Abstract
INTRODUCTION: Non?communicable diseases (NCD) lead to substantial mortality and morbidity worldwide. Malaysia is currently experiencing the epidemic of NCDs. In response to this challenge, an intervention package known as Enhanced Primary Health Care (EnPHC) has been designed by the Ministry of Health to improve the primary healthcare programme and service delivery related the non-communicable diseases. The intervention was piloted in 20 health clinics in Malaysia. This paper describes the evaluation of impacts of the intervention programme. METHODS: In measuring the impact of the intervention, 20 matched control health clinics were selected. The evaluation of EnPHC was divided into two types, i.e. outcome evaluation and process evaluation. The outcome evaluation was done through population-based survey and facility-based survey at the pre and post intervention. The process evaluation was done through qualitative studies on patients and healthcare providers. A difference-in-difference (DID) analysis was used to measure the effect of EnPHC interventions. RESULTS: The prevalence of screening for diabetes mellitus, hypertension and hypercholesterolemia increased by 8.7%, 9.9% and 9.2% respectively. The prevalence of undiagnosed diabetes mellitus and hypercholesterolemia decreased by 17.6% and 13.7%. Based on the facility survey, the proportion of HbA1c test done among diabetes patients has increased 29% in intervention clinics. Based on process evaluation, some interventions have positive perception among the ground implementers, especially in improving patientsÂ’ NCD care management. Although patient cannot identify interventions, but they can detect changes in services, make critical appraisal and recognise its impact on their health CONCLUSION: Beneficial changes were noted in the intervention clinics in relation to NCD healthcare services. The positive outcome of this evaluation support further strengthening and scaling up of the intervention programme.
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@proceedings{APCPH-2019-15,
title = {Evaluation of The Impact of Primary Healthcare Enhancement Programme: Malaysia's Experience},
author = {Muhammad Fadhli Mohd Yusoff and Sheamini Sivasampu and Low Lee Lan and Thamil Arasu Saminathan and Jane Ling Miaw Yn and Mohd Shafie Ismail and Tahir Aris},
year = {2019},
date = {2019-07-22},
urldate = {2019-07-22},
journal = {6th Asia-Pacific Conference on Public Health 2019 Proceedings},
issue = {6},
abstract = {INTRODUCTION: Non?communicable diseases (NCD) lead to substantial mortality and morbidity worldwide. Malaysia is currently experiencing the epidemic of NCDs. In response to this challenge, an intervention package known as Enhanced Primary Health Care (EnPHC) has been designed by the Ministry of Health to improve the primary healthcare programme and service delivery related the non-communicable diseases. The intervention was piloted in 20 health clinics in Malaysia. This paper describes the evaluation of impacts of the intervention programme. METHODS: In measuring the impact of the intervention, 20 matched control health clinics were selected. The evaluation of EnPHC was divided into two types, i.e. outcome evaluation and process evaluation. The outcome evaluation was done through population-based survey and facility-based survey at the pre and post intervention. The process evaluation was done through qualitative studies on patients and healthcare providers. A difference-in-difference (DID) analysis was used to measure the effect of EnPHC interventions. RESULTS: The prevalence of screening for diabetes mellitus, hypertension and hypercholesterolemia increased by 8.7%, 9.9% and 9.2% respectively. The prevalence of undiagnosed diabetes mellitus and hypercholesterolemia decreased by 17.6% and 13.7%. Based on the facility survey, the proportion of HbA1c test done among diabetes patients has increased 29% in intervention clinics. Based on process evaluation, some interventions have positive perception among the ground implementers, especially in improving patientsÂ’ NCD care management. Although patient cannot identify interventions, but they can detect changes in services, make critical appraisal and recognise its impact on their health CONCLUSION: Beneficial changes were noted in the intervention clinics in relation to NCD healthcare services. The positive outcome of this evaluation support further strengthening and scaling up of the intervention programme.},
note = {Type: PLENARY AND SYMPOSIUM; Organisation: 1Institute for Public Health, National Institute of Health, Ministry of Health Malaysia, 2Institute for Clinical Research, National Institute of Health, Ministry of Health Malaysia, 3Institute for Health System Research, National Institute of Health, Ministry of Health Malaysia, 4Family Health Development Division, Ministry of Health Malaysia},
keywords = {community intervention, enhanced primary healthcare, evaluation, non-communicable disease, primary healthcare intervention},
pubstate = {published},
tppubtype = {proceedings}
}