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OCCUPATIONAL THERAPY Detailed Implementation Plan for Occupational Therapy

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.2: Increasing accessibility and quality of care for stroke patient

Profession Activity Indicator Target
Implementation Plan

1. Establish stroke Stroke programme to be Percentage of cluster lead hospitals 70% of specialised
rehabilitation programme in established in non-specialised referred stroke patients to non- hospitals by 2025
hospital cluster hospital specialised hospitals

Main Implementation Plan No.15: To provide seamless care for the aging population in the current healthcare settings

Profession Activity Indicator Target
Implementation Plan

2. Enhance Occupational To implement Cognitive Percentage of facilities with geriatric 80% implemented by
Therapy roles in Geriatric Stimulation Therapy (CST) in Occupational Therapy implemented 2025
Rehabilitation facilities with geriatric Cognitive Stimulation Therapy (CST)
Occupational Therapy

284 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 OCCUPATIONAL THERAPY
Main Implementation Plan No. 22:

To optimise utilisation of existing underutilised/ unused facilities via Hospital Cluster platform

Profession Activity Indicator Target
Implementation Plan

1. Integrate or coordinate Provide specialist procedures Number of specialist procedures being At least one procedure
healthcare service delivery in non-specialist hospital carried out in non-specialised hospital in each non-specialised
that provides comprehensive hospital per year
and seamless care

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

2. Optimise resource Appointment of contract Number of contract therapists Minimum 2 person per
management (human officers appointed profession per
resource) specialised hospital by
2025

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

Profession Activity Indicator Target
Implementation Plan

3. Enhance capabilities of OTs Enhance OTs roles in palliative Number of OTs who obtained At least 1 OT for each
in specialised areas care Advanced Diploma in Palliative Care state per year
Enhance occupational therapy Number of OTs who obtained At least 1 for each state
roles in neurological Advanced Diploma in Neurological per year
rehabilitation Rehabilitation

4. Strengthen competency Increase competency and Number of OTs who obtained local/ Increase in numbers
through post-grad study/ training overseas clinical attachment, degree yearly
attachment conversion, postgraduate and
doctorate qualification

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 285

OCCUPATIONAL THERAPY (C) Allied Health Sciences Division - Profession Occupational Therapy

Profession Activity Indicator Target
Implementation Plan
To reform clinical audit Percentage of facilities been audited At least 30% of facilities
1. Strengthen OT services in yearly at each state audited yearly
alignment with current
medical development Incorporating current Percentage of patients treated 80% by 2025
Standard Operating according to current SOPs at each
Procedures (SOPs) in OT facility
services

Enhance quality activities (case Number of quality activities been done Minimum 1 per state per
reports/ research/ Quality at every state per year year
Assurance Projects/ KIK/
Innovation Projects)

Strengthen and expand Percentage of state hospitals an 80% by 2025
Occupational Therapy service hospitals with major specialists
in Work Rehabilitation implement Work Rehabilitation
Programme Programme by 2025

Enhance Occupational Therapy
health promotion and
prevention for:
Percentage of OT health education 10% increase yearly per
sessions conducted yearly state
1. Mental health
2. Strengthen OT services in 2. Diabetic foot care
Public Health 3. Healthy ageing

Health screening programme Percentage of Hajj Candidate 100% by 2025
for Hajj Candidates (ADL and screened for ADL and cognitive
Cognitive function) function

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

OCCUPATIONAL THERAPY

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

OPTOMETRY

OPTOMETRY

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

Background Workforce

Optometry services in the Ministry of Health Year 293
Malaysia (MOH) were started in October 1985 with
five (5) pioneer optometrists graduated from 2020
Universiti Kebangsaan Malaysia (UKM) which HOSPITAL
were posted in four (4) state hospitals. There were
one (1) in Hospital Ipoh, one (1) in Hospital Pulau MOH 7
Pinang, one (1) in Hospital Sultanah Aminah, HEADQUARTER
Johor Bahru and two (2) in Hospital Kuala Lumpur.
The number of optometrists gradually increased Year HEALTH 2
through the years, and currently (2020), there are CLINIC
309 posts throughout the country. Throughout 1985
three (3) decades, the optometry service in the INSTITUTION 6
MOH has evolved through its expanded and 5HOSPITAL CADRE POST 1
extended roles. The majority of hospitals now
provide subspecialty services, such as therapeutic Total : 5 Total : 309
contact lenses, low vision & visual rehabilitation,
paediatric optometry, binocular vision & orthoptics, OPTOMETRY
visual therapy and accepting complicated case
referrals from various parties. To ensure the
services are more accessible to the public,
hospitals without ophthalmologist began providing
optometry services in 2004, followed by health
clinics in 2011.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 291

OPTOMETRY Introduction This involves Hospital Tengku Ampuan Najihah,
Kuala Pilah as the lead hospital and the Hospital
An optometrist is an autonomous and qualified Jempol and Hospital Tampin as the district
eye health professional with a Bachelor’s Degree hospitals, serving as a single entity to provide
in Optometry and legislated by the Optical Act ophthalmology-optometry services to the local
1991. Optometrists are responsible for conducting population. As a result, there is a double increment
eye examinations to detect, diagnose, treat and of accessibility to care for cataract, including
manage any visual function anomalies, refractive error.
specifically refractive abnormalities. The National Health Morbidity Survey III indicated
that 15 per cent of Malaysians have diabetes. This
Functions is a major driver for the policy of integrated care.
Management of diabetes mellitus (DM) must
At the hospital level, optometrists provide include care of the disease complications,
subspecialty services such as contact lenses, including diabetic retinopathy, glaucoma and
binocular vision and orthoptic, low vision and cataract. Integrated care or multidisciplinary
visual rehabilitation and paediatric optometry, teamwork of physician, optometrist and other
special diagnostic tests and ophthalmic healthcare providers is essential. Study showed
dispensing. Optometrists who work at health clinic that at least half of patients with known DM have
also conduct primary eye care for the community. never had an eye examination. Optometrists have
been conducting screening and grading for DM
Performance and Achievements patients at the hospital and an outreach
programme.
Enhancement of Service Delivery As there is an absence of spectacle dispensing
A cataract is the most common cause of blindness service at MOH hospitals, optometrists embarked
and low vision (NES II 2014). The prevalence of on a public-private partnership for spectacle
blindness caused by cataract is 58 per cent provision in early 2018 under the Amblyopia and
(63,628), with the percentage of people having a Visual Impairment Screening (AVIS) programme.
cataract is highest in East Malaysia (Sabah, 1.9% This novel partnership in optometry currently
& Sarawak, 1.6%) and Terengganu (1.4%). recruited 127 private optometrists nationwide and
Optometrists contribute to the excellent surgical is growing in numbers. This collaboration has
outcomes for cataract services nationwide (2017) been selected as one of the projects being
due to quality biometry and refraction procedure. monitored by this strategic plan.
The monitoring of cataract outcomes includes Advanced orthoptic assessments are also
aspects such as visual acuity outcome at 12 weeks provided at Hospital Kuala Lumpur by two (2)
post-cataract operation. This has been recognised optometrists with Subject Matter Expert
by the International Agency of Prevention of recognition. Their work and expertise are highly
Blindness (IAPB) during the Western Pacific commended by the Ophthalmologists who receive
Cataract Surgical Outcomes Meeting in 2018 held strabismus referrals across the country.
in Kuala Lumpur.
To improve accessibility to cataract service, Workload/ Census
optometrists are also essential team players in The workload of optometrists has increased
Klinik Katarak Kementerian Kesihatan Malaysia consistently with the burden of blindness and
(KK-KKM), an outreach programme involving visual impairment in the country. Table 45 shows
mobile eye services to rural and remote areas. The the total number of patients treated by optometrists
other recent project which optometrists are over the last three (3) years, including paediatrics
diligently participating in is the Cluster Hospital and adults:
Ophthalmology-Optometry.

Table 45 :The Total Number of Patients Attended by Optometrists According to Procedures
in the Year 2017 - 2019

No. of Procedures/ Year 2017 2018 2019

Refraction (Adult & Paediatric) 273,107 278,969 286,114

Primary Eye Care 20,011 16,943 17,200

Binocular Vision/ Orthoptic Clinic 13,767 16,219 17,840

Low Vision Clinic 2,029 2,246 1,901

Contact Lens Clinic 2,176 2,153 2,444

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

Research/ Innovation/ Publication/ Presentation Recognition/ Achievements OPTOMETRY
On 4 Nov 2019, optometrist Dr Asmah Ahmad Primary Eye Care
and Nor Aini Hanafi from Ophthalmology In early 2019, the Primary Eye Care Committee
Department, Hospital Tuanku Jaafar Seremban (consist of ophthalmologists and optometrists)
won 1st prize in the Design Thinking has successfully developed a Comprehensive
Association of Malaysia (DTAM), at d.school Primary Eye Care training module for an
Malaysia (Genovasi), Petaling Jaya under optometrist to be used as a reference by
category People-Centric Award for their optometrists working in hospitals without
innovative eye chart called Carta Inovasi. This specialist and health clinics.
child-friendly eye chart utilises symbols helps to Standard Operating Procedure
screen vision in children as early as four (4) In 2019, Allied Health Sciences Division
years old at the health clinics, as a vision chart launched a Standard of Operating Procedure
for children is not available at health clinic. (SOP) for optometrists (2nd revision) with some
On 25 Jul 2020, AVIS Glasses Scheme, a improvement from the first edition. This SOP
public-private collaboration innovation project consists of seven (7) optometry services:
for spectacle provision for preschool children, Plan Operation Management.
won the 1st prize (Service Category) at the Hari General Optometry Service.
Inovasi Bahagian Sains Kesihatan Bersekutu. Contact Lenses Service.
Three (3) months later (30 Oct 2020) the same Binocular Vision and Orthoptic Service.
project won the Anugerah Khas Juri at the Hari Low Vision Service.
Inovasi MOH. Optometry Primer Service.
Cluster Primary Eye Care Services (CPECS) Paediatric Optometry Service.
Kuala Lumpur Health Clinic (KKHKL) project
has been selected by the World Council Subject Matter Expert
Optometry and Brien Holden Vision Institute for In 2019, two (2) optometrists were recognised
its value in reducing the percentage of as Subject Matter Expert (SME) in the
unnecessary referral by 40 per cent to the orthoptics sub-specialty by the Public Service
Ophthalmology Clinic at Hospital Kuala Lumpur. Department (Jabatan Perkhidmatan Awam,
The project was presented as an excellent JPA).
example to neighbouring countries at the Asia Credentialing and Privileging
Pacific Optometric Conference in Manila, Since 2017, a total of 221 (75.9%) optometrists
Philippines, on 19 Jun 2019 to highlight its have been credentialed for their competency in
accomplishments in the field. their specific related area of practice. As for July
In 2018, the IAPB has included Malaysia as one 2021, a total of 374 advanced procedures, 82
(1) member country for Myopia Control in the specialised procedures and 11 optional
Western Pacific Meeting held in Singapore. This procedures have been credentialed to MOH
is due to optometrists’ important role in the field, optometrists.
which has been regarded as significant. With Quality Assurance (QA) Activities
their assistance, an action plan was made to Optometrists are also involved in quality
initiate collaboration in research and myopia assurance activities. The most recent awards
prevention programme with universities and won in QA are:
institutions. On 27 Oct 2019, an optometrist
from Hospital Kuala Lumpur was invited to 1st prize Category of People-Centric Award
co-present at the international level, a at Design Thinking Association of Malaysia
symposium entitled ‘How optometrists inform (DTAM), GENOVASI d.school Malaysia for
Public Health responses to Myopia Epidemic in CARTA INOVASI (eye chart for children) on 4
the Western Pacific’ at the 3rd World Congress Nov 2019 – National level.
of Optometry at Orlando, USA. 1st prize (Service Category – AVIS Glasses
Scheme) of the Allied Health Professional
Training Innovation Day on 25 Jul 2019 – National
Currently, a total of 35 optometrists have a Level.
master’s degree and five (5) optometrists have a
PhD. Optometrists also receive specialty
structured training in therapeutic contact lenses,
binocular vision & vision therapy and low vision &
visual rehabilitation.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 293

Anugerah Khas Juri (Service Category – AVIS Global Design Thinking Week 2020
Glasses Scheme) of the Ministry of Health
Malaysia Hari Anugerah Inovasi 2019 on 30 Topic : From Inspiration to Ideas ‘Library
Oct 2019. as a third place’
1st prize (Service Delivery Category) – 21 Mar Presenter : Dr Asmah Ahmad
2019, LEAN Innovation - Pertandingan Organizer : University of Potsdam (HPI),
Kumpulan Inovasi Dan Kreativiti Kebangsaan Germany
KKM at Institute Health S y s t e m R e s e a r c h Date : 10 Mac - 30 Apr 2020
S e t i a A l a m S e l a n g o r b y optometrist from
Hospital Tuanku Ja’afar, Seremban. 3rd World Congress of Optometry and
3rd prize (Service Delivery Category) – 23 to Academy 2019 Orlando Meeting
24 Oct 2018 LEAN Innovation Penciptaan
Carta Inovasi at Summit Hotel, Petaling Jaya. Topic : IAPB: How Optometrists Inform
1st prize (Service Delivery Category) Public Health Responses to
Anugerah Inovasi Peringkat Kebangsaan 2018 Myopia Epidemic in the Western
– Putrajaya (Project Report: Blind and Visually Pacific
Impaired Registry and Support Group). Speaker : Mr Drew Keys, Dr Duratul ‘Ain
Research and Development Hussin, Mr John Farmer, Dr Suit
Optometrists have actively participated in May Ho
OPTOMETRY research activities at state, national and Organizer : American Academy of Optometry
international conferences. The recent last three Date : 23 - 27 Oct 2019
(3) years’ achievements are:
Asia Pacific Optometric Congress

Topic : i. Changing the role of Optometry
in the Hospital and Community
ii. WCO Advocacy Program in
Action – outcomes
Speaker : Dr Duratul ‘Ain Hussin
Research Oral and Poster Presentation Organizer : Optometric Association of the
− 1st Prize oral presentation - The Status of Philippines
Date : 17 - 20 Jun 2019
Accommodation After Active Near Work by
Using Smartphone at 2nd National Meeting on Cataract Surgery Outcomes
Ophthalmology Research Day 2019. Monitoring Systems

− 2nd prize oral presentation - The Topic : Role of Optometrists in the Local
Measurement of Ocular Parameter Using Action Plan to Eliminate Avoidable
IOL Master 700 on the Cataract Patient Blindness
Before and After Dilatation at the 2nd Speaker : Dr Duratul ‘Ain Hussin
National Ophthalmology Research Day Organizer : World Health Organization
2019. (WHO), International Agency of

− 1st prize oral presentation - Intraocular Prevention of Blindness (IAPB)
Western Pacific Region,
Lens Power Calculation Using IOL Master Ophthalmology Service MOH
700 and Various Formula in Short, Normal
and Long Axial Length Malaysia
Date : 19 - 21 Sep 2018
atOphthalmology-Optometry Conference
2018.

International Symposium Presentation and Meeting on Myopia Control Strategies
Meeting Representative
Topic : Developing Myopia Control
Strategies in Malaysia
Speaker : Dr Duratul ‘Ain Hussin, Datin
Eye Health in a Changing World International Rosmawati Uthman, Dr Noorhaire
Virtual Conference Sumarlie Nordin

Topic : Optometry in Asia: Malaysia Organizer : World Health Organization
Speaker : Dr Duratul ‘Ain Hussin
Organizer : India Vision Institute (WHO), Brien Holden Vision
Institute, International Agency of
Date : 2 - 4 Oct 2020 Prevention of Blindness (IAPB)

Western Pacific Region &
Singapore Eye Research Institute
Date : 13 - 14 Nov 2018

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

International Advocacy due to human resource posts allocation and
availability. However, they should be able to
Study Tour from the Ministry of Health Vietnam practise their knowledge and skill within the
Date : 27 - 28 Sep 2019 available capacity at their current hospital.
Objective : i. To understand the scope of Adequacy and Optimisation of Health
Resources
practice, governance and registration As only two (2) optometrists are working at health
of optometrists in Malaysia. clinics, there is an urgent need to employ more
ii.To study examples of integration of optometrists to serve as primary eye care providers.
optometry into public and private In addition, as DM is increasing in prevalence, the
health facilities and contribution to demand for screening and grading is also
blindness prevention in Malaysia. increasing. However, as there is no dedicated eye
care manager at the health clinic to handle the
Study Tour from the Philippine Society of Public nationwide initiatives, the sustainability of the
Health and Occupational Optometry outreach programme is a challenge.
Strengthen/ Enhance Career Pathway
Date : 3 - 4 Oct 2019 There is a limited area and number of optometrists
Objective : i. To understand the justification of recognised as SME. Only two (2) of them were
establishing optometry services selected as SMEs in the Orthoptic specialty.
in the public sector, optometry
service, governance, financial Limited Training Opportunity OPTOMETRY
implications to the Ministry, Training is limited to specific disciplines available
optometry job description, at local universities. Training needs analysis needs
registration and legislation. to be carried out to ensure optometrists further
ii. To observe/informal visit to a their studies in areas needed for service provision.
facility and health clinic setting
with optometry services in Kuala
Lumpur.

Issues and Challenges

Strengthen/ Enhance Service Provision

Increased demand for optometry services is Lack of Collaboration Intra/ Interagency/
consistent with an increased number of Community
Ophthalmology sub-specialities in the country as Collaboration with private optometrists for
in Table 46. spectacles dispensing has been initiated
However, the number of formally trained voluntarily since 2018 through the Amblyopia and
optometrists for these subspecialties is still Visual Impairment Screening (AVIS) Programme
inadequate. Therefore, the opportunity for inproviding spectacles at an affordable cost.
optometrists to pursue postgraduate studies in However, there is slow growth and minimal
the related field is needed. participation among private optometrists due to
Empower for specialty optometry at lack of recognition on their contribution, absence
non-subspecialty ophthalmology services. of funding from the programme and lack of
awareness of the public-private partnership
Most optometrists with specialty areas (PhD/ benefits. To ensure the long-term viability of
masters/ certificate) are not necessarily posted networking, private optometrists need incentives
at ophthalmology services with sub-specialty and recognition from the government.

Table 46: The List of Subspecialty Ophthalmology and Specialty Optometry

No. Subspecialty Ophthalmology Specialty Optometry
1. Paediatric Ophthalmology Orthoptic and Binocular Vision

2. Cornea Contact Lenses

3. Medical retina, Vitreo Retinal, Glaucoma Low Vision & Visual Rehabilitation

4. Glaucoma Glaucoma Shared Care

5. Public Health Ophthalmology Public Health Optometry

6. Comprehensive Ophthalmology Primary Eye Care Optometry

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 295

OPTOMETRY Due to the current low participation, spectacles highlights the importance of primary healthcare
provision is limited and cannot be implemented to advance the protection and promotion of
nationwide. This leads to the ineffectiveness of the health strengthened by the Astana Declaration
optometry service for refractive error, causing 2018. The Malaysian Ministry of Health has also
amblyopia and visual impairment in the included strengthening primary healthcare in
community. This consequently affecting the its Plan of Action 2016 - 2020 (Strategic Thrust
physical, intellectual, social and emotional 1). Both Strategic Measure 1 and 3 outline two
development of children. (2) policies to support the expansion of primary
eye care led by optometrists at community
Increasing Disease Burden and Change of clinics. Ineffective ocular health assessment at
Demography the community level can be enhanced through
As the prevalence of diabetes mellitus (9.4%) establishing optometrists-led primary eye care
increases in Malaysia (NHMS 2019), preventive services.
measures for eye disorders complications through
primary eye care are very important at the Public-Private Partnership
community level. However, there are only two (2) Sustainable Developmental Goal (SDG) also
optometrists deployed at health clinics since 2011 prioritises access to eye care so that no one will
(Jinjang Health Clinic, Wilayah Persekutuan Kuala be left behind. This is to ensure everyone can
Lumpur and Bandar Baru Ayer Itam Health Clinic, access essential quality health services without
Pulau Pinang). As a result, many eye diseases are facing financial hardship. Strategic Plan of MOH
present late, and accessibility to eye care is limited for 12th Malaysia Plan emphasises the
for people from rural and low-income families. importance of networking outside MOH to
increase access to quality healthcare services
Way Forward and enable choices for all regardless of
affordability. This applies to spectacle provision
Philosophy and correction of refractive error initiated by the
Optometry focuses on three (3) philosophies in AVIS programme led by optometrists.
future planning: Principles

Specialty & Subspecialty Framework of MOH Current Achievements - Sustain/ Maintain
under 11th Malaysia Plan (2016 - 2020) Specialty optometry care.
emphasis the development of clinical services
for MOH hospitals. Existing issues that have not been solved -
Strengthen, expand and enhance optometry Reform
care in public health. This is in line with the
Alma-Ata Declaration 1978 that puts health Human resource at Public Health to expand
equity on the international agenda, including primary eye care services.
primary eye care. This is further supported by
Sustainable Developmental Goal (SDG) 3.8 and New Issues - New Strategies
Universal Health Coverage (UHC) that Public-private partnership in spectacle
provision for preschool and school children.

Conclusion : The Strategic Plan 2021 - 2025 for optometry is aligned with the
previous strategic plan and consistent with the Ministry of Health’s Strategic
Plan to ensure improved quality of optometry care to the population’s visual
status. The framework will serve as a guide for planning, implementing,
monitoring and evaluating optometry’s profession to further strengthen
services in the country.

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

Detailed Implementation Plan for Optometry

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 OPTOMETRY
No Profession Strategy

(B) Medical Framework - Allied Health Sciences Division

Strategy 2: Optimise resource management including facility, equipment and financing

Main Implementation Plan No. 26:
To optimise healthcare resources through interagency collaboration in service delivery

Profession Activity Indicator Target
Implementation Plan

1. Expansion of optometrist-led To employ contract optometrists Number of contract optometrists 15 contract optometrists
primary eye care services at health clinics appointed appointed in selected
health clinics by 2025
2. Establishing Public-Private To strengthen collaboration Number of optometry public-private 300 in 5 years
Partnership between between public and private partnership established in PPP-S
optometry MOH with private sector in correction of refractive (AVIS)
optometrist practise error for spectacle provision
(PPP-S) for children

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

Main Implementation Plan No. 28: To ensure adequate supply of in-service competent medical personnel

Profession Activity Indicator Target
Implementation Plan
To appoint sessional optometrist Number of sessional optometrists Minimum 2 sessional
3. Improve accessibility to at required subspeciality appointed per subspeciality optometrists by 2025
specialised optometry ophthalmology services
services ophthalmology services

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 297

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

Profession Activity Indicator Target
Implementation Plan

4. Strengthen the competency To facilitate optometrists in Number of optometrists trained in sub Minimum 2 optometrists
of optometrists through pursuing masters/ PhD/ clinical speciality optometry per year
Master/ PhD/ clinical attachment with or without
attachment programme scholarship in related sub
speciality optometry:
OPTOMETRY
i. Orthoptic and Binocular
Vision

ii. Contact Lenses
iii. Low Vision & Visual

Rehabilitation
iv. Glaucoma Shared Care
v. Public Health Optometry
vi. Primary Eye Care Optometry

(C) Allied Health Sciences Division - Profession Optometry
No Profession Strategy

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

OPTOMETRY

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

PHYSIOTHERAPY

PHYSIOTHERAPY

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

Background Workforce

Physiotherapy services in Malaysia began in the Year
1950s, and British Expatriates managed the
services. In the 1960s, physiotherapists trained 2020
from the United Kingdom provided physiotherapy
services. Subsequently, those qualified from HOSPITAL 1,094
Australia, New Zealand, and India under the
Colombo Scholarship Scheme joined the services. HEALTH 372
The School of Physiotherapy, Hospital Kuala CLINIC
Lumpur, Ministry of Health Malaysia (MOH) was
established in 1974, offering three (3) years of 6MOH
training for each selected state representative.
The trainees who had completed their training HEADQUARTER
successfully were awarded a Physiotherapy
Certificate. The first batch of graduates consisted Year MOH 21
of four (4) graduates who served as COLLEGE 49
physiotherapists grades B9 in the MOH in 1977. In 1950’s CADRE POST
1991, under the New Remuneration System
(Sistem Saraan Baru, SSB), new appointment 15HOSPITAL 90INSTITUTION
grades were changed to U8. Later, under the
Malaysia Remuneration System (Sistem Saraan Total : 15 Total : 1,632
Malaysia, SSM) in 2002, the new appointment
grade changed to U29. Meanwhile, physiotherapy
service in the private sector began in the early
1990s.

The School of Physiotherapy was renamed the Pegawai Pemulihan Perubatan (Anggota) were PHYSIOTHERAPY
Physiotherapy College in 1994. The appointed at Hospital Kuala Lumpur and Hospital
Physiotherapy Certificate was upgraded to Sungai Buloh, Selangor. However, based on the
Diploma in Physiotherapy. In 2004, the demand for global medical developments in
Physiotherapy College was relocated to Sungai Malaysia, the post of Pegawai Pemulihan
Buloh and become part of the Allied Health Perubatan (Anggota) is extended to primary
Sciences College, MOH. In 1996 a few healthcare. In 2014, the Pegawai Pemulihan
physiotherapists were offered post-basic training Perubatan Fisioterapi and Jurupulih Perubatan
in Cardiorespiratory and Neurology. In line with the Fisioterapi schemes were approved.
medical progress, the Degree in Physiotherapy Physiotherapy is used as the profession’s title in
programme from abroad was introduced in the Second Schedule Allied Health Professions
Malaysia via a twinning programme in 2003. Act 2016 (Act 774).
Subsequently, the Degree in Physiotherapy
programme was started by Universiti Kebangsaan Physiotherapy roles in Malaysia progressed and
Malaysia (UKM) in 2004. changed in tandem with countries such as
Initially, physiotherapy services were only provided Australia and the United Kingdom. Job
in state capital hospitals in the public sector, where specification and responsibilities of the
facilities and posts existed. In line with current physiotherapist saw a transformation. The scope
medical and health developments,physiotherapy of physiotherapy services is divided into four (4)
services have expanded to health clinics main fields: musculoskeletal, cardiorespiratory,
beginning with the visit of Jurupulih Perubatan neurology, and paediatrics. Extended and
(Anggota) from nearby hospitals on a scheduled expanded roles were developed to provide holistic
basis. The service was extended to the care to the patients. The added extended and
Department of Social Welfare, Department of expanded services were:
Defence and Sports School. In 1997 the post of
Jurupulih Perubatan (Anggota) was established at Women’s health
Luyang Health Clinic, Sabah. In 2002, another 12 Neuromedical/ surgical
new Jurupulih Perubatan (Anggota) U29 posts Musculoskeletal
were established at health clinics nationwide. Acupuncture
Physiotherapists expand promotional and curative Extended Scope Practitioner (ESP)
activities in public health. Initially, the Pegawai
Pemulihan Perubatan (Anggota) post was
established in specialist government hospitals
throughout Malaysia and in 2005, the two (2)

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 303

PHYSIOTHERAPY Introduction Performance and Achievements

The World Confederation of Physical Therapy Enhancement of Service Delivery
(WCPT), 1999 defines physiotherapy as a Physiotherapy in MOH is governed under the
healthcare profession that provides services to umbrella of the Allied Health Sciences Division,
people and populations to develop, maintain, and MOH. Physiotherapists are involved in education,
restore maximum movement and functional ability research, and service management to individual
throughout the lifespan. Physiotherapy services clients, communities, employers and government
involve identifying and maximising movement agencies. The functions of physiotherapy service
potential within the scopes of health promotion, are:
prevention, treatment, and rehabilitation across all
health care settings. The profession name differs Promotion of physical activity and overall health
in different countries. In some countries, the and wellness.
therapists are known as physical therapists, while Prevention of disease/ injury/ disability and
in commonwealth countries, including Malaysia, mobility limitations.
they are called physiotherapists. Managing acute, subacute and chronic
A physiotherapist is an individual who is trained conditions with functional/ activity limitations.
and registered. A physiotherapist promotes Restoration of function and rehabilitation of
physical health, analyses the subjective and disease/ injury/ disability with therapeutic
objective assessment, makes physiotherapy exercise programmes and other interventions.
diagnoses, and carries out physiotherapy Counselling and planning of maintenance and
treatment to habilitate, rehabilitate and profile any support programmes to prevent re-occurrence,
form of physical condition and disabilities to re-injury or functional in clinical practice.
restore and optimise movement and functional The scope of physiotherapy services has evolved
abilities. The scope of practice shall include from hospital-based tertiary care to
promotion, prevention, curative, and rehabilitative community-based secondary care and primary
services. The holistic management includes care, such as in sports institutions, industrial and
assessing movements, structures, and functions higher education facilities. Physiotherapy services
of the human body, identification of disabilities, in primary care were minimal in the 1990s. The
plan, and advocate treatment, and re-evaluating services then were:
their conditions. Besides, carrying out health Physiotherapists visit the community for
promotion and prevention activities through intervention programmes from nearby
screening, health education and providing hospitals.
domiciliary care. Physiotherapists participated in a
multidisciplinary home care team approach,
Functions e.g., for stroke cases.
Physiotherapists developed training modules
Physiotherapists play their role in education, for nurses and assistant medical officers to
research, and service management to individual manage special needs children and the elderly.
clients, communities, employers and government The scopes of services in primary care involve
agencies. Physiotherapists are the key personnel prevention, promotion, curative and rehabilitation.
involved in the promotion of physical activity and The services include homecare, community
overall health and wellness, prevention of disease, services, mental health, and mobile physiotherapy
injury, disability and mobility limitations. clinics. In addition to outpatient department
Physiotherapists use therapeutic exercise services, physiotherapy in health clinics also run
programmes and other interventions to manage community programmes such as Program Warga
acute, subacute, and chronic conditions with Emas, Ante-Natal Classes, and Diabetes
functional or activity limitations. They help to Programme. The target group for public health
restore function and provide rehabilitation during services is the elderly, infants and children,
disease, injury, or disability. Additionally, they play pregnant mothers and mothers, teenagers,
their role in counselling and planning maintenance children with special needs, men’s and women’s
and support programmes to prevent health, and the working community.
re-occurrence, re-injury or function in clinical
practice.

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

In parallel with the current global developments, Research/ Innovation/ Publication/ Presentation
physiotherapy sub-specialisation was established Quality Initiative Activities
in specialist hospitals to ensure comprehensive,
effective, and efficient services. The areas of Physiotherapists are active in an innovation
specialisation include outpatient services, project to improve the delivery of care. Below
in-patient services, multidisciplinary approach are examples of achievements of
services and primary care services. In the physiotherapists in innovation projects:
outpatient department, physiotherapy services > Innovated web-based exercise
cover intervention related to women and men’s
health, lymphoedema management, sports (www.mysenaman.com), 2019.
injuries, paediatric neurodevelopment, vestibular > Innovation Project PT on the Run is a system
rehabilitation, chronic pain management,
hydrotherapy, cardiac rehabilitation, manual for patient’s registration and modalities used
therapy and pulmonary rehabilitation. during patient management. It is an
Physiotherapy service is expanded to intensive open-source system and web-based. It is
care, traumatology and orthopaedic, vascular applicable for physiotherapists working in
rehabilitation, and pre and post-operative care in hospital settings and health clinic settings,
in-patient services. The multidisciplinary team 2011.
approach focuses on rehabilitation in spinal cord > Established Advanced Diploma in Neuro
injury, amputee, traumatic brain injury, stroke, Rehab, Sports Injuries and Palliative Care,
geriatric, and paediatrics. 2018.
> Developed a curriculum for Advanced
Workload/ Census Diploma in Musculoskeletal and Exercise
The numbers of patients attended by Therapy, 2020.
physiotherapist for the last three (3) years are as
in the table below (Table 47). PHYSIOTHERAPY

Table 47 : The Numbers of Patients Attended by Physiotherapists in the Year 2017 - 2019

Year 2017 2018 2019

Total number of patients attended by 2,179,064 2,223,025 2,271,238
physiotherapist

Table 48: List of Physiotherapy Quality Initiative Activities

No. State Hospital/ Category KIK/ Title Level Achievement Years
Health Innovation/ 4th place 2019
Clinic QAP
2018
1. Wilayah Hospital QA Increasing the JKWPKL & 2019
Persekutuan Putrajaya Discharge Rate of Putrajaya 2020
Acute Shoulder Pain 2018
Patients Referred to
Physiotherapy 2018
Department

2. Terengganu Kuala Innovation Easy Lifting Gorment JKN Terengganu 1st place on
Berang (Elegant) Konvensyen
Health Inovasi JKNT
Clinic

3. Pulau Hospital Innovation Simple Slide Hospital 2nd place
Pinang Pulau Innovation Exercise 2.0 Hospital 2nd place
Pinang Smart Board 1.0

Hospital Innovation i-premium Bike : International 1st
Seberang Indoor Peads Invention and (gold award)
Jaya Workout Creation
Exhibition (IIICE)

Hospital Innovation Ancore State 1st place
Bukit National Participant
Mertajam

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 305

No. State Hospital/ Category KIK/ Achievement Years
Health Innovation/ Title Level
Clinic QAP

Hospital QAP Enhancing the Hospital Participant 2019
Kepala Compliance in (Merit Award)
Batas Practicing Shoulder
Exercise Together in
Improving Their
Quality of Life in
Shoulder Pain
Patients (2019)

4. Melaka Hospital Innovation Lymph Book Department 3rd place / 2019
5. Kelantan Melaka Department 2019
Hospital Innovation Hello Physio Department Consolation prize
6. Kedah Tengku Innovation Standing frame Anugerah
7. Johor Anis (Product/ Inovasi Finalist 2020
Technical Perdana
Category)

Hospital Innovation Aplikasi Combat Fat Persada Inovasi 1st place 2019
Raja (Technology JKN Kelantan 1st place 2019
Perempuan category) Anugerah
Zainab II Inovasi 2019
Kebangsaan 2020
PHYSIOTHERAPY BSKB 2020

Anugerah Finalist
Inovasi
KKM

KIK (Product EXSco (Scoliosis Persada Inovasi 2nd place
category) support) JKN Kelantan
Innovation
(Product Smart exercise Persada Inovasi 2nd place
category) board HRPZII
Innovation
Hospital Multi-Tasking Easy MOH 2nd place 2018
Sik Innovation Box International
Indoor Paeds
Workout Award from 2018
International
Innovation,
Invention &
Creation Exhibition
(IIICE)

Hospital Innovation Smart Belt Hospital 1st place 2018
Sultanah KIK
Bahiyah Clinical Audit Happy Sleepy Hospital 3rd place 2018

An Audit on Hospital 3rd place 2018
Physiotherapy Early
Intervention with Mas
for In-patient Stroke

Hospital Innovation Physio Go Go MOH Special Award 2018
Sultanah (Service Challenge
Aminah category)

Hospital Innovation Easy Thumb Flex AHSD 1st place 2018
Sultanah (Process
Nora Ismail category)

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

Training
Training of physiotherapist as the table below (Table 49):

Table 49: The Number of Physiotherapists based on Type of Training

Year Number of Physiotherapist

Post basic 48

Degree (for those with diploma as entry level) 236

Postgraduate Diploma 22

Masters 15

PhD 1

List of credentialing procedures in physiotherapy profession as the Table 50:

Table 50: The List of Credentialing Procedures in Physiotherapy Profession

No. Advanced Procedures Specialised Procedures Optional Procedures
1. Physiotherapy in Cardiorespiratory
Hand Hand

2. Physiotherapy in Musculoskeletal Incontinence Incontinence PHYSIOTHERAPY

3. Physiotherapy in Neurology Lymphoedema Lymphoedema

4. Physiotherapy in Paediatric Vestibular Vestibular
(Cardiorespiratory & Neuromusculoskeletal) Musculoskeletal Phototherapy

5.

6. Cardiorespiratory Hydrotherapy

7. Neurology

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 307

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

Credentialing of physiotherapist in every state based on specialisation and optional procedures as the table below (Table 51):

Table 51: Credentialing of Physiotherapists in Every State Based on Specialisation and Optional Procedures

State JKWP KL, HKL Sabah Pahang Negeri Selangor Perlis Kedah Terengganu Melaka Sarawak Kelantan Pulau Perak Johor
Putrajaya, Sembilan Pinang 3
Credentialing Labuan 2 3
1 1
Post Basic in 2 4
Rehabilitation 1 21 121 1
PhD 21 2 11 1 1
Cardiorespiratory 1
Post Basic in 1
Sport 1
Phototherapy 4 11 21 3 1 11 1
Musculoskeletal 12 5
Hand 11 1 11
Neurology 2 13 1
Vestibular
Science Social 7 5
Haemophilia 1
Lymphoedema 1
Palliative
Advance 17
Complete
Decongestive 6 14 3 1 22 3
Men’s &
Women’s Health 3 12 2
Sport Science
Oversea 1
Attachment
Hydrotherapy 1
Kinesiotape
International 2 13 1 1
classifier
91 1 1
2

Others Strengthen/ Enhance Career Pathway PHYSIOTHERAPY
The profession of physiotherapy has published Lack of specialty and subspecialty training
three essential documents to ensure the quality of focusing on special areas of interest such as
care delivery: advanced diploma and higher-level education.
The shortage of higher grade posts limits career
Standard of Practice (SOP) in Musculoskeletal, pathways for physiotherapists.
Sports Injuries, Adult Neurology, Women’s Limited Training Opportunity
Health Incontinence, Geriatric and Paediatric
Neurology were endorsed in 2014 and reviewed Inadequate hands-on training opportunity due to
in 2020. high costs.
Buku Garis Panduan Perkhidmatan Fisioterapi Limited opportunity for training abroad.
di Hospital dan Klinik Kesihatan in 2014.
Prosedur Operasi Standard Perkhidmatan Lack of Collaboration Inter/ Interagency/
Fisioterapi di Kesihatan Primer in 2016. Community

Issues and Challenges Lack of human resources (inadequate numbers
of physiotherapists).
Strengthen/ Enhance Service Provision Increasing Disease Burden and Change of
Demography
The system for patient registration, appointment Non-communicable diseases and disabilities are
scheduling and statistics are not standardised, increasing yearly. Rehabilitation services need to
and many facilities are still using manual address these issues. However, there is an
documentation. Some facilities are using IT inadequate number of physiotherapists in the
systems but not integrated between hospitals or country.
clinics in MOH.
Lack of awareness of rehabilitation services Way Forward
among the community.
Philosophy
Human Resource Capability and Competency In line with the MOH’s vision, Sustainable
Currently, the numbers of patients and Development Goals and Universal Health
non-communication disease and infectious Coverage, the physiotherapy profession is
diseases are increasing. Many new services dedicated to promote and improve global health
have been extended and expanded without an by providing full accessibility, availability,
additional workforce. Shortage of workforce affordability quality health services to everyone,
leads to inadequate quality of treatment and and when and where needed.
services. WHO projected Malaysia to be an elderly nation
Increase numbers of the complexity of cases by 2030, with 15 per cent of the population are 60
that require specialised technical skills and years old and above. With the rise of the elderly
training. population, the risk of falls and their complications
are expected to increase. Therefore, there is a
Adequacy and Optimisation of Health need for a strategy to tackle falls among the
Resources elderly. Thus, service delivery related to screening
of falls among elderly patients needs attention.
There are many worn-out high technology assets. Profession priorities are to reform the resources
Many facilities do not receive a replacement for management, including human resources,
Beyond Economical Repair (BER) equipment, facilities, and equipment, and enhance healthy
impacting services requiring high technology ageing by strengthening networking and
equipment. connections at the community level. Besides that,
As the number of patients increases each day, specialised training for subject matter experts
the demands of space facilities are needed to should align with the medical technologies
enhance the patient’s services. Inadequate advancement and development.
space in the physio unit is unable to capture the
demands. Furthermore, the need to upgrade old
facilities to technology-friendly facilities is crucial.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 309

PHYSIOTHERAPY Principles
Current Achievements - Sustain/ Maintain
Standard of Practice (SOP).
Existing Issues That Have Not Been Solved - Reform
Mapping of assets - Cluster Hospital.
New Issues - New Strategies
Service delivery related to screening of falls among elderly patients.

Conclusion : Physiotherapists have been providing excellent rehabilitation
services across healthcare facilities nationwide. The profession has expanded
at primary, secondary, and tertiary settings over the years to pursue quality
care across age groups and disability types. However, there is still room for
expansion and improvement in human resources, medical equipment
optimisation, career development, and training needs. The strategies under
12MP aimed to enhance service delivery, population quality of life and
professional development.

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

Detailed Implementation Plan for Physiotherapy

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 1: Strengthen healthcare service delivery in hospitals PHYSIOTHERAPY
Main Implementation Plan No. 15:

To provide seamless care for the aging population in the current healthcare settings

Profession Activity Indicator Target
Implementation Plan

1. Strengthen fall prevention To implement fall prevention Percentage of facilities implementing 80% of all hospitals/ primary
strategies in elderly population screening for elderly population screening for elderly population by using health clinics implementing
by using Elderly Mobility Scale EMS fall prevention screening for
(EMS) elderly population by using
EMS by 2025

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

2. Optimise medical equipment To optimise usage/ mobilisation of Percentage usage/ mobilisation of 100% usage/ mobilisation of
usage physiotherapy related medical physiotherapy related medical physiotherapy related
equipment in cluster hospitals equipment in cluster hospitals medical equipment in cluster
hospitals by 2025

(C) Allied Health Sciences Division - Profession Physiotherapy

No Profession Strategy

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 311

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

RADIATION
THERAPY

RADIATION THERAPY

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

Background Workforce

The radiation therapy profession in Malaysia Year 20Ye2ar 0
began as early as the 1950s at the Hospital Kuala HOSPITAL/ 328
Lumpur (HKL). It was first started by Dr Lynch, an 1964 INSTITUTION
Irish radiotherapist and Dr Lal from Singapore. HOSPITAL 4
They managed to get two (2) radiographers, a staff MOH 2
nurse, a secretary, and an attendant to develop Total : 4 HEADQUARTER
their support team. In the early 1960s, four (4)
radiation therapists (RTTs) trainees were sent to Total : 330
the United Kingdom (UK) for training. The trainees
were selected under Colombo Plan, and it took
them two (2) years to complete their study. Upon
completion, they were awarded the Diploma
Society of Radiographers (Therapy) United
Kingdom (DSR [T]).

In 1960, Dato’ Dr S.K. Dharmalingam was the first
Malaysian Radiotherapist Specialist that led the
radiotherapy service in Malaysia. The HKL
established its X-Ray Training School in 1963,
based on the X-Ray Association of the United
Kingdom syllabus. Four (4) RTTs trainees have
completed their course at this school a year later.
They were sent to Hong Kong to complete their
training programme due to the lack of facilities at
the Hospital Kuala Lumpur (HKL). In 1967, the
radiotherapy training programme resumed with
establishing the modern Institute of Radiotherapy,
Oncology and Nuclear Medicine in HKL. Currently,
all trainees are trained locally under the
supervision of the Ministry of Health (MOH).
Trainees who have completed their training were
awarded the Diploma College of Radiographers
(T) (UK).

In the 1970s, the Radiation Therapy Services Scheme was in category B, with new appointments starting RADIATION THERAPY
from B9 grade and a senior grade at B3. In 1981, a three (3) years Radiation Therapy Training Curriculum
was developed by the MOH. Upon completion, the trainees were awarded a Radiotherapy Certificate,
Ministry of Health, equivalent to the diploma from Universiti Teknologi MARA (UiTM). In 1998, the training
division of MOH upgraded the Radiotherapy Certificate to Radiotherapy Diploma. Radiotherapy Diploma is
the basic qualification for the current Malaysian RTTs entry into public service appointment under the MOH.

When the government introduced the New Remuneration System (Sistem Saraan Baru, SSB) in 1991, the
RTTs entry-level into civil service was changed from grade B9 to grade U8. In 2002, the appointment grade
was changed again to U29 under the Malaysian Remuneration System (Sistem Saraan Malaysia, SSM).
Later in 2005, the scheme of service for RTTs was incorporated under the Integrated Services Scheme
(Skim Perkhidmatan Bersepadu). Grade U38 and U40 were abolished under this scheme, where they were
required to take a transition course to be upgraded to grade U41. The diploma holder was maintained at
U29, and those with bachelor’s degree were placed at U41. Under this scheme, RTTs in grade U36 are
eligible to be promoted to grade U42 until U54. To date, the highest grade that had been filled is U48,
although the gazetted post-approval is up to U54. Currently, 301 RTTs are working in the hospitals under
the MOH, providing radiotherapy and oncology services. The hospitals are HKL, Hospital Umum Sarawak,
Hospital Sultan Ismail, Johor; Women & Children Hospital Likas, Sabah; Hospital Penang, National Cancer
Institute (NCI) and MOH headquarters.

RTTs provide radiotherapy services according to the current technology development. The technology has
been advancing from conventional (2D) to conformal (3D) techniques, followed by Intensity Modulated
Radiotherapy (IMRT)/ Volumetric Modulated Arc Therapy (VMAT) and Stereotactic. As such, RTTs are
urged to enhance their knowledge and skills to deliver accurate, precise, and safe radiotherapy treatment
in line with the technology development.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 315

RADIATION THERAPY Introduction To improve access and enhance the oncology
services in Malaysia, the NCI Stereotactic
Radiotherapy is a method of treatment utilising Radiosurgery (SRS) team has started an SRS
high energy radiation to treat malignant and programme in 2017. It consists of four (4) phases;
non-malignant diseases. visiting each centre, forming a SRS team, training,
Radiotherapy treatment can be given both developing standard operating procedures, and
externally and internally. External radiotherapy initiating SRS/ SRT services in Hospital Umum
aims at high energy radiation from outside the Sarawak and Hospital Sultan Ismail, Johor Bahru.
body into the affected area using high technology On 20 Dec 2017, Hospital Umum Sarawak
dedicated equipment. Internal radiotherapy successfully started the first SRT case.
involved having radioactive material placed inside Meanwhile, Hospital Sultan Ismail, Johor Bahru
the body. successfully treated its first patient on 14 Mar
An RTT is a professional trained to perform 2018. NCI provides prostate implant and
radiotherapy imaging, evaluate and verify stereotactic body radiotherapy (SBRT), which was
treatment plans, deliver the planned and initiated in 2014. The Oncology Information
prescribed treatment using accurate and safe System (OIS) was upgraded to better service
radiation therapy. RTTs also monitor and assess delivery in most radiotherapy hospitals.
radiation side effects to cure or palliation of As no government/ public hospitals provide
diseases treated with radiotherapy. radiotherapy modalities in the northern region,
patients in need of radiotherapy treatment will be
Functions referred to private hospitals in Penang through
Public-Private Partnership (PPP). In addition, to
RTTs are involved in two (2) modes of radiation address the need for radiotherapy services in the
delivery which are Teletherapy (External Beam northern region, the government has approved
Radiotherapy) and Brachytherapy, a treatment RM 500 million to construct a cancer centre in
technique that uses sophisticated computerised Sungai Petani, Kedah, equipped with CT
machines. The function of RTTs comprises Simulator and Linear Accelerator machines.
multidisciplinary teams that facilitate patient
clinical and psychosocial care in the treatment Workload/ Census
preparation and delivery services. The table below (Table 52) shows the number of
patients attended for the last three (3) years in
Performance and Achievements MOH. The number of patients treated has
increased since the service was first offered.
Enhancement of Service Delivery
Radiotherapy services are being offered for both Research/ Innovation/ Publication/ Presentation
in-patient and outpatient services. Radiotherapy Innovation
techniques that being offered are conventional 1st place in Innovation Category Johor State
(2-Dimensional), conformal (3-Dimensional), Health Department Level, 2018 representing
IMRT/ VMAT, and special technique, such as Total Hospital Sultan Ismail entitled ‘Blood
Body Irradiation (TBI) and stereotactic. HKL has Irradiation Kit’.
provided TBI service since 6 May 1998. In 1999, 2nd place in KIK Convention 2018, Ministry of
HKL initiated a Stereotactic Radiosurgery/ Health represents the Johor state in category
Stereotactic Radiotherapy (SRS/ SRT) service. of primary maintenance (primer
penambaikan).

Table 52: The Number of Patients Attended by Radiation Therapists in the Year 2017 - 2019

Year 2017 2018 2019
New Treated New Treated New Treated
patients patients patients patients patients patients

Number of patients attended by RTTs 7,734 130,913 8,239 137,615 9,088 147,503

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

Training Adequacy and Optimisation of Health Resources
Due to the fact that every radiotherapy centre’s
Education Achievement Oncology Information System (OIS) was not
synchronised and upgraded, it was difficult to
To achieve international standards, RTTs are collect standard data for radiotherapy services.
encouraged to pursue an advanced diploma or The majority of radiation centres still collect data
postgraduate study. The Advanced Diploma in manually. As a result of human mistake, the
CT Simulation began accepting applications in data may be inaccurate.
2018, with a maximum of ten (10) candidates Dissolution of radiotherapy stigma caused by
each intake. The annual projection for the misconception and insufficient knowledge in the
courses is ten (10) candidates for the Advanced effectiveness of radiotherapy treatment. It has
Diploma in CT Simulation, one (1) candidate for led to the absences of patients during
the master’s degree, and one (1) candidate for radiotherapy procedures. Therefore, patient
the PhD. To date, the numbers of RTTs with an absences might cause the waste of disposable
advanced diploma and postgraduate items that have been prepared in the
qualification are as follow: radiotherapy planning procedure.
Except for the National Cancer Institute, most
Advanced Diploma - 9 hospitals are experiencing issues with ageing
Masters - 2 (2019-2021) buildings. For example, patients will experience
PhD - 1 (2019-2022) longer wait times for radiotherapy treatment if
machines break down frequently.
Training in Specialisation Field
Way Forward
IMRT, TBI, Image Guided Radiotherapy (IGRT),
Stereotactic Radiosurgery/ Radiotherapy, and Philosophy
Stereotactic Body Radiotherapy were among Radiotherapy services are aligned with the MOH
the advanced techniques and technologies vision to lead and work in partnership. RTTs are
learnt by nine (9) RTTs in various countries one of the team members in radiotherapy
(Singapore, India, Philippines, Australia, Korea, services. They execute the radiotherapy treatment
Hong Kong, Germany and Canada). on patients, especially cancer patients. This
service provides support to people in dealing with
Recognition/ Achievements their health problems positively. RTTs role is to RADIATION THERAPY
Subject Matter Expert (SME) educate their cancer patients to appreciate health
The Subject Matter Expert (SME) position for as a valuable asset. They also encourage patients
RTTs in radiotherapy was endorsed in 2019, to be concerned and take personal responsibility
and eligible candidates will be appointed by for living a healthier lifestyle.
2021. RTTs with a grade U44 are eligible to The provision of radiotherapy services needs to be
apply. SME candidate must have at least seven efficient, equitable, affordable and safe. In order to
(7) years of working experience in provide accurate, precise, and safe radiotherapy
Image-Guided Radiotherapy and Stereotactic treatment to the patient, the radiation machine
Radiosurgery/ Stereotactic Radiotherapy/ must be technologically updated. In addition, RTTs
Stereotactic Body Radiotherapy specialisation. shall carry out some innovative programmes to
They can be considered as highly skilled and ensure the quality of the radiotherapy services.
able to make good decision making and RTTs uphold and practice values of
problem-solving regarding radiotherapy professionalism, care, and teamwork to deliver
treatment and verification. SME person is a better quality radiotherapy services. They respect
professional reference to national, regional and patient’s dignity and are involved in community
world. activities, such as cancer prevention programmes.
According to World Health Organization (WHO)
Issues and Challenges Sustainable Developmental Goals (SDG) 3, good
health and well-being in radiotherapyare important
Human Resource Capability and Competency to ensure the continuity of radiotherapy services
Difficulty in pursuing study in degree level of and not disrupted by the shortage and equipment
radiotherapy because there are no universities that breakdown.
offer part-time programmes.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 317

Meanwhile, our community has good access to Existing issues that have not been solved -
quality radiotherapy services through government Reform
initiative like PeKa B40 Programme. For example,
the scheme includes benefits for cancer patients to Facilities (Radiotherapy Machine) - machines
complete their radiotherapy treatment and cash that have been used for more than ten (10)
incentive for transport to hospitals. years frequently encountered breakdowns
Principles contributing to long waiting times for
radiotherapy treatment. To overcome this
Current Achievements - Sustain/ Maintain problem, patients are referred to either another
Revision of syllabus for Advanced Diploma in government hospital with the same service or
Computed Tomography (Post Basic) a nearby private hospital through
Programme in collaboration with Training public-private partnership (PPP).
Management Division MOH (Bahagian
Pengurusan Latihan KKM). At present, most radiotherapy machines and
Revision of syllabus for Diploma in facilities do not synchronise with the OIS. It
Radiotherapy in collaboration with Training has different types of versions; therefore, it is
Management Division MOH and Institute for unable to link with one another. The solution is
Training, MOH. to upgrade the existing system to have the
Targeted Key Performance Indicator (KPI) same version and connected in every
was achieved. government radiotherapy facility.
Credentialing & Privileging Programme was
established. New Issues - New Strategies
Standard Operational Procedure (SOP) was Based on global practice, especially in
established. Canada and Australia, RTTs have excellent
career development. The creation of a higher
position enhanced their skills and knowledge.
The introduction of advanced practice in
radiotherapy services in our country has
encouraged RTTs to further their study. SME
was a good start towards this goal. Hence,
RTTs are encouraged to acquire multi-level
skills and knowledge in order to be recognised
internationally by the Quality Assurance Team
in Radiation Oncology (QUATRO) and to be
on par with oncologists and medical
physicists.

RADIATION THERAPY Conclusion : The Strategic Plan 2021 - 2025 for radiation therapy (2021 -
2025 12MP) is based on the Vision and Mission of the Medical Programme
MOH as well as WHO’s Universal Health Coverage (UHC) and Sustainable
Development Goals (SDG). This plan is a translation of the direction of the
RTTs services that focuses on what can be achieved yearly, mid-term, and long
term and clear outlines on what actions need to be taken through planned
programmes and projects. This strategic plan’s sophistication will be reflected
in the planning and implementation of projects, which may change depending
on needs and suitability. The implementation of a strategic plan improves the
quality of the radiation therapy profession. The success of the strategic plan
requires the cooperation and involvement of all parties, including the MOH. All
decision making processes such as budget preparation and other key planning
needs to be done based on this strategic plan. All RTTs will commit to
translating this plan through ongoing implementation, monitoring and
evaluation.

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

Detailed Implementation Plan for Radiation Therapy

The allied health profession’s Detailed Implementation Plan (DIP) outlined in this Strategic Plan is divided into three (3) tiers
which are:

(A) Strategic Framework - Medical Programme
The activities/ indicators/ achievements will directly be monitored under the Head of Services, and the allied health
profession involved will report to their respective service in the Medical Programme/ Public Health Programme or other
relevant departments.

(B) Medical Framework - Allied Health Sciences Division
The activities/ indicators/ achievements will be monitored by AHSD, and then will report to the Medical Programme/
Public Health Programme or other relevant departments.

(C) Allied Health Sciences Division - Profession
The activites/ indicators/ achievements will be monitored by AHSD for internal report and discussion between AHSD and
allied health professions.

(A) Strategic Framework - Medical Programme
No Profession Strategy

(B) Medical Framework - Allied Health Sciences Division

Strategy 3: Enhance capacity and capability of human resource for health
Main Implementation Plan No. 30: To advance clinical competencies of in-service medical personnel

Profession Activity Indicator Target
Implementation Plan

To train radiation therapists in Number of radiation therapists trained At least 50 radiation
advanced diploma in advanced diploma/ year therapists trained by
2025

1. Enhance capability of To train radiation therapists in Number of radiation therapists trained 30 radiation therapists RADIATION THERAPY
radiation therapists in Degree Programme in in degree every 2 years trained by 2025
specialised areas within Radiotherapy
MOH (as required in To train radiation therapists in Number of radiation therapists done At least 4 radiation
National Strategic Plan for Master’s in Science master’s in science (Radiotherapy) therapists completed
Cancer Control Programme, (Radiotherapy) under government scholarship Master’s in Science
2021 - 2025) (Radiotherapy) by 2025

To train radiation therapists in Number of radiation therapists done 2 radiation therapists
PhD in Science PhD in Science (Radiotherapy) completed PhD in
(Radiotherapy) Science (Radiotherapy)
by 2025

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

Profession Activity Indicator Target
Implementation Plan
2 radiation therapists
2. Enhance career pathway for To recognise radiation Number of radiation therapists appointed as SME by
radiation therapist therapists as Subject Matter appointed as SME 2025
Expert in Radiotherapy for
level 1 (from grade U44 to U48
SME)

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 319

(C) Allied Health Sciences Division - Profession Radiation Therapy

Profession Activity Indicator Target
Implementation Plan
5 radiotherapy centres by
1. Strengthen implementation To coordinate and monitor the Number of facilities that using OIS 2025
of Oncology Information implementation of OIS in every fully to generate report 1 activity/ year
System (OIS) radiotherapy facility

2. Empowerment with current, Engagement with communities Number of activities at community
relevant, and evidence- on issues of radiotherapy level
based information regarding treatment for cancer patients
radiotherapy among
communities

RADIATION THERAPY

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

RADIATION THERAPY

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 321

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

SPEECH-LANGUAGE
THERAPY

SPEECH-LANGUAGE THERAPY

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

Background Workforce SPEECH-LANGUAGE THERAPY

The speech-language therapy services started in Year
2001 with eight (8) speech-language therapists
(SLT) in major hospitals nationwide within Ministry 2020
of Health (MOH), Malaysia. They were deployed to
the Otorhinolaryngology (ORL) Department to set HOSPITAL 157
up Speech-Language Therapy Units and provide
basic services. Since then, speech-language Year 14INSTITUTION
therapy services have evolved into more
specialised fields, and the number of human 2001 HEALTH 6
resources has also increased to meet the service CLINIC
needs. In line with the high demand, 8HOSPITAL
speech-language therapy services also CADRE POST 2
commenced in rehabilitation medical service in
2008. Total : 8 Total : 179
This profession continues to grow in numbers. In
2020, the number of SLTs increased to 179. They
are deployed to 45 public hospitals, two (2) health
clinics, and one (1) Early Intervention Programme
centre. The SLTs are placed in various
departments to ensure wider service coverage of
patients.
The speech-language therapy services in
hospitals offer both in-patient and outpatient
services. Some hospitals also provide visiting
clinics to cater to patients from areas that do not
have the service. The service has expanded to
include specialised clinics such as Voice Clinics
and Dysphagia Clinics in recent years. In line with
the mission and vision of the service to provide
quality speech rehabilitation services to patients,
various improvements have been made to achieve
this goal.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 325

SPEECH-LANGUAGE THERAPY Introduction Performance and Achievements

The ability to communicate effectively is one of the Enhancement of Service Delivery
most important skills in human life and requires SLTs are actively involved in multidisciplinary and
adequate speech, language, hearing, and interdisciplinary teams (Table 53) and provide
cognitive abilities. Through communication, specialist services (Table 54) for more
humans can share their thoughts and feelings, comprehensive and holistic patient treatment.
teach and learn and build relationships. SLTs are The National Cochlear Implant Programme, MOH,
responsible for providing clinical services for first started in 2008 to provide aural rehabilitation
speech, language, communication, and services to children with hearing impairment
swallowing problems. requiring cochlear implants. Currently, SLTs from
10 satellite hospitals are directly involved in this
Functions programme.
Since 2018, SLTs have initiated programmes for
SLTs are involved in the assessments, empowering family members in assisting in patient
interventions, and counselling of individuals with care and intervention. Currently, there are 31
speech, language, social communication, hospitals running training programmes for family
cognitive-communication, and swallowing members of children with speech and language
disorders. The SLTs work closely with other delays.
healthcare and non-healthcare professionals in a The speech-language therapy profession
multidisciplinary team and/ or interdisciplinary collaborates yearly with the audiology profession
team to provide comprehensive management. and otorhinolaryngology medical service to run
Additionally, SLTs play an essential role in the ‘Better-Hearing and Speech Month’
educating, creating awareness, and empowering programme. The programme includes activities
the public in speech, language, communication, such as talks to increase awareness,
and swallowing problems through campaigns, speech-language and hearing screenings to the
talks, and programmes. SLTs also conduct public, workshops for professionals and
research, develop policies, procedures, and non-professionals, fun runs, and games.
standards of speech-language therapy services.

Table 53 : Types of Multidisciplinary and Interdisciplinary
Teams Involved by Speech-Language Therapists

Multi/ Interdisciplinary Teams Hospital Involved Focuses On

The Multidisciplinary stroke 11 hospitals Post-stroke patient management
rehabilitation team 17 hospitals - Children with Autism Spectrum
The Paediatric multidisciplinary
teams Disorder
- Children with Cerebral Palsy
- Children with Cleft Lip/ Palate

The Geriatric multidisciplinary 2 hospitals Elderly patients
teams

Table 54 : Types of Specialist Services Provided by Speech-Language Therapists

Specialised clinic Hospital Involved Focuses On

Combined Dysphagia Clinics 24 hospitals Patients with swallowing difficulties
Combined Voice Clinics 2 hospitals Patients with voice disorders

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

Workload - 1st prize poster presentation - The Prevalence SPEECH-LANGUAGE THERAPY
The number of patients attended and treated by of Dysphagia among Patients Attending
SLTs has grown since the service was first offered. Speech Therapy Clinic in Hospital Queen
The number of patients for the last three (3) years, Elizabeth Sabah at the 17th Sabah State
including paediatrics and adults with difficulties in Clinical Conference 2017.
speech, language, social communication, cognitive
communication, and swallowing, is shown in the - 3rd prize poster presentation - Efficacy of
table below (Table 55). Adapted Melodic Intonation Therapy: A Case
Study at the 17th Sabah State Clinical
Research/ Innovation/ Publication/ Presentation Conference 2017.
Research and Development
SLTs have actively participated in research Training
activities at state, national and international
conferences. The recent last three (3) years’ Postgraduate study is a great way to gain
achievements are: additional knowledge, build specialisation in areas
Research Oral and Poster Presentation of interest, and increase earning potential and
- Best Research Poster Presentation Award career advancement. To date, 13 SLTs have
(1st Prize) - Improving Care for Patients with completed their master’s degree either in local
Dysphagia: Monitoring Sustainability of universities or abroad, while another nine (9) are
Patient’s Compliance Towards Diet still pursuing their master’s degrees or PhDs.
Modifications at 12th International These SLTs specialise in dysphagia, paediatric
Symposium of Health Sciences (i-SIHAT communication, voice, hearing impairment,
2019). psychology, augmentative and alternative
- Best Research Poster Presentation Award communication, fluency, motor speech, and
(1st Prize) - Hidden Patient Safety Threat: special education. Many other SLTs have also
Dietary Patient Errors in Hospital at 10th taken the initiative to obtain additional
Annual Rehabilitation Medicine Conference postgraduate certification in internationally
(AMRMC) 2018. recognised programmes.
- Best Research Poster Presentation Award - Recognition/ Achievements
Clinical (Allied Health) Category (2nd Prize) -
Compliance Towards Diet Modification and Since 2017, SLTs have been credentialed in
Liquid Consistency amongst in Patients with procedures as recognition of their competency in a
Dysphagia: Revisited at 10th Annual particular practice. All 98 SLTs with at least five (5)
Rehabilitation Medicine Conference years of working experience are credentialed in
(AMRMC) 2018. advanced core procedures. Additionally, 10 per cent
- Best Oral Presentation Recipient (2nd Prize) of SLTs are credentialed in specialised areas of
- Improving Patient's Compliance towards speech-language, communication, and
Modified Consistencies Diets amongst swallowing. Three (3) SLTs are recognised to be
In-patients with Dysphagia at Hospital Subject Matter Experts (SME). Two (2) of them are
Rehabilitasi Cheras at 9th National Quality in Rehabilitation and one (1) in Geriatrics
Assurance (QA) Convention 2017. Speech-Language Therapy.
- Best Oral Presentation Recipient (1st Prize) -
Treatment of Single-Word Writing for a Malay SLTs are also actively involved in quality
Patient with Acquired Dysgraphia Following assurance activities. The most recent awards
Stroke: A Single-Case Experimental Study at won in QA are:
The International Symposium of Health
Sciences 2017. Best Award in Budding Inventors Camp
2019 ‘Development of Mobile Application’ -
National level.

1st Runner Up in (Product Category -
Lemonade Finger) in Allied Health
Professional Innovation Day on 25 Jul 2019
- National Level.

Table 55 : The Number of Patients Attended by Speech-LanguageTherapists in the Year 2017 - 2019

Year 2017 2018 2019

Number of patients attended by SLTs 86,497 97,277 105,490

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 327

SPEECH-LANGUAGE THERAPY SLTs actively participated in national and Limited Training Opportunity
international conferences. Some of the topics Currently, only 8.5 per cent of SLTs have obtained
presented and won in these conferences are: their master’s degree through scholarships such as
Government Scholarship (Hadiah Latihan
1st Prize (Oral Presentation) during Persekutuan, HLP) and Chevening Scholarship,
Selangor Research Week 2018 - Benefit of or through self-funding. More opportunities for
Parent-Led Intervention in Children further studies and training are necessary to
Expressive Words Performance - State ensure improved skills and knowledge for better
level. service delivery.
2nd Prize (Poster Presentation) during Lack of Collaboration Intra/ Interagency/
Selangor Research Week 2018 - Mom & Community
Dad, Lets Be My Communication Partner! - There is high dependence on SLTs in
State level. speech-language therapy care. At the same time,
there is an untapped potential of family members,
Issues and Challenges NGOs, and the community in assisting in patient
care and intervention.
Strengthen/ Enhance Service Provision Increasing Disease Burden and Change of
Speech-language therapy services cover a broad Demography
and diverse field of speech, language, The geriatric population in Malaysia is increasing
communication, and swallowing. More specialised at an unprecedented rate, and it is estimated by
clinics such as feeding and oncology and palliative the year 2040, there will be six (6) million
rehabilitation clinics are needed to cover areas of individuals aged 65 and above. These individuals
advanced expertise to provide the best treatment are at increased risks for diseases such as
in speech-language therapy. neurodegeneration, cancer, and cardiovascular
Human Resource Capability and Competency disease. The standard process of ageing and
The number of SLTs is inadequate at the MOH other comorbidities may affect an elderly’s
facilities. Currently, there are 179 SLTs in MOH, abilities to communicate or swallow, thus
with the ratio of one (1) SLTs serving a 250,000 requiring the services of SLTs.
population. Ideally, there should be a ratio of
1:7,000 or 4,000 SLTs to ensure the best speech Way Forward
therapy care for the population.
Philosophy
Adequacy and Optimisation of Health
Resources

Inadequate numbers of SLTs leading to long The speech-language therapy adheres to the
waiting times for new and follow-up cases. Vision of the MOH’s and commits to provide full
Inadequate space and number of rooms to access and to deliver quality health service to
provide speech-language therapy services. everyone. The service is aligned with Sustainable
Limited accessibility to speech-language therapy Development Goal 3, which ensures healthy lives
services, especially in rural areas as SLTs are and promotes well-being for all ages. The
primarily available at state and specialist profession prioritises the reform of resource
hospitals. management that involves human resources and
Unequal distribution of posts based on workload facilities to achieve the above objectives.
and needs. The profession also hopes to introduce a new
Strengthen/ Enhance Career Pathway programme to reach out to individuals who have
There are limited opportunities for promotion due trouble accessing speech-language therapy
to a lack of higher-grade posts. On average, it services due to distance and/or financial
takes six (6) years for an SLT grade U41 to be difficulties to achieve Universal Health Coverage
promoted to U44 and eight (8) years for an SLT (UHC), which intends to leave no one behind.
grade U44 to U48. There are 73 SLTs (52%) Next, the profession intends to foster
eligible for a promotion, not promoted mainly due public-private partnership through collaboration
to a lack of posts. with the community in health promotion,
awareness, and prevention of speech-language
and communication-related disorders
programmes.

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

Principles Existing issues that have not been solved -
Reform
Current Achievements - Sustain/ Maintain in SPEECH-LANGUAGE THERAPY
Families’ empowerment to assist Human resource.
intervention care.
New Issues - New Strategies
Knowledge, skills, and competencies of SLTs. Service accessibility through telerehabilitation.

Conclusion : The strategic plan 2021 - 2025 for speech-language therapy
aligns with the MOH’s vision to provide optimum healthcare services to all,
covering a five-year plan with yearly reviews to reflect on changes and updates
in the profession’s priorities and initiatives. The strategic plan 2021 - 2025 for
speech-language therapy will be a road map for the profession to develop and
advance speech-language therapy services in the country.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 329

SPEECH-LANGUAGE THERAPY Detailed Implementation Plan for Speech-Language Therapy

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 1: Strengthen healthcare services delivery in hospitals
Main Implementation Plan No. 13:

To enhance existing paediatric services to cater to the needs of special groups of paediatric population

Profession Activity Indicator Target
Implementation Plan

To develop training programme
module for family members of
children with speech & Completion of module for training Completed by 2024
1. To strengthen speech- language delay Number of facilities implementing the
language therapy for children training programme Minimum of 5 facilities
with speech-language delay Number of family members trained by 2025
through empowerment of At least 1 family
families, NGOs and To strengthen speech-language member trained per
community and home care therapy for children with speech facility by 2025
services -language delay through
empowerment of families,
NGOs, and community and
home care services

Strategy 2: Optimise resource management including facility, equipment and financing
Main Implementation Plan No. 26:

To optimise healthcare resources through interagency collaboration in service delivery

Profession Activity Indicator Target
Implementation Plan

To develop module of dysphagia Completion of module Completed by 2024
2. Utilise and empower families, management in elderly Number of TOT for dysphagia Minimum 3 TOT by
management in elderly implemented 2025
NGOs and community in
intervention care

To implement training of trainer
(TOT)

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

Strategy 3: Enhance capacity and capability of human resource for health SPEECH-LANGUAGE THERAPY
Main Implementation Plan No. 28: To ensure adequate supply of in-service competent medical personnel

Profession Activity Indicator Target
Implementation Plan

3. Optimise resource Appointment of contract/ Number of contract/ sessional speech- Minimum 2 person
management (Human sessional officers language therapists appointed per profession per
resource) specialist hospital by
2025

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

Profession Activity Indicator Target
Implementation Plan

4. Enhance capabilities of SLTs Equip SLTs with postgraduate Number of SLTs with Masters/ PhD Minimum 1 SLT
in specialised areas qualifications (core services) Number of SLTs done certification pursuing Masters/
Equip SLTs with trainings and course or completed attachments PhD in every 2 years
certification (core services) Minimum 1 SLT in
every 2 years
Establish specialised geriatric Number of specialised SLT geriatric Minimum 2 SLT
clinic for acquired language and clinics geriatric clinic by
swallowing 2025

Strategy 6: Leverage the use of information technology to improve efficiency

Main Implementation Plan No. 58: To improve/ enhance services delivery through use of technology

Profession Activity Indicator Target
Implementation Plan
Minimum 3 facilities
5. Enhance accessibility of SLT Initiate tele-rehabilitation Number of facilities involved in SLT implemented SLT tele
services through application services that bring SLT service tele-rehabilitation services -rehabilitation services
of technology to homes by 2025

(C) Allied Health Sciences Division - Profession Speech-Language Therapy

No Profession Strategy

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 331

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

TUTOR