Suspected Child Abuse and Neglect Team (SCAN Team) : early establishment, success stories, challenges and the way forward / Yarina Ahmad ... [et al.]

This paper presents a pioneering program/initiative to prevent child abuse in Malaysia: Suspected Child Abuse and Neglect Team (hereafter SCAN Team). While there are three main initiative/programs to prevent child abuse in Malaysia, namely Child Protection Team, Child Protection Unit and SCAN Team; this paper focuses on only one initiative – SCAN Team which based at the General Hospital Kuala Lumpur (hereafter GHKL). The presentation of this paper is based on the findings of in-depth interview with focal person who manages SCAN Team, and further supported by relevant important documents related to SCAN Team (i.e. archives newspaper from SCAN Team, Malaysian Social Institute (Institut Sosial Malaysia – ISM) and relevant secondary data). Findings of this study revealed that SCAN Team has effectively deal with challenges during its early establishment; notably, SCAN Team has received international recognition in 1998 for ‘protecting the lives of children’. Nonetheless, the awareness of public about the existence of SCAN Team has waned in 21st Century due to several issues and challenges. Despite this, SCAN Team is moving forward through initiatives, in particular, re-marketing their program through various activities and campaigns to prevent child abuse in Malaysia

The rural bite in population pyramids: what are the implications for responsiveness of health systems in middle income countries?

BackgroundHealth services can only be responsive if they are designed to service the needs of the population at hand. In many low and middle income countries, the rate of urbanisation can leave the profile of the rural population quite different from the urban population. As a consequence, the kinds of services required for an urban population may be quite different from that required for a rural population. This is examined using data from the South East Asia Community Observatory in rural Malaysia and contrasting it with the national Malaysia population profile.MethodsCensus data were collected from 10,373 household and the sex and age of household members was recorded. Approximate Malaysian national age and sex profiles were downloaded from the US Census Bureau. The population pyramids, and the dependency and support ratios for the whole population and the SEACO sub-district population are compared.ResultsBased on the population profiles and the dependency ratios, the rural sub-district shows need for health services in the under 14 age group similar to that required nationally. In the older age group, however, the rural sub-district shows twice the need for services as the national data indicate.ConclusionThe health services needs of an older population will tend towards chronic conditions, rather than the typically acute conditions of childhood. The relatively greater number of older people in the rural population suggest a very different health services mix need. Community based population monitoring provides critical information to inform health systems

The rural bite in population pyramids: what are the implications for responsiveness of health systems in middle income countries?

Daniel Reidpath - ORCID: 0000-0002-8796-0420 https://orcid.org/0000-0002-8796-0420Background Health services can only be responsive if they are designed to service the needs of the population at hand. In many low and middle income countries, the rate of urbanisation can leave the profile of the rural population quite different from the urban population. As a consequence, the kinds of services required for an urban population may be quite different from that required for a rural population. This is examined using data from the South East Asia Community Observatory in rural Malaysia and contrasting it with the national Malaysia population profile. Methods Census data were collected from 10,373 household and the sex and age of household members was recorded. Approximate Malaysian national age and sex profiles were downloaded from the US Census Bureau. The population pyramids, and the dependency and support ratios for the whole population and the SEACO sub-district population are compared. Results Based on the population profiles and the dependency ratios, the rural sub-district shows need for health services in the under 14 age group similar to that required nationally. In the older age group, however, the rural sub-district shows twice the need for services as the national data indicate. Conclusion The health services needs of an older population will tend towards chronic conditions, rather than the typically acute conditions of childhood. The relatively greater number of older people in the rural population suggest a very different health services mix need. Community based population monitoring provides critical information to inform health systems.https://doi.org/10.1186/1471-2458-14-S2-S814S

Cohorts and community: a case study of community engagement in the establishment of a health and demographic surveillance site in Malaysia

Daniel Reidpath - ORCID: 0000-0002-8796-0420 https://orcid.org/0000-0002-8796-0420Background Community engagement is an increasingly important requirement of public health research and plays an important role in the informed consent and recruitment process. However, there is very little guidance about how it should be done, the indicators for assessing effectiveness of the community engagement process and the impact it has on recruitment, retention, and ultimately on the quality of the data collected as part of longitudinal cohort studies. Methods An instrumental case study approach, with data from field notes, policy documents, unstructured interviews, and focus group discussions with key community stakeholders and informants, was used to explore systematically the implementation and outcomes of the community engagement strategy for recruitment of an entire community into a demographic and health surveillance site in Malaysia. Results For a dynamic cohort, community engagement needs to be an ongoing process. The community engagement process has likely helped to facilitate the current response rate of 85% in the research communities. The case study highlights the importance of systematic documentation of the community engagement process to ensure an understanding of the effects of the research on recruitment and the community. Conclusions A critical lesson from the case study data is the importance of relationships in the recruitment process for large population-based studies, and the need for ongoing documentation and analysis of the impact of cumulative interactions between research and community engagement.https://doi.org/10.3402/gha.v7.231767pubpub

Explaining the fertility puzzle in Sri Lanka

Fertility transition in Sri Lanka began in the mid-1960s and the declining trend continued over the decades. The Demographic and Health Survey (DHS) of 2000 showed the total fertility rate (TFR) reaching 1.9 births per woman, a level below replacement fertility. The next DHS of 2006/7 showed a TFR of 2.3. Some have interpreted this pattern as indicating a reversal of the fertility transition. This paper casts doubts on the below-replacement fertility revealed in the 2000 survey

POLITICAL BOUNDARY VERSUS SOCIAL CONTEXT: DYNAMICS OF SOCIOECONOMIC DIFFERENTIALS IN FERTILITY IN INDIAN STATES

Using data from India's first (1992-93) and third (2005-06) National Family Health Surveys (NFHS-I and NFHS-III) this study examined the fertility differentials between major social groups and the extent to which these varied between states and over time. The analysis was based on a sample of 54,030 and 55,369 currently married women aged 15-34 in the NFHS-I and NFHS-III respectively. Reported parity and desired family size were used to assess variations in fertility behaviour. The results show that interstate variation in childbearing patterns within social groups was at least as high as, if not higher than, variation between states (net of other influences) in both periods, 1992-93 and 2005-06. The variations among Hindus, the poor and Muslims were more noticeable than for other groups. These variations did not decline between 1992-93 and 2005-06 and may have even increased slightly for some groups. Further, there was no consistent north-south divide in either fertility behaviour or desired family size. Together, these results may point to the gradual disappearance of the influences that were once unique to southern or northern India, and the simultaneous emergence of social, political, economic and cultural forces that are pan-Indian in their reach