MOH presentation about 1Care for 1Malaysia as outlined in the 10th Malaysia Plan (2011-2015)

1. THE MALAYSIAN
HEALTH CARE
SYSTEM
Dr Mahani Binti Ahmad Hamidy
Senior Principal Assistant Director
Planning and Development Division, MOH

2. MALAYSIA

5. 80
75 76.46
70 Male
71.7
65 Female
60
55
50
1957 1970 1980 1990 1995 2003
Year

7. BURDEN OF DISEASE STUDY
(mortality & morbidity)
 The principle cause of death in Malaysia for both males and
females in 2000 were :
• ischaemic health disease and
• cerebrovascular disease.
 Top 5 burden of diseases (taking into consideration mortality
and morbidity) in Malaysia are:
• IHD,
• Mental Illness,
• Cerebrovascular disease / stoke and road traffic accidence,
cancers,
• asthma and chronic obstructive pulmonary diseases,
• diabetes mellitus
Source : Burden of Disease Study

8. MALAYSIAN HEALTH CARE SYSTEM
PUBLIC SECTOR
PRIVATE SECTOR& NGO
FEDERAL GOVERNMENT STATE-LOCAL GOVERNMENT
PRIVATE HEALTH CARE
ENVIRONMENTAL SANIT. FACILITIES
PUBLIC HEALTH / MEDICINE
HOUSING STANDARDS
DISEASE CONTROL IMPLEMENTATION
LAW ENFORCEMENT LAW ENFORCEMENT
PUBLIC HEALTH/ PREVENTION DISTRICT HEALTH OFFICE PRIVATE HOSPITAL
HOSPITALS WITH SPECIALIST
PRIVATE MEDICAL
PRACTITIONER CLINICS
HOSPITALS HOSPITALS WITHOUT
SPECIALIST
ESTATE & MINES
HEALTH CLINICS HOSPITALS
CLINICS
RURAL CLINICS
MINISTRY OF HEALTH CLINICS IN FACTORIES
SPECIAL INSTITUTIONS LEPROSY/ PSYCHIATRY/ & INDUSTRIES
TUBERCULOSIS
OTHERS
MATERNAL/ CHILD HEALTH RURAL/ MIDWIFE CLINICS
ARMED FORCES
NURSE/ PARAMEDIC TRAINING CENTRES
EDUCATION
NURSING HOMES
ENFORCEMENT/SUPERVISION
DEPT. OF ABORIGINES PHARMACEUTICALMS
• DENTAL PRACTITIONERS
LICENSING PRIVATE HOSPITALS • PHARMACISTS
• LABORATORIES
MILITARY HOSPITALS • X-RAY SURGERIES
MIN. OF HOME AFFAIRS SPECIAL INSTITUTIONS • NURSING HOMES
ABORIGINE HOSPITAL • MEDICAL SCHOOLS
DRUG ADDICT REHAB. CENTRE
• TRADITIONA/ALTERNATIVE
MEDICINE PRACTITIONERS
UNI. EDUCATION /
MIN. OF EDUCATION UNIVERSITY HOSPITALS
MEDICAL SCHOOLS

9. ORGANISATION OF THE MINISTRY OF HEALTH
(CENTRALISED SYSTEM)
MINISTER
OF HEALTH
DEPUTY
MINISTER OF
HEALTH
SECRETARY
-GENERAL
DIRECTOR-GENERAL
PUBLIC OF HEALTH
RELATIONS OFFICER
LEGAL ADVISOR
DEP. D-G OF DEP. D-G OF HEALTH
DEP. D-G OF HEALTH DIRECTOR
HEALTH (RESEARCH & DIRECTOR
(MEDICAL) (DENTAL)
(PUBLIC HEALTH) TECHNICAL (PHARMACY)
INTERNAL AUDITOR SUPPORT)
* Medical Development * Disease Control * Planning & Development D
POLICY & • Medical Practice * Dental Services * Engineering Services
• Telehealth * Family Health * TCM
INTERNATIONAL • Nursing Development * Research / NIH (7 Institutes)
AFFAIRS * Food Quality Control
* Health Education
DEP. SEC-GENERAL DEP. SEC-GENERAL
(MANAGEMENT) (FINANCE)
* Information Technology Centre * Finance 13 State Health Directors
* Human Resource * Procurement and Privatization
* Manpower Planning & Training * Accounts
• Management
• Competency

10. ORGANISATION AT STATE HEALTH
DEPARTMENT
STATE
HEALTH
DIRECTOR
DEPUTY STATE
DEPUTY STATE DEPUTY STATE DEPUTY STATE DEPUTY STATE
HEALTH
HEALTH HEALTH HEALTH HEALTH
DIRECTOR
DIRECTOR DIRECTOR DIRECTOR DIRECTOR
(PUBLIC
(MEDICAL) (DENTAL) (PHARMACY) (MANAGEMENT)
HEALTH)

11. FLOW OF RESOURCES
(CENTRALISED SYSTEM)
FEDERAL
Allocation of resources
(money, man, material)
STATES

12. Reference

13. PROGRAMMES AND ACTIVITIES (9 & 10MP)
PUBLIC HEALTH PROGRAMME MEDICAL PROGRAMME
• DISEASE CONTROL ACTIVITY • MEDICAL CARE ACTIVITY
• FAMILY HEALTH DEVELOPMENT • EXTENDED MEDICAL CARE ACTIVITY
ACTIVITY • MEDICAL LEGISLATION AND
• HEALTH EDUCATION ACTIVITY REGULATIONS ACTIVITY
• FOOD SAFETY & QUALITY • MEDICAL CARE QUALITY ACTIVITY
ACTIVITY
RESEARCH AND TECHNICAL SUPPORT MANAGEMENT PROGRAMME
PROGRAMME
• HQ/STATE MANAGEMENT ACTIVITY
• RESEARCH ACTIVITY • HUMAN RESOURCE ACTIVITY
• PLANNING AND DEVELOPMENT ACTIVITY • FINANCE ACTIVITY
• HEALTH ENGINEERING ACTIVITY • MANPOWER PLANNING & TRAINING
• TRADITIONAL & COMPLEMENTARY ACTIVITY
MEDICINE ACTIVITY* • INFORMATION TECHNOLOCY ACTIVITY
DENTAL PROGRAMME PHARMACY PROGRAMME
• DENTAL POLICY AND DEVELOPMENT • PHARMACY ENFORCEMENT
• DENTAL PRACTICES, CONTROL • PHARMACY PRACTICES & DEVELOPMENT
AND PROMOTION • NATIONAL PHARMACEUTICAL BIRO

14. Management Programme
 Plan, formulate, implement, monitor and
evaluate policies related to :
• human resource planning and training and
competencies of HR
• ICT /technologies & communication system
• Financing and audit
• Logistic needs
• Privatization effort

15. Public Health Programme
 Plan, formulate, implement, monitor and
evaluate policies related to :
• Disease control
• Food quality and safety
• Family Health Development
• Health Promotion and education
• Technical input on public health roles and
functions
• Formulation and enforcement of Acts pertaining to
public health
• Resource planning and distribution – Health
Services

16. Medical Programme
 Plan, formulate, implement, monitor and
evaluate policies related to :
• Medical activity and treatment
• HTA
• Medical practices and quality of medical services
• HR development
• Accreditation and Credentialling
• Telehealth and teleconsultation
• Resource Planning and Distribution – Medical
Services

17. Research and Technical
Support Programme
• Health System Research
• Health and Facility Planning, Implementation,
Monitoring and Evaluation
• Traditional and Complementary Medicine
• Engineering Services

18. DENTAL PROGRAMME
 Formulate policies, guidelines &
standards for public and private sectors
 Registration, licensing and enforcement
 Formulation of Acts related to Dentistry
 Resource planning and distribution

19. PHARMACY PROGRAMME
 Formulate policies, guidelines & standards
for public and private sectors
 Registration, lisencing and enforcement of
pharmaceutical products
• Monitor & analyses
• Ensure effectiveness, quality and safety of
products (local and imported)
 Formulation of Acts related to
Pharmaceutical Products
 Resource planning and distribution

20. TENTH MALAYSIA HEALTH PLAN
HEALTH SECTOR STRATEGIC DIRECTION
1CARE FOR 1MALAYSIA

21. Formulation of Health Plan
• Health plan is an integral part of national development
Malaysia Development Plans
Outline Perspectives Plan
OPPI (1971 -1990)
OPP2 (1991-2000)
OPP3 (2001 - 2010)
Five Year Malaysia Plan
First Malaya Plan (1956-1960)
Second Malaya Plan (1961 - 1965)
First Malaysia Plan (1966- 1970)...
Eighth Malaysia Plan (2001 - 2005)
Ninth Malaysia Plan (2006 - 2010)
Tenth Malaysia Plan (2011 – 2015)

22. The Outline Perspective Plan
- Long Term Strategic Plan
OPP-1 OPP-2
New Economic Policy National Development Policy
(1971-1990) (1991-2000)
 alleviating poverty
 restructuring of
 eliminating economic imbalances
community
 private sector as engine of growth
 eradication of poverty
OPP3- National Vision Policy
 fostering unity & eradicating poverty
 sustaining high economic growth & enhancing
competitiveness
 developing a knowledge-based economy
 strengthening human resource development
 pursuing environmentally sustainable
development

23. VISION 2020
States that "by the year 2020, Malaysia is to be a united nation
with a confident Malaysian Society infused by strong moral and
ethical values, living in a society that is democratic, liberal and
tolerant, caring, economically just and equitable, progressive
and prosperous, and in full possession of an economy that is
competitive, dynamic, robust and resilient".
23

24. NATIONAL MISSION THRUSTS
(Introduced during 9MP)
 THRUST 1 :To move the economy up the value chain
 THRUST 2 :To raise the capacity for knowledge and
innovation and nurture ‘first class
mentality’
 THRUST 3 : To address persistent socio-economic
inequalities constructively and
productively
 THRUST 4 : To improve the standard and
sustainability of quality of life
 THRUST 5 :To strengthen the institutional and
implementation capacity
24

25. INTRODUCTION
MONITORING
IMPLEMENTATION &
CONTROL
PLAN EVALUATION
FORMULATION
10MP : 5 YEAR PLAN
(2011-2015)
HEALTH
PRIORITISATION SITUATIONAL
ANALYSIS
PROBLEM/
NEEDS
IDENTIFICATION
25

26. Background
MTR 9MP Outcome Based Assessment Approach
7 Sept 2009 10MP : 1ST GUIDELINE
– 10MP Strategic Directions
5 Dec 2009 10MP : 2nd GUIDELINE
– Preparation of Programmes & Projects
26

27. CHALLENGE
In order to achieve Vision 2020, Malaysia needs
to become a country of high income economy.
To achieve the lowest limit for a high income
nation, Malaysia has to make at least 5.5%
yearly growth
27

28. 28

29. FOCUS OF 10MP
HIGH INCOME
ADVANCED
ECONOMY
29

30. 10MP 6 STRATEGIC DIRECTIONS
(HALATUJU STRATEGIK – HS)
HS 1
Competitive HS2
Private Sector as
Productivity &
Engine of Growth
Innovation
HS 6
Government
Through K-Economy
As an Effective
Facilitator
HIGH INCOME
ADVANCED
ECONOMY HS3
Creative & Innovative
HS5 Human Capital
Quality Of Life With 21st Century
Of An Advanced Skill
HS4
Nation Inclusiveness
In Bridging
Development
Gap 30

31. KRAs for HS5 : Quality of Life of An Advanced Nation
KRA2 KRA1
Ensure Access Enhance HIGH INCOME
To Quality Public ADVANCED
Healthcare & Safety &
Promote ECONOMY
Security
Healthy
Lifestyle
HS5. Quality
KRA3 Of Life
Commit to the
Of An Intensify
Delivery of Preservation &
Advanced
Efficient Acculturate
Public Nation
Appreciation
Transport Of Culture &
Heritage
KRA6
Mainstream
Sustainable Nurture civil
KRA4 Development Society
KRA5 31

32. FOCUS OF 10MP
HIGH INCOME
HS 1 ADVANCED
HS 6
ECONOMY
HS 2
KRA 6 KRA 5
HS 3
HS 5
HS 4 Quality of life KRA 4
of an advanced
nation KRA 3
KRA 1 KRA 2
Ensure Access to Quality
Healthcare & Promote Healthy
32
Lifestyle

33. 10MP STRATEGIES FOR KRA 2 :
Ensure Access to Quality Healthcare & Promote Healthy Lifestyle
HS5
Quality HIGH INCOME
Of Life ADVANCED
Of An ECONOMY
Advanced
Nation
KRA 2
Ensure Access To Quality Healthcare & Promote Healthy Lifestyle
OUTCOME
(Ensure provision of and Increase accessibility to Quality health care and
Public recreational and Sports facilities to support Active healthy lifestyle)
STRATEGY 1 STRATEGY 2 STRATEGY 3 STRATEGY 4
Establish a Transform the
Encourage Empower the community to plan
comprehensive health sector to
health awareness or conduct individual wellness
healthcare system increase the efficiency
& healthy lifestyle programme (responsible for own
& recreational & effectiveness of the
activities health)
infrastructure delivery system
33

34. 10MP STRATEGIES FOR KRA 2 :
Ensure Access to Quality Healthcare & Promote Healthy Lifestyle
STRATEGY 1
 Establish a comprehensive healthcare
system & recreational infrastructure
STRATEGY 2
 Encourage health awareness & healthy
lifestyle activities
34

35. 10MP STRATEGIES FOR KRA 2 :
Ensure Access to Quality Healthcare & Promote Healthy Lifestyle
STRATEGY 3
o Empower the community to plan or conduct
individual wellness programme (responsible for
own health)
STRATEGY 4
 Transform the health sector to increase the
efficiency & effectiveness of the delivery
system
35

36. SUMMARY
Transformation Agenda
VISION 2020
NATIONAL MISSION THRUST
2006-2020
THRUST 1 THRUST 2 THRUST 3 THRUST 4 THRUST 5
To move the To raise the capacity To address persistent
socio-economic To improve the To strengthen the
economy up the for knowledge & innovation & inequalities standard & sustainability institutional &
value chain nurture ‘first class mentality’ constructively & of quality of life implementation capacity
productively
Quality of Life of An
10MPSTRATEGIC DIRECTION 5 (HS5)
Advanced Nation
Ensure access to quality
10MP KRA 2 FOR HS5 Healthcare & promote
Healthy lifestyle
10MP OUTCOME FOR HS5 Ensure provision of & Increase accessibility to
Quality health care & Public Recreational &
Sports facilities to support Active healthy
lifestyle
10MP STRATEGIES FOR HS5
Strategy 4
Strategy 1 Strategy 2 Strategy 3
-- Health Sector
36
-- comprehensive -- health awareness & -- Empowering the Community
Transformation
36
healthcare & recreation Healthy lifestyle towards self care (Universal Access)

37. 10MP STRATEGY & HEALTH SECTOR KEY RESULT AREAS
10MP STRATEGY HEALTH SECTOR KRAs
Strategy 1 Establish a comprehensive KRA 1 Health Sector Transformation
healthcare system & recreational Towards A More Efficient &
infrastructure Effective Health System in
Ensuring Universal Access to
Healthcare
Strategy 4 Transform the health sector to
increase the efficiency &
effectiveness of the delivery system
Strategy 2 Encourage health awareness & KRA 2 Health Awareness &
healthy lifestyle activities Healthy Lifestyle
Strategy 3 Empower the community to plan or KRA 3 Empowerment of Individual and
conduct individual wellness Community to be responsible for
programme (responsible for own their health
health)
37

38. HEALTH SECTOR KRAs
1. Health Sector Transformation Towards A
More Efficient & Effective Health System in
Ensuring Universal Access to Healthcare
2. Health Awareness & Healthy Lifestyle
3. Empowerment of Individual and Community to
be responsible for their health
38

39. Outcome, Strategy and KPIs for Health Sector KRA 1
HEALTH SECTOR OUTCOME STRATEGY HEALTH SECTOR
KRA OUTCOME KPI
I. Health Sector 1. DELIVERY 1. Streamline / realign healthcare delivery system 1. Integrated PHC plan by 2011
Transformation 1.1 Integrated public - (keywords: PHC as thrust, gatekeeping, zoning, referral 2. Integrated secondary care plan by 2013
Towards A More private health services system, preventive/ promotive, resource sharing,
Efficient & Effective delivery resource mobilization, appropriate technologies,
Health System In registered population, registered providers)
Ensuring Universal 1.2 Universal Access All population will get access to the basic
Access To Equity of access – physical 2.Unified healthcare financing system PHC services by (2014)
Healthcare ease of access (keywords: Safety net, financial risk protection, case 1. All PHC providers will be registered by
mix, benefit packages, provider-payment mechanism, 2011
social health insurance, co-payment, increase 2. All population will be registered to a
government contribution, equity in resource allocation, Primary Health Care Physician starting
equity in distribution of facilities, enforcement of PHFSA 2011
1.3 High quality and safe 1998, cost structure information) 1. Decrease mortality & morbidity of
care selected conditions
3.Common quality and standard of care
(keywords: Accreditation, credentialing, CPD, HTA,
2. FINANCE practice guidelines, clinical governance, care, uniform 1. Reduce Out Of Pocket ( OOP )
2.1Universal access standard of care, standardised regulations, laws and
Equity of access - financial enforcement)
2.2 Cost containment 2. Reduce medical inflation rate
4.Adequate and competent workforce
(keywords: number, mix, competency, performance
reward/ incentive , quality, distribution )
3. GOVERNANCE 1. Increase GDP in health
3.1 Sustainability of 5.Strengthening healthcare legislation and
healthcare delivery enforcement
system (keywords: review, revise act & regulation, codes of
ethic & conducts, capacity )
3.2 Compliance to defined 2. % of accredited facilities
quality and standard
6. Strengthening implementation, monitoring and
evaluation system
3.3 Responsiveness to 3. Waiting time for selected procedures
(keywords: competency in stewardship, real time, data
population needs
& information, research, evidence, informed decision,
capacity)
7.ICT as enabler
(keywords: prerequisites for integrated unified system )
39

40. Outcome, Strategy and KPIs for Health Sector KRA 2 & 3
HEALTH SECTOR OUTCOME STRATEGY HEALTH SECTOR
KRA OUTCOME KPI
II. Health 1.Malaysians will 1. Increase access to health knowledge 1. % health literacy
Awareness & be health literate (keywords: innovative, incentive, 2. Increase in the
Healthy Lifestyle 2.Malaysian empowerment, information sharing) percentage of physical
practise healthy 2. Motivate individuals, family and activity of Malaysian adult
lifestyle community to acquire knowledge and skill 3. Reduce the prevalence
(keywords: innovative, incentive) of overweight and obesity
3. Increase opportunities to practice among adult
healthy lifestyle at workplace, schools, 4. Reduce the prevalence
home etc. among adolescent
4. Formulate and enforce public policy smokers
towards healthy lifestyle
III. Empowerment Individuals, family 1. Strategies to increase health literacy % of individuals able to
Of Individual And and community to 2. Provision of health information, including make decision on their
Community To Be have adequate cost of care and governance policies own health
Responsible For knowledge and 2. Providing avenues for effective
Their Health skills to make complaints or enquiries regarding health
decision about providers
their health 4. Mobilize civil society
( selfcare, choice of (NGOs, support groups, community
treatment / leaders)
provider)
40

41. DEVELOPMENT BUDGET
9MP BUDGET  230 B
10MP BUDGET 165 B Development Expenditure
 15 B PFI Facilitation Fund
TOTAL
 50 B PFI 230 B
Ceiling for 2011-2012 (2 year rolling plan)
(RM 75 B for the whole country)
NKRA projects – 21B
Continued 9MP Projects – 40B
New projects & Private Facilitation Fund – 14B
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