Kuala Muda District Office - Day 8

Public Health Care -Day 8

We were received by Mister Chong, Senior MA around 9am in the Meeting Room of Kuala Muda District Health Office. Mr. Chong seemingly a peoples' person wanted us to introduce ourselves before we officially started the topic of the day. Starting from the group leader Vinod, we introduced our names and hometown; also a little about what's famous in each hometown.

He later screened two Power Point presentations regarding the Primary Health Care in Kuala Muda district.

Content of the presentation consists of the Vision and Mission of Malaysian Health Ministry’s approach to the Primary Health Care(PHC).

Definition Of PHC

Essential health care, Based on practical, scientifically sound and socially acceptable methods and technology. Made Universally accessible to individuals and families in the community by means acceptable to them.

It is the first level of contact of individuals, the family and the community with the national health system, bringing health care as close as possible to where people live and work and constitute the first element of a continuing health care process

The Malaysian Health Ministry looks forward to achieving healthy individual, family and society through health programme that is fair & just, affordable, efficient, with appropriate technology and one that caters for the need of the locals. This programme also gives importance to health promotion, health education, and the improvement of quality of life.

MISSION

To promote the involvement of the public in the health promotion and to enable the public to achieve optimal health status possible

To value health as an asset

To steps to further enhance and maintain health status

To enjoy a better quality of life

To achieve this, the ministry has come up with 8 Aims ;

Wellness Focus – devoted to provide health for life

Person Focus – focusing on one's service and ensure that the service is available on time and at placed required

Informed Person - provide accurate information and knowledge through health education campaigns that allow a person to make decision about health

Self Help - enhance the ability of individuals to handle their own health through knowledge care Provided at Home or Close to Home - using multimedia network in providing physical and virtual service in home or community

Coordinated, Continuous, Seamless Care - providing integrated health care services that cover a wide range of facilities and levels of life

Services Tailored to Individual or Group Need - special services to meet the needs of individuals or the groups in certain circumstances

Effective, Efficient and Affordable Service - quality health services that are accessible, integrated, simple and affordable

Basic 8 elements

Health education

Food supply and proper nutrition, safe water and basic sanitation

Maternal and child care, immunization

Family planning

Mental health

Prevention and control of endemic disease

Basic treatment of health problems

Provisions of essential drugs

Basic Health Services

Out-patient care service, including mental health and provision of essential drug

Food supply and proper nutrition

Safe water and basic sanitation (BAKAS)

Maternal and child care, including immunisation and family planning

Home delivery and nursing

Prevention and control of endemic diseases

Dental care

School health service

Additional Services With Expanded Scope

- Geriatric health care

- Adolescent health care

- Community mental health

- Occupational health

- Rehabilitative services

- Home care nursing

Research Findings:

40% need not be admitted

60% seen at OPD, are unnecessary visits

70% are preventable conditions

The Focus of PHC

Medicine vs Health

Centralised vs Distributed

Disparate vs Integrated

Inequitable vs Equitable

Your “NEW” Role

AS A MA

Health advocator

Counselor

Team Player

Call-Center Manager

Clinic Practitioner

AS A CLINICAL PRACTITIONER

Well Adult Clinic

Geriatric Clinic

Adolescent Clinic

Quit Smoking Clinic

HIV/AIDS Clinic

Special Clinics- Hypertension, Diabetes, Asthma

The Malaysian Hospital system is a 2 tiers system.

Where the main hospitals are centered around district health clinics. Patients are to go to district health clinic out patient department for their problems and if required are sent to hospitals for referral. (details available in day 2)

Mr. Chong had then taken us for a stroll around the district clinic mainly to the NCD(Non-Communicable Disease) outpatient. He then explained the management steps and statistics of these disease reported each year. He also told steps of case follow up and how the diagnosis are made before commencement of treatment. He showed us around the "card room" as how all the cases are recorded manually.

There are over 12,952 recorded cases of diabetic mellitus type 2 in this district clinic alone!! And there are 10 new cases recorded daily, on an average. Kedah holds the 2nd highest record for people with diabetic type 2 after Negeri Sembilan. The statistics has doubled from a 11% to 30% in over 5 years.

Ninth MP (Malaysian Plan)

Primary Goals

- Prevent and Reduce Disease Burden

- Enhance Health Care Delivery

Supporting Goals

- Optimisation of Resources

- Enhance Research

- Manage Crisis and Disasters

- Strengthen Health Information MS

Primary Care Services

1.Prevent and Reduce Disease Burden

- Treat the ill

- Manage those with risk

- Prevent the onset of preventable risks

2.Enhance Health Care Delivery

- Fast Access

- Safe and high quality

- Hassle-free and better comfort

3.Optimisation of Resources

- Multi-skilling

- Sharing

- Remote management

4.Enhance Research

- Participate towards evidence based planning and intervention

5.Manage Crisis and Disasters

- Increase HR capacity and capability

- Adequate and appropriate facilities

- Current’ protocols for management

6.Strengthen Health Information MS

- Reduce repetitive request

- Increase safety through reducing error

- Enhance sharing of data and info facilitate continuity of care.

7.Current challenges - PHC

- High load of patients to doctor

- (30m & 13m) = 40 -50 m (total encounters)

- (Medical assistants / Nurses)

- 1000 drs (130 FMS)

- 6300 nurses (3700 SN)

- 2000 MAs

- Increasing scope of services

- Lack of building space and equipment

- Poor maintenance

- Increasing demands by clients

The card room

The different cards as patient copy and staff copy

(small - patient)

Organisation chart of Kuala Muda district Hospital

Organisation chart for OPD

This image is that of four different types of survey form:

• Teenagers
  


• Adult female


• Adult male


• Senior citizens

These survey form are for screening purposes that target and attempts to get hold of specific problems faced by society of varying age groups. The surveys are done as and when required and collected back for assessment. If problems are detected through this survey form, the patient are called up for review and treatment.

-vachalla-