Ma l a y s i a Population over 65 Commonwealth Health Partnerships 2015 205 2013 under-five mortality stood at nine deaths per 1,000 live births and measles immunisation at 96 per cent. Given these results, Malaysia is close to achieving MDG 4 and with progress could to do so by 2015. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. For Malaysia, maternal mortality should fall to 13 cases per 100,000 live births. In 2013 Malaysia had an adjusted maternal mortality ratio of 29 deaths per 100,000 live births (this figure was estimated at 29 deaths per 100,000 by UN agencies/World Bank in 2010). Given that this figure has remained static for three years and is more than double the target figure, this part of the goal is unlikely to be met. Part of the goal also stipulates that 100 per cent of births should be attended by a skilled health professional. In the period 2007–12 this figure stood at 99 per cent, so it is very likely that this target will be achieved. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. Malaysia’s prevalence of HIV was 0.4 per cent in 2012 (in the 15–49 age group), having seen no decrease since 1990. The estimated mortality (when mortality data excludes cases comorbid with HIV) rate for tuberculosis is showing slight improvement; this is also the case for malaria. Given the decline of prevalence in these areas, Malaysia could achieve the targets set out by MDG 6. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage Almost half of all health care in Malaysia (45 per cent) was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 3.9 per cent of GDP in 2012, of which 55 per cent (US$230 per capita) was covered by the government. Malaysia boasts one of the world’s most sophisticated health care sectors. The public health care programme is accessible to everyone as it is subsidised by the government and is used by the majority of the Malaysian population. In general, Malaysian doctors are required to complete three years of service in public hospitals before being allowed to move into the private sphere, ensuring that there is adequate public cover for the general population. In light of improving access to health care, and ensuring universal health coverage for the county, the Tenth Malaysia Plan 2011–15 addresses several challenges and opportunities for the country’s health sector. This includes increasing expectations for quality of health care; the growing pressure on the public health care system; the increasing workload in public hospitals, stretching capacity; shifting lifestyles and demography; and advances in technology. In response to these challenges, the government of Malaysia is reforming the health care delivery system by increasing quality, capacity and coverage of the health care infrastructure; shifting towards prevention rather than treatment; and increasing the quality of human resources for health. Malaysia is not a signatory to the International Covenant on Economic, Social and Cultural Rights, the covenant that commits signees to ensuring ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. Care for the elderly: Around 1.5 million people in Malaysia are over the age of 65 – five per cent of the total population (2013). At the age of 60 a person living in Malaysia can be expected to live for an additional 19 years, on average (2013). Malaysia’s Bantuan Orang Tua (elderly assistance scheme) dates back to 1982. Today, monthly pension credits are paid by the state at a rate of US$94 per person (2007–12) on a means-tested basis. Overall, public pension spending is equivalent to 3.8 per cent of the country’s total economic output (2012). 5% Traditionally, the responsibility of caring for the elderly would fall on the shoulders of their children and extended family. However, in modern times these practices are becoming less and less prevalent. With Malaysia’s population ageing quickly, the question of elderly care is becoming increasingly important. Home care services have popped up across the country to cater to the ageing population. One such organisation is Love on Wheels, an elderly home care service provider that works in collaboration with the private and public sectors to provide elderly citizens with in-home, medical and personal care, and rehabilitation services. There are several private and government-run nursing homes and retirement centres. Further information Ministry of Health: www.moh.gov.my Commonwealth Health Online: www.commonwealthhealth.org/health/asia/malaysia
Commonwealth Health Partnerships 2015
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