MEDICAL RECORD
234 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
MEDICAL
SOCIAL WORK
MEDICAL RECORD
MEDICAL SOCIAL WORK
236 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce
In Malaysia, medical social work service was first Year
introduced in 1952, where major hospitals such as
Hospital Kuala Lumpur, hospitals in Penang, 2020
Sabah and Sarawak were selected to provide this
service. Apart from the Ministry of Health (MOH), HOSPITAL 219
Malaysia the service is also available in hospitals 25INSTITUTION
under the Ministry of Higher Education (MOHE) at
Pusat Perubatan Universiti Malaya (PPUM), 19Ye9ar 1 11MOH
Hospital Canselor Tuanku Muhriz UKM (HCTM),
Hospital Universiti Sains Malaysia (HUSM) and 8HOSPITAL HEADQUARTER
Hospital UiTM. The services provided are primarily
in the form of financial and social support. Then Total : 8 2DISTRICT
the service expanded to all state and district
hospitals throughout the country. The medical HEALTH OFFICE
social work service faces increasing challenges
with the rise of social issues in line with the HEALTH 20
country's rapidly expanding development. In CLINIC
accordance with this development, the name of
the medical welfare officer has also been changed Total : 277
to medical social worker (MSW) as outlined in the
Public Service Department (Jabatan MEDICAL SOCIAL WORK
Perkhidmatan Awam, JPA) approval letter no.
JPA(S)253/2/13klt.85(16) dated 13 Nov 2002.
In 2010, medical social work services were
expanded to primary healthcare facilities (health
clinics). As of December 2015, there were 263
MSWs at MOH, and 21 were at the health clinics.
The medical social work is an allied health
profession in MOH and governs by Allied Health
Sciences Division under the clinical group.
Currently, services are available in 43 hospitals
around the country.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 237
MEDICAL SOCIAL WORK Introduction emotional support, and crisis interventions,
including domestic violence cases, unmarried
An MSW is a trained individual in making mothers, child abuse and neglect, sexual crimes,
biopsychosocial assessments and interventions and other related cases, including acute and
on patients, family members/ next of kin or carers chronic patients.
in healthcare services. Meanwhile, practical assistance interventions
The medical social work service offers involving financial assistance (medical
evidence-based practice to individuals, family equipment, medicines, treatment or general
members, and communities. The main concept of service), institutional placement, patient relatives’
this field is to improve and enhance the social identification and helpful aids for acute and
functioning of each individual, family and chronic patients. Meanwhile, the management of
community towards fulfilling better wellbeing. supportive therapy and practical assistance cases
MSWs have been assigned to hospitals, health requires collaborative networking with various
clinics and institutions offering health services medical profession disciplines, government and
based on clients’ current needs. MSW provide non-government agencies, and local communities
healthcare services in various clinical disciplines to obtain the resources needed by the patient.
based on clients’ diagnosis and treatment plans.
MSWs offer services to various medical Performance and Achievements
disciplines. The MSW placed in the public health
setting acts as a joint expert in specific Enhancement of Service Delivery
programmes covering preventive measures Medical social work services are offered for both
against diseases on a larger scale. Thus, the role in-patient and outpatient care as well as other
of MSW shall be aligned with international MOH facilities. MSWs play an active role in
standards if human resource meets the quality and multidisciplinary and interdisciplinary teams and
quantity of the standards. provide more comprehensive and holistic
treatment. Multidisciplinary teams such as
Functions One-Stop Crisis Centre (OSCC), Suspected Child
Abused and Neglect Team (SCAN), stroke
MSW provides biopsychosocial assessments and rehabilitation team, geriatric team and community
interventions to individuals, family and health for mental patients are part of the services
communities in the health services. The that involve MSWs.
biopsychosocial interventions include
psychosocial counselling, case management, Other Involvements:
discharge planning, psychosocial rehabilitation Tabung Bantuan Perubatan (TBP), MOH aims
and education, and networking with relevant to help the less fortunate finance medical
agencies to support the clients’ social functioning treatment costs. Therefore, MSW’s main task
and well-being. MSW collaborates with other is to assist MOH in evaluating all TBP’s
health professionals as part of a multidisciplinary applications regarding patient’s socioeconomic
team in providing services. The primary function of status.
an MSW is to help patients with psychosocial MSW is one of the donor’s advocates for the
problems. Patients are referred by specialists and Independent Donor Advocates Team (IDAT).
medical officers from all clinical departments in the Other members of IDAT are medical donor
hospital. Per MOH’s concept of treatment, this advocates and psychiatrists. In general, the
emphasizes total patient care in physical, mental, role of IDAT is to carefully evaluate the
social, and spiritual aspects. The scope of the prospective living donor and provide him/ her
medical social work service is to provide with the necessary information required to
psychosocial assistance to patients and/ or family make an informed consent. MSW will assess
members. detailed social history, financial status,
education and social support of the potential
This psychosocial assistance involves the donor and recipient. Financial stability is one of
biopsychosocial assessment that needs to be the main criteria to avoid any possible
carried out by MSW on patients and/ or family economic issues before and after the surgery.
members before the supportive therapy and Since 2008, MSW has been involved in the
practical assistance interventions are provided. National Cochlear Implant Programme, MOH
The medical social work intervention process as an elected member of the National Core
focuses on three (3) main processes: casework,
group work, and community work. The supportive
therapy interventions involve consultation,
238 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Committee. MSW’s main task is to conduct the Workload/ Census
biopsychosocial assessment for the selected The number of patients attended has grown since
candidates, evaluate family supports for the the service was first offered. The number of
rehabilitation process and assist patients and patients for the last three (3) years includes
families from low socioeconomic backgrounds. paediatrics and adults with difficulties in social
functioning and required MSWs assistance in
MOH, as in Table 37.
Table 37: The Number of Patients Attended by Medical Social Workers in the Year 2017 - 2019
Year 2017 2018 2019
Number of patients attended by MSWs 116,996 120,877 124,402
Research/ Innovation/ Publication/ Presentation Garis Panduan Laporan Penilaian
Throughout the 11th Malaysia Plan (11MP), MSWs Sosisoekonomi Perkhidmatan Kerja Sosial
have successfully conducted research related to Perubatan, 2017.
the medical social field. Kod Etika Pegawai Kerja Sosial Perubatan.
Innovation Training
The medical social worker had the opportunity to
Sistem Pengurusan Bantuan Pesakit (2020) - expand their training and attachment for 1 (one)
Jawatankuasa Anugerah Inovasi, month in 2017 under the Elderly Healthcare
Kementerian Kesihatan Malaysia (KKM). Programme JPA-JICA, Japan.
> Master’s: 38
Sistem Pendaftaran Perkhidmatan Kerja > PhD: 3 MEDICAL SOCIAL WORK
Sosial Perubatan, HRPB Ipoh Perak (2019) -
Jawatankuasa Anugerah Inovasi Peringkat
Hospital Kluster Negeri Perak.
Audit Klinikal Ke Atas Proses Semakan Recognition/ Achievements
Permohonan Bantuan Bagi Kes yang Dirujuk Sistem Pengurusan Bantuan Pesakit (2020) -
Ke Jabatan Kerja Sosial Perubatan, HRPB, Hadiah Khas Juri, Jawatankuasa Anugerah
Ipoh, Perak (2018) - Kumpulan Audit Inovasi, Kementerian Kesihatan Malaysia (KKM).
Kesihatan Bersekutu. Sistem Pendaftaran Pesakit HBUK (2009) -
Johan Anugerah Inovasi Kategori Pengurusan,
Projek Ziarah Amal, Jabatan Kerja Sosial Pertandingan Inovasi Sempena Hari Kualiti
Perubatan Hospital Seberang Jaya (2016) - Jabatan Kesihatan Negeri Perak.
Jawatankuasa Anugerah Inovasi, Sistem Rekod Kes Pesakit (SRKP), 2008 -
Kementerian Kesihatan Malaysia (KKM). Johan Projek Inovasi, Jabatan Kesihatan Negeri
Pulau Pinang & Tempat ke-3 Projek Inovasi
Sistem Pendaftaran Pesakit HBUK (2009) - Kebangsaan, KKM.
Pertandingan Inovasi Sempena Hari Kualiti
Jabatan Kesihatan Negeri Perak. Issues and Challenges
Sistem Rekod Kes Pesakit (SRKP), 2008 - Strengthen/ Enhance Service Provision
Jabatan Kesihatan Negeri Pulau Pinang. Delay in providing and distributing aids to
patients due to the procedures involved in
Publications - Standard Operating Procedures, retrieving aids from aid provider agencies, such
Code of Ethics, Guidelines as aspects of eligibility, documentation, approval
period, and the number of aids involved.
Pelan Pengurusan Operasi Perkhidmatan The scarcity of institutions for placement of
Kerja Sosial Perubatan, 2018. abandoned, mentally ill patients, the elderly, and
those with infectious diseases drive the delay in
Prosedur Operasi Standard pengurusan
Bantuan Terapi Sokongan, 2018.
Prosedur Operasi Standard pengurusan
Bantuan Praktik, 2018.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 239
MEDICAL RECORD discharging the patients. This has led to an sectors, non-government organisations (NGOs)
increase in hospital beds in use as well as the and community in health promotion, awareness
MEDICAL SOCIAL WORK healthcare costs incurred cost for hospital care. and prevention of medical social work services.
The service offered to patients attending health Plan of Action/ Activities/ Initiatives
clinics hardly gets optimised due to various
factors, including shortage of officers and To strengthen cooperation between various aid
patients’ compliance to health appointments. provider agencies.
Human Resource Capability and Competency
Specialisation area still needs improvement in To strengthen the cooperation with various
collaboration and relationship with the agencies to simplify the relevant procedure and
academicians in the medical social work field, e.g., processing involved in patient’s application.
geriatric social work, mental health social work,
oncology social work, and health social work. To enhance cooperation with various agencies,
Adequacy and Optimisation of Health GO, NGO and the private bodies in providing
Resources placement of abandoned patients, mentally ill,
Lack of various resources in the community to the elderly and infectious disease patients.
fulfil the different needs of patients.
Limitation of human resources in managing case To optimise follow-up task procedures and
comprehensively to optimise patient’s interventions to improve patients’ and families’
functionality. quality of life.
Lack of Collaboration Intra/ Interagency/
Community To enhance collaboration with public and private
To Increase the number of strategic partners of universities, be it locally or internationally, to
GOs and NGOs as well as the private sector to develop a specialised sector of medical social
diversify resources. work.
Way Forward To empower the system of medical social work
services delivery using technology, e.g., Virtual
Philosophy Advisory Service System for patients who
The medical social work adheres to the MOH’s cannot attend an appointment with MSW.
Vision and commitment to provide full access and
deliver quality health service to everyone. This Principles
obligation is aligned with the objectives of MOH, Current Achievements - Sustain/ Maintain
which is to assist an individual in achieving and Family empowerment and resources in the
sustaining as well as maintaining a certain level of community to assist in interventional care.
health status to further facilitate them in leading a
productive lifestyle - economically and socially. Knowledge, skills and competencies of
Above all is to ensure healthy lives and promote MSWs.
wellbeing at all ages. To achieve the stated Existing Issues that have not been solved -
objectives, the profession prioritises resource Reform
management reform, including human resources Human resource in public health: To expand
and facilities. medical social work services in the primary
The profession intends to foster public-private care setting.
partnership through collaboration with the private New Issues - New Strategies
Service accessibility through the virtual
advisory service system.
Conclusion : In the 12th Malaysia Plan, the medical social work services will
strive to achieve the goals based on the strategies outlined. Following the
Ministry of Health Malaysia’s holistic care targets, it is hoped that more patients
would benefit from the social assistance provided by the medical social work.
The initiatives can be accomplished by expanding human capital, financial
resources, community resources and distribution system.
240 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Detailed Implementation Plan for Medical Social Work
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 MEDICAL SOCIAL WORK
Main Implementation Plan No. 26:
To optimise healthcare resources through interagency collaboration in service delivery
Profession Activity Indicator Target
Implementation Plan
To develop a training module Completion of training module Training module
for social workers in managing Number of social workers trained developed by 2023
interventions for stroke patients To initiate a dedicated fund for stroke 20 social workers
patients trained by 2025
1. To strengthen collaboration To train social workers in Completion of TOPP Module Stroke Fund for patient
with various government managing step down care established by 2025
organisation, NGO and services for stroke patients 5 subtopics of TOPP
private agencies to diversify To collaborate with several modules completed by
resources and accelerate agencies to establish a 2025
aid dedicated financial support
system for stroke patients
To develop a Training of
Psychiatric Placement (TOPP)
Module
To implement training of trainers Number of ToT for TOPP Module Minimum 4 ToT for
(ToT) for TOPP Module TOPP Module by 2025
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 241
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
MEDICAL RECORD 2. Enhance Medical Social To employ new post or contract Total numbers of MSW in hospital 106 new MSW posts
Work services MSW and primary healthcare in hospital and primary
a) For 'One Stop Centre healthcare by 2025
of Addiction (OSCA)
Programme' in primary
healthcare
b) For 'Stroke Patients
Stepdown Care Programme'
in hospital
Main Implementation Plan No. 30: To advance clinical competencies of in-service medical personnel
Profession Activity Indicator Target
Implementation Plan
MEDICAL SOCIAL WORK To increase number of MSW Number of officers pursue 3 MSWs awarded
pursue postgraduate study in postgraduate studies in medical scholarship by 2025
specialised field (Masters/ PhD) social work field 1 action plan for
academic pathways by
To develop action plan for MSW Number of action plan prepared for 2025
academic pathway academic pathways At least 2 agencies and
1 university by 2025
3. Improve competency in Collaboration with related Number of related agencies or 14 applied courses/
specialised medical social agencies to equip officers with universities in social work field workshops by 2025
work field knowledge and skill to Number of training and workshop in 1 action plan for training
complement social work specialised medical social work field developed by 2023
practice Number of action plan prepared for
training
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 develop a Tele-Social Work Completion of TSW system TSW completed by 2025
4. To enhance social work (TSW) assessment that can
delivery system through assist patient from home
virtual assessment
(C) Allied Health Sciences Division - Profession Medical Social Work
No Profession Strategy
242 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
MEDICAL SOCIAL WORK
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 243
MEDICAL RECORD
244 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
MICROBIOLOGY
MICROBIOLOGY
246 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce
The microbiologist, formerly known as the Ahli Year
Kajikuman, was established by the Ministry of 2020
Health Malaysia (MOH) in the 1960s with the first HOSPITAL 310
placement at the Institute of Medical Research
(IMR), Kuala Lumpur. INSTITUTION 17
In the 1970s, more microbiologists were appointed
and deployed at hospitals. The microbiologist 10MOH
plans and initiates microbiological laboratory
services at state level, hospitals and the National HEADQUARTER
Blood Centre Transfusion Laboratory. They have
also successfully developed routine microbiology Year 66PUBLIC HEALTH
services, evaluated test methods and created new
services in line with technology development in 1960 LABORATORY
medicine and health.
In 1999, the microbiologists were responsible for Total: 27NATIONAL
developing microbiology services at the public Not more than 10
health laboratories. Microbiologists were also BLOOD CENTRE
entrusted to lead the Ipoh Public Health
Laboratory from 2000 to 2010. They have CADRE POST 2
successfully leveraged laboratory diagnostic
services on enteric pathogens by establishing a Total : 432
molecular unit using the latest polymerase chain
reaction (PCR) and pulsed-field gel MICROBIOLOGY
electrophoresis (PFGE) to diagnose and control
an outbreak. Success in obtaining the MS ISO
9001: 2000 Certificate and the MS ISO/IEC 17025
Certificate of Accreditation recognises the quality
of service and proof of service provided by the
Ipoh Public Health Laboratory is of quality
standard.
With the challenges and developments of new
technologies such as emerging and re-emerging
diseases, the use of microorganisms for
bioterrorism, the need for laboratory accreditation
and the increasing awareness of the public on
environmental health, more microbiologists with
advanced degrees are needed.
Various institutions in MOH employ microbiologists
as listed below:
Hospital pathology laboratory.
National Blood Centre and transfusion
microbiology laboratory (TML) in hospital.
Public health laboratory.
Engineering Services Division.
Institute of Medical Research.
Public Health Institutes.
Institute of Respiratory Medicine (Institut
Perubatan Respiratori, IPR).
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 247
Introduction leading roles in development and optimisation of
test methods and protocols, equipment
Microbiology is the study of all living organisms evaluation and preparation of technical
that are too small to be visible to the naked eye. specifications in the following fields of
The microorganisms include bacteria, viruses, specialisation: advanced bacteriology, mycology,
fungi, prions, protozoa and algae, collectively virology, immunology, parasitology,
known as microbes. mycobacteriology, electron microscopy, biosafety
A microbiologist is a scientist who studies and biosecurity, outbreak investigation,
microscopic life forms and processes, which biostatistics, transfusion microbiology (molecular
includes learning the growth, interactions, and and/or surveillance) advanced quality
characteristics of microscopic organisms such as programmes (such as National External Quality
bacteria, algae, fungi, and some parasites and Assessment Programme (NEQAP)).
their vectors. A microbiologist is known as a
clinical scientist (microbiology) in the government Microbiologists who are working in the blood
sector and is trained to provide a range of services transfusion service conduct blood screening tests
related to bacteriology, mycobacteriology, on blood donor samples. Serological and
parasitology, mycology, and virology field to molecular (nucleic acid testing (NAT)) procedures
support preventive, curative and rehabilitative must be used to screen the donated blood types
programmes to individuals and communities for transfusion-transmitted infection (TTI) agents
through laboratory services. such as the Human Immunodeficiency Virus (HIV),
In general, it is the duty and responsibility of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV),
microbiologists to carry out technical tasks in and syphilis. Microbiologists also do confirmatory
solving problems based on the methods and lab tests on the reactive blood to determine the
procedures of microorganisms. Microbiologists infection status of the blood donor and the
also participate in quality monitoring, conducting seroconvert donor. The TTI data is compiled and
complex tests, participating in research and analysed to keep track of the prevalence and
development, training, consulting, and providing transmission risk.
technical advisory services. Microbiologist also
interprets and offers technical advice(s) to ensure Performance and Achievements
the continuity of services.
Microbiologists also design training and evaluate Enhancement of Service Delivery
competencies regularly, manage laboratory
resources, and oversee the accreditation process Expansion of scope in microbiology laboratory
to improve service quality in medical microbiology testing:
laboratories.
Established NAT for blood donation samples
Functions throughout Malaysia by 2019 (95%) and
achieved 100 per cent by 2020.
Established COVID-19 testing in state
hospitals and public health laboratories in
2020.
MICROBIOLOGY A microbiologist’s functions in a pathology Central tender for:
laboratory are divided into two scopes of service: 2019 - National Blood Culture Bottle for all
basic and advance. state hospitals in Malaysia.
The basic scopes of a microbiologist are
pre-analytical activities, technical interpretation, 2020 - National Automated Identification
technical result verification and validation; analysis System for all state hospitals and major
of Quality Control (QC) and Quality Assurance hospitals in Malaysia.
(QA) activities; troubleshooting, problem-solving,
supervision of technical tasks, and data analysis in 2020 - National Diagnostic Virus Molecular
the following areas: bacteriology, mycology, Assay (Hepatitis B, C and HIV).
virology, serology, immunology, parasitology,
mycobacteriology, environmental microbiology 2020/ 2021 - Autoimmune testings.
and transfusion microbiology. Workload/ Census
The advance or specific/ specialisation scopes
include all the basic scopes and also performing The number of samples has grown tremendously
special tests; analysis and synthesis of tests since the service was first offered. The numbers of
results, technical consultancy, analysis of data, samples processed for the last three (3) years in
MOH as in Table 38.
248 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Table 38: The Number of Samples Attended by Microbiologists in the Year 2017 - 2019
Year 2017 2018 2019
Number of samples processed by 3,000 - 3,500 3,500 - 4,400 5,000 samples/
microbiologists samples/ samples/ microbiologist
microbiologist microbiologist
Number of samples processed by 690,000 donation 700,000 donation 730,000 donation
microbiologist (Transfusion) - Workload samples/ 3,700,000 samples/ 3,600,000 samples/ 3,900,000
for the whole Malaysia tests tests tests
Research/ Innovation/ Publication/ Presentation Guidelines for Influenza in Malaysia and MICROBIOLOGY
Journals/ Publications: become WHO Reference Laboratory for
Measles & Japanese Encephalitis (JE),
Journal of Health Management. A member of the Young Scientist
The American Journal of Tropical Medicine and Programme participated in the International
Hygiene. Society for Blood Transfusion (ISBT),
The Public Health Journal of Burapha The National Strategic Plan for Hepatitis B &
University. C (2019 - 2023), and
The Southeast Asian Journal of Tropical As an expert in TB & Malaria diagnosis.
Medicine and Public Health.
Journal of Clinical Microbiology. As a result, seven (7) scientific officers
The Southeast Asian Journal of Tropical (Transfusion Microbiology) continue/ further
Medicine and Public Health. their studies in Masters of Biotechnology/
International Medical Research Journal 1998; Transfusion Science.
2(2): 93 - 95. Three (3) microbiologists from the National
Training Blood Centre had been selected and involved in
Currently, there are 107 microbiologists with the International Society Blood Transfusion
master’s degrees in various fields, including in (ISBT) Academy programme named ‘I TRY IT’
bacteriology, molecular in virology and as ISBT Transfusion Research Young
bacteriology, mycology, virology and parasitology. Investigator Training for the year 2015, 2016
Meanwhile, several PhD holders specialised in and 2019.
vaccinology, molecular in virology and Participated in scientific poster and oral
bacteriology, mycobacteriology (TB) and presentations, scientific conferences/ seminars
parasitology. at national and international levels.
Responsible for the expansion of the NAT
Recognition/ Achievements testing programme on all blood donors’ samples
In 2019, Mycobacteria (Latent TB-Vaccine), nationwide.
Virology (Dengue), and Parasitology (Malaria) As lecturers/ tutors for students in Master of
were approved as Subject Matter Expert (SME) Transfusion Science and Medical Laboratory
fields. Technology Post Basic in blood transfusion and
In 2019, three (3) microbiologists pursued committee members for the examination board.
advanced degrees in mycology and immunology Responsible for ensuring that the blood and
to develop microbiology expertise. blood products are safe to use (from four
Microbiologist involved as a technical committee infectious diseases, namely HIV, HBV, HCV,
member at National and International level, for Syphilis by both technologies) and reducing the
example: risk of TTI in the recipients (by identifying
window period cases of the TTI).
As a member in formulating the National
Strategic Plan for Hepatitis B and C 2019 -
2023.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 249
As National External Quality Assurance Realignment of laboratory services in the
(NEQAP) provider for Hepatitis B and C NEQAP MOH is required to prepare microbiologists
Programme. for organisational changes per the Pathology
Strategic Plan. The organisational structure,
Issues and Challenges management and technical policies, scope
and function of service, test menu and
Strengthen/ Enhance Service Provision methodology need harmonisation and
Delay in-patient treatment due to laboratory standardisation. Besides standardisation of
turnaround time (LTAT). all relevant procedures, policy evaluations on
Delay in-patient management due to limited resource distribution and management are
access to laboratory networking between health critical.
facilities. For example, LIS is accessible within a Strengthening of the scope of services
facility. needed at all levels of healthcare. Existing and
new test methodologies will be harmonised
Adequacy and Optimisation of Health and standardised with appropriate equipment
Resources and technologies. Good IT networking is
expected to be established within MOH
Lack of budget for procurement of assets, medical laboratories by 2025 and non-MOH
reagents and consumables required in laboratories by 2030.
microbiology testing. Principles
Lack of space in hospitals for laboratories to Current Achievements - Sustain/ Maintain
develop tests in line with the latest medical and In 2019, three (3) SME were appointed in
technological advances and reference Mycobacteria (Latent TB-Vaccine), Virology
laboratories. (Dengue), and Parasitology (Malaria) among
There is a high demand to expand the test’s microbiologists.
scope, develop new laboratory testing methods,
and upgrade further the microbiology services. In 2019, three (3) microbiologists pursued
However, the current number of microbiologists advanced degrees, one (1) in microbiology
is scarce. and two (2) in mycology and immunology,
Many trained and competent microbiologists are respectively, which is part of personal
transferred to other facilities due to promotion, development and establishing expertise in
causing a vacuum of expertise in some centres. microbiology.
Strengthen/ Enhance Career Pathway Microbiologist involved as a technical
committee member at National and
International level, for example:
MICROBIOLOGY There is limited recognition for the expert − Guidelines for Influenza in Malaysia and
microbiologist in the specific microbiology field. become WHO Reference Laboratory for
Measles & JE,
Limited Training Opportunity
− A member of the Young Scientist
Limited microbiologists approved for a Programme participated in the
government scholarship (Hadiah Latihan International Society for Blood Transfusion
Persekutuan, HLP). In 2019 only 0.7 per cent (3/ (ISBT),
393) approved for HLP to pursue a masters and
PhD. − The National Strategic Plan for Hepatitis B
& C (2019 - 2023), and
Way Forward
− As an expert in TB & malaria diagnosis.
Philosophy Established three (3) additional NAT
To meet the difficulties posed by rising disease Screening Laboratories for screening blood
burdens and the emergence of novel infectious donor samples (Hospital Sultanah Bahiyah,
illnesses in the community, capacity building is Hospital Queen Elizabeth II & Hospital
critical. We aim to produce knowledgeable, Umum Sarawak).
competent, and technologically savvy
microbiologists in medical microbiology and
transfusion microbiology.
250 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Established new Blood Bank Information For integrated LIS, we will embark on short
Systems for 22 hospitals (blood banks) - term and long term LIS implementation plans
involves transfusion microbiology. and explore the possibility of expanding the
scope of 1GovUC for LIS networking.
Existing issues that have not been solved -
Reform To provide a quality-focused service through
centralisation of quality activities and
Propose to upgrade existing post to flexi post monitoring of performance (this is under
C41/ C44/ C48/ C52/ C54 to retain trained Pathology).
and expert microbiologists in specific areas
to ensure service continuity. Microbiologists are responsible for quality
Automated System in Microbiology testing assurance. Currently, almost all EQA
proposed to improve LTAT. programmes are from overseas, and MOH
To upgrade Hospital Information Systems to spends much money acquiring the
facilitate laboratory networking among all programmes. The plan is to develop an
health facilities. in-house EQA programme.
The system is to enhance data sharing Activities planned are:
and strengthen strategic communication.
At present, a patient’s medical records, To consolidate and expand current EQA
including treatment history and laboratory programme, and to support and
results, are only available at health strengthen local programme;
facilities that he/ she sought treatment.
Therefore, it is difficult to ensure a holistic To develop a new EQA programme
approach to patient care if the patient according to priority;
seeks treatment in another health facility/
hospital without the previous treatment To fulfil all requirements for certification;
and laboratory results. Furthermore, it
might lead to repeated laboratory To propose policy to participate in locally
investigations with unnecessary wastage available EQA programme;
of resources (reagents, time, human
resources, and machine load). Write up a proposal for budgeting;
Several activities implemented are
acquiring Laboratory Information System To standardise Interlaboratory
(LIS) with instrument placement, procedures; and,
utilisation of LIS as part of HIS and
implementation of statewide LIS (e.g., in To standardise reporting and scoring of
Penang and Sabah). EQA.
Integrated LIS and Pathology Transportation
System provide efficient networking between New Issues - New Strategies Career pathway MICROBIOLOGY
pathology laboratories in MOH. To expand the flexi post C48/ C52 for
microbiologists at major specialised
A pilot study has been ongoing to identify hospitals/ institutions/ agencies.
the best method of transportation of
pathology specimens for the whole Foster a public-private partnership in
country. providing services to the public. The private
At present, the choice of transportation for sector will provide space/ building and
samples between laboratories is using equipment while the public sector provides
hospital transportation and POS Malaysia. experts.
However, understaffing and maintenance
of vehicles pose a significant problem.
There are shortcomings in using POS
Malaysia. Thus, new areas such as
e-hailing for samples and other services
are needed.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 251
MICROBIOLOGY Conclusion : The strategic plan 2021 - 2025 for microbiology in 12MP focuses
on producing a more knowledgeable, trained and competent workforce. The
capabilities align with advancement, challenges and changes in medicine,
technology and the increasing trend of infectious diseases. The aim is to
improve services at various levels by producing more competent
microbiologists and retaining specialised staff.
The strategic plan for microbiology services is aligned with the pathology,
transfusion medicine, and MOH strategic plan. The initiatives and activities will
help microbiologists deal with changes and reforms in organisational structure,
management, technical policies, scope and functions, test menu and
methodology.
252 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Detailed Implementation Plan for Microbiology
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. 17: To consolidate and integrate laboratory service delivery in MOH facilities
Profession Activity Indicator Target
Implementation Plan
To establish a dedicated Percentage of hospitals/ health 100% by 2023
1. Strengthening the transportation system to facilities using the transport system
transportation system for deliver the samples from and
samples delivery to to reference lab
reference laboratories
2. To consolidate laboratory Consolidation of blood No. of consolidated TML 6 TMLs by 2025
service in blood transfusion screening lab (transfusion
service microbiology lab (TML))
Main Implementation Plan No. 18: MICROBIOLOGY
To increase the availability of safe, quality and accessible blood, labile blood components and plasma derived
medicinal products
Profession Activity Indicator Target
Implementation Plan
3. Strengthening of Nucleic To expand NAT service to No. of NAT lab operationalised Another 3 screening
Acid Testing (NAT) for other blood screening centres centres by 2022
donated blood nationwide 98-100% by 2021
To introduce NAT for donated Percentage of blood donation
blood samples nationwide samples screened with NAT
4. Enhancing Syphilis To introduce fully automated Percentage of Syphilis screening 100% by 2023
screening for donated blood Syphilis screening testing done by automated machine
5. Extension of Blood Bank To upgrade and extend the No. of centres using BBIS 2.0 – TML First phase
Information System (BBIS) BBIS to other blood banks/ Module implementation for 22
module Blood Transfusion Service hospitals is already
(Transfusion Microbiology complete.
Module) Second phase
implementation by 2025
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 253
Profession Activity Indicator Target
Implementation Plan
No. of consolidated TML 6 TMLs by 2025
6. Consolidation of laboratory Consolidation of blood
blood transfusion service screening laboratory
7. Strengthening the To establish a dedicated Percentage of Transfusion 100% by 2025
transportation system for transport system to deliver Microbiology Labs using appropriate
sending samples to the blood samples to designated the transport system
screening lab from blood screening centres
collection centres
8. To establish TML in NBC as To get accredited as PT Accredited as PT Provider ISO/IEC By 2023
Proficiency Testing (PT) Provider under ISO/IEC 17043
Provider 17043
MICROBIOLOGY
254 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
(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 expand of range of Type of test & facilities provide the Consolidation of
microbiology testing in health test screening/ confirmation
facilities via hospital cluster No. of states hospitals providing for rare/ specialised/ not
platform to cover for increasing microbiology testing routine test
disease burden of emerging All states hospitals
and re-emerging diseases providing microbiology
screening/ confirmation
1. Strengthening microbiology To develop proposal for No. of centralised procurement via for rare/ specialised/ not
testing and Transfusion procurement of reagents, hospital cluster platform routine testing – in
Microbiology Laboratory consumables, and assets via stages by 2025 or
(TML) hospital cluster platform zoning of tests
At least one in every
state by 2025
To introduce automated ID Percentage of MOH facilities having 100% of state hospitals
system in Microbiology Lab automated ID system have automated ID
systems by 2025
20% of major specialist
hospitals have
automated ID systems
by 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
MICROBIOLOGY
To provide short attachment 2-5 per year (mode of
(few weeks/ month) for training can be online
microbiologists in established No. of microbiologists attended and attending physically)
laboratory/ institutes like MKAs, attachment by 2023
2. Strengthen competency and NIH, universities
capability in microbiology
testing (routine and To conduct technical courses/ No. of technical courses/ training 2 technical courses/
specialised) training for microbiologists organised training per year
To increase number of At least 3-4 people per
microbiologists pursue year (including TML) in
postgraduate study in No. of microbiologists pursue the field of Transfusion
specialised field (Masters/ PhD) postgraduate study in specialised field Transmissible Infection
(TTI)
in microbiology
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 255
Main Implementation Plan No. 33: To improve career pathway for medical personnel
Profession Activity Indicator Target
Implementation Plan
8 -12 microbiologists by
3. Establish career pathway To recognise microbiologists in No. of microbiologists appointed as 2025 (including 3-4 for
framework for microbiologists specialised fields SME in specialised fields TMLs) in the field of
Transfusion Transmissible
Infection (TTI): HIV, HBV,
HCV, Syphilis
Information Technology
in BBIS
MICROBIOLOGY
256 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
(C) Allied Health Sciences Division - Profession Microbiology
Profession Activity Indicator Target
Implementation Plan
To develop National SOP and No. of SOP and protocols 2-4 (including TML) by
protocols for laboratory testing 2023
1. Strengthen microbiology To establish networking or No. of networking or collaboration 2 by 2023 (using SMEs)
service delivery/ coverage of collaboration with National and
services International agencies, e.g.,
universities, VRI, WHO
To separate post from code All posts in transfusion
2.21 to 2.29 in facilities No. of separation of code 2.21 to 2.29 service to convert to 2.29
To mapping of existing
microbiologist posts by 2025
Percentage of posts remapped At least 10% of post in
state and major
specialist hospitals
Achieve ISO 15189 Number of laboratories accredited All state laboratories will
accreditation for Medical be accredited by 2025
Laboratories
2. Strengthen the technical Participate in EQA or Inter lab Number of EQA/ Inter lab comparison At least participate in one
quality of microbiology comparison programme programmes enrolled by the laboratory EQA Programme for
testing services bacteriology (IMR)
Performance of EQA/ Inter lab Achieved performance of
comparison programme > 80%
3. Ensuring optimum numbers To create flexi post C48/ C52/ Submit to Human
of microbiologists in C54 at specialised institutions Paperwork submitted for endorsement Resources Division,
important areas to ensure trained staff are MOH by 2022
retained at the institutions upon TML – 20; Institutions –
promotion, e.g., IMR, MKA, NCI 20 by 2025
NIH, IPR, Blood Bank/ NBC, Number of flexi posts approved
engineering
4.Request of manpower for To create more C54 posts/ Number of new C54 and JUSA posts 1 JUSA post each in
new facilities & programme JUSA created Pathology and
Transfusion Medicine
Services; 5 posts for C54
MICROBIOLOGY
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 257
258 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
NUTRITION
NUTRITION
260 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce
Nutrition service in the Ministry of Health (MOH), Year
Malaysia was introduced in the early years of
1900s at the Institute for Medical Research (IMR), 2020
Kuala Lumpur. Subsequently, the evolution of
Nutrition Programme in the MOH has been MOH 59 INSTITUTION 14
growing significantly. In 1967, nutrition services in HEADQUARTER
the Institute of Public Health, Kuala Lumpur, (Institute of Public Health,
expanded its scope to include nutrition training and (Nutrition Division, Food Safety & Institute of Medical Research)
services. In 1974, nutrition services were Quality Division, Disease Control
incorporated into the Maternal and Child Health Division)
Unit in the Family Health Development Division in
the Ministry of Health (MOH). Nutrition was 46 HEALTH 332
previously one (1) of the three (3) branches of the CLINIC
Family Health Development Division in 1995. This
Nutrition Branch was later upgraded into division DISTRICT 28 HOSPITAL 1
on 16 Oct 2009. The Nutrition Division was HEALTH OFFICE
established to strengthen the organisational
structure of nutrition services and to enhance the Total: 480
effectiveness of nutrition programmes and
activities. Nutrition was later incorporated into
Food Safety and Quality Division in 1997 and
Disease Control Division in 2013.
Since 1996, the implementation of nutrition
programmes in the country has been in line with
the National Nutrition Policy of Malaysia and
National Plan of Action for Nutrition of Malaysia
(NPANM) in addressing food and nutrition
challenges in the country via multi and
trans-sectorial agencies. These include the
involvement of relevant ministries and government
agencies, research institutions, academia,
professional bodies, non-government
organisations (NGOs) including consumer groups
and food industries.
As for the human resource development for
Nutritionists in MOH, it has slowly evolved over the
years. It was first known as Nutrition Officer or
Pegawai Sains (Zat Makanan) (PZM) under the
scheme of Researcher. However, in 2011, this
designation was amended to Science Officer
(Nutrition) or Pegawai Sains (Pemakanan) to give
a better reflection of the job scope as a Science
Officer (Nutrition) in the public sector.
NUTRITION
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 261
Introduction xiii. Provide nutrition communication materials
complying with the prevailing regulations and
Nutritionist plays a significant role in ensuring the guidelines.
nutritional wellbeing of the population. A registered
nutritionist advocates and promotes nutritional Performance and Achievement
wellbeing of the individual and population as well
as to prevent and control nutrition-related diseases Nutritionists at Priority Areas and Settings
of various target groups at different settings and As of December 2020, a total of 480 posts of
levels through policies and regulations, education, nutritionist were created in the MOH at various
training, assessment and monitoring of nutritional levels at the federal, states, districts and health
status, carrying out nutrition interventions, clinics. About 69 per cent of these nutritionists are
consultancy, research, and development. posted at the health clinics. Their main job scope
at the health clinics is to provide services on food
Functions and nutrition to the community, patients and clients
through nutrition education, promotions,
Nutritionists are involved in the assessments and consultations and intervention programmes. There
monitoring of nutritional status, carrying out is currently a huge shortage of nutritionists at
nutrition interventions, education, training, various priority areas or settings throughout the
consultancy, research, and development. The country. Therefore, it is crucial to regularly
scopes of practice of nutritionists as stipulated in increase the number of nutritionists particularly at
Draft Guideline for Nutritionist (2019) are as district health offices and major health clinics in the
follows: country.
i. Advocate nutritional wellbeing of individual, Enhancement of Service Delivery
communities and population groups.
NUTRITION ii. Prevent and control nutrition-related diseases of The implementation of strategies and initiatives
various groups at different settings and levels. under NPANM III (2016 - 2025) requires
nutritionists to engage actively with multi-sectoral
iii. Assess, monitor and evaluate nutritional status partnerships such as with ministries, agencies,
of individual, communities and population private sectors and NGOs. Nutritionists have
groups. considerable roles to play together with the
Ministry of Agriculture and Food Industry in
iv. Provide input for the development and ensuring food and nutrition security for the
implementation of nutrition and related policies population in the country as stipulated in the
and action plans. National Nutrition Policy of Malaysia and the
National Agro Food Policy. Thus, nutritionists also
v. Undertake and support nutrition research and provide technical input in ensuring food is
communicate findings at various levels. available, accessible, and affordable to improve
the nutritional status of Malaysians.
vi. Develop, implement and evaluate nutrition In line with the Industrial Revolution 4 and latest
intervention programmes. technological developments, nutritionists are
required to adopt appropriate technology to
vii. Undertake capacity building in nutrition through strengthen the delivery of nutrition services such
education and training. as online application for Healthier Choice Logo
(HCL), MyNutridiari2 Apps and a web based
viii. Coordinate and carry out multi-sectorial nutrition dissemination of nutrition information such as
activities/ programmes. Malaysian Food Composition Database (MyFCD).
The increasing trend of double burden of
ix. Provide guidance on nutritional aspects for the malnutrition in the country since for the past few
formulation and development of products and years has demanded nutritionists to undertake
services. more comprehensive nutrition surveillance and
monitoring as well as to scale up appropriate
x. Provide technical advice for the development nutrition strategies and solutions to address the
and implementation on nutritional aspects of nutrition problems.
food regulations and guidelines. The delivery of nutrition services is also expanded
and strengthened to reach out to all age groups.
xi. Provide technical advice and consultations in These include, empowering members of
nutrition and nutrition-related matters. Parent-Teacher Associations (PTAs) to conduct
xii. Provide input on product quality and safety from
nutrition perspectives.
262 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Cara Hidup Anda Terbaik (C-HAT) activities as (NHMS 2019), the prevalence of stunting among
well as via mass and social media in disseminating under five (5) children had increased from 17.7 per
nutrition information and ensuring a conducive cent (NHMS 2015) to 21.8 per cent (NHMS 2019).
environment for healthy eating. Workload/ Census
Nutrition Programmes Achievements The scope of practice of nutritionists in MOH not
There was an overall improvement of Nutrition only focuses on nutrition services in the health
programmes and activities during the first term clinics but also on nutrition advocacy and
(2016 - 2020) of NPANM III (2016 - 2025). The intervention in the community. However, there is
objectives of NPANM III are to strengthen food still a huge gap of nutritionist to the population
and nutrition security, to enhance nutritional status ratio of 1:70,000 as compared the standard norm
and to reduce diet-related non-communicable by the WHO of 1:10,000.
diseases (NCDs). This NPANM III has 12 Double burden malnutrition is increasing every
strategies, 46 indicators, and 170 activities. The year. As the nutrition problem escalates, the role of
implementation of NPANM III is mobilised and nutritionists becomes increasingly important.
monitored by the National Coordinating Based on the analysis of the workload for
Committee on Food and Nutrition (NCCFN). In the nutritionists at the health clinics, about 47 per cent
midterm review of NPANM III for the second term of their time was spent at the health clinic for
of 2021 - 2025, several priority activities have nutrition advocacy activities, baby-friendly
been identified and strengthened. initiatives, infant and young children feeding
Despite major improvement on certain selected promotion, nutrition surveillance and other
nutritional problems of the population, double nutrition activities. Nutritionists spent 35 per cent
burden malnutrition (stunting among under five of their time in a year to carry out nutrition activities
children, obesity, anaemia) remains as national in the community such as to carry out nutrition
nutrition priority issues that need to be urgently programmes in schools, child care centres,
addressed. The prevalence of stunting among conducting weight loss programmes, and others.
under five (5) children was 20.7 per cent in 2016 Nutritionists also spent the remaining of their time
as compared to 12.6 per cent in 2006 while the for nutrition consultation (13%) as well as nutrition
prevalence of overweight and obesity among management, nutrition quality initiatives, and
adults were 30 per cent and 17.7 per cent in 2015 nutrition research (5%).
respectively. Although the findings of National For nutrition consultation at the health clinics,
Health and Morbidity Survey (NHMS) 2019 there is an increment in the number of clients seen
showed a reduction in the prevalence of anaemia by nutritionists in health clinics, as shown in Table
among women of the reproductive age group from 39.
35.5 per cent (NHMS 2015) to 29.9 per cent
Table 39: Types of Clients Seen by Nutritionists at the Government Health Clinics
Types of clients seen by Nutritionists 2017 2018 2019
Maternal nutrition related problems such as 75,067 84,935 49,112
anaemia, inappropriate gestational weight gain
Underweight children 63,169 67,433 77,984
Breastfeeding 3,753 3,186 1,881
Overweight and obesity 17,991 18,735 20,708
Research/ Innovation/ Publication/ Presentation of nutrition research publications from 1985 until NUTRITION
Nutritionists are actively involved in nutrition present. The publication of this nutrition
research at various levels. The Technical Working bibliography will hopefully benefit the programme
Group (TWG) on Nutrition Research was managers and planners for more evidence-based
established under the governance of NCCFN. programme planning, implementation and
One of the terms of references for this TWG is to evaluation. Meanwhile, the Clearing House for
identify nutrition research priorities for the country Nutrition research, an online database of nutrition
and to coordinate the compilation and research in Malaysia was also established. This
dissemination of nutrition research findings. online database aims to facilitate public access to
A total of three (3) volumes of Nutrition Research a wide range of nutrition research including
in Malaysia-Selected Bibliography of Published maternal, infant, and young child nutrition, obesity
Journal Articles has been published which consist and diet-related non-communicable diseases.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 263
Training Issues and Challenges
With the advances of technology and the
complexity of nutrition problems, there is a dire Shortage and No Nutritionist at Priority Areas
need for nutritionists to align with these and Settings
transformations in terms of knowledge, skills, Since 2015, there is no creation of new post of
values and abilities. Currently, there is a very Nutritionist in MOH. This situation has resulted in
limited number of nutritionists who have had the a huge increase in the workload of existing
opportunity to pursue the postgraduate nutritionists at various levels. There is still a major
programmes such as master’s and PhD gap for the nutritionist to population ratio and also
programmes. Thus, there are only two (2) nutritionist to a specific workload. According to
nutritionists who are undergoing Master’s level WHO norms of 1 nutritionist: 10,000 populations,
while one nutritionist for PhD level each year. More a total of 3000 nutritionists are currently required
opportunity for post graduate study is warranted to to render the nutrition services to the Malaysian
meet the urgent need for Subject Matter Expert population as compared to only 480 nutritionists.
(SME) pathways that have been recognised by the
Public Service Department (Jabatan There is an increase in the workload of
Perkhidmatan Awam, JPA) and also the 11 nutritionists at the health clinic over the years.
specialty areas for nutritionists under Allied Health Apart from their core functions of carrying out
Professions Act 774. nutrition activities at the community level such as
Post of Nutritionist with Specialty Area and childcare centres, kindergarten, schools,
Opportunity for Training in Specialty Area institutional, nutritionists at the health clinic are
Currently, the post of nutritionist with specialty also currently seeing a significant number of
area is only limited to those in the SME. With the referred patients for nutrition consultation from
implementation of Subject Matter Expert (SME) for Family Medicine Specialist. On average, one (1)
the Allied Health Profession by the Public Service nutritionist is covering several major visiting
Department, three (3) SME areas were approved health clinics to manage various referred patients.
for nutritionist are as follows: Therefore, there is a very limited time available for
− Public Health Nutrition (Level 1-4) a nutritionist to focus on their core functions to
− Nutrition Epidemiology (Level 1-4) execute nutrition prevention and intervention
− Maternal, Infant and Young Child Nutrition programmes and activities. Urgent measures to
address the shortage of nutritionists on a
(Level 1-4) medium- and long-term basis should be
As of December 2020, there was only one (1) undertaken.
nutritionist has been recognised as SME for Strengthen/ Enhance Career Pathway
Nutritional Epidemiology at Level 3. The remaining
categories of SME are still currently in the process There are 11 specialty areas for nutritionist as
to be filled. listed in the Guidelines for Nutritionists under
Allied Health Professions Act 774 as shown in
Table 40. However, only three (3) specialty areas
are currently recognised as SME pathways under
the JPA. Therefore, to develop the career pathway
for nutritionists, more opportunities for SME
pathway and postgraduate training in specialty
areas in nutrition need to be looked into and given
more priority.
Table 40 : Area of Specialty of Nutritionists
NUTRITION No. Area Notes
SME under the Public Service Department,
1. Public Health Nutrition Malaysia since 2019.
2. Nutrition Epidemiology
3. Maternal, Infant and Young Child Nutrition There are 11 specialty areas proposed under
4. Geriatric Nutrition the AHP Act 774 for nutritionists. Thus, no. 3
5. Child and Adolescent Nutrition has been split into 2 categories as follows:
6. Clinical Nutrition i) Maternal Nutrition
7. Sports Nutrition ii) Infant and Young Child Nutrition
8. Nutritional Biochemistry
9. Nutrition and Food Regulations
10. Nutrition Promotion and Communication
Source: Guidelines for Nutritionist Under Allied Health Professions Act 774
264 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Limited Post of Nutritionist with Specialty Area industries, inadequate Malaysian Food NUTRITION
and Lack of Opportunity for Training in Composition Database, and also inadequate
Specialty Area coverage of online undernourished children
With the rapid mega-trend changes of population registry of the rehabilitation programme.
health, the increasing burden of ageing population
and diet-related NCDs as well as, a Way Forward
multi-disciplinary team with the involvement of
nutrition experts to address multi-dimensional To Regularly Increase the Number of
health issues via public health approach and Nutritionists at Priority Areas and Settings and
strategies are urgently required. Thus, taking into Register under AHP Act 774
consideration the complexity of nutrition issues in
the country, more post for nutritionists with Taking into consideration the stagnant number of
specialty areas need to be created. nutritionists in MOH to render nutrition services in
the country, an appropriate measure to increase
Apart from that, since the past decade, there has the number of nutritionists at priority areas and
been limited opportunity for nutritionists to pursue settings especially at the district health offices
postgraduate studies in specialty areas in the and major health clinics is warranted.
SME for nutritionist recognised by JPA as well as To strengthen the implementation of NPANM III,
the proposed additional seven (7) specialty areas nutritionists are also greatly needed in other
for nutritionist under AHP Act 774. government agencies, including the Ministry of
Limited Nutrition Policies/ Programmes for the Education, Ministry of Agriculture and Agro-based
Ageing/ Older Persons Industry, Ministry of Youth and Sports, Ministry of
According to the United Nation Standard, by 2030, Rural & Regional Development, and Ministry of
Malaysia will be an ageing population which is Women, Family and Community Development.
defined as the prevalence of older persons aged Therefore, concerted efforts to place permanent
65 and above years of 7 per cent. It is projected nutritionists in these core Ministries are urgently
that the proportion of the population older than 65 required.
years in Malaysia will increase from 14 per cent in To Increase the Number of Post and
2020 to 20 per cent in 2030. The findings of NHMS Opportunity for Post Graduate Training in
2018 showed that 10.4 per cent of elderly aged 60 Speciality Areas for Nutritionist
and above were having food insecurity while 5 per In line with the complexity of public health
cent of them were underweight. Currently, there is nutrition issues and problems, there is a direct
no established and structured national nutrition need to create and increase the number of posts
programme targeted for an older person in in speciality areas for the nutritionists to
Malaysia. Therefore, more nutrition policies/ effectively address nutrition problems in the
programmes and action plans should be country. Thus, more opportunities for
developed and established for the ageing/ older post-graduate training should also be given to
persons in order to achieve healthy ageing. nutritionists particularly in priority nutrition
Increased Double Burden of Malnutrition speciality areas.
Malaysia is currently facing the double burden of To Strengthen Nutrition Programmes and
malnutrition with the coexistence of undernutrition Policies to Address Double Burden of
such as stunting among under five (5) children and Malnutrition at Various Settings and Life
anaemia among women of the reproductive group Cycles
and at the same time facing overnutrition such as With the increasing double burden of malnutrition
overweight and obesity among adults. These are in the country which is reflected by the co-existent
emerging major public health concerns that need of under nutrition and over nutrition, nutritionists
to be addressed particularly on nutrition and need to address and help mobilise not only for the
lifestyle changes. clinic based programmes and interventions but
Current Technology (Software and Hardware) also other non-clinic based programmes together
for Service Delivery Are Not at Par with the with other stakeholders. Therefore, more
Rapid Technology Advances structured and targeted nutrition programmes and
policies to address priority national nutrition
There is a rapid advance technology in health in issues are required such as:
line with the Industrial Revolution 4 (IR-4).
However, there are still conventional service and i. Scaling-up of reproductive age (WRA)
system delivery that need further improvement nutrition services programmes and activities.
and strengthening such as manual application of
Healthier Choices Logo (HCL) by the food
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 265
ii. Nutrition programmes for children under five b) Strengthen the web-based of Malaysian Food
(5) years old. Composition Database
Relevant, reliable and up-to-date food
iii. Further strengthening nutrition programmes in composition data are of fundamental
schools. importance not only in nutrition, dietetic and
health, but also for other disciplines such as
iv. More extensive implementation of obesity food science, biodiversity, plant breeding, food
intervention via the Trim & Fit Programme at industry, and trade and food regulation. The
the workplace. use of inadequate food composition data may
lead to erroneous research results,
v. Strengthening the monitoring of nutrition inappropriate policy decisions (particularly in
parameters under SDG/ UHC 2030. nutrition, agriculture and health), misleading
food labels, false health claims and inadequate
vi. Strengthening nutrition consultation at the food choices.
government health clinics such as In the 12th MP, the improvement and inclusion
management of gestational weight gain and of more food items and nutrients on the
stunting among under five (5) children. web-based Food Composition Database will
facilitate the public to access the nutrient
vii. Strengthening strategies and activities for the information. Thus, it will subsequently improve
second phase of NPANM III (2021 - 2025). their healthy eating practices at a minimal cost.
Refer to the Mid-term Review of NPANM III The public will also get timely and reliable
(2021 - 2025) reviewed document. information from a reliable authority.
To Strengthen the Nutrition Policies/ c) To strengthen the Rehabilitation Programme
Programmes for Healthy Ageing for Undernourished Children Registry
With the nationwide baseline data generated from The availability and basic internet network at
NHMS 2018 which focus on elderly health the major health clinics need to be upgraded
including nutrition, specific nutrition programmes and strengthened. These will facilitate more
or policies need to be established. effective management of the recipient of
undernourished children in the registry of the
To improve Service Delivery by Upgrading the rehabilitation programme.
Technology on a Regular Basis
There are three (3) focus areas for improvement in Strengthening Multi-Sectoral Efforts in
12th MP as follows: Sustaining the Food System to Support &
a) Further strengthening of Healthier Choices Promote Healthy Eating Practices by Ensuring
Availability, Accessibility and Affordability of
Logo (HCL) Healthy Food and Food Products for the
Food and beverage industries are currently Population
required to submit their HCL applications to In line with the establishment of the Cabinet
the HCL Secretariat manually. This method is Committee for Food Security Policy chaired by the
less friendly and takes longer time to process Prime Minister, nutritionists are greatly involved in
and complete the HCL applications. the four main clusters in sustaining the food system
Therefore, the HCL online system has been to support and promote healthy diet of the
established to replace the current population.
conventional way of HCL applications. In the
12th MP, this system will be further
strengthened.
NUTRITION Conclusion : In conclusion, this five (5) years’ strategic plan under 12th MP is
to enhance and strengthen nutrition services particularly in the MOH, with the
aim to ensure the overall nutritional wellbeing of Malaysia is achieved in all
levels.
266 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Detailed Implementation Plan for Nutrition NUTRITION
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
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 267
(C) Allied Health Sciences Division - Profession Nutrition
Detailed Implementation Plan for Nutrition Services in the 12th Malaysia Plan
Achievement/ Profession Plan of actions/ Initiatives Indicator Target
No. Challenges/ Strategies 5% increase of PKD with
nutritionist/ year
Issues 3% increase of major
health clinics with
1. Shortage and To regularly a) To increase the number of at Percentage of district health nutritionist/ year
no nutritionist increase the the district health offices and offices (167 PKD) with
at priority areas number of major health clinics nutritionists increased
and settings nutritionists at
priority areas Percentage of major Health
Clinics (KK/ KKIA) with
nutritionists increased
b) To employ nutritionists in the Number of nutritionists employed 2021: 1 nutritionist at
following Ministry: at the PPD level (138 PPD) PPD/ Zone
Ministry of Education (MOE) 2022: 2% of PPD with
nutritionist
2023 - 2025:
3% of PPD with
nutritionist
Ministry of Women, Family Nutritionist employed at the HQ 2021 - 2022:
& Community Development of MWFCD 2 nutritionists
(MWFCD) at HQ of MWFCD
Enhance To create post of JUSA Khas C Two posts of JUSA Khas C 2021: 1 post JUSA Khas
capacity of at Nutrition Division for selected created at Nutrition Division by C created
human head of the branches 2025 2023: 1 post JUSA Khas
resources for C created
nutrition
To create post of C54/ JUSA 8 posts of C54/ JUSA Khas C at 2021: 3 post C54 created
Khas C at state health level with state level by 2025 2022: 3 post C54 created
state director of JUSA Utama B (8 State Directors with JUSA 2023: 2 post C54 created
2024: 1 post JUSA Khas
Utama B - Kedah, Perak, C created
Pahang, Kelantan, Johor,
Sabah, Sarawak, Selangor)
2025: 1 post JUSA Khas
C created
2. Lack of To increase the To work closely with the Yearly increase on the number of 2021 - 2025:
opportunity for opportunity for relevant institutions/ partners nutritionists undergoing Master - at least 5
training in postgraduate to create more opportunities or postgraduate courses nutritionists/ year
speciality areas courses in scholarships to further study
speciality areas i. Master- at least 5 Nutritionists/
for nutritionist year
ii. PhD- at least 2 Nutritionists/ 2021 - 2025:
year PhD - at least 2
nutritionists/ year
NUTRITION 3. Increased To Strengthen a) Scaling-up women of National Fortification of wheat 2021 - 2022:
double burden Nutrition reproductive age (WRA) flour with iron and folic acid Fortification of wheat
of malnutrition. Programmes nutrition services implemented by 2021/ 2022 flour implemented
and Policies to programmes and activities
Stunting among Address
under five Double Burden Fortification of wheat flour
children: of Malnutrition with iron and folic acid
21.8% at various *Based on the policy decision and the availability
(high public settings and life of the funding
significance) cycles
268 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Detailed Implementation Plan for Nutrition Services in the 12th Malaysia Plan
Achievement/ Profession Plan of actions/ Initiatives Indicator Target
No. Challenges/ Strategies 2021 - 2022:
National Strategic Plan
Issues Develop National Strategic National Strategic Plan developed and
3. Overweight and Plan for the Prevention and developed by 2022 established
Control of Anaemia
obesity among
adults: 30.4% &
19.7%
Anaemia 2023 - 2025:
among WRA: Advocacy and monitoring
29.9% on the implementation of
(moderate the strategic plan
public health
problem) To conduct activities to raise Number of awareness and 2021 - 2025:
awareness and education on education activities conducted at 1 activity/ district/ year
the importance of preventing work setting or institutions on
anaemia, knowing WRA healthy eating
responsibilities initiative
Haemoglobin status and
importance of micronutrients More extensive d)
implementation of obesity
among WRA at: intervention via the Trim &
- Community Fit Programme at workplace
- Work Setting
- Institutions
Close monitoring of Number of staff trained with 2021:
gestational weight gain GWG guideline 40% PSP and nurses at
(GWG) among antenatal health clinic trained
case inhealth clinic 2022:
60% PSP and nurses at
health clinic trained
2023:
80% PSP and nurses at
health clinic trained
b) Nutrition Programme for Percentage of private hospitals 2024 - 2025:
Children Under 5 Years Old designated as Baby Friendly 100% PSP and nurses at
increased health clinic trained
2021 - 2025:
Baby-Friendly Hospital 5 private hospitals are
Initiative (BFHI) Baby Friendly/ year
implementation in Private
Hospitals NA
2021: Milk Bank
Establishment of Milk National Milk Bank was established in 1 zone
Sharing Initiative (Milk established at Hospital Tunku 2022: Milk Bank
Bank) in government Azizah by 2020 established in 2 zones
hospital Milk Bank established in each
zone by 2023
2023: Milk Bank NUTRITION
established in other 3 zones
2024: Evaluation of the
existing milk bank
2025: Expansion to
selected state/ major
specialist hospitals
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 269
Detailed Implementation Plan for Nutrition Services in the 12th Malaysia Plan
Achievement/ Profession Plan of actions/ Initiatives Indicator Target
No. Challenges/ Strategies
Issues To increase the Number of PCF (new) in the 2021 - 2025:
3. establishment of Community interior established 1 new PCF established/
Feeding Programme (PCF) Number of modified PCF (new) year
at priority areas in the interior in poor urban settlements 2021 - 2025:
and modified PCF at poor 2 new PCF established/
urban settlements year
*Based on the policy decision and the
availability of the funding
c) Further Strengthening Number of primary/ secondary 2021 - 2022:
nutrition programmes in schools implementing school At least 4 schools in
schools meal programme increased every state/ year
Implementation of School 2023 - 2025:
Meal Programme (HiTS) At least 5 schools in
every state/ year
Implementation of School Percentage of primary and 2021: At least 30% of
Canteen Guidelines secondary school canteens school canteens complied
(nutrition components) comply with the School Canteen
Guidelines 2022: At least 35% of
school canteens complied
2023: At least 40% of
school canteens complied
2024: At least 45% of
school canteens complied
2025: At least 50% of
school canteens complied
d) More extensive Yearly increment on the number 2021 - 2022:
implementation of obesity of government/ private sectors At least 1 (new)
intervention via the Trim & participation government/ private
Fit Programme at workplace sector at national or state
level per year
2023 - 2024:
At least 2 (new)
government/ private
sector at national or state
level per year
2025:
At least 3 (new)
government/ private
sector at national or state
level per year
e) Strengthening the Prevalence of moderate or 2024: Proposed to be
monitoring of nutrition severe food insecurity in incorporated in the
parameters under SDG population-based on FIES NHMS 2024
(Food Insecurity Experience
NUTRITION Scale)
Prevalence of malnutrition 2025:
among children under five Stunting Reduction of
children; 40% from baseline in
i. Stunting 2015 (17.7%)
270 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Detailed Implementation Plan for Nutrition Services in the 12th Malaysia Plan
Achievement/ Profession Plan of actions/ Initiatives Indicator Target
No. Challenges/ Strategies 2023:
Reduce childhood
Issues ii. Wasting (weight for height) wasting to <7%
3.
2025:
Reduce and maintain
childhood wasting to <5%
iii. Overweight (weight for height) 2021 - 2025:
Reduce or no increment
from baseline in 2015
(7.1%)
f) Strengthening the Exclusively breastfed rate in NHMS 2022:
monitoring of nutrition infants 0-5 months of age More than 48%
parameters under UHC 2025:
2030 More than 50% by 2025
Incidence of low birth weight 2025:
(LBW) among newborn LBW reduction of 30%
(8.1%) from baseline,
2015 (11.5%)
Anaemia prevalence among 2025:
women of reproduction age Anaemia reduction of
15-49 years 50% from baseline,
2015 (34.7%)
Prevalence of anaemia in 2022:
children under 6-59 months To get national baseline
data for this indicator via
inclusion in the NHMS
2022
2023 - 2025:
The actual target by 2025
once the baseline data is
obtained from NHMS
2022
Age-standardised prevalence of 2021 - 2025:
overweight and obesity in No increase from
person aged 18+ years baseline in 2015 (32.8%)
g) Strengthening nutrition Number of patients received 2021:
consultation at the nutrition consultation for: Baseline data collection
government health clinics i. Gestational Weight Gain 2022 - 2025:
At least 50% of referred
(GWG) problems pregnant women with
GWG problems seen by
nutritionists (TBC with the NUTRITION
baseline)
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 271
Detailed Implementation Plan for Nutrition Services in the 12th Malaysia Plan
Achievement/ Profession Plan of actions/ Initiatives Indicator Target
No. Challenges/ Strategies
Issues
ii. Anaemia among pregnant 2021:
mothers Baseline data collection
2022 - 2025:
At least 50% of referred
pregnant women with
anaemia problems seen
by nutritionists (TBC with
the baseline)
iii.Undernutrition for under-five 2021:
children (i.e., stunting, Baseline data collection
underweight, etc.) 2022 - 2025:
At least 50% of referred
undernourished under-
five children seen by
Nutritionist (TBC with the
baseline)
4. Limited nutrition To strengthen a) Empowerment of volunteers Increased on the number of 2021 - 2023:
policies/ the nutrition to conduct healthy eating empowerments to volunteers At least one training/
programmes for policies/ activities at Pusat Aktiviti on healthy eating activities PAWE/ year
the ageing/ programmes for Warga Emas (PAWE) conducted 2024 - 2025:
older persons healthy ageing At least two training/
PAWE/ year
b) Inter-agencies partnership Meals on Wheels Initiative 2021:
on the implementation of (MWI) implemented by 2022 Pilot Implementation of
Meals on Wheels Initiative the MWI
(MWI) to ensure accessible 2022:
healthy food for older MWI implemented at
persons from low-income selected region
households 2023:
Evaluation of MWI
implementation
2024-2025:
Expansion of MWI
5. Current To improve a) Further strengthen the Real-time case management 2021 - 2025:
technology service delivery management of and reporting via online registry Increment base on the
(software and by upgrading the undernourished children in all major health clinics by 2025 baseline from 2019
hardware) for technology on a registered in the registry of
service delivery regular basis rehabilitation programme for
is not at par undernourished children
with the rapid
NUTRITION technological b) Further strengthening of Full online system 2021 - 2022: Full
advances Healthier Choices Logo implementation for HCL implementation
(HCL) Online System application and registration by 2023: Re-evaluation
2021
c) Strengthen the web-based Inclusion of more food items with 2021 - 2025:
of Food Composition nutrients analysed and reported Increment on food items
Database (MyFCD) online via MyFCD website analysed and reported
online/ year
*Based on the policy decision and the
availability of the funding
272 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
NUTRITION
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 273
274 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
OCCUPATIONAL
THERAPY
OCCUPATIONAL THERAPY
276 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce OCCUPATIONAL THERAPY
The first occupational therapy service in Malaysia Year
was initiated by Mrs Babra Tyldesley (UK) at
Leprosy Centre, Sungai Buloh, in 1957. 2020
From 1958 to 1980, several qualified occupational
therapists (OTs) trained abroad in the United HOSPITAL 939
Kingdom, Australia, New Zealand, and India under
the Colombo Scholarship Scheme provided INSTITUTION 137
occupational therapy services in the country.
In 1984, the Ministry of Health Malaysia (MOH) MOH 5
established the School of Occupational Therapy, HEADQUARTER
offering a three (3) years training course. The
trainees who had completed their training Year HEALTH 268
successfully were awarded an occupational CLINIC
therapy certificate. In 1988 locally graduated OTs 1980
started working at mainly all general hospitals and 37CADRE POST
psychiatric institutions. 30HOSPITAL/
Primary care occupational therapy first started in Total : 1,386
1998 at Penampang Health Clinic, Kota Kinabalu INSTITUTION
Sabah, focusing mainly on community-based
rehabilitation. Total : 30
In 1993, Institutions of Higher Education such as
UiTM started the Faculty of Health Sciences,
including studies in occupational therapy, followed
by Universiti Kebangsaan Malaysia, which started
the full-time degree programme in 2004. Since
then, more private educational institutes have also
begun the programme under the Faculty of Health
Sciences.
In the beginning, occupational therapy services
were only available in general hospitals. The
service expanded and extended to health clinics,
institutions (mental health Hospital Bahagia Ulu
Kinta (HBUK), Hospital Permai Johor Bahru
(HPJB), Hospital Sentosa Sarawak (HSS),
Hospital Mesra Bukit Padang Sabah (HMBPS),
National Leprosy Centre (Pusat Kawalan Kusta
Negara, PKKN), Institute of Respiratory Medicine
(Institut Perubatan Respiratori, IPR), ‘Genius
Kurnia’ (KPM), Community Welfare Department
and military hospitals (cadre post) as well as
private agencies.
The profession of occupational therapy has grown
year after year as more occupational therapy
schools have been established to produce more
OTs in Malaysia to meet the growing demand for
the service in both the government and private
sectors.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 277
OCCUPATIONAL THERAPY Introduction Functions
The World Federation of Occupational Therapy The main function of occupational therapy is to
defines occupational therapy as a client-centred improve the client’s ability to perform daily
health profession concerned with promoting health occupations (activities and valued life roles at work
and wellbeing through occupation (WFOT, 2012). and home), leisure and socially, facilitate
The primary goal of occupational therapy is to successful adaptation due to disruption in lifestyle,
enable people to participate in the activities of prevent losses of function and improve or maintain
everyday life. psychological status.
In Malaysia, occupational therapy services are The chart below shows occupational therapy
available at public and private hospitals, health settings in various areas:
clinics, and institutions under Public Welfare
Department, schools, and private agencies.
32%
21%% 19%
2%
7%
2% 10%
3%
1% 3% 8%
1%
1% 7%
Performance and Achievements with mild to moderate dementia, encourage
independence, and reduce the carer’s burden.
Enhancement of Service Delivery OTs in hospitals or institutions with Pusat
The occupational therapy services commonly Kesihatan Mental Komuniti (MENTARI) and
offered are in-patient, outpatient, day-care and psychiatry services has significant role in
community services. In recent years, OTs have psychiatric work rehabilitation, including supported
been actively involved in the multidisciplinary and employment programme where OTs give job
interdisciplinary teams and provide specialist support & training and social enterprises
services that are comprehensive and holistic for integrating with multiple agencies.
patient rehabilitation process. Children with learning difficulties are also
The multidisciplinary rehabilitation team focuses commonly referred to as early intervention
on post-stroke management, amputation programmes, sensory integration therapy, and
management, neurodevelopmental paediatric pre-school interventions. OTs are also involved
such as cerebral palsy, spinal cord injury and with low vision rehabilitation, assessment for
traumatic brain injury conducted in hospitals with cochlear implant candidates, pre-driving
rehabilitation medicine specialists. OTs are assessment, and return to work for those with
actively involved in geriatric services particularly physical and cognitive impairment.
with cognitive stimulation therapy for patient
278 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Workload/ Census Research/ Innovation/ Publication/ Presentation OCCUPATIONAL THERAPY
The number of patients that received occupational OTs have always been active participants in quality
therapy services has increased since the service initiative projects. Every year, they take part in
was first offered. The number of patients for the MOH-organised innovation and quality assurance
last three (3) years includes paediatrics and adults projects. In recent years, there has been an
in MOH, as in the table below (Table 41). increase in the number of OTs involved in research
projects. The following (Table 42) is a list of
quality initiative and research projects.
Table 41: The Number of Patients Attended by Occupational Therapists in the Year 2017 - 2019
Year 2017 2018 2019
Number of patients attended by 1, 209,258 1,330,922 1,369,547
occupational therapists
Table 42 : The List of Quality Initiative and Research Projects
No. State Hospital/ Category Title Level Achievement
1. WP Clinic KKM:
Saringan
Putrajaya Putrajaya KIK Wheelchair Climb: National 2019 (KKM & Akhir
Health Penciptaan Kesukaran Kementerian Kebangsaan
Office dan Menurunkan Perumahan dan KPKT
Anugerah Mangsa di Kerajaan Tempatan 2nd
Inovasi Bangunan Tinggi Malaysia) Place
Menteri Melalui Tangga (Kategori
Hibrid)
2. WP Putrajaya KIK Smart Sensory Vest: National 2018 2nd Place
Putrajaya Health Penciptaan Kesukaran Proses (Kategori
Office Pembelajaran Hibrid
Kanak-Kanak Penciptaan)
Pendidikan Khas 1st place
JKN - 4th place
3. Johor Hospital Inovasi E-Servis Or Job Map JKN 2016 BSKB -1st place
4. Johor Permai National -
Hospital Inovasi Urine Bag Pouch JKN 2018 Participant
Sultanah 2nd place
Aminah
1st place
5. Penang Hospital Inovasi Harness as Walking Hospital 2018
6. Penang Pulau Inovasi Aids 1st place
7. Selangor Pinang Megneto Cabaran Inovasi
Hospital Inklusif Zon Utara
Pulau KIK/ Inovasi Multihand Function 2017
Pinang Exercise Box (Multi Hospital 2017
Hospital Feb)
Selayang
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 279
OCCUPATIONAL THERAPY No. State Hospital/ Category Title Level Achievement
8. Selangor Clinic KIK/ Inovasi Multihand Function JKN 2017 2nd place
9. Perak Hospital Exercise Box (Multi JKN 2018
Selayang Feb) National 2018 Anugerah
10. Kedah Sensory Kit Hospital 2018 Khas Juri
11. Kedah Hospital Inovasi Multi-tasking Easy 2nd place
Tapah Inovasi Box JKN 2018 1st place
12. Perlis Hospital KIK Recon Aids
Sik JKN 2017 1st place
13. Pahang Hospital Haft Dynamic
Sultanah Equipment National 2018 1st place
14. Sarawak Bahiyah
Smart 1st place
Hospital Inovasi Developmental
Tuanku Wheel
Fauziah Blind and Visually
Impaired Registry
Hospital Inovasi (BVIR) & Support
Kuala Lipis Group (BVISG)
Hospital Inovasi
Miri
Training ten (10) graduates). In addition, the evolution of
Training has been the most crucial element in the profession has brought upgrading of
occupational therapy service development. It qualification among the OTs. As a result, 335 OTs
begins with mental health services and now who had a diploma as entry-level possesses
evolved to various specialised areas. Previously, degree qualifications. In addition to that, 28 OTs
OTs have diploma graduates from MOH colleges have successfully finished their studies at the
only. Now many institutions are offering master’s level, and six (6) still are in the progress of
occupational therapy programmes. Within MOH, completing their PhD programme.
two (2) advanced diploma programmes have been Apart from formal educations, OTs in MOH have
developed, namely, Advanced Diploma in been sent for specialised attachments as well. The
Palliative Care (six (6) Cohorts with 26 list of attachments is as below (Table 43).
graduates) and Advanced Diploma in
Neurological Rehabilitation (two (2) Cohorts with
Table 43 : The List of Occupational Therapists with Specialised Attachments
No. Name Area Location Duration Year
1. Shahril Azizul Bin Leman JICA – Job Coach Training Course Japan 4 weeks 2013
2. Mohd Shahril Bin Ahmad JICA – Work Coach Japan 4 weeks 2014
Japan 4 weeks 2016
3. Harnisha Haidhir JICA – Elderly Care (Ageing In Place)
4. Mohd Effendi Hashim JICA – Elderly Care (Ageing In Place) Japan 4 weeks 2016
5. Aznita Binti Ahmad JICA – Elderly Care (Ageing In Place) Japan 4 weeks 2017
6. Mohammad Luqman JICA – Social Participation And Inclusion Japan 4 weeks 2017
Bin Abd. Rani
280 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
No. Name Area Location Duration Year OCCUPATIONAL THERAPY
4 weeks 2018
7. Muhammad Najib Bin JICA – Elderly Care (Ageing In Place) Japan 3 weeks 2019
Mohd Amin
3 weeks 2019
8. Zullydee Bin Saiman JICA – Employment Transition Program Japan
for PWD
9. Shahril Azizul Bin Leman JICA – Employment Transition Program Japan
for PWD
Recognition/ Achievements
The number of OTs with credentialing is as in Table 44.
Table 44: The Number of Occupational Therapists with Credentialing
Procedure Area No. of Occupational
Core Procedure Therapists
Specialised Procedure - 862
15
Optional Procedure Pre-Driving Rehabilitation 19
Work Rehabilitation 6
*Data provided until May 2020 Cardiac Rehabilitation 3
Sensory Integration 8
Low Vision Rehabilitation
Traumatic Brain Injury 4
Rehabilitation
27
Child Psychiatric &
Adolescence 1
Forensic Rehabilitation 12
Geriatric Rehabilitation 25
Neurology Rehabilitation
Oncology and Palliative 9
Care Rehab
15
Spinal Rehabilitation
Occupational therapy also has published five (5) Occupational Therapy Standard of Practice for
standard of practice (SOP) books and distributed Psychiatry and Mental Health.
them in 2015 to ensure a standard quality for
service. The list is as below: Issues and Challenges
Occupational Therapy Standard of Practice for Strengthen/ Enhance Service Provision
Cardiac Rehabilitation. Specialised services are only available in certain
Occupational Therapy Standard of Practice for facilities. Clients need to travel a long distance to
Hand and Upper Limb Injuries. access the services (e.g., Driving Assessment,
Occupational Therapy Standard of Practice for Return to Work and Cognitive Rehabilitation).
Stroke.
Occupational Therapy Standard of Practice for
Cerebral Palsy.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 281
OCCUPATIONAL THERAPY Human Resource Capability and Competency Strengthen/ Enhance Career Pathway
Increased demand for OTs (increasing numbers Occupational therapy profession has been
of facilities like hospitals and health clinics, evolving drastically in recent years, and we are
rehabilitation wards, increase in the number of witnessing the demand for the service
beds). There are no promotional posts for OTs increasing over time, both in government and
for the executive and top management level, private settings. Medical advancement has
currently limited to grade U48. brought more subspecialty and the need for
Comparatively, other units within the Allied occupational therapy services to establish the
Health Professions offer a position of grades quality of life among patients. On the other hand,
beyond U48. This glass ceiling needs to be medical management has shifted from curative to
broken to allow OTs within the unit to foresee preventive. Occupational therapy services are
their career growth as professionals in their needed in primary care for health promotion
future and not limit themselves to this plateau. purposes.
Increased demand for OTs with specialised However, the wages and recognition are not
training (certification, masters, and PhD) and equitable with the education and service provided.
subspecialties. The number is increasing over For example, a mastered graduate occupational
the years. However, the wages and recognition therapy who is still in grade U41 should
are not at par with the education qualification supposedly be in grade U48. Furthermore, more
and service provided. The current situation is OTs are pursuing a PhD but not in a higher grade,
demotivated for therapists to upgrade their which will lessen their motivation to remain in
knowledge and competency. government service.
Loss of trained and expert clinical (loss of talent) The career pathway for OTs within MOH needs to
due to promotion and transfer to a new facility. be reviewed according to recent development and
Unable to keep them due to unavailability of evolution of the profession. OTs with postgraduate
higher posts. The clinical areas developed by an qualifications and specialisation need to be
expert at respective facilities are unable to be recognised. As more senior therapists are still at
continued because of this. the entry level, more promotion opportunities must
be created. Thus, increasing the higher grade and
Adequacy and Optimisation of Health promotion process needs to be in place
Resources immediately to prevent losing specialised OTs. A
proper plan is required to relocate specialised OTs
Space: Limited, old departments (poorly to the specialised area and prevent therapists
maintained and unsafe) and unconducive from becoming demotivated to upgrade their
treatment rooms. The working space allocated knowledge and competency due to a lack of
to OTs is inadequate to carry out our promotion grade.
professional services in a particular Limited Training Opportunity
establishment. Modifying therapy and regimes Occupational therapy training is limited due to
to accommodate limited working space would budget constraints for fees and other costs.
give a poor outcome of the intervention, which Lack of Collaboration Intra/ Interagency/
could be detrimental in certain circumstances. Community
A medical insurance policy does not cover
Equipment: Old and outdated equipment for occupational therapy service; thus, it limits our
patient’s assessment and intervention. clients to acquire occupational therapy services
outside the MOH facility.
Accessibilities: Facilities without
disabled-friendly specification and some Increasing Disease Burden and Change of
Occupational Therapy Units far from clinics and Demography
wards. Non-communicable diseases, the ageing
population and disability are increasing yearly.
Insufficient consumables: Splinting Materials Apart from rehabilitation, OTs are needed for the
and Accessories, Pressure Garment, etc. prevention of diseases as well. The numbers of
occupational therapist in MOH are insufficient to
Worn out assets: Splinting Heating Pan, Hand meet the demand for rehabilitation services,
Evaluation Tools, Fluidotherapy, Work especially in the suburban and rural area.
Hardening Tools, Upper Limb Training Tools,
Sewing Machines, etc.
282 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Others Principles OCCUPATIONAL THERAPY
Telehealth implementation to facilitate Current Achievements
practitioners, educators, and patients in managing Enhance Occupational Therapy Profession
the pandemic and reaching out to clients/ patients Clinical Audit.
who are unable to attend therapy in clinical
settings. The technological platform must be Strengthen quality improvement activities
updated. (Research, QA, Innovation).
Way Forward Enhance service delivery (NCD, mental health,
healthy ageing, geriatric rehabilitation,
Philosophy palliative care, neuro rehabilitation and return
The occupational therapy profession will strive to to work).
improve current care delivery to uphold the MOH’s
Mission and Vision of reforming the National Existing Issues That Have Not Been Solved
Health System via public sector transformation, Reform human resources (outsources,
private sector regulatory reforms, sustainable sessional, contract).
health financing, and patient-centred integrated
care. This principle aligns with the World Restructure financial provisions
Federation of Occupational Therapy in (consumables and assets).
engaging with WHO goals and objectives of the
Rehabilitation 2030: A Call for Action. New Issues - New Strategies
Implementation of Universal Health Coverage Implement new services (health screening
enables all people to receive the quality, essential for hajj candidates and cognitive stimulation
health services they need without being exposed programme for dementia).
to financial hardship.
Conclusion : Occupational therapy is an evolving profession that needs
continuous development in line with national and international medical
advancements. The profession is working hard and committed to giving
excellent service to support the MOH’s Vision and Mission of providing better
health occupational therapy services. The profession must be expanded into
specialised areas and become a global reference and training centre for
therapists worldwide. Hence, the activities in this strategic plan are relevant to
occupational therapy’s mission and service demand. Furthermore, this
strategic plan implies the importance of evidence-based practice in
occupational therapy intervention to assist the community in maintaining their
life satisfaction and quality of life.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 283
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