Health, Education and Welfare

Basu Govindaraju · John Jeyasingam · Md. Mamun Habib · Uvarani Letchmana · Sasidevi Ratnam ·International Journal of Supply Chain Management ·2019

This empirical study employed structural equation modeling (SEM) to investigate the impact of sustainable practices on sustainable performance of higher education institutions. Firstly, the sustainable performance survey is designed to investigate its main influencing factors among the pool of constructs includes; economic, environment, social and top management support factors. Secondly, based on the SEM, the levels of sustainable performance of the universities are quantified in accordance with factors. The findings were supported by empirical evidence, as the study established that only economic and environment factors have significant positive relationship and impact sustainability performance. This paper provides a greater understanding of the interactions between key elements of sustainable practices associated with university performance provision.

Shui Ling Wong · Saliza Ibrahim · Norazlin Abdul Kadir · Salbiah Mohd Salleh ·Applied Health Economics and Health Policy ·2019

Background High medicines prices are a barrier to medicines access, and their impact is greater in developing countries. Objective This study assessed the availability, prices and affordability of medicines in public and private sectors in Malaysia to understand the pharmaceutical environment and guide policy recommendations. Methods This nationwide cross-sectional study adapted the World Health Organization/Health Action International (WHO/HAI) methodology. A total of 87 premises from both public and private sectors participated in this study. Data on 50 medicines were collected to analyze availability, prices and affordability. Medicine prices were compared against the international reference prices (IRPs), and affordability was assessed by daily income level. Results In the public sector, the average availability of generics (74.8%) was higher than that of the originator brand name products (19.4%). However, in the private sector, the availability of originator brands was higher (52.2%) than generics (49.1%). Procurement prices in the public sector were up to 1.5 times the IRPs, but up to 8.4 times in the private sector. The study also observed large price variation across medicines in the private sector. Median retail mark-ups in private hospitals (generics 166.9%; originators 51.0%) were higher than in retail pharmacies (generics 94.7%; originators 22.4%). Generics were generally affordable, but originator brands were unaffordable. Conclusion Current policies on generic medicines need to be strengthened to improve the availability and use of generics in the country. High medicine prices and large price variation in the current free market suggest that coherent pricing policies and regulations are needed to safeguard the accessibility and affordability of medicines for the people.

Zeinab Jannoo · Bee WahYap · Naushad Mamode Khan · AlessioFarcomeni ·Value in Health Regional Issues ·2019

Objectives To validate, from a psychometric perspective, the Problem Areas in Diabetes (PAID) questionnaire in patients with type 2 diabetes mellitus from Malaysia. Methods A total of 497 patients with type 2 diabetes mellitus were recruited from public hospitals in the state of Selangor through convenience sampling. Construct validity was evaluated through confirmatory factor analysis. Internal consistency of the instrument was tested by Cronbach α. Criterion validity and discriminant validity were also used. Results The PAID instrument consisted of 3 factors: social support problem, food-related problem, and emotional distress problem. The Cronbach α values of the 3 factors showed adequate internal consistency with α values greater than 0.90. The present confirmatory factor analysis model achieved a good fit with a comparative fit index value of 0.923. Satisfactory criterion validity was also demonstrated because there existed positive significant association between glycated hemoglobin A1c and diabetes duration. Conclusions The PAID questionnaire in Malaysia was found to be a reliable and valid instrument exhibiting good psychometric properties.

Asrul Akmal Shafie · Haarathi Chandriah · Yee Vern Yong · Sharifa Ezat Wan Puteh ·Value in Health Regional Issues ·2019

Objective To describe the process and role of health technology assessment (HTA) in the context of drug policy in Malaysia. Methods We summarized the HTA process through review of documents and reports available in the public domain combined with the authors' experience. Results Health technology assessment plays an integral part in prioritizing treatment in public health facilities in Malaysia, particularly for the Ministry of Health Medicines Formulary (MOHMF). The MOHMF is the reference list of drugs allowed to be prescribed in the Ministry of Health (MOH) facilities. There are 2 organizations within the MOH that conduct HTA as their core activities, namely the Malaysian Health Technology Assessment Section and the Formulary Management Branch of Pharmacy Practice & Development Division. The assessment of pharmaceuticals for the purpose of listing medicines into the MOHMF is under the purview of the Formulary Management Branch. The evidence-based assessment focuses on safety, efficacy, effectiveness, and budget impact of the drug. Cost-effectiveness evidence is currently not mandatory but is of interest to the decision makers. The assessment outcomes are considered by the MOH Medicines List Review Panel for formulary decisions. Conclusions Health technology assessment has supported formulary decisions in MOH. Evidence generation needs to progress beyond efficacy or effectiveness, safety, and budget impact to incorporate cost-effectiveness. Nevertheless, there are challenges to be met to achieve this. The impact of the HTA process is currently unknown and is yet to be evaluated formally.

C. S. Tan · M. A. Hassali · C. F. Neoh · F. Saleem · Rob Horne ·Value in Health Regional Issues ·2018

Background Low rate of adherence was found strongly associated with patients’ beliefs across the studies about chronic diseases with hypertension. A crucial move is needed to bridge the gap between appropriate assessment tools and local hypertensive patients’ medication adherence. Objective To produce a translated version in Malay language of Beliefs about Medicines Questionnaire (BMQ) that was “conceptually equivalent” to the original English version for use in local clinical practice and research. Methods The forward translation process was conducted by two independent professional translators and back translation was done by two other independent translators. A reliability analysis was conducted on 238 conveniently selected hypertensive patients. Intraclass correlation coefficient (ICC) was used to assess test-retest reliability for the randomly selected 40 patients in a period of 2 weeks. Discriminant validity was tested through Necessity-Concerns differential, BMQ subscales, and other parameters. Results The overall Cronbach alpha for the internal consistency was good (0.860). The subscales of the BMQ demonstrated adequate internal consistency, with Cronbach alpha value of 0.759 for Specific-Necessity, 0.762 for Specific Concern, 0.624 for General-Overuse, and 0.756 for General-Harm. The ICC was excellent (0.922). Discriminant validity revealed that BMQ Specific-Necessity score was significantly inversely correlated with the systolic blood pressure level. Systolic and diastolic blood pressure levels (P = 0.038; P = 0.05) were reported to be significantly correlated with the Necessity-Concerns differential, with Necessity score equal or exceeding Concerns score. Conclusions The Malay-translated version of BMQ is a reliable and valid tool to assess patient belief about medication, especially medication adherence among the hypertensive patients in Malaysia.

Bakri Mat (Universiti Utara Malaysia (UUM)) · Ku Nurasyiqin Ku Amir (Universiti Utara Malaysia (UUM)) ·International Journal of Supply Chain Management ·2019

Food security is one of the non-traditional security components that forms the basic needs of a nation, households, and individuals. Any problem in food supply or disruption in any of the four key elements of food security will threaten security and well-being of the citizens. In Malaysia, although food availability is ensured through via local production and imports at national level, accessibility and utilization are not yet fulfilled as certain groups and households are still unable to access and utilise adequate food accordingly. Therefore, this research attempts to examine the socioeconomic factors that may contribute towards food insecurity among Malaysian households within communities in Malaysia-Thailand border using human security approach. This study is conducted using qualitative research method to collect and analyse both primary and secondary data. Primary data was obtained through official documents and an in-depth interview with key informants among Malaysian households of the communities near Malaysia-Thailand border, local leaders and academicians. Meanwhile, the secondary source of data was obtained from published materials and online documents such as books, journal articles and reports. The findings indicate that socioeconomic factors were pertinent in contributing towards food insecurity among the households in form of household income, insufficient assistance program, and high living costs. These factors form the main foundation in ensuring the sanctity and wellbeing of the households. In designing state policies, the socioeconomic issues should be prioritized as in ensuring human security of the vulnerable groups, specifically the B40 households. In addition, continuous effort in developing societal empowerment and resilience are vital to achieve citizen wellbeing.