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

BIOCHEMISTRY

BIOCHEMISTRY

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

Background Workforce

Biochemists in the Ministry of Health (MOH) began Year
in 1900 with foreign scientists who developed tests 2020
at the Institute for Medical Research (IMR). Dr HOSPITAL 394
George Francis De Witt was appointed in 1957 as
the first local biochemist. He served in IMR and INSTITUTION 38
was appointed as Director of IMR from 1975 to
1984. Together with other biochemists, he CADRE POST 1
developed diagnostic test methodologies and
placed the IMR as the country’s reference centre. 17PUBLIC HEALTH
In the 1970s, more biochemist posts were created
in hospitals under the MOH. These biochemists LABORATORY
headed the laboratories and pioneered the
development of clinical diagnostic testing services Year 29NATIONAL
in MOH hospitals.
In 1992, the job title for biochemists in MOH was 1960’s BLOOD CENTRE
changed from Ahli Kimia Hayat to Pegawai Sains
(Kimia Hayat) in line with the implementation of the 11STATE HEALTH
New Remuneration System (Sistem Saraan Baru,
SSB) scheme for civil servants. DEPARTMENT

MOH 9
HEADQUARTER

Total:499 BIOCHEMISTRY

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 37

Introduction International Journal Blood Research Disorder.
The Medical Journal of Malaysia.
Biochemistry is the study of biochemical Journal Analytical of Toxicology.
processes occurring within living things. Journal Analytical and Bioanalytical Chemistry.
Biochemist provides a range of medical and public Journal Inherited Metabolic Disease.
health biochemistry services to support International Journal of Chronic Diseases.
preventive, curative, and rehabilitative Brain and Development Journal.
programmes to individuals and communities Neurology Asia.
through laboratory services.
Biochemists are also actively involved in the
Functions technical committee and contribute to the
development of biochemistry services, such as:
BIOCHEMISTRY According to established international standards,
biochemists are responsible for providing Technical Committee on Clinical Laboratory
comprehensive biochemical services for medical Testing and In Vitro Diagnostic Test System
and public health programmes to ensure timely for the Department of Standards Malaysia.
and quality service. They are also responsible for
planning and managing the latest biochemical Working Technical Committee Group for
testing in pathology, blood transfusion, and public Requirement of Quality and Competence for
health services to fulfil clinical/ public health needs Primary Healthcare Laboratory for the
through continuous training and competency. Department of Standards Malaysia.

Performance and Achievements Scientific Committee (Cellular analysis and
Flow Cytometry) for the International Society
Enhancement of Service Delivery for Laboratory Haematology.

The biochemistry services are offered for both Guideline for Method Verification of
in-patient and outpatient. In addition, the services Quantitative Measurement In Medical
have expanded to environmental health, nuclear Laboratories, Pathology Services, Ministry of
medicine, research, and other specialised areas in Health, Malaysia.
recent years.
Various technical committees in Pathology
Workload/ Census Services in MOH, Malaysia.

The number of samples has grown tremendously Various technical committees in Chemical
since the service was first offered. Below (Table 4) Pathology Services, MOH Malaysia.
is the number of samples managed by
biochemists for the last three (3) years in MOH. Technical Assessor for Department of
Standards Malaysia for MS ISO 15189:
Research/ Innovation/ Publication/ Medical laboratories – particular requirement
Presentation for quality and competence accreditation
programme.
Biochemists were actively involved in research
and published their findings and write-up either Coordinator for National External Quality
locally or internationally, such as in the following Assessment for Blood Banking.
journals:
Industry Advisor for local universities.
Malaysian Journal of Medicine & Health
Science. Guest lecturer for master’s programme in local
International Journal of Biomedical Science universities.
and Engineering.

Table 4: The Number of Samples Attended by Biochemists in the Year 2017 - 2019

Year 2017 2018 2019

Number of samples attended by biochemists 27,923,280 25,515,347 27,084,822
*In biochemistry lab only

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

Training As of March 2019, one (1) biochemist is
recognised by the government as a Subject
At the moment, seven (7) biochemists have a Matter Expert (SME) in the field of
postgraduate diploma, 122 master’s degrees and immunohaematology.
10 PhD. In 2020, four (4) biochemists are still Currently, 139 biochemists hold postgraduate
studying in the master’s programme and 11 in PhD. qualifications in various fields such as
Areas of interest are: toxicology, forensic toxicology, molecular
medicine, protein and proteomics, molecular
Clinical biochemistry/ Biochemistry. genetics, transfusion science, clinical
Geriatric biochemistry. biochemistry, laboratory management,
Biochemical genetic. occupational safety and health, pharmacology,
Laboratory management/ Quality management environmental health, etc.
system.

Toxicology. Research projects related to laboratory services BIOCHEMISTRY
Environmental toxicology. such as QAP study and scientific paper were
Therapeutic Drug Monitoring. done. In addition, two (2) innovation projects
Inborn Error of Metabolism. had won the awards.
Radiochemistry. > Innovation project ‘Alat Pengering Ujian
Transfusion science/ Blood banking.
Cord blood banking. Dadah’ won 2nd place at Pertandingan
Analytical technique in molecular clinical Inovasi Peringkat Kementerian Kesihatan
biochemistry and haematology. Malaysia 2011. It is an innovation that can
Data Science/ Clinical laboratory statistical reduce the cost of tests for confirmation drug
analysis. of abuse and laboratory turnaround time.
Recognition/ Achievements > Innovation project Specimen Management
Information System (SMIS) won Anugerah
Biochemists have expertise in the management and Khas Inovasi Kementerian Kesihatan
technical aspect of medical laboratory and are Malaysia 2021. SMIS was invited by the
competent to provide technical consultation on: Ministry of Science, Technology and
Innovation (MOSTI) toparticipate in Malaysia
Quality control management. Commercialisation Year (MCY) Summit 2020
Measurement of uncertainty. from 17 to 18 Dec 2020. The MCY Summit
Method/ equipment validation. 2020 carried the theme ‘Designing
Method/ equipment verification. Technologies for a Sustainable Future’ with
Method optimisation. the objective to facilitate the penetration of
local R&D products and services into the
market via appropriate commercialisation
interventions.

Specifications for equipment, laboratory reagent Issues and Challenges
and consumables.
Selection and evaluation of tests/ methods/ Strengthen/ Enhance Service Provision
instruments. Subspecialty areas like drugs of abuse testing,
Laboratory safety. radiochemistry, an inborn error of metabolism,
Good Manufacturing Practices. histocompatibility and immunogenetics,
Good Laboratory Practices. environmental toxicology are not recognised
Many biochemists are involved in providing well and underutilised.
training on medical laboratory quality Placement of biochemist not in accordance with
management to MOH staff and university specialities, workload, and facilities. Placement
students. Furthermore, some of them are should be done according to the norm and
appointed as technical assessors for the medical need.
laboratory accreditation programme. Career development for the profession is not in
line with the complexity of services and
Biochemists are also involved in developing a expansion of specialised medical and public
standard for ‘MS 2702:2020 Primary healthcare health programmes.
laboratories: Requirements for quality and
competence’ and ‘MS ISO 15189: 2012 Medical
laboratories: Particular requirement for quality
and competence’.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 39

Human Resource Capability and Competency Principles
> Current Achievement – Sustain/ Maintain
The number of biochemists is inadequate at the
MOH facilities. There are no biochemist Immunohaematology, a subspecialty in the
positions available in some hospitals, especially field of clinical biochemistry, is being
those in remote areas. However, clinical recognised as SME.
biochemistry service standards in that area > New Issues – New Strategies
require technical and scientific supervision. Resources
There are currently 499 biochemists in MOH,
with one (1) biochemist ratio serving a 64,000 Establish more biochemist positions in
population. More human resource is needed to hospitals to provide transfusion services,
ensure the optimal care for the population. primary healthcare, environmental health
and related services to implement Good
There is a lack of structured training. Training Laboratory Practice (GLP) and Good
must be conducted or planned following the job Manufacturing Practice (GMP) according to
scope for each service provided. the right norm and needs.
Career pathway
BIOCHEMISTRY Adequacy and Optimisation of Health Expand the flexi post C48/ C52 for
Resources biochemists in specialise agencies and
create C54 positions for every state
Imbalance between workload and current hospital, institution and specialised agency.
number of biochemists. Posting should be done
according to the norm and need. Services
To strengthen the quality management
There is a lack of coordination to ensure proper programme of biochemistry services in
deployment, the right person doing the right job hospitals and primary care.
at the right place.
To establish standard competency
Strengthen/ Enhance Career Pathway assessment for all categories of
biochemists in various agencies.
Forming flexi posts in specific agencies such as
IMR, MOH Engineering Services, National To strengthen the training programmes.
Public Health Laboratory, Institute for Public
Health and Malaysian Health Technology To apply automation and integration in the
Assessment Section. work process with an increasing workload
and limited resources.
More Subject Matter Experts (SME) are needed
in toxicology, radiochemistry, inborn error of
metabolism, histocompatibility and
immunogenetic.

Way Forward

Philosophy
Develop biochemistry services with well-trained
and skilled (competent) biochemists who are also
inspired and committed to providing high-quality,
safe, and comprehensive laboratory services. In
line with the direction of pathology services 2020 -
2030, enhance the current laboratory service to
achieve a more comprehensive, high quality, and
value-added, customer focused service that is
cost-effective across all care levels.

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

Conclusion : The strategic plan 2021 - 2025 for biochemists is to strengthen BIOCHEMISTRY
and optimise human resources, finance, equipment, enhance technical quality
and data management systems in the biochemical laboratory to support
medical and public health services.
To achieve the strategies in 12MP, we have outlined several activities and
initiatives. These include expanding services, improving the turnaround time,
upgrading existing laboratory facilities, implementing central procurement,
reviewing laboratory work processes, and utilising the laboratory data
management system.
To achieve the objectives for 12MP, we need to enhance the capacity and
capability of biochemists through well-structured training modules, competency
assessment, creation of flexi posts, and recognition of expertise in the field of
clinical biochemistry.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 41

Detailed Implementation Plan for Biochemistry

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

BIOCHEMISTRY 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
At least 3 tests by 2023
1. Strengthen biochemical Expand the range of Number of new tests introduced in One Histocompatibility
testing services in hospitals, biochemical tests provided to the State hospital and Immunogenetics
Public Health and Blood support the development of Number of new Histocompatibility centre/ laboratory by
Transfusion new Medical and Public and Immunogenetics centre/ 2024
Health services, e.g. laboratory At least 80% of urgent
Procalcitonin, Troponin, Percentage of monthly urgent samples from
Interleukin, Expansion of laboratory tests within 90 minutes emergency department
Histocompatibility and LTAT One integrated
Immunogenetics lab laboratory concept
Improve the Laboratory Turn established per state
Around Time (LTAT) for by 2025
laboratory testing

Integrated laboratory concept Number of new integrated
to be implemented nationwide laboratories established

Strategy 6: Leverage the use of information technology to improve efficiency
Main Implementation Plan No. 54:

To implement of Electronic Medical Record (Hospital Information System) in MOH Hospitals

Profession Activity Indicator Target
Implementation Plan

2. Strengthen the usage of Equip Laboratory Information Number of biochemistry laboratories At least 85% of
information systems in the System (LIS) in biochemistry equipped with LIS biochemistry
hospital laboratory/ blood laboratories laboratories by 2025
bank /public health
laboratory Expansion of the Blood Bank Number of hospitals equipped with 14 hospitals equipped
Information System (BBIS) in BBIS with BBIS by 2025
the northern region and
Bintulu, Sarawak

42 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
Implementation Plan No. 22:

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

Profession Activity Indicator Target
Implementation Plan
Implement centralised Number of centralised procurements At least one in every
1. Strengthen and optimise procurement at state/ done at state/ region/ national level state by 2025
resources in laboratory region/ national level
services
Optimise the usage of sample Percentage reduction in number of At least 5% reduction
tubes in biochemistry, sample tubes used in a facility of tubes usage per
immunoassay tests facility yearly

Upgrade or replace aged Number of analyser/ equipment At least 75% of BIOCHEMISTRY
analyser/ equipment replaced/ upgraded analyser/ equipment
(>10 years) replaced/ upgraded
by 2025

Implement fully automated Number of fully automated analysers At least 50% of non-
platform to perform laboratory procured in non-specialist hospital specialist hospitals use
testing in non-specialist automated platform
hospital for biochemical testing
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

Develop specific training Number of training modules At least one module
modules for different grades/ developed per year
sub-disciplines At least one training
2. Enhance competency of per year
biochemist Provide training for
biochemists according to the
complexity of services in Number of training conducted
specialised medical and
public health programmes

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

Profession Activity Indicator Target
Implementation Plan
At least one SME
3. Establishment of career To gazette sub-speciality in Number of SME gazette for clinical gazetted in the
pathway framework for AHP Drugs of Abuse Testing, scientist (biochemist) proposed speciality by
Radiochemistry, Inborn Error 2025
of Metabolism,
Histocompatibility and
Immunogenetics,
Environmental Toxicology and
Medical Laboratory Quality
Management System

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 43

(C) Allied Health Sciences Division - Profession Biochemistry

Profession Activity Indicator Target
Implementation Plan

Implement KPI for all Percentage of KPI standard > 90% KPI standard
laboratories providing achievement achievement yearly
biochemical testing
Implement KPI in blood banks Percentage of KPI standard > 90% KPI standard
at state hospitals achievement in blood banks at state achievement yearly
hospital
Achieve ISO 15189
accreditation for medical Number of laboratories accredited All state laboratories
laboratories (14) to be accredited
by 2025
Implement Quality System One major specialist
(QS) and GMP in all blood hospital in each state
banks: accredited by 2025
a) Develop and implement
BIOCHEMISTRY 1. Strengthen technical quality Number of blood banks achieving All transfusion services
in biochemical testing guidelines for internal GMP implemented QMS and
quality control (QC) Number of guidelines established for GMP by 2025
b) Participate in EQA or inter- monitoring IQC One SOP for monitoring
laboratory comparison of IQC established by
programme and matrix- 2022
matched
Number of EQA/ inter-laboratory At least one EQA
comparison programmes enrolled Programme enrolled by
each laboratory yearly

Performance in EQA/ inter-laboratory 100% of biochemistry
comparison programme laboratories conduct
comparison with peer’s
performance (other labs
with the same
methodology/
platform/ reagent)

Creation of biochemist post in Performance in CV, SDI, TEa, bias, All state biochemist
primary healthcare laboratory and Sigma for various analyses review performance and
Number of biochemist posts compare with established
approved in primary care testing quality specification yearly
centres One C41 post approved
for primary healthcare
laboratory centre in each
state and one C48
post at Family Health
Development Unit at
each state
by 2025

2. Ensure optimum number Create flexi post C48/ C52 at Submission to Public
of biochemists to be specialised agencies to ensure Service Department
made available trained staff are retained at the (Jabatan Perkhidmatan
agencies upon promotion, e.g. Awam, JPA) by 2023
IMR, MKA, PDN/ Blood Bank,
engineering, Medical
development Division and IKU

Create senior biochemist C54 Development of proposal paper
post in each state and
specialised agency (PDN,
MKA, Engineering)

Create optimum number of
posts for biochemists
according to norm and
workload

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

BIOCHEMISTRY

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 45

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

BIOMEDICAL
SCIENCE

BIOMEDICAL SCIENCE

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

Background Workforce

The history of biomedical science degrees in 20Ye0ar9 20Ye2ar1 81
Malaysia is intertwined with medical laboratory HOSPITAL
technology diploma programmes. In line with 2HOSPITAL
global developments, a degree level medical INSTITUTION 7
laboratory-based programme was proposed by the Total: 2
Ministry of Higher Education (MoHE) and a few CADRE POST 2
Public Institute of Higher Education (Institut
Pengajian Tinggi Awam, IPTA) in the middle of the Total: 90
1980s. In 1992, Universiti Kebangsaan Malaysia
(UKM) and Universiti Malaya (UM) started the BIOMEDICAL SCIENCE
Bachelor of Science in Biomedical Science and
followed by other universities. Currently, there are
25 higher institutions (public and private) offering
degrees in biomedical science. The main objective
is to equip graduates with knowledge and skills
related to medical laboratory practices and
research.
Graduates of biomedical science have worked as
scientific officers in various clinical diagnostic
laboratories, such as microbiology, chemical
pathology, blood bank, haematology, and
histopathology. The Ministry of Health (MOH)
created the biomedical scientist scheme with
grade C41, and two (2) officers were appointed in
February 2009. Subsequently, in August 2009, the
biomedical service scope expanded to the specific
laboratories in pathology, which included the
haematology, histopathology, cytology, and blood
transfusion laboratory. The focus was to develop
and perform special tests such as Dual In-Situ
Hybridisation (DISH), immunochemistry, and many
others. Until November 2016, 82 biomedical
scientists were placed in state hospitals, major
hospitals, minor hospitals, and the Institute of
Medical Research (IMR), which involved
management and technical aspects. In 2019 grade
C44 was approved.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 49

Introduction Performance and Achievements

Biomedical science is a biology and Enhancement of Service Delivery
chemistry-related discipline used mainly in health Development of KPI for Biomedical Profession in
laboratories to classify, study, track, and treat Histopathology, Haematology, Blood transfusion,
diseases. As one of the broadest fields of modern and Cytology.
science, it continually moves forward and
underpins much of modern medicine. Biomedical In 2016, the profession developed a Key
services focus primarily on laboratories, focusing Performance Index (KPI) on the accuracy of the
on the complexity of the human body, the EQA report for full blood count (FBC) from
functioning of cells, organs, and processes, and Haematology as a professional service
how diseases and medicines affect them. standard. This KPI focuses on EQA system
Biomedical science is ever-changing and diverse, diagnostic accuracy, which is critical in providing
providing exciting career opportunities in patients with accurate laboratory results. As the
advanced laboratory work, consulting work, KPI achieved outstanding results for seven (7)
research, education, and management while at cycles (until July to December 2019) with a
the service of human society. In addition, the standard of over 80 per cent, the biomedical
findings of biomedical sciences are instrumental in profession increased the standard to more than
the growth of modern medicine. 95 per cent in the year 2020. In addition, the
Biomedical scientists carry out various laboratory profession plans to extend the KPI to cover all
and scientific tests on tissue samples and fluids to the fields of biomedical services.
help clinicians diagnose and treat diseases. They Workload
also measure the efficacy of therapies.
Below (Table 5) is the number of specimens
Functions managed by biomedical scientists for the last three
(3) years in MOH.
A biomedical scientist performs the role of
BIOMEDICAL SCIENCE maintaining and ensuring service quality Research/ Innovation/ Publication/ Presentation
measures such as external quality assurance
(EQA), internal quality control (IQC) and Guidelines
nonconformities, monitors the National Indicator
Approach (NIA), and carries out a post-mortem > Interim Guideline on Management of
when there are shortcomings. The biomedical Histopathologcal Examination (HPE)
scientist is also involved in developing complex Specimen for COVID-19 Positive Cases, 2020
tests in laboratory services, including DISH, (Name of publication - for internal use only).
immunochemistry, and cytogenetics.
Innovation
> Sistem e-Paps, Anugerah Inovasi 2019 -

organised in Hospital Queen Elizabeth, Kota
Kinabalu Sabah, 2019.

Table 5: Workload of Biomedical Scientists in the Year 2017 - 2019

Area Year No. of Specimen No. of Tests
Histopathology
2017 329,710 1,866,040
Cytology 2018 338,999 1,899,851
Haematology 2019 352,893 2,027,227

2017 344,856 507,162
2018 397,567 578,213
2019 387,604 586,080

2017 12,243,916 14,528,586
2018 12,666,166 14,887,841
2019 12,848,330 15,930,670

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

Training Recognition/ Achievements

At the moment, 12 biomedical scientists have Biomedical scientists are also actively involved in
postgraduate qualifications. Over the last 11 years various quality-related programmes, and their recent
of service, the profession has successfully sent achievements are as below:
officers to postgraduate courses, with or without a
scholarship. Areas of interest include: Anugerah Inovasi 2019 (Sistem e-Paps)
organised in Hospital Queen Elizabeth, Kota
PhD in Molecular Medicine (Haemato-Oncology). Kinabalu Sabah.
PhD in Molecular Medicine (Parasitology).
Master of Science. 1st prize in Anugerah JKN Sabah (Technology
Master of Molecular Medicine. Category) in Sabah.
Master of Law (Enforcement Law).
Master of Occupational Safety and Health. Issues and Challenges
Master of Transfusion Science.
Strengthen/ Enhance Service Provision
Future field: Most hospitals run routine and basic
• Data Science and Analytics. immunohaematology tests due to lack of budget,
• Clinical Bioinformatics. e.g., transfusion medicine services receive a
• Health Technology Evaluation. small allocation each year and need budget
support from pathology services. This situation
The biomedical scientist has undergone has led to difficulties in expanding the service. BIOMEDICAL SCIENCE
subspecialty training to support pathology services Service expansion was done as needed by
in areas of: clinicians to meet patient management without
any additional human resources.
Molecular Haemato-Oncology (Haematology).
Chimerism (Haematology). Unclear pathway of handling Human
Bone Marrow Transplant (Haematology). Papilloma-virus Deoxyribonucleic Acid (HPV
Immunophenotyping (Haematology). DNA) molecular testing. In some hospitals, the
HPV DNA molecular testing is managed in the
Molecular In-Situ Hybridisation cytology laboratory and virology laboratory. This
(Histopathology). conflict of interest may affect the training of the
scientist in the future.
Human Resource Capability and Competency

Biomedical scientists have minimal exposure to the
advanced test (PCR, in-situ hybridisation, and
molecular in-situ hybridisation) since new
technologies are offered in selected hospitals like
HKL.

Polymerase Chain Reaction (PCR) Tissue Adequacy and Optimisation of Health
(Histopathology). Resources
Human Papilloma-virus (HPV) Molecular
Testing and Immunocytochemistry (Cytology). Expansion of scope for a certain test cannot be
Immunohaematology-Red Cell Serology done because of a lack of human resources,
(Medical Transfusion). such as Janus Kinase 2 (JAK2) mutation.
In conjunction with Industrial Revolution 4.0 and
increasing developments in automation, the New technology or advanced tests not offered in
Internet of Things (IoT), big data, and cloud most hospitals due to budget constraints will
computing technologies, the profession has affect the effectiveness of the service delivery in
intended to include fields such as data science and the future.
analytics, clinical bioinformatics, and health Strengthen/ Enhance Career Pathway
technology evaluation in the list of postgraduate Lack of SME for the biochemical science
study courses. profession.

Unclear job description and differentiation
compared to biochemists who supervise certain
hospitals’ blood bank and haematology section
(especially routine haematology).

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 51

The current government policy that halts the new Principles
post seems to have impacted the officers’ morale > Current Achievement - Sustain/ Maintain
in service.
Limited Training Opportunity Between 2020 and 2021:
Due to budget constraints, limited training Four (4) new permanent officers were
opportunities in molecular (across all fields) have appointed to fill vacancies in Hospital
led to poor skill and competency development among Selayang, Hospital Pulau Pinang and Hospital
biomedical scientists. Raja Permaisuri Bainun.
Lack of Collaboration Intra/ Interagency/ Five (5) new contract biomedical scientists
Community were appointed to help the MOH in COVID-19.
Due to workload, biomedical scientists, have They were assigned to Hospital Sungai Buloh,
limited time for research and inter or intra-agency Hospital Kuala Lumpur, Hospital Tunku Azizah
collaboration, even though some biomedical and Hospital Sultanah Aminah.
scientists exist in both diagnostics and research
facilities in the MOH. Currently, there are numbers of biomedical
scientists continue their postgraduate studies in
Way Forward Malaysia and overseas:

Philosophy PhD in Molecular Medicine (Parasitology) at
A biomedical scientist functions mainly in four Universiti Sains Malaysia,
main areas: haematology, histopathology,
cytology and blood transfusion. Each area carries Master of Science in Medical Genetics and
its challenges that must be addressed to optimise Genomics (University of Glasgow, Scotland),
service delivery to the public. Master of Molecular Medicine (International
The vision and mission statement mentioned Medical University), and;
above shows the direction that the profession
BIOMEDICAL SCIENCE needs to fulfil in 12MP. The message will only be Master of Science - Molecular Medicine
achieved with the Ministry of Health’s support, (Universiti Putra Malaysia).
particularly the Allied Health Sciences Division,
National Pathology Service and National The profession has established its Key
Transfusion Medicine Service. Performance Indicator for histopathology,
Human resource issues must be prioritised to haematology, blood transfusion, and cytology.
empower the profession to deliver the best service > Existing Issues That Have Not Been Solved -
to the people. According to a Workload Indicated Reform
Staffing Need (WISN) and Workload-to-Norms
study done by the profession and National Staffing: insufficient officers for each field
Pathology Services, an existing officer is (histopathology, haematology, blood
burdened with twice the current workload. This transfusion, and cytology).
somehow has affected the morale of all the
officers in the service. With the current policy that These four (4) areas are separate fields that
halts the formation of new posts and unclear need a different set of skills.
career pathways (no C48 and above posts have An increasing number of workloads does not
been created for the profession), it is high time for match the norms for existing officers.
the management to look seriously into this matter.
There is also a need to enhance the competency, Equipment: Equipment provided in the lab is
skill and knowledge among biomedical scientists. not fully integrated and semi-automated.
Additional training budget is needed to support
postgraduate education, advanced courses, and Training & competency: Insufficient training for
short attachments to support service expansion. the molecular tests.
Most of the master’s degree and PhD courses for
scientists are not available in the country. Subject Matter Expert: The previous
application is subjected to Public Service
Department (Jabatan Perkhidmatan Awam,
JPA)’s approval.
> New Issues - New Strategies

Specific issues in medical transfusion services

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

Shortage of officers. Research/ Innovation
Unclear job description for a biomedical To create posts in the research facilities such as
scientist. the Clinical Research Centre (CRC) and IMR to
The organisational structure that does not support their diagnostic and research area.
support medical transfusion activities in some
facilities - the absence of medical officers, To increase opportunities for further studies in a
clerks, public relation officers (PRO), U36 has specialised field.
caused the workload to be burdened by
biomedical scientists alone.
Career advancement
Creation of C48/ C52 and C54 posts in strategic
facilities.
More biomedical scientists will be appointed to
support service expansion at the district
hospitals’ blood banks.
Placement of biomedical scientists in cytology
laboratory to reduce workload burden.

Conclusion : This Strategic Plan 2021 - 2025 for biomedical science is BIOMEDICAL SCIENCE
planned based on the previous MOH Strategic Plan 2016 - 2020, MOH Action
Plan 2016 - 2020 and the Strategic Framework of the Medical Programme
2021 - 2025. It is a strategy to fulfil the vision and mission of the profession. It
is hoped that this strategic plan will act as a roadmap for establishing initiatives
and activities for the next five (5) years.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 53

Detailed Implementation Plan for Biomedical Science

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

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

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

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

(A) Strategic Framework - Medical Programme
Strategy 1: Strengthen healthcare service delivery in hospitals

Main Implementation Plan No. 17: To consolidate and integrate laboratory service delivery in MOH facilities

Profession Activity Indicator Target
Implementation Plan

BIOMEDICAL SCIENCE 1. Total Laboratory Procurement of fully Number of Total Laboratory One Total Laboratory
Automation automated equipment for Automation concept set up Automation concept
laboratory set-up per state by 2025

54 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 3: Enhance capacity and capability of human resource for health
Main Implementation Plan No. 28: To ensure adequate supply of in-service competent medical personnel

Profession Activity Indicator Target
Implementation Plan

1. Optimising resource Appointment of permanent Number of permanent science Minimum 3 officers per
management (human science officer (biomedical) officers (biomedical) appointed state (one each for
resource) Histopathology,
Cytology and
Haematology) hospital
by 2025 (to follow
recommendation on
WISN and Norms by
profession and
Pathology Service)

Main Implementation Plan No. 32:
To improve competencies and provide incentives for medical doctors involved in clinical governance,

public health practice, enforcement and other areas of special interest

Profession Activity Indicator Target
Implementation Plan

2. Enhance capabilities of Continuing professional Number of Cuti Belajar Bergaji Minimum 1 officer for BIOMEDICAL SCIENCE
science officer (biomedical) development of science officer Penuh (CBBP) with Hadiah Latihan Master or PhD every
in core and area of special (biomedical) through structured Persekutuan (HLP) for science year
interest to support clinical course – postgraduate officer (biomedical) Minimum 1 person for
demand qualifications Number of science officers each technical field
Continuing professional (biomedical) with certification (Histopathology,
development, including through or technical and analysis Cytology, Haematology
short courses/ workshops and attachment (local or overseas) and Transfusion
seminars Medicine) to obtain
certification/ attachment
every year

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

Profession Activity Indicator Target
Implementation Plan
Minimum 1 person for
3. Establishment of career Creation of SME field offers in Number of officers with SME each field (total : 4)
pathway framework for the Haematology, Career pathway framework for Submission of career
science officer (biomedical) Histopathology, Cytology, and science officer (biomedical) pathway framework for
Transfusion Medicine science officer
To establish career pathway (biomedical) to be
framework for science officer submitted by 2023
(biomedical)

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 55

(C) Allied Health Sciences Division - Profession Biomedical Science

Profession Activity Indicator Target
Implementation Plan

1. Establishing of C48, C52 Set the number of new C48, Number of new C48, C52 and C54 Minimum of;
and C54 posts in state or C52 and C54 posts in state post in state health department, state C48 : 4 post
major specialist hospital health department, state hospital and major specialist hospital C52 : 2 post
hospital and major specialist C54 : 1 post
hospital in state health
department, state
hospital and major
specialist hospital

2. Creating more C41 and C44 Set the number of new C41 Number of new C41 and C44 posts in Minimum of one C41 and
posts under Transfusion and C44 posts according to each facility one C44 post in each
Medicine (Activity 2.29) facility collection/ screening sit

BIOMEDICAL SCIENCE

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

BIOMEDICAL SCIENCE

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 57

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

CLINICAL
PSYCHOLOGY

CLINICAL PSYCHOLOGY

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

Background Workforce

Clinical psychology service has been operating 20Ye0ar 7 20Ye2ar 0 31
within the Ministry of Health Malaysia (MOH) since 1HOSPITAL
the 1980s under the Counsellor’s Scheme. It is HOSPITAL
important to note that from 1983 to 2007, clinical
psychology services were offered as sessional 11INSTITUTION
services by private (clinical) psychology officers at
Hospital Kuala Lumpur (HKL) and Hospital Pulau Total:1 Total:42
Pinang (HPP). In 2007, a Psychology Scheme had
been approved, which consisted of the
psychologist (general), counsellor, and clinical
psychologist, leading to establishing function and
service requirements of various fields in mental
health. To date, 42 clinical psychologists are
working full time at the Ministry of Health. Although
clinical psychologists serve under the Psychology
Scheme, they have their own head of profession.

Clinical psychologists working for the Ministry of
Health must have a Master’s Degree in Clinical
Psychology from a government-approved local or
international institution. Clinical psychologists are
trained in the areas of evaluation, case
formulation, and intervention. These abilities are
used at all levels of work and facilities, from direct
client interaction to indirect client interaction.

Clinical psychology services are currently offered
in nine (9) MOH hospitals which are, Hospital
Kuala Lumpur, Hospital Putrajaya, Hospital
Rehabilitasi Cheras, Hospital Kajang (Selangor),
Hospital Permai (Johor), Hospital Pulau Pinang,
Hospital Bahagia Ulu Kinta (Perak), Hospital Raja
Perempuan Zainab II (Kelantan), and Hospital
Mesra Bukit Padang (Sabah).

The job scope of the profession includes
psychological assessments, psychotherapy,
intervention, psycho-education, case
management, providing assessment reports,
wellness, family, youth clinic, pain management,
addiction, anxiety, depression, learning difficulties
and other mental health-related cases (National CLINICAL PSYCHOLOGY
Mental Health Policy, 2012).

Apart from assessing the mental condition and
providing intervention, clinical psychologists are
trained to provide consultation, supervision,
research, psychological first aid (PFA), weight
management at the endocrine clinic and skills
training to patients (National Mental Health Policy,
2012).

The role requires specific competencies and skills.
Some necessary skills needed are thorough
knowledge in theory and practice, interest in
human behaviour and its processes, able to
communicate effectively and relate to patients,
patience and empathy, able to work
independently and professionally (Health
Careers, The NHS Constitution).

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 61

Introduction The clinical psychologist is bound within the Allied
Health Professions Act 2016 (Act 774), which has
Clinical psychology includes the service provision particular objectives; to protect the public from the
of psychological assessments, psychotherapy, risk of inappropriate and dangerous practices by
intervention, psycho-education, case registering health practitioners and ensuring they
management, assessment reports, Wellness and have the appropriate training, competencies and
Family Link Programme, Youth Clinic, pain ethical standards.
management, addiction, anxiety, depression, The practice of clinical psychologist would include
learning difficulties and service related to other the following:
mental health-related cases.
Assessment and diagnosis of disorders.
A clinical psychologist works mainly with people in Treatment intervention.
health and social care settings, such as mental Supervision of psychologists and other health
health, geriatric, rehabilitation, and paediatric professionals.
settings. Clinical psychology is the psychological Provision of expert advice and opinions as part
specialty that provides continuous and of the consultation.
comprehensive mental and behavioural Research.
healthcare for individuals and families; Populations: Clinical psychology provides
consultation to agencies and communities; specialised services to individuals and families
training, education, supervision; and across the lifespan and from all ethnic, cultural and
research-based practice. Its specialty is broadly socioeconomic backgrounds, as well as groups
inclusive of severe psychopathology and marked and communities.
by comprehensiveness and integration of
knowledge and skill from a broad array of
disciplines (National Mental Health Policy, 2012).

Functions

Clinical psychologists work with a diverse group of Problems/ Issues: The specialty of clinical
clients or patients (e.g., adults, children, psychology addresses behavioural and mental
teenagers, elderly etc.) and in various settings health issues faced by individuals across the
(e.g., outpatient, in-patient, community etc.). The lifespan, including:
services are provided at all stages of life-long
development with various therapeutic approaches Intellectual, emotional, psychological, social
(using the concept of ‘what works for whom’). and behavioural maladjustment

CLINICAL PSYCHOLOGY A clinical psychologist’s duties and responsibilities Disability and discomfort.
include conducting psychological assessments, Minor adjustment issues as well as
diagnosing, and treating mental disorders, severepsychopathology.
behaviours, emotions, personality and learning Procedures:
problems to achieve comprehensive healing for
the patient. Clinical psychologist’s interventions Assessment: diagnostic interviewing,
include cognitive, behavioural, systemic, behavioural assessment, administration, and
interpersonal, mindfulness, psychodynamic or interpretation of psychological test measures.
other psychotherapy and psycho-education Intervention (primary, secondary, and tertiary
services. The clinical psychologist also uses the levels): clinical services to individuals,
empirical approach in selecting, evaluating, and families, and groups.
modifying treatment programmes.

Performance and Achievement

Enhancement of Service Delivery Consultation: inter-and intra-professional
Clinical psychologists work within the health practice with other health and behavioural
domain and become part of a healthcare team health professionals and organisations.
player either in government within health facilities Research: engagement with specific research
or private clinics. In addition, clinical psychologists and critical review of science, knowledge, and
support community members in overcoming their ill methods on clinical psychology.
health, enhancing their chances of preventing
illness, and dealing with social or personal distress.

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

Workload/ Census

The number of patients treated had grown since the service was first offered. The number of patients for
the last three (3) years, including paediatrics and adults with mental health and the number of clinical
psychologists in MOH, are shown in Table 6.

Table 6 : Number of Patients Attended by Clinical Psychologists in the Year 2017-2019

2017 2018 2019

Year Assessment Intervention Assessment Intervention Assessment Intervention

Referral Referral Referral Referral Referral Referral

Number of patients 8,506 21,111 12,022 32,455 17,465 41,212
attended by clinical
psychologists

Research/ Innovation/ Publication/ Presentation Mental Health and Psychosocial Support Team CLINICAL PSYCHOLOGY
Clinical psychologist involved actively in research for Kim Kim River Toxic Pollution Pasir Gudang
and technical committees in hospital, state and Johor (2019).
national levels such as: Mental Health and Psychosocial Support Team
Respiratory Symptoms Outbreak (2019).
Optimal Health Programme Malaysia (2019 – Mental Health and Psychosocial Support Team
current). for MOH staff and residents affected by Malaysia
Clinical practice guidelines (CPG) for floods (2014 - 2015).
Management of Major Depressive Disorder Mental Health and Psychosocial Support Team
(MDD) 2nd edition MOH. for residents affected by Ranau Earthquake
Clinical practice guidelines (CPG) for Attention Sabah 2015.
Deficit Hyperactivity Disorder (ADHD) 2nd
edition MOH. Training
Guidelines Management of Mass Hysteria for Clinical psychologists have to earn a Bachelor’s
Healthcare Providers, MOH. Degree in Psychology before continuing their study
Clinical practice guidelines (CPG) for with a Master’s Degree in Clinical Psychology for
Management of Schizophrenia in Adults two (2) years. In addition, a clinical psychologist
(Nonpharmacological Management), MOH. must complete at least 1,200 credit hours of clinical
Chemical, Biological, Radiological, Nuclear and practicum as part of this postgraduate programme.
Explosives (CBRNE) Disaster Management Subspecialty training in various clinical psychology
Plan, MOH. fields available through PhD/ D-Psych/ Clinical
Hospital Selayang’s National Pain Management Psychology Privileging as below:
Programme (MENANG) (2018 – current).
Cognitive Behavioural Group Therapy Clinical Child Psychology.
(2017-current) with a total of 152 patients Clinical Pain Psychology.
involved. Clinical Geropsychology.
Mental Health and Psychosocial Support Team Clinical Forensic Psychology.
for COVID-19 Outbreak (2020). Clinical Neuropsychology.
Mental Health and Psychosocial Support Team Clinical Health Psychology.
for Orang Asli Suku Batek di Kampung Kuala Clinical Psychology - Rehabilitation Track.
Koh, Gua Musang (2019).

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 63

Issues and Challenges There is no specific service and management
budget allocation for clinical psychology
Enhancement of Service Provision and Lack of services to enhance the professional’s skills
Human Resource and knowledge.
Strengthen/ Enhance Career Pathway
Expansion of community mental health services At the MOH, we have proposed Subject Matter
such as One Stop Centre for Addiction (OSCA), Expert (SME) recognition, enhancing the
Mental Health Community Centre (MHCC) or clinical psychologist’s career pathways for
MENTARI, are established using existing those who have specialisation in a specific
clinical psychologists. interest area such as clinical neuropsychology
Expansion of services in other disciplines and clinical forensic psychology.
besides psychiatry and mental health is Subspecialty training in areas such as clinical
unavoidable. For example, in Kompleks Wanita, geropsychology, clinical neuropsychology,
Kanak-Kanak dan Kardiovaskular (KWKK) clinical health psychology, clinical pain
Hospital Raja Permasuri Bainun (HRPB), psychology (fellowship), clinical psychology
Hospital Tunku Azizah and pain management addiction, clinical psychology rehabilitation
clinic in few state hospitals providing clinical track, clinical child psychology and others
psychology services without additional human needs strengthening.
resources. Limited Training Opportunities
Lack of understanding of the role and services
provided by a clinical psychologist in both Budget for training is limited for clinical
management and operational levels. psychologists for advanced psychotherapy.
Human Resource Capability and Competency The local expert trainers in clinical psychology
Despite increased workload and demand, the specialty areas are limited, and it is costly to
MOH has a shortage of clinical engage trainers from abroad.
psychologists.There are currently 42 clinical Lack of Collaboration Intra/ Interagency/
psychologists in MOH, with the ratio of one (1) Community
clinical psychologist serving a 779,761 Malaysian The number of clinical psychologists in other
population. According to WHO, there should be a ministries and other agencies is scarce. Thus,
ratio of one (1) clinical psychologist to 5,000 or collaboration and interagency programmes are
6,634 population to ensure optimal patient care. limited. The number of clinical psychologists in
Adequacy and Optimisation of Health other ministries is stated in the table below (Table
Resources 7).
There is a financial constraint to purchase the
CLINICAL PSYCHOLOGY psychological assessment instruments and
original answering forms/ feedback forms of the
psychological assessment. However, original
tools/ instruments are required for managing
legal implications.

Table 7 : Number of Clinical Psychologists in other Ministries

Ministry/ Agency Number of Clinical Psychologists

Ministry of Education 2
Ministry of Women, Family and Community Development 2
Ministry of Home Affairs 3
Other ministries 4
Total 11

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

Increasing Disease Burden and Change of Mental health programmes and activities will be CLINICAL PSYCHOLOGY
Demography integrated into the existing programmes
According to the Malaysian Mental Healthcare provided through the primary healthcare
Report (2016), mental health disorders are of system, and;
major public health importance worldwide. The A multi-sectoral collaboration between mental
first Global Burden of Disease Study (GBOD health services and the various programmes
1990) reported that it accounted for a significant made available to patients in need.
proportion of the world’s disease burden. Mental According to Psychiatry and Mental Health
health disorders became the leading cause of Services Operational Policy (2011), the objectives
Years Lost due to Disability (YLD). Thus, mental of clinical psychology services are:
healthcare is a crucial element of a healthcare To provide psychological assessments,
system. consultations and psychological interventions
National Health and Morbidity Survey (NHMS) for people who need help with psychological or
2011 reported generalised anxiety disorder (GAD) behavioural difficulties,
prevalence among the adults 16 years old and To coordinate the provision of Clinical
above was 1.7 per cent (95% CI: 1.5-2.0). The Psychology services within the MOH, Malaysia,
prevalence of lifetime depression and current To provide advice, support, training, consultation
depression were 2.4 per cent (95% CI: 2.1- 2.8) and supervision to clinical psychologists,
and 1.8 per cent (95% CI: 1.5-2.1) respectively. To contribute to the interdisciplinary
NHMS in 2012 focused on health issues among understanding of the causes and consequences
the adolescent age group in school. Attempted of health and illness by participation in
suicide that reflects the adolescent’s mental collaborative research, service evaluation and
health status was reported as 6.8 per cent (95% treatment programmes with other specialities,
CI: 6.11-7.52), which needs to be addressed. To play a full role in developing the clinical
Clinical psychologists are actively involved in psychology services and to contribute to the
Mental Health and Support Services (MHPSS) as broader service and ministry objectives, and;
frontline health workers due to the outbreak of To empower society on the prevention of mental
COVID-19 in 2020. The main role is to provide health issues in regards to promoting
PFA to COVID-19 patients and healthcare psychological wellbeing.
workers, which includes diagnosis, recovery and
care via physical and virtual support. Moreover, Based on this service’s objectives, clinical
the pandemic has already led to diverse mental psychologists play an important role in providing
health problems among healthcare workers and comprehensive and extensive mental health
the public. Thus, the roles of clinical psychologists services to the public and nation.
and other mental health professionals are The above objectives, also in line with the National
essential in providing support and treatment. Mental Health Policy (2012), 11th Malaysia Plan
(11MP), Sustainable Development Goals (SDG) of
Way Forward Malaysia 2019 and Malaysian Health
Transformation Plan, are all focused on increasing
Philosophy the accessibility of quality healthcare services to
The National Mental Health Policy 2011 aims to the public. Furthermore, it is congruent also with
create a well-balanced population in terms of the profession’s objectives to make clinical
physical and psychosocial health. It emphasised psychology services accessible to all populations.
on promotion, prevention, treatment, and Therefore, in this strategic plan, clinical
rehabilitation of mental health patients with chronic psychologist is committed to upholding the
disabilities. objectives of clinical psychology services
The visions of National Mental Health Policy 2012 mentioned in the National Mental Health
stated four (4) motions which are: Operational Policy (2012) by aiming to increase
patient’s access to clinical psychology service in
Accessibility and equal access of mental line with the recent guidelines, policies and
healthcare to all populations, Malaysian Health Plan proposed by MOH.
A comprehensive range of mental healthcare
and services which include promotive,
preventive, treatment and rehabilitative
activities,

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 65

Principles Lack of understanding regarding the role of a
> Current Achievements – Sustain/ Maintain clinical psychologist in management and
sometimes at the operational level.
The competency of clinical psychologists in Confusion in terms of role and functions with
managing mental health cases is following other psychology professions resulted in
national and international standards. overlapping as well as overgeneralisation
Continuous training and development of clinical issues.
psychologists at every level of services. Lack of promotion opportunities because
Collaboration with external agencies/ promotion is based on general criteria and
organisations/ institutions for research, training, vacancies. It is suggested that promotions are
and promotion. given based on the experiences and
Performance measurement based on key competency of the clinical psychologists in
performance indicators identified. service.
Availability of at least four necessary diagnostic Pathway to be recognised as an SME in Neuro
psychological assessment tests at each state Clinical Psychology and Clinical Forensic
hospital (Wechsler Adult Intelligence Scale, Psychology based on contribution and
Wechsler Intelligence Scale for Children, expertise takes a long time.
Minnesota Multiphasic Personality Inventory > New Issues – New Strategies
and Vineland Adaptive Behavior Scales). Additional role as ‘Mental Health &
Provision of psychotherapy in group-based Psychosocial Support for Healthcare Workers
modes and task shifting and task sharing and Public’ during COVID-19 pandemic.
format. The surge in new cases and blockages of
existing cases as a result of the COVID-19
> Existing Issues That Have Not Been Solved – pandemic require additional workforce and
Reform resources.
Shortage of clinical psychologists in the MOH to A higher skill set is needed in managing
support increasing workload and complexity of complex cases with multiple comorbidities,
cases. especially for patients presenting acute and
There is no specific budget allocation for severe symptoms post Movement Control
training and development as well as to Order (MCO).
purchase essentials assessment tools. Urgent need for virtual and telepsychology
services due to ‘new normal’ practices.

CLINICAL PSYCHOLOGY Conclusion : In this strategic plan 2021 - 2025 for clinical psychology aspire to
utilise more innovative and virtual-based platforms in their service delivery. We
would like to embark on a more practical psychotherapy approach such as
group-based intervention through task shifting and task sharing. It is also
hoped that the number of clinical psychologists will be increased in line with the
needs of the mental health field. Recognition as an expert/ SME and
registration as a qualified practitioner/ expert will also be expected to be
implemented soon. This ensures quality, qualified, professional, ethical, and
safe services are being rendered to patients.

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

Detailed Implementation Plan for Clinical Psychology

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. 5:

Improving accessibility, effectiveness and quality of the psychiatric services in Medical Programme

Profession Activity Indicator Target
Implementation Plan

1. Enhance the mental health Provide Youth Connect Clinic Number of sessions at Youth 4 sessions per month,
services at community level at selected Pusat Kesihatan Connect Clinic implemented at maximum 40 sessions
Mental Komuniti (MENTARI) MENTARI Simee Health Clinic, Ipoh per year

2. Optimising cognitive Providing cognitive Number of Stroke/ Dementia/ Number of patients with
rehabilitation programme to rehabilitation programme to Alzheimer’s patients receiving mild to moderate
post-Stroke/ Dementia/ Stroke/ Dementia/ Alzheimer’s cognitive rehabilitations conditions received a
Alzheimer’s patients at patients at selected centre/ minimum of 4 cognitive
hospital level hospital rehab after being
referred to clinical
psychologist yearly

CLINICAL PSYCHOLOGY

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 67

(B) Medical Framework - Allied Health Sciences Division

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

Profession Activity Indicator Target
Implementation Plan

1. Improve accessibility to Develop a working paper with Numbers of contract clinical Minimum 2 person per
clinical psychology services engagement between psychologists (CP) hired profession per specialist
at crucial location Psychiatry Technical hospital until 2025
Committee collaboration
with Clinical Psychology
Technical Committee

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

2. Optimise the treatment for Provide Virtual Assisted Number of Virtual Assisted Therapy Minimum 1 digital/ virtual
Major Depressive Disorder Therapy System to MDD for MDD established assisted psychotherapy
(MDD) and anxiety disorder patients modality per year
patients Provide Virtual Assisted
Therapy System to Anxiety Number of Virtual Assisted Therapy Minimum 1 digital/ virtual
Disorder patients for Anxiety Disorder established assisted psychotherapy
modality per year

CLINICAL PSYCHOLOGY

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

(C) Allied Health Sciences Division - Profession Clinical Psychology

Profession Activity Indicator Target
Implementation Plan
MENTARI Batu Gajah,
1. Optimising of existing CP Perform task shifting in the Number of MOH facilities that MENTARI Putrajaya,
through task sharing/ shared concept of Interpersonal implement task shifting/ task MENTARI HTAR,
care Social Rhythm Therapy sharing MENTARI HSNZ,
MENTARI Masai,
MENTARI Miri, MENTARI
Pendang, MENTARI
Simee, MENTARI
Selayang, MENTARI Alor
Gajah, MENTARI Kota
Kinabalu, MENTARI
Petra Jaya (by 2025)

2. Treatment optimisation of Establishment of psychotherapy Number of psychotherapy groups Minimum 2
Major Depressive Disorder group such as Cognitive (CBT group) in selected facilities psychotherapy groups
(MDD) Behavioural Therapy (CBT) (state hospitals, mental institutions, (CBT group) per year
group for patient with MDD and district hospitals with clinical per facility
psychologist services)

3. Treatment optimisation of Establishment of psychotherapy Numbers of psychotherapy groups Minimum 2
anxiety disorder patient group such as CBT group for (CBT group) in selected facilities (all psychotherapy groups
patients with anxiety disorder state hospitals, mental institutions, (CBT group) per year
and district hospitals with clinical per facility
psychologist services)

CLINICAL PSYCHOLOGY

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 69

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

COUNSELLING
PSYCHOLOGY

COUNSELLING PSYCHOLOGY

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

Background Workforce COUNSELLING PSYCHOLOGY

Counselling psychology service in the Ministry of Year 79
Health (MOH) started in the 1980s with one (1) 10
officer called as Pegawai Ilmu Jiwa. The scheme 2020
was later changed to Pegawai Rundingcara
(Consultation Officer) in 1993 and revised in 1994 HOSPITAL
with the job designation as Pegawai Kaunselor
(Counsellor). In 2007, the Public Service INSTITUTION
Department (Jabatan Perkhidmatan Awam, JPA)
revised the scheme to Pegawai Psikologi/ MOH 8
Psychology Officer (counsellor/ clinical/ general), HEADQUARTER
and it remains until now.
In MOH, counselling services began at the 41STATE HEALTH
General Hospital of Kuala Lumpur in 1993 under
the Psychiatric Department to provide service to DEPARTMENT
the patient with psychiatric issues and their
families as well. The services were extended later Year 7DISTRICT
to Hospital Alor Setar, Hospital Pulau Pinang,
Hospital Ipoh, Hospital Klang, Hospital Johor 1983 HEALTH OFFICE
Bahru, and Hospital Permai. Up to date, more than
50 hospitals including mental health institutions HEALTH 19
are providing counselling services. In 2015, the CLINIC
service was expanded to Public Health
Department that oversees the cases in the HOSPITAL 1 MOH 5
government health clinic. The expansion of these COLLEGE
services made it accessible to the community, and
in return, enabled early psychological intervention. Total:1 Total:169
The counselling psychology services also cater for
the need for psychological help among staff in
MOH. The services are provided in all government
health agencies, including headquarters, state
health departments, hospitals, training institutions
and the National Institution of Health, with at least
one (1) or two (2) psychology officers.
The minimum requirement for the appointment of a
psychology officer (counsellor) is a Bachelor of
Psychology/ Counselling from any universities
recognised by the Malaysian Government. To
date, 86 psychology officers (counselling/ general)
have master’s degrees in counselling psychology,
family counselling, drug abuse counselling,
genetic counselling and so forth.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 73

COUNSELLING PSYCHOLOGY Introduction among communities in dealing with mental health
issues.
As a part of psychological field, counselling
psychology plays a significant role in treating a As the demand for counselling psychology
wide range of mental health problems such as services has grown tremendously, the services
depression, anxiety, domestic violence, emotional were expanded to healthcare workers in MOH.
and physical abuse, and trauma and relationship These psychological services were in line with the
issues. It examines a person experience and JPA circular to provide counselling services to
explores underlying issues. The aims of government staff.
counselling psychology services are to improve
their sense of well-being, lessen feelings of Workload/ Census
distress and resolve crises. In MOH, counselling
psychology services are offered by counsellors in The number of patients seen by counsellors has
three (3) settings namely primary, secondary and grown since the service was first offered. Table 8
tertiary care. Its main focus is to provide prevention shows the number of sessions conducted for the
and treatment plan, promoting healthy behaviour past three (3) years.
and mental health, enhancing psychological
well-being and improving quality of life. Research/ Innovation/ Publication/
Presentation

Functions Counsellors are actively involved in research and
technical committees, modules and guidelines
Counselling psychology services/ counsellors in development at the hospital, state and national
MOH operate at different system levels. The levels such as:
service offered included individual and group
counselling, therapies, crisis intervention, One Standard Operating Procedure (SOP) on
Stop Crises Centre (OSCC) intervention, Individual Counselling for MOH Counsellors.
behavioural analysis and modification, cognitive Standard Operating Procedure (SOP) on
restructuring, palliative care, Psychological First Group Counselling for MOH Counsellors.
Aid (PFA), stress management, psycho-education Standard Operating Procedure (SOP) on
and training aligned with evidence-based practise. Marital Counselling for MOH Counsellors.
Apart from that, the counselling psychology Manual on Mental Health and Psychosocial
services/ counsellors are also actively involved in Response to Disaster in Community;
evaluating and assessing patient’s psychological Published by Mental Health Unit,
functions, providing advice to treatment team, Non-Communicable Disease Section, Ministry
rendering psychological interventions to patients of Health in Collaboration with World Health
and their families and conducting research Organization (2013), revised in 2019.
projects. They work closely with other health care Psychological First aid: Pocket Guide,
professionals to provide more holistic Published by Mental Health Unit,
interventions. Fundamentally, a combination of Non-Communicable Disease Section, Ministry
non-pharmacological (counselling) and of Health in Collaboration with World Health
pharmacological intervention has been found to be Organization (2013), revised in 2019.
the best potential treatment plan for patients in
improving their mental health and psychological
well-being.

Performance and Achievements Guidelines For Mental Health and
Psychosocial Response to Disaster, Published
Enhancement of Service Delivery by Mental Health Unit, Non-Communicable
The counselling psychology services started by Disease Section, Ministry of Health in
serving the psychiatric patients in the hospital in Collaboration with World Health Organization
the 1980s and evolved to patients from (2013), revised in 2019.
multi-discipline cases, e.g., medical, surgical, Child Sexual Crime Protection Module;
paediatric, emergency & trauma, obstetrics & Published by Mental Health, Substance Abuse
gynaecology, and radiology, in 2001. & Violence Injury Protection Programme
The services were expanded to patients from (MeSVIPP), Disease Control Division, Ministry
hospital settings to public health in 2002, with the of Health, 2020.
aim to provide earlier psychological intervention

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

Table 8 : The Number of Sessions Carried Out from Year 2017 - 2019 COUNSELLING PSYCHOLOGY

Year 2017 2018 2019
69,112
Number of sessions managed 68,953 69,462

Standard Operating Procedure in Mental Health Two (2) Bronze Medals Award: I-COUNNOVAS
& Psychological Support Services (MHPSS) for 2019, International Counselling Innovation
Covid-19 Response in Quarantine Stations, Showcase & Competition in Conjunction with
Published by Mental Health, Substance Abuse & PERKAMA International Counselling
Violence Injury Protection Program (MeSVIPP), Convention, 2019.
Disease Control Division, Ministry of Health,
2020. Crossroad Counselling Card: Are We Doing
Web-based programme, KES Management Right Decision? Hospital Kuala Lumpur, 2019.
System, for online case registration in 2015.
Training Module for Inhalant Abuse at Primary I-SEAZ Module in Opiate Addiction Treatment,
Health, Published by Mental Health, Substance Hospital Kuala Lumpur, 2019.
Abuse & Violence Injury Protection Program
(MeSVIPP), Disease Control Division, Ministry Gold Medal Award in International Conference
of Health, 2013. and Innovation Exhibition on Global Education,
Training Universiti Utara Malaysia, Sintok Kedah, 2018.
The professional development and specialisation
training allows counsellors to enhance their skills Issues and Challenges
and knowledge in specialised fields. One (1) PhD
holder with expertise in substance abuse has Strengthen/ Enhance Service Provision
graduated. Meanwhile, nine (9) other PhD
candidates are pursuing their studies in various The psychology counselling services can be
fields such as child and adolescent, gerontology, strengthened and enhanced by focusing on the
suicide, family counselling, art therapy, and community on two (2) aspects:
industrial organisation. There are 86 master’s
holders among counsellors in MOH. Apart from To give special attention to psychological care
that, some of them had obtained professional of the ageing population.
certifications such as Mental Health Psychosocial
Response to the Disaster by Japan International To empower the resilience skills among
Cooperation Agency (JICA), Certified Creative Art adolescents in managing mental health issues.
Therapy from Universiti Malaya and Mental Health
Counselling Certification from Universiti Human Resource Capability and Competency
Pendidikan Sultan Idris.
Recognition/ Achievements There is a lack of comprehensive, coordinated,
The counsellors are actively involved in innovation and integrated services to manage profession
and quality improvement activities. Most recent issues in human resources.
achievements are:
Malaysia Book of Record: Patchwork Way Forward
Expressive Art Therapy the Biggest Hope,
‘Patient as A Partner’, Hospital Rehabilitasi, Philosophy
Cheras Kuala Lumpur, 2019. Based on the Mental Health Action Plan for the
Gold Medal Award in International Invention, 12th Malaysia Plan, our way forward is to provide
Innovation & Technology Exhibition (ITEX) comprehensive, integrated, and responsive
2019, World Young Inventors Exhibition. El mental health and psychological care services in
RASALA Project (Psychology Approach in the hospital and community-based settings among
Learning Process), Kuala Lumpur and adolescence and older adults. This plan could be
Putrajaya Health Department, 2019. accomplished by assisting a person in achieving,
sustaining, maintaining a certain level of
psychological health status and promoting a
productive and quality lifestyle. To implement the
strategies for promotion and prevention in mental
health, we proposed to provide a promotional and
preventive psychological approach focusing on
enhancing the coping skills to be integrated with
medical treatments.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 75

COUNSELLING PSYCHOLOGY Principles Inadequacy of human resources.
> Current Achievement – Sustain/ Maintain Lack of awareness of the psychology services
in the community.
To enhance psychological service delivery.
> New Issues – New Strategies
> Existing Issues That Have Not Been Solved – Readiness in competency, facility, and
Reform workforce to address increasing mental health
Non-standardised organisation structure at issues.
facilities. Expanding the counselling services to the
Lack of competencies development versus community to prevent mental health illness
current demands. through early intervention.

Conclusion : In line with the Ministry of Health’s Strategic Plan and Mental
Health Action Plan, the psychology counselling services for the 12th Malaysia
Plan is to focus on enhancing the resilience among adolescents as a coping
skill in dealing with psychological issues and ensuring psychological well-being
among older adults. These services support healthcare treatment for a better
quality of life.

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

Detailed Implementation Plan for Counselling Pshychology COUNSELLING PSYCHOLOGY

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

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

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

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

(A) Strategic Framework - Medical Programme
No Profession Strategy

(B) Medical Framework - Allied Health Sciences Division

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

Profession Activity Indicator Target
Implementation Plan
Number of officers appointed Minimum 2 person per
1. Ensure optimum number of Appointment of contract district by 2025
psychology officers officers
(counselling)

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 77

(C) Allied Health Sciences Division - Profession Counselling Psychology

COUNSELLING PSYCHOLOGY Profession Activity Indicator Target
Implementation Plan
4 for each state by 2023
Centralisation of ‘Task Number centralisation of ‘Task 50% of psychology
Allocation Optimisation’ Allocation Optimisation’ technique officers (counselling)
technique by state by 2025
i) 25% out of 158 of
1. Strengthen the psychological Implementation of Disease Percentage of psychology officers
service delivery primary, Based Counselling (DBC) in (counselling) attended credentialing district health offices
community and hospital health setting and privileging training ii) 20% out of 1001 health

Mapping of existing psychology Percentage of psychology officer clinics by 2025
officer (counselling) posts (counselling) posts remapped

Develop psychological Number of comprehensive modules Minimum 1
wellbeing module for ageing developed comprehensive module
population - MoKWE (Modul developed by 2022
Kesejahteraan Psikologi Warga
Emas)

2. Psychological well-being Implementation MokWE Percentage of ageing population
intervention programme Module in existing MOH (> 65y) given psychological well-being Minimum 1% of ageing
for the ageing population Programmes intervention using existing MOH population by 2025
programme

Collaboration with other Number of collaborations in research Minimum 2 research by
agencies (e.g., My Ageing related to psychological needs of 2025
(UPM) or UPSI) - gerontology ageing population
psychology research and
consultation

3. Enhancement of Develop Resilience Module for Number of Resilience Module Minimum 1
Psychological Coping Skills adolescence - Power of developed comprehensive module
(Resilience) for adolescent Resilience (PORes) Percentage of adolescent age developed by 2022
Implementation of PORes (13-17 years old) given PORes Minimum 1% of
Module in existing MOH Module through MOH existing adolescents by 2025
Programmes programme such as Minda Sihat
Sekolah, PEARL & PROSIS

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

COUNSELLING PSYCHOLOGY

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 79

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

DENTAL
TECHNOLOGY

DENTAL TECHNOLOGY

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

Background Workforce

The dental technology profession was established 20Ye2ar 0 94
in 1948 and trained in 1952 with certificate level HOSPITAL
(Sijil Teknologi Pergigian). Dental technologist
started as a dental mechanic trained at King 8INSTITUTION
Edward VII College, Singapore. Next, the College
of Dental Training in Penang set up the first dental 19Ye4ar 8 12STATE HEALTH
mechanics course in 1951. The dental mechanic
classification was reclassified to the dental DEPARTMENT
technician in 1959 and dental technologist in 1996,
reflecting its vast scope. Although dental 881HEALTH CLINIC
technologists work in the Ministry of Health (MOH)
dental laboratory, the practitioners are also Total : > 50 Total : 995
responsible for biomedical engineering aspects of
dental equipment management. Unlike dental DENTAL TECHNOLOGY
therapists, dental technologists may work in the
private sector. Dental technology is a dynamic
career, and many evaluations of the training
programme have backed up its development as
listed:

Dental technology training upgraded from
certificate to diplomas in dental technology in
1996.
Post basic training in orthodontic and
maxillofacial specialities started in 1998 and
has broadened the scope of dental
technologists in MOH.
Degree in dental technology established in
2015.
The dental technologist started with grade C9 in
MOH and upgraded to three (3) grades, U29, U32
and U36 and later changed to five (5) grades U29,
U32, U36, U38 and U40.
The scope of dental technology services has
grown over the past 60 years to meet the
increasing demands of complex prosthetics. This
is in line with the advancement of dental health
services, the rise of specialities in dental health,
and the establishment of specialist dental services
in various areas. Most dental technologists in
private dental laboratories provide private dental
clinics with dental prosthesis services. For private
hospitals with dental services, dental technologists
offer support services to dental specialists as per
need.

Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 83