Challenges
gradually to the Dutch Hilversum. As of 17
Sept 2014, 25 members of the Malaysian DVI Strengthen/ Enhance Service Provision
Team in Hilversum have returned home. Forensic Laboratory Facilities
Not all forensic medicine departments have
Recognition laboratory facilities. Only five (5) out of a total
Forensic Medicine Laboratory has been of 14 departments have laboratory facilities
recognised as MOH’s reference laboratory for (Table 29).
Methanol Poisoning since 2013 In this regard, the forensic scientists who work
Approximately 1,000 analyses for clinical and in the department without laboratory facilities
medicolegal samples pertaining to the took the initiative to carry out a laboratory
methanol analysis were performed throughout rotation in the histopathology unit of the
the three (3) incidents of methanol poisoning pathology department. There are also forensic
outbreaks in Malaysia (2013, 2018 and 2019). scientists working in the drug laboratory in the
In addition, the laboratory received samples department of pathology. The officers will carry
from all hospitals and medical centres. out the benchwork according to the schedule
The service offered significantly helps set in the department of pathology. This step is
physicians detect and treat patients with to ensure that the professional development of
symptoms of methanol poisoning at an earlier the officers is not left behind.
phase, helping them anticipate the later Uniformity of Standard Operating Procedure (SOP)
stages of the poisoning process. for Routine Procedure among Forensic Laboratories
There is no SOP for routine procedures
among forensic laboratories to be carried out
correctly and consistently in the same manner.

Table 29: List of Hospitals with and without Forensic Laboratory Facilities

Hospitals with Forensic Laboratory Facilities Hospitals without Forensic Laboratory Facilities

1. Hospital Sungai Buloh 1. Hospital Pulau Pinang
2. Hospital Sultanah Bahiyah, Alor Setar 2. Hospital Raja Permaisuri Bainun, Ipoh
3. Hospital Queen Elizabeth, Kota Kinabalu 3. Hospital Tg. Ampuan Rahimah, Klang
4. Hospital Umum Sarawak, Kuching 4. Hospital Tuanku Ja'afar, Seremban
5. Hospital Tengku Ampuan Afzan, Kuantan 5. Hospital Sultanah Aminah, Johor Bahru
6. Hospital Raja Perempuan Zainab II, Kota Bharu
7. Hospital Kuala Lumpur
8. Hospital Melaka
9. Hospital Serdang

166 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Accreditation of Forensic Laboratory − Forensic Histopathology and Toxicology FORENSIC SCIENCE
None of the forensic laboratories has been Laboratories in Hospital Sungai Buloh.
accredited by any recognised or accreditation
body. − Forensic Histopathology Laboratory in
Hospital Sultanah Bahiyah, Alor Setar.
Adequacy and Optimisation of Health
Resources − Forensic Histopathology and Entomology
Laboratories in Hospital Queen Elizabeth,
Budgets for forensic science laboratories have Kota Kinabalu.
always been limited, but the pressure to do
more with less has been overgrowing for − Forensic Histopathology Laboratory in
laboratories worldwide. As a result, the Hospital Umum Sarawak, Kuching.
laboratories are expected to provide the
services at the lowest possible cost. − Forensic Histopathology, Anthropology and
The laboratories are struggling to replace Biology (Diatom Analysis) Laboratories in
outdated machines and cannot afford new Hospital Tengku Ampuan Afzan, Kuantan.
equipment because there are insufficient funds
to replace them. Forensic Medicine Laboratory is recognised
The current infrastructure needs are not in line as MOH’s reference laboratory for methanol
with the development of services and human poisoning since 2013.
resources.
The lack of space for laboratory facilities and Existing Issues That Have Not Been Solved -
equipment as well as financial constraints Reform
resulted in no laboratory development in the
department despite having sufficient staff to Human resource issues
carry out the laboratory functions. − Increasing workload compared to the number
Strengthen/ Enhance Career Pathway
No proper structured competency module for of officers working in a laboratory. There are
staff. not enough officers working in the Forensic
Need for recognition of competency by a Laboratory in Hospital Sultanah Bahiyah and
professional body that signifies the commitment Hospital Sungai Buloh. The insufficiency is
to provide quality services. based on WISN.
− Reform: Attachment of staff at the Forensic
Way Forward Laboratory in Hospital Sungai Buloh.

Philosophy Facilities issues
Forensic scientists are committed to adhering to − Currently, there are only five (5) forensic
the 12th Malaysia Plan of the MOH’s strategy to
strengthen healthcare services delivery in laboratories under MOH and nine (9)
hospitals. Thus, forensic scientists’ responsibility is departments without laboratories
to ensure that only accepted and well-established − To reform, set up the attachment of
methods are being used for forensic analysis. forensic scientists at pathology laboratory
Furthermore, to deliver the best quality services to in hospitals without forensic laboratory.
the clients, every laboratory must upgrade and New Issues - New Strategies
update all its sections to the latest advancements The validity of the toxicological results
in the field. The professionals also must undergo produced by the forensic scientists in the court
continuous training in their respective of law
specialisations. − New strategies - Strengthening and
Principles reforming current laboratories through
quality management systems or
Current Achievement - Sustain/ Maintain accreditation.
The Forensic Medicine Laboratories under Establishment of grade C48 to C54 in the
MOH are as follows: forensic laboratory
− New strategies - Strengthening and
reforming the job scope and description of
the grade C48 and C54 in the forensic
laboratory.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 167

FORENSIC SCIENCE Conclusion : Forensic scientists are committed to aligning our forensic
laboratory services in MOH to support the organisation. This strategic plan will
serve as a blueprint for optimising the resources and services, developing
competency among forensic scientists, and monitoring and evaluating the
forensic laboratory services for continuous improvement.

168 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Detailed Implementation Plan for Forensic Science FORENSIC SCIENCE

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

Strategy 1: Strengthen healthcare service delivery in hospitals
Main Implementation Plan No. 19: To strengthen Forensic Medicine service

Profession Activity Indicator Target
Implementation Plan
Develop paperwork to Paperwork to establish forensic Endorsement of the
1. Strengthen Forensic establish forensic laboratory laboratory services in facilities paperwork by the
Medical Laboratory services in facilities without without forensic medical laboratories National Forensic
Services forensic medical laboratories development Medicine Institute
(Institut Perubatan
Forensik Negara, IPFN)
by 2024

To update medical brief of Document of MBOR for Forensic Endorsement of
requirement (MBOR) for Medical Laboratory updated document by IPFN 2024
Forensic Medical Laboratory
for 6 centres by region

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 169

(B) Medical Framework - Allied Health Sciences Division

FORENSIC SCIENCE Strategy 3: Enhance capacity and capability of human resource for health

Main Implementation Plan No. 30: To advance clinical competencies of in-service medical personne

Profession Activity Indicator Target
Implementation Plan

1. Strengthen competency To consolidate training modules A consolidated training module Training module ready
through structured on forensic anthropology, produced by 2023
competency module histology, entomology, 80% of forensic science
toxicology, and biology officers by 2024

To train forensic science officers Percentage of forensic science
using consolidated training officers trained
modules

(C) Allied Health Sciences Division - Profession Forensic Science

Profession Activity Indicator Target
Implementation Plan
Minimum 5 guidelines
1. Standardising routine To develop guidelines for each Number of guidelines developed completed by 2025
procedures among forensic procedure in Forensic Medical At least 1 by 2025
laboratories Laboratories

2. Accreditation of Forensic To participate in MS ISO Number of Forensics Medical
Medical Laboratory 17025/15189 certification Laboratories participate in MS ISO
programme of Forensic 17025/15189
Medical Laboratory

170 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

FORENSIC SCIENCE

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 171

172 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

HEALTH
EDUCATION

HEALTH EDUCATION

174 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Introduction Scope of practice of Health Education Officers HEALTH EDUCATION
is to:
According to World Health Organization (WHO), a) Develop policies, strategies and programmes
health promotion is a process of enabling people
to increase control over, and to improve, their for improving health;
health. It moves beyond a focus on individual b) Examine the root causes of related health
behaviour towards a wide range of social and
environmental interventions. behaviour through community diagnosis,
According to the Ottawa Charter (1986), health epidemiological analysis and situational
education officers’ scope of practice shifted from synthesis;
addressing traditional determinants of health to c) Prescribe healthy behaviours to prevent illness
more complex health behaviours via primary and sustain healthy living;
health promotion strategies. As a result, Ottawa d) Develop a strategic plan for communication for
Charter selected the three (3) words to describe behavioural modification based on cognitive,
the core activities, which are: a) advocate: to boost affective and psychomotor assessment;
the factors which encourage health; b) enable: e) Develop creative and appealing promotional
allowing all people to achieve health equity; c) and educational campaigns or materials
mediate: through collaboration across all sectors. through any media;
Health education services in Malaysia began in f) Develop intervention programmes to modify
the 1960s by focusing on increasing the risk behaviours towards healthy living;
awareness and skills of the community to prevent g) Develop a partnership with key people in
infectious diseases. The Health Education Unit different agencies, communities and
(Unit Pendidikan Kesihatan, UPK) at Ministry of organisations who can affect or influence
Health (MOH) headquarters developed the public health, and to enable these partnerships
administration structure of health education for better health promotion;
services in the 1980s. h) Advocate and lobby for health promotion
UPK has been upgraded to the Health Education causes;
Division and is placed under the Department of i) Mobilise the community via strategic
Public Health, and uses a health promotion behavioural change communication plan for
strategy based on the Ottawa Charter in line with community empowerment; and
global health promotion. At the same time, the j) Research and evaluate health promotion
Patient Health Education Unit was established. In programmes and activities that stress health
the 2000s, health promotion services were behaviour determinants.
expanded to institutions such as the National
Blood Centre, Respiratory Medicine Institute,
Institutes for Health Systems Research and
National Transplant Resource Centre. In addition,
the Institute for Health Behavioural Research
(Institut Penyelidikan Tingkahlaku Kesihatan,
IPTK) was also established as a health
behavioural research wing to support the health
promotion programme the formation of the
National Health Policy.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 175

Implementation of Health Promotion Programme

Health promotion programmes and activities are carried out at various levels; national, state, district,
hospital and institution. Health promotion programmes and activities involve multiple initiatives:

Table 30 : Health Promotion Programmes and Activities with Various Initiatives

Initiatives Programmes and Activities

HEALTH EDUCATION Information Accessibility and Awareness InfoSihat Portal
Enhancement Initiatives MyHealth Portal
Active Living Initiatives Social Media Platform
Conventional Media
Health Media Awards
Publication of Health Education and Promotion
materials
Active Living Campaign
X-Break
Weight Management Programme (IFitEr)
KospenActiv
National Strategic Plan for Active Living (NASPAL)

Smoke-Free Initiative Quitline
Behaviour Modification Intervention Therapy of Quit
Smoking in Hospital
Speak Out Campaign

Health Promotion in Learning Tunas Doktor Muda
Institutions (HePiLI) Initiatives Doktor Muda (Primary School and Secondary
School)
Program Siswa Sihat (PROSIS)
Health Promoting Institutions (HPI)
Program Ekspresi Anak Remaja Lestari (PEARL)

Risk Communication and Prevention Communicable Diseases
Community Empowerment Communication for Behavioral Impact (COMBI)
Initiatives Community Engagement for WOLBACHIA Project
MyChampions

Healthy Supportive Wellness Hub
Environment Initiatives Wellness on Wheels (WoW)
10,000 Steps Track
Outreach Programme
E-Sihat Complex
Advocacy and Strategic Collaboration

Achievements Active Living Initiatives
The Active Living Campaign aims to raise
Health Literacy Initiatives Malaysians’ awareness of the importance of living
an active lifestyle. It was launched by the Prime
To date, 4,628 materials have been uploaded to Minister of Malaysia, on 3 Nov 2018, in Oval
the Infosihat portal (http://www.infosihat.gov.my). Lawn, Setia City Park, Setia Alam. During the
While in the MyHEALTH portal, 4,741 articles were ceremony, the Prime Minister recommended that
uploaded, 32 games online and received visitors all government and private offices take a short
of 76,899,953 hits. The Division uses social break from work and perform a 15-minute
media, communication channels, and exercise (X-break). As a result of this
conventional media to disseminate health recommendation, X-Break was approved by the
information to the people. The Division has Cabinet to encourage each ministry to implement
accounts on Facebook (96,435 followers), Twitter X-break during working hours, discussions,
(54,205 followers), Instagram (2,075 followers), meetings, workshops and courses.
YouTube (24,235 subscribers) and Telegram
(10,369 subscribers).

176 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

In promoting the active living community, the Health Education Division has successfully trained 320
physical fitness instructors in the community. In addition, the ‘I Fit and Eat Right Programme’ (IFitEr) is a
health intervention to help people who face overweight and obese problems in managing their body weight
(Figure 2).

Figure 2: Achievement of IFitEr Programme for the Year 2017-2020

100 94.6% 90.5% 12.7% 16.3% 15.0% 12.5% A total of 28 Wellness Hubs had HEALTH EDUCATION
82.9% Lose Weight 10% implemented IFitEr programme
in 2020. 505 people had joined
80 IFitEr and 12.5% of the number
63.6% managed to decrease by 10%
from the original weight.
60

40

20

0
Lose Weight

2017 2018 2019 2020

Risk Communication and Community Smoke-Free Initiatives
Empowerment Initiatives Quit Smoking Services in hospitals conducted by
Until 2019, 2,855 Communication for Behavioral Health Education Officers using behaviour
Impact (COMBI) teams were established, modification strategy is based on a Motivational
including 30,958 volunteers throughout Malaysia. Interviewing (MI) and Mental Stimulation
In addition, 7,652 leaders and the COMBI team approach. In 2019, the division had successfully
were trained to educate people about dengue prelaunched the Speakout Campaign to empower
fever prevention. There were 1,972 community Malaysians to voice their rights to inhale the clean
service projects, 2,987 searches and destroy air free from cigarette smoke prudently.
activities, and 161,398 face-to-face
communication events were held. The Division has
also successfully mobilised a dedicated Health
Education Team (PAKAT) for the community
mobilisation to prevent and control infectious
diseases.

Figure 3: The Performance of the Quit Smoking Clinic for Six (6) Years in a Row

6000 54.30% 54.30% 60.00%
5000 50.00%
4000 51.0% 40.00%
3000 30.00%
40.00% 45.10% 5015

4021 4043 39.00% 5093

3150

2000 1284 1589 2327 2115 20.00%
501 717 1292 552
1000 1124 702 285 1010 10.00%
450

0 2016 2017 2018 2019 2020 0.00%
2015

No. of Clients Set Quit Smoking Date Successfully Quit Smoking % Success

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 177

HEALTH EDUCATION Health Promotion in Learning Institutions Initiative
Health promotion in Learning Institutions Initiative or HePiLI covers from pre-school children to the
institutions of higher learning. The HePiLI programme activity incorporates the four (4) main components
of a healthy lifestyle, i.e. active life, healthy eating, non-smoking and healthy mind.

1,778 TABIKA KEMAS
1,036 Pre Schools (KPM)

61,280 cumulative members of Tunas Doktor Muda

Doktor Muda of Primary School
Number of schools: 3,482 (44.8%)
91,321 cumulative members of Doktor Muda

Doktor Muda of Secondary School
Number of schools: 816 (33.5%)
29,633 cumulative members of Doktor Muda

Doktor Muda of Orang Asli School
Number of schools: 38
665 cumulative members of Doktor Muda

Doktor Muda of Special Integrated Education
Programme

Number of schools: 36
559 cumulative members of Doktor Muda

Institutes of Higher Education (IPT) joined PROSIS
Number of IPT: 80
3,499 cumulative members of PROSIS

Healthy Supportive Environment Initiatives
The Community Health Promotion Centre, now known as the Wellness Hub (WH), offers care services
such as risk screening on a healthy lifestyle, healthy lifestyle consultancy, intervention, and outreach
activity. 28 WH centres were established throughout the country and received 54,008 attendances during
the year 2020 across the country.

Figure 4: Number of Customer Presence at Wellness Hub in Year 2020

10,157

43,851

Repeat customer New customer

178 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Figure 5: The Distribution of Wellness Hub in Malaysia

Issues & Challenges Considering the complexities of behaviour and HEALTH EDUCATION
increasingly challenging health determinants,
The burden of non-communicable diseases this requires an extension of the scope of health
(NCD) is increasing. Factors that influence the promotion beyond public health.
increase in the prevalence of these diseases Malaysia’s population is expected to double to
are unhealthy health behaviours such as 14.5 per cent by 2040, while the productive
inactivity, unhealthy nutrition and smoking. population is expected to fall from 69.3 to 66.9
Therefore, trained technical officers should per cent. The increase in the elderly will result in
implement health promotion programmes and the ratio of dependents increasing more than
interventions more systematically and planned. two-fold from 7.4 to 16.6 per cent. This means
At present, the number of health education that those in the working-age group (15 - 64
officers is 1:128,000, less than 92 per cent of years) must bear the increasing number of old
the supposed average (1:10,000). Health residents.
promotion efforts at the grassroots level have
been hindered by a shortage of qualified health
education officers.
Adequate financial resources are an important
aspect of the implementation of an effective
health promotion programme. However, the
allocation was reduced by 38 per cent from
2016 (RM47 million) to RM18 million in 2019.

Age Age Age
0-14 years 15-64 years 65+ years

2020 23.4% 69.3% 7.2%
2030 68.0% 11.0%
2040 21.2% 66.9% 14.5%
18.6%

Source: DoSM (2016)
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 179

HEALTH EDUCATION The Way Forward

Policies and Strategic Plan
The development of a strategic plan considering health and non-health related strategies, initiatives, and
strategic action plans to be used as a foundation and guide for health promotion, and education
programmes encompass various ministries and agencies. This is consistent with the
Whole-of-Government and Whole-of-Society Approach, as well as the Health in All Policy.

Agenda Nasional Malaysia Sihat (ANMS)
This plan is one of the new deals under the Malaysia National Health Plan for ten (10) years
implementation. The goal is to strengthen nationwide health promotion programmes and community
empowerment for healthy lifestyles. It comprises four (4) Thrusts, 13 Strategic Plans, and 24 Initiatives
to be jointly implemented by various ministries, agencies and private sectors.

180 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Sustainable Development Goal (SDG) HEALTH EDUCATION
Health Promotion in the Sustainability Development Goal 2018 - 2030: Regional Action Plan

Figure 6: Strategic Approaches for Promoting Health through Sustainable Development

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 181

HEALTH EDUCATION The Ottawa Charter for Health PromotionBUILD HEA

LTH PUBLIC POLICY

Shanghai Declaration on Promoting Health in the 2030 Agenda for Sustainable Development

182 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025

Global Action Plan on Physical Activity 2018 - 2030 HEALTH EDUCATION

Strategic Framework

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 183