Prevalence and Factors Affecting Child Marriage Practice among Rural Indigenous Communities in Sibu, Sarawak

Child marriage could impinge the accomplishment of at least six out of eight of the Sustainable Development Goals (SDG). Malaysia recorded an average of 1000 child marriage applications annually. Sarawak recorded the highest child marriage cases. This study aimed to determine the prevalence and factors affecting child marriage among rural indigenous communities in Sibu, Sarawak, Malaysia. A validated questionnaire assessed the socio-demographic, knowledge on marriage law, and perceptions on child marriage factors among 244 respondents, aged between 13 to 50 years old. The mean age of the respondents was 34.9 (SD=10.4) years old. The prevalence of female child marriage was as high as 13.2%. More than 50% respondents perceived that child marriage could protect girls from premarital sex and unwanted pregnancy. Almost all respondents (91%) have a misconception about the minimum age of marriage. Education and gender were significant factors that explained about 25% of the total variance of the child marriage occurrence. Based on these findings, there is an urgency for an effective education for sexual health among teens to prevent teenage pregnancy; reformation of the educational system for each child to complete their secondary education up to Form 5; and certainly to establish a clear legal age for marriage at 18 consistent with the international standard

Late antenatal booking and its predictors in Lundu district of Sarawak, Malaysia

Introduction: Antenatal care is widely acknowledged as an effective tool to prevent adverse outcomes in antenatal mother and their children. In Malaysia, early entry to antenatal care refers to first visit within the 12th week of gestation. Delayed access to antenatal care has not been extensively studied in Malaysia, whereas several literatures reported high prevalence of late antenatal booking in the developing countries. The objective of this study was to determine factors and barriers associated with late antenatal booking and level of knowledge on timing of antenatal booking among child bearing age mother in Lundu District of Sarawak. Method: This was a cross sectional study among 284 pregnant women in all five Maternal and Child Health (MCH) Clinics of Lundu. Results: The prevalence of late antenatal booking in Lundu was 28.2%. Unmarried women were more likely to book their pregnancy late compared to the married women. The prevalence of late antenatal booking was also higher among the unemployed women than those who were employed. Respondents without their own income also tend to book their pregnancy later than those who had their own income. Significantly high percentage of late antenatal booking were also reported among those who never utilise any contraceptive method, unplanned their pregnancy, without past medical illness or history of complication in previous pregnancy and among those who has problem with marriage certificate. Those who booked their pregnancy beyond the 12th week of gestation also reported to have lower level of knowledge on antenatal booking as compared to those who started their antenatal care early. Conclusions: In conclusion, intervention strategies should be formulated and to be carried out in order to tackle issues related to late entry to antenatal care in order to prevent unwanted adverse outcome associated with delayed antenatal care

Using teleprimary care to monitor immunization status in Sarikei Health Clinic, Sarikei, Sarawak

The purpose of this paper is to demonstrate the effectiveness of using TelePrimary Care (TPC) to monitor immunization programmed in a clinic. Japanese Encephalitis (JE) vaccination was selected as an example because its coverage has not been satisfactory when compared to that of other vaccinations, which generally exceed 90%. Data for all children who were eligible for JE vaccination (age range from 9 months to 30 months) who attended Sarikei Health Clinic between 1 January 2007 till 31 June 2008, was extracted from the TPC database and analyzed for completeness and timeliness of JE vaccination. The analysis showed that although 1,243 children were eligible to receive their first dose of J vaccine at 9 months of age, only 560 (45%) received it. 15 (3%) received on time, and 545 (97%) received it late (age range from 10 months to 20 months). Out of the 560 who were scheduled to receive their second dose of JE vaccine four weeks after the first, 382 (88%) received it on time, and 55 (12%) received it late. Only 78 (18%) out of 429 children aged between 18 months to 24 months received their booster dose; 52 (67%) received it on time and 26 (33%) received it late.TPC not only enables health staff to monitor immunization coverage and timeliness accurately, but it also helps them to identify defaulters quickly so that these children can be traced and immunized. Doing these tasks manually is time-consuming and tedious, leading to delays in tracing defaulters. TPC provides an effective system for staff to easily access real time child health data to monitor and audit their immunization programme and take remedial action where necessary

Does Entitlement Card ensure Utilization of Urban Primary Healthcare Clinic in Bangladesh?

Background: Although Bangladesh substantial­ly reduced 40% maternal death in the last deca­des, it is still challenging, especially among the ur­ban poor. The achievements are not equitable bet­ween different economic quintiles and bet­ween the rich and the urban poor. This study aims to examine the extent to which the entitle­ment card affects the utilization of maternal and child health care and identifies other factors that influence MCH services.Subjects and Method: This cross-sectional study was carried out in the working areas of the Ur­ban Primary Healthcare Project (UPHCP) in Bang­ladesh. A two-stage cluster sampling tech­ni­que was used to select the participants. A total of 3,949 women aged 15-49 years, having at least one child aged two years or less were selected for this study. The data were collected through face-to-face inter­views. The data were analyzed using multinomial logistic regression.Results: The proportion of utilization of UPH­CC was 49.9%. One-fourth (26.6%) of them fully utilized it and another 23.3% utilized it partially. Stepwise multinomial logistic regression analysis revealed that those who had an Entitlement Card from the UPHC project were 11.75 times (95% CI= 9.481, 14.549; p= 0.001) more likely to fully Utilized and 3.64 times (95% CI= 3.643, 2.911; p= 0.001) likely be utilized partially compared to non-utilizer. Respondents having no formal edu­cation utilized UPHCC fully (AOR=2.32; 95% CI= 1.46, 3.68; p= 0.001) and partially (AOR= 1.76; 95% CI= 1.12, 2.77; p= 0.014) used UPHCC. It was 3.08 (95% CI= 2.03, 4.67; p= 0.001) times for fully and 2.71 (95% CI= 1.82, 4.04; p= 0.001) times for partially utilized UPHCC compared to non-users among the primary level of education. Small family size (≤4) and monthly family in­come in the range of BDT 10,000 above were likely to utilise UPHCC. However, non-Muslims were less likely to Utilized UPHCC.Conclusion: Apart from the entitlement card, other factors such as monthly income BDT> 10,000, small family size, no formal educated mo­ther appeared to be potential predictors for utilization of the Urban Primary Health care clinic.Keywords: entitlement card, maternal care, Utilization, urban primary healthcareCorrespondence: Md Mizanur Rahman. Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sa­rawak. Email: [email protected], [email protected] of Maternal and Child Health (2020), 5(2): 213-225https://doi.org/10.26911/thejmch.2020.05.02.1

Disclosure of Traditional and Complementary Medicine Use and Its Associated Factors to Medical Doctor in Primary Care Clinics in Kuching Division, Sarawak, Malaysia

The decision by the patients to disclose traditional and complementary medicine (TCM) use to their doctor is an important area to be explored. This study aimed to determine the disclosure of TCM use and its associated factors to medical doctor among primary care clinic attendees in Kuching Division, Sarawak. It was a cross-sectional study using questionnaire, interviewer administered questionnaire. A total of 1130 patients were screened with 80.2% reporting using TCM. Logistic regression analysis revealed that being female (AOR = 3.219, 95% CI: 1.385, 7.481), perceived benefits that TCM can prevent complication of illness (AOR = 3.999, 95% CI: 1.850, 8.644) and that TCM is more gentle and safer (AOR = 4.537, 95% CI: 2.332, 8.828), perceived barriers of not having enough knowledge about TCM (AOR = 0.530, 95% CI: 0.309, 0.910), patient dissatisfaction towards healthcare providers being too business-like and impersonal (AOR = 0.365, 95% CI: 0.199, 0.669) and paying more for healthcare than one can afford (AOR = 0.413, 95% CI: 0.250, 0.680), and accessibility of doctors (AOR = 3.971, 95% CI: 2.245, 7.023) are the predictors of disclosure of TCM use. An open communication between patients and doctor is important to ensure safe implementation and integration of both TCM and medical treatment

Patient’s Decision to Disclose the Use of Traditional and Complementary Medicine to Medical Doctor: A Descriptive Phenomenology Study

Nondisclosure of traditional and complementary medicine (T&CM) use may cause individual to be at risk of undue harm. This study aimed to explore patient’s experience and views on their decision to disclose the use of T&CM to the doctor. An exploratory qualitative study using in-depth interview involving 10 primary care clinics attendees in Kuching was conducted. The results indicated that disclosure of T&CM use will motivate them to get information, increase doctor’s awareness, and get support from family and friends for disclosure. Fear of negative relationship and negative response from doctors was a barrier for disclosure. Doctor’s interpersonal and communication skills of being involved, treating patients respectfully, listening attentively, respecting privacy, and taking time for the patient were a critical component for disclosure. Intrapersonal trust regarding doctor influences their satisfaction on healthcare. Women are more open and receptive to a health concern and expressing negative emotions and tend to share problems, whereas men always described themselves as healthy, tended to keep their own personal feeling to themselves, and tended to not share. The doctor should consider gender differences in disclosure, their attitude towards T&CM use, and gained patient’s trust in the delivery of healthcare services. Good interpersonal and communication skills must be maintained between doctor and patients

Prevalence and Factors Associated with Alcohol Use among Dayak Adolescents in Sarawak, Malaysia.

Introduction: Alcohol is classified as a psychoactive substance, and its dependence is one of the three leading risk factors for death, disability, or disease. Early age alcohol use by the age of 15 is implied to be harmful due to interference in the brain development of adolescents, causing alcohol-related problems later in life. This study aims to determine the prevalence and factors associated with alcohol use among Dayak adolescents in Sarawak, Malaysia. Methods: This was a cross-sectional quantitative research approach. A total of 12 districts within the 12 divisions were selected by multistage stratified cluster sampling. Dayak housing area lists were obtained from district offices and the local councils. The respondents were selected systematically according to male and female respondent houses, and they were interviewed using an interviewer-administered questionnaire. Data were entered into Microsoft Excel and analysed through IBM SPSS Version 27.0. Results: Dayak adolescents’ mean age was 17.31 years. They were either low-risk (50.0 %), hazardous (31.0%), abstainers (11.0%), harmful (5.0%) or alcohol dependant (3.0%) drinkers. Age (p<.001), gender (p<.05), ethnicity (p<.001), religion (p<.05), employment (p<.001), level of education (p<.01), allowance (p<.001), family relationship (p<.05), and family size (p<.05) were the potential predictors of alcohol use disorder. Conclusion: Dayak adolescent alcohol drinking is prevalent and a public health problem, particularly among disadvantaged socio-economic families. The lower proportion of abstainers suggested that alcohol use among adolescents is on the rise. Hence, the results should be utilised to do targeted health promotion regarding harmful alcohol use among adolescents since early use of alcohol among adolescents may lead to more severe health and non-health outcomes in the futur

Validation and Reliability of Sexually Transmitted Infections (STIs) Health Care-Seeking Behaviour Questionnaire based on the Theory of Planned Behaviour, and Stigma-Shame Scales among Men who have Sex with Man (MSM) in Malaysian

Introduction: The rising numbers of men who have sex with men (MSM) population showed a significant health issue in recent years. However, the utilisation of sexually transmitted infections (STI)-related health care services among MSM was found to be very low. Understanding the factors is essential in improving the STIs healthcare-seeking behaviour among MSM. Objective: This pilot study aimed to evaluate the instrument’s feasibility for a fullscale study and assess the respondents’ experience answering the questionnaires. Methods: Sexually transmitted infections healthcare-seeking behaviour was measured based on the frequency of the visit to STIs services in 12 months using the theory of planned behaviour (TPB) variables (i.e. attitudes, subjective norms, and perceived behavioural control). Besides, the STIs knowledge and STIs-related stigma-shame scales were also evaluated for content validity and internal reliability. Result: Within 12 months, 54.3% of respondents had frequent visits (>1 time), 17.1% had infrequent visits and 28.6% never visit the services. About 85.7% of participants had ever had an STI test. The item-level content validity index (I-CVI) for 47 items scale ranged between 0.67 to 1.00. The scale-level index per average (S-CVI/Ave) for subscales ranged between 0.94 to 1.00. The Cronbach’s alpha coefficient for each subscale ranged from 0.844 to 0.929 with an overall scale was 0.892. Conclusion: The scales were valid and reliable measures for assessing possible contributing factors of STIs healthcare-seeking behaviour among MSM in Malaysian Borneo. The scales could be used for a full-scale study

Piecewise linear modelling and change-point analysis of COVID-19 outbreak in Malaysia

In Malaysia, COVID-19 were first detected as imported cases on 25 January and as local infection on 4 February 2020. A surge of positive cases ensued by March 2020 which led to a series of countrywide containment and mitigation measures known as Movement Control Order (MCO). We study the direct effects of MCO on the course of epidemic by analyzing the cumulative and daily infection cases of COVID-19 up to 31 December 2020 in Malaysia and its states using piecewise linear regression and segment neighborhoods algorithm of change-point analysis, respectively. Through piecewise regression on nationwide cases, MCO were likely to almost flatten the epidemic curve in just one month after it was first initiated. While for stateswise cases, the average length of series of concave downward is six months before it turn to concave upward, indicating the period of which deceleration of new cases can be expected. However, the starting of this wave of COVID-19 can be relatively vary for three months in different states and federal territories. Together with change-point analysis on daily cases, the statewise epidemic phases could be subdivided into two to four regimes, whereby the majority of phase transitions fall in April and last quarter of 2020. Overall, the statistical modelling shows that the immediate effect of MCO appears to be effective

Does Entitlement Card ensure Utilization of Urban Primary Healthcare Clinic in Bangladesh?

Background:Although Bangladesh substantial-ly reduced 40% maternal death in the last deca-des, it is still challenging, especially among the urban poor. The achievements are not equitable between different economic quintiles and bet-ween the rich and the urban poor. This study aims to examine the extent to which the entitle-ment card affects the utilizationof maternal and child health care and identifies other factors that influence MCH services.Subjects and Method:This cross-sectional study was carried out in the working areas of the Urban Primary Healthcare Project (UPHCP) in Bangladesh. A two-stage cluster sampling techni-que was used to select the participants. Atotal of3,949 women aged 15-49 years, having at least one child aged two years or lesswere selected for this study. The data were collected through face-to-face interviews. The data were analyzed using multinomial logistic regression.Results:The proportion of utilizationof UPHCC was 49.9%. One-fourth (26.6%) of them fully utilized it and another 23.3% utilized it partially. Stepwise multinomial logistic regression analysis revealed that those who had an Entitlement Card from the UPHC project were 11.75 times (95% CI= 9.481, 14.549; p= 0.001) more likely to fully Utilized and 3.64 times (95% CI= 3.643, 2.911; p= 0.001) likely be utilized partially compared to non-utilizer. Respondents having no formal edu-cation utilized UPHCC fully (AOR=2.32; 95% CI= 1.46, 3.68; p= 0.001) and partially (AOR=1.76; 95% CI= 1.12, 2.77; p= 0.014) used UPHCC. It was 3.08 (95% CI= 2.03, 4.67; p= 0.001) times for fully and 2.71 (95% CI= 1.82, 4.04;p= 0.001) times for partially utilized UPHCC compared to non-users among the primary level of education. Small family size (≤4) and monthly family in-come in the range of BDT 10,000 above were likely to utilise UPHCC. However, non-Muslims were less likelyto Utilized UPHCC.Conclusion:Apart from the entitlement card, other factors such as monthly income BDT>10,000, small family size, no formal educated mother appeared to be potential predictors for utilizationof the Urban Primary Health care clinic