The experiences of parents and caregivers of children with disability on community-based rehabilitation (CBR) services in Malaysia: A Qualitative study

Background: The rehabilitation program for disabled children is provided through community-based rehabilitation (CBR) services by an initiative of the Department of Social Welfare Malaysia. This long-term program needs commitment and compliance, which relates to the quality of services experienced by parents and caregivers. Thus, the purpose of this study was to explore the experiences of the parents and caregivers of disabled children on the CBR services. Methods: This qualitative study utilized in-depth interview sessions held from March to May 2015. Fifteen parents and caregivers who had disabled children participating in the CBR program were selected using a purposive sampling method. All recorded conversations were transcribed verbatim and analyzed using Atlas.ti version 8.0. The thematic analysis was used for identifying, analyzing, and reporting the data obtained. The themes that emerged were read, reread, and peer checked until the researcher agreed on the thematic representation of the data. Results: Six major themes emerged from this study, including CBR activity, facilities, environment, communication, program impact, and management system. Conclusion: The majority of the parents and caregivers had good experiences with CBR services. However, several aspects could be given further attention to improve the CBR quality and to sustain its services for disabled children

The costs of caregivers for children with disabilities that participate in centre-based and home-based community-based rehabilitation (CBR) programmes in the East Coast of Malaysia.

Rehabilitation for disabled children requires long-term programmes which are expensive to the family. This study aimed to estimate the cost incurred by caregivers’ children with disabilities from Pahang, Terengganu and Kelantan participating in Community-Based ehabilitation (CBR) (CentreBased and Home-Based) and cost of seeking alternative rehabilitation. Cost analysis using the Activity-Based Costing (ABC) method was used to estimate twelve-months’ expenditure in 2014 institutional year on 297 caregivers of children with disability, aged 0 to 18 years who attended CBR. Data were collected using a self-administered costing questionnaire and presented in median (IQR). Results showed that the median direct and indirect costs, excluding medications and alternative care were nearly four times as high in Home-Based compared to Centre-Based (RM2, 376 (11,228) vs. RM608 (739) (p = <0.001). Both groups of caregivers spent a significant amount of resources on alternative rehabilitation. The high costs incurred for alternative rehabilitation is a major economic burden to the family

The experiences of parents and caregivers of children with disability on community-based rehabilitation (CBR) services in Malaysia: a qualitative Study

Background: The rehabilitation program for disabled children is provided through community-based rehabilitation (CBR) services by an initiative of the Department of Social Welfare Malaysia. This long-term program needs commitment and compliance, which relates to the quality of services experienced by parents and caregivers. Thus, the purpose of this study was to explore the experiences of the parents and caregivers of disabled children on the CBR services. Methods: This qualitative study utilized in-depth interview sessions held from March to May 2015. Fifteen parents and caregivers who had disabled children participating in the CBR program were selected using a purposive sampling method. All recorded conversations were transcribed verbatim and analyzed using Atlas.ti version 8.0. The thematic analysis was used for identifying, analyzing, and reporting the data obtained. The themes that emerged were read, reread, and peer checked until the researcher agreed on the thematic representation of the data. Results: Six major themes emerged from this study, including CBR activity, facilities, environment, communication, program impact, and management system. Conclusion: The majority of the parents and caregivers had good experiences with CBR services. However, several aspects could be given further attention to improve the CBR quality and to sustain its services for disabled children

Willingness to pay for outpatient services user fees: Malaysian community perspective

Health care services are not often accessible and available for all people in one country due to multiple reasons such as the geographical barrier, affordability, etc. The aim of this study was to analyse willingness to pay (WTP) for healthcare services user fees among Malaysian population and determine its’ influencing factors. Structured interviews were conducted involving 774 households in 4 states represents Peninsular Malaysia. Validated questionnaires with open ended, followed by bidding games were applied to elicit maximum amount of WTP. The study was analysed descriptively and with multivariate regression method to adjust for potential confounding factors. More than half of respondents WTP more than current fee for the government clinic outpatient registration fee with mean MYR3.76 (SD2.71). Majority of respondents not WTP more than usual for private clinic simple outpatient treatment charges with the mean MYR38.76 (SD5.45). Factors that were found to have significant associations with WTP for both government and private clinic were income and having health insurance. Community willing to pay for healthcare services user fees and charges but at certain amount. The healthcare services user fees and charges can be increased up to community WTP level to avoid from catastrophic expenditure

The cost of radiology procedures using Activity Based Costing (ABC) for development of cost weights in implementation of casemix system in Malaysia

Presently there is a gross lack of information on cost and cost weights in many developing countries that implement casemix system. Furthermore, studies that employed Activity Based Costing method (ABC) to estimate the costs of radiology procedures were rarely done in developing countries, including Malaysia. The main objective of this study is to determine the costs of radiology procedures for each group in casemix system, in order to develop cost weights to be used in the implementation of the casemix system. An economic evaluation study was conducted in all units in the Department of Radiology in the first teaching hospital using the casemix system in Malaysia. From the 25,754 cases, 16,173 (62.8%) of them were from medical discipline. Low One Third and High One Third (L3H3) method was employed to trim the outlier cases. Output from the trimming, 15,387 cases were included in the study. The results revealed that the total inpatients’ charges of all the radiology procedures was RM1,820,533.00 while the cost imputed using ABC method was RM2,970,505.54. The biggest cost component were human resources in Radiology Unit (Mobile) (57.5%), consumables (78.5%) of Endovascular Interventional Radiology (EIR) Unit, equipment (81.4%) of Magnetic Resonance Imaging (MRI) Unit, reagents (68.1%) of Medical Nuclear Unit. The one highest radiology cost weight, was for Malaysia Diagnosis Related Group (MY-DRG®) B-4-11-II (Hepatobiliary and Pancreas Neoplasms with severity level II, 2.8301). The method of calculation of the cost of procedures need to be revised by the hospital as findings from this study showed that the cost imposed to patient is lower than the actual cost

Coupling heterostructure of thickness-controlled nickel oxidenanosheets layer and titanium dioxide nanorod arrays via immersionroute for self-powered solid-state ultraviolet photosensor applications

A coupling heterostructure consisting of nickel oxide nanosheets (NNS) and titanium dioxide nanorod arrays (TNAs) was fabricated for self-powered solid-state ultraviolet (UV) photosensor applications. By controlling the thickness of the NNS layer by via varying the growth time from 1 to 5 h at a deposition temperature of 90 °C, the coupling NNS/TNAs heterojunction films were formed and their structural, optical, electrical and UV photoresponse properties were investigated. The photocurrent measured from the fabricated self-powered UV photosensor was improved by increasing the thickness of NNS from 140 to 170 nm under UV irradiation (365 nm, 750 µWcm−2) at 0 V bias. A maximum photocurrent density of 0.510 µA∙cm−2 was achieved for a sample with a NNS thickness of 170 nm and prepared with a 3 h NNS growth time. Our results showed that the fabricated NNS/TNAs heterojunction has potential applications for self-powered UV photosensors

Parents' and caregivers' satisfaction with community-based rehabilitation (CBR) services for children with disability in east coast states in Peninsular Malaysia

The Community-Based Rehabilitation (CBR) services under the Malaysian Ministry of Women, Family and Community Development have provided two types of services for disabled children: centre-based and home-based care since 1984. A cross-sectional study was conducted among parents and caregivers with children receiving treatment at CBRs on the east coast of Peninsular Malaysia, to determine the level of satisfaction with the services provided. Respondents were recruited via multi-staged sampling, and simple randomisation at CBR level. Respondents self-administered the Physical Therapy Satisfaction Questionnaire (PTSQ) and provided sociodemographic data. A total of 297 respondents were recruited and all the questionnaires were returned complete, making the response rate 100%. Total satisfaction scores and factors influencing respondents’ satisfaction for both groups were analysed. The mean total satisfaction score for centre-based and home-based were 84.69 (SD = 10.01) and 75.30 (SD = 12.23; t = 7.160, p ≤ .001) respectively. Ninety-eight per cent of centre-based and 89% of home-based respondents were satisfied with the current services. There were significantly mean differences in the satisfaction level of respondents of different states respectively (Kelantan mean 84.92 10.83, Terengganu mean 77.49 11.16 and Pahang mean 77.47 12.93, p ≤ .001). Factors associated with satisfaction were education (p = .002), occupation (p = <0.001), monthly income (p = .001) and source of income (p = .001). In conclusion, majority of parents and caregivers were satisfied with current services provided at CBR and satisfaction with services was dependent on CBR centre location and education and financial earning capacity

A study on cost effectiveness of impregnated bed-nets; in the aboriginal villages of district of Temerloh, Pahang Darul Makmur, 1997

A comparative study was carried out in two aboriginal villages in Temerloh District of Pahang Darul Makmur. The aim of the study is to compare the cost effectiveness of DDT spraying reinforced with impregnated bed-nets with DDT spraying activity alone and cost of treating malarial case in the hospital. The villages were clustered according to the distribution of impregnated bed-nets. Eventually all villages receiving impregnated bed-nets between February and March, 1995 with DDT sprays were selected. Also all villages receiving only DDT sprays until September, 1996 were selected for the study. Two methods of data collection being carried out, the first method is by guided questionnaire to the respondent from the two selected villages. 13 8 respondent from Kg. Pian (villages receiving impregnated bed-nets and DDT sprays) and 77 respondent from Kg. Leleh (villages receiving only DDT sprays). Secondly, by collecting data from Hospital Mentakab and Health Office of District Temerloh on finance, malarial cases and activities. Health outcome is measured in terms of cost per malaria case avoided. The outcome from this study shows that the cost per case avoided through DDT spraying in combination with impregnated bed nets is RM 354.00, the cost per case avoided through only DDT spraying activity is RM 3,820.63 and cost of treating per malaria case in the hospital is RM 2,478.00. Thus showing that DDT spraying reinforced with impregnated bed nets is more cost effective in avoiding malaria than a program that uses only DDT spraying. This study also shows that the cost of DDT spraying reinforced with impregnated bed-nets is relatively cheaper than the cost of treating malaria case in hospital. In this study it was found that going into the nearby jungle for economic reasons, wrong perception of the respondent that there is no association between DDT sprays and malaria control and villagers attitude of not using bed-nets when sleeping at night can hamper the malaria control program. Health education program can alleviate the above problem so also in upgrading the knowledge and perception of the staff involved with the program and thus increases the effectiveness of malaria control program in the district