Effectiveness of safe patient handling intervention on musculoskeletal disorder among government nurses in elderly care homes West Coast Malaysia: study protocol

Background: Health care worker are susceptible to develop musculoskeletal disorder (MSD). Nurses in nursing home setting exposed with physical and psychological stressors and they are prone to develop MSD due to these conditions (Simon et al., 2008). Manual handling while handling elderly patient involved awkward posture which lead to MSD among nurses. Therefore safe patient handling intervention is important in reducing prevalence of MSD among nurses. Materials and Methods: The cluster pre-test and post-test with control group quasi experimental study will be done involving 8 government elderly care homes in West Coast Malaysia. Total 256 nurses and assistant nurses will be involved in this study. Four home care will be in the intervention group. While another 4 home care will be in the control group. Safe patient handling intervention program will be conducted. During health education, health belief model theory will be used to increase the knowledge and subsequently change the practice to safe patient handling. Result: Prior to intervention program, module intervention and health education material will be developed. The health education and training will be given according to module provided. Outcome measurements are musculoskeletal disorder, knowledge and practice of safe patient handling. These outcomes will be measured through self- administered questionnaires. Data will be analysed using SPSS version 22. To measure the association, Chi-square test, Mann Whitney U test, independent t test, dependent t test and Wilcoxon signed rank test will be used and for multivariate analysis, the Generalized Estimating Equation (GEE) will be used. Conclusion: Health education on safe patient handling is important in order to reduce the MSD among nurses in elderly care homes

Health planning in Malaysia: a case study of the National Strategic Plan Ending Aids 2016-2030 (NSPEA)

Introduction: Health planning is an essential part of healthcare system whereby policies will be translated into actions. There are many health planning theories that can be used which deal with the complexity of data and addressing the questions within the process. This paper reviewed the National Strategic Plan Ending AIDS 2016-2030 (NSPEA 2016-2030) which is one of the health planning in Malaysia. Methodology: A literature review was conducted through online database and related AIDS health planning documents in Malaysia were identified and reviewed. World Health Organization (WHO) recommendations were used as a reference tools to discuss the health planning process. Strength, weakness, opportunity and threat (SWOT) analysis was done as part of the discussion process. Recommendations are based on literature reviews and health planning documents of other countries. Result: The Malaysia Health Planning Framework consists of seven (7) processes which are situational analysis, goal setting, prioritisation, strategy, budgeting, implementation, monitoring and evaluation. There are various approaches being used. Rational planning used in situational analysis as a tool to identify the disease burden. Incremental planning also applied where all previous performances especially from AIDS National Strategic Plan (NSP) was considered in the making of the new strategies and budgeting. Meanwhile other process was based on selected alternatives which fits into mixed-scanning approach. Conclusion: From this case study, it can be identified that the health planning process and practices in NSPEA 2016-2030 comprises of seven (7) steps. It can be concluded that AIDS health planning in Malaysia mostly adopting the mixed-scanning planning approach. However, there are some steps and area of planning which can be benefited by adopting mixed-scanning planning

District health management cycle in Malaysia

Background: Imbalance between needs, demands and resources are commonly seen in the public sector. Management team needs to manage the available resources in the best possible way to meet the health needs. This is decided by the District Health Management Team (DHMT) in the district health. The concept of District Health Management Cycle (DHMC) was initially introduced by the World Health Organization (WHO) in its District Health Management Models as part of health sector reform initiatives. This review aim to discuss the principle and concept of DHMC in Malaysia. Methods: A literature review was conducted through online database such as Google Scholar and Pubmed to identify the current concept of DHMC. Related government documents on district health management was also identified and reviewed through official government websites. Initial keywords used are district health services and district health management. Then, combined keywords used are district health services in Malaysia and district health management in Malaysia. Finally, about 14 articles that are related were selected and reviewed. Logic framework for district management cycle and SWOT analysis was applied to highlight the internal factors (strength and weakness) and external factor (opportunity and threats) of district health management in Malaysia. Result: DHMC is a cycle involving situational analysis, planning, implementation, with continuous monitoring and eventually the evaluation. Situational analysis identified the current requirement of the district. Then district health plan will be carried out to get a clear picture of the range of inputs needed and how these inputs will be combined to achieve goals. Implementation is the process of carrying out the activity or intervention as well as using the resources without any interruption to the existing service delivery. Followed by monitoring, where it implies checking progress of District Health Plan. Finally, evaluation is a systematic way of reviewing at the implemented plan including the strengths and the shortfalls accounted during the entire process. District health management in Malaysia is not completely decentralized, therefore there are some different in its concept and principle. Conclusion: Healthcare system in Malaysia has some strength and threat. Some of the weaknesses are lack of human resources and top to down planning. The threat comes from internally such as resource constraints and externally due to social groups and political interference. District health management is the starting point of the district health service delivery. It aims to constantly balance the needs, and demands with the limited resources to improve the quality of health service