Valuation of impacts in cost benefit analysis

Background: Despite being a very useful tool in programme evaluation, CBA struggles from the problems of valuating a diverse range of impacts from a program or intervention into monetary terms. Objectives: To review the methods that had been used in the valuation of impacts for CBA including the recommendations related to the valuation as well as the advantages and disadvantages of each method. Methodology: This is a review of literatures on methods for the valuation of impacts for CBA using major healthcare databases such as PubMed, CINAHL and Google Scholar. Also performed are hand searching of relevant articles, health reports, and papers issued by government bodies and international health organizations.Result and Discussion: Among the approaches that has generally been suggested for the valuation of impacts are; the human capital approach, revealed preferences and the contingent valuation method. The human capital approach is simple to operationalize but there are several economic and ethical disadvantages that reduces its applicability. The revealed preference approach is mostly applicable in the labour market, where wage premiums are offered to workers to accept more risky jobs. But besides safety, there are also a number of other factors that affect wages which may influence the result of the study. The contingent valuation method uses surveys in the valuation of its impacts but as this method involves hypothetical data, what people say they would pay might not necessarily be the amount that they would really pay in an actual situation. Conclusion: All three methods of valuation of impacts have its equal share of strengths and limitations, thus the decision to choose between the three methods will be a matter of situation, study objectives and preferences

The concept of district health management in Malaysia

Background: In Malaysia, public health services sector are administered by the Ministry of Health through its central headquarters to the state and district offices. The District Health Offices particularly manage and coordinate the delivery of an effective, efficient and affordable health services in the districts throughout Malaysia. Materials and Methods: The information and statistics used in this article are based on the data collected from reports, articles, and publications by the Ministry of Health Malaysia and journals published pertaining to the District Health Management in Malaysia. Result: A District Health Office is entrusted with two major roles; to deliver public health services and to manage resources within a district. Led by a Public Health Physician, it acts as a body to oversee the execution of the national health policies and strategies at the ground level and serves to enforce existing health related legislation. It is also responsible in disease monitoring and surveillance and also the achievement of specific health indicators for each activity. There are six major services provided by the District Health Office, namely the Family Health, Disease Control, Occupational Health, Food Quality Control, Health Education, as well as Environmental Health and Water Supply Services. Conclusion: A District Health Office functions as the basic operational level in Malaysia healthcare system. Being the backbone in government healthcare system, it is essential to provide a well organised and integrated health service in delivering quality healthcare services to the population

Assessment of neck circumference in a sample of primary school children

Background: Neck circumference (NC) is one of the proposed assessments for child obesity, but limited information is available for Malaysian children. This study assessed NC and its relationship with anthropometric indices in a sample of primary school children. Materials and Methods: This cross-sectional study recruited 758 children aged 7-10 years old from a selected primary school in Serdang, Selangor. Anthropometric indices included assessments of height, weight, waist circumference (WC) and NC. Body mass index (BMI) was calculated which was then used to determine BMI-for-age Z-score based on the WHO Child Growth Standard. Results: Their mean age of the children were 8.2±1.1 years old, mainly boys (54.6%) and Malays/Bumiputera (91.0%). The prevalence of overweight and obesity were 8.3% and 3.8% respectively, lower than the thinness (16.6%). The mean NC was 27.8±2.5cm with no differences between boys and girls. There was a significant difference between BMI and NC in which thinness (25.7±1.3cm) and normal weight (27.6±1.9cm) children had significantly lower NC as compared to overweight (31.6±1.8cm) and obese (32.5±2.5cm) children (p< 0. 001). However, no different in NC between overweight and obese children. NC was also significantly higher in children with WC of more than 90th percentiles as compared to those less (31.5±2.2 vs 27.2±1.8 cm) (p< 0. 001). NC was positively correlated with BMI-for-age (r = 0.781), BMI-for-age Z-score (r= 0.762), WC (r= 0.755), body weight (r= 0.752), height (r= 0.430) and age (r= 0.117) (p< 0. 001). There were a significant relationship of BMI and WC with NC (Adjusted R2 = 0.625, F (2, 753) = 630.9 p < 0.000). Conclusion: NC was significantly related to excess weight and adiposity. The results suggest that NC assessments can potentially be used to assess child obesity