Health care has emerged as one of the fastest growing industry worldwide. This induced health care costto rise tramendously. However, it is important to preserve high quality health care services that are equitable and affordable. In many countries, people are expected to contribute to the cost of the health care. Are populations ready to accept the concept and willing to pay for health financing scheme? What possible factors that may associate with their decision? This is the objective of the study, to examine the relevance evidence for this through a systematic review of literatures.We systematically searched Ovid MEDLINE and Google Schoolar databases until April 2016. We assessed the study population willingness to pay for health financing scheme and determine the significant variables that associate with WTP. 19 full-text articles were included in the review. Factors that were found significantly associated with WTP for health financing scheme by many studies were age, education, income and residential locality. Other factors that also found associated with WTP were health care services utilization and expenditure. The review findings showed that WTP for health financing scheme is beyond the households’ financial capacity and has multifactorial influences.
Willingness to pay, health financial scheme, health insurance, social health insurance

The quality of education is one of the controversial topics and vital issues that requires more emphases from researchers due to the current challenges in education at the university level. Involvement and participation from the studentis essential to implement quality assurance and to reach for academic accreditation. The aim of this study is to assess knowledge, attitudes, and practices (KAP) of students towards TQM in education and its influencing factorsatHigh Institute of Health Sciences (HIHS) in Sana'a, Yemen. A cross-sectional study using a self-administered questionnaire was conducted in 2016. A total of 208 students from second and third study levels in HIHS had participated from 268 students were observed (study population). Descriptive statistics, chi-square, and one-way ANOVA were used to determine the association between students’ KAP towards TQM in education with its influencing factors. Mean age of the students were 22.44(SD±2.027) year old. Majority of HIHS students were male 135 (64.9%) and 108 (51.9%) were from the third studying level. The highest students' KAP scores were 53.4%, 65.4%, and 41.3% for good knowledge, good attitudes, and moderate practices respectively. Education Department was found to be significantly associated with students' knowledge and practices with p<0.05. In addition, the means of knowledge, attitudes, and practices were higher among pharmacy, radiology, and physiotherapy students respectively than laboratory students. Students' practices were found to be significantly associated with management, academic, and material factors with p<0.001. HIHS students were observed to have good knowledge, good attitudes, and moderate practices towards TQM.​

Health services are considered to be of good quality if customers’ expectations and perceptions are well balanced. Determinants confirming customers’ expectations will lead to satisfaction, while factors disconfirming it will result in customers’ dissatisfaction, reduced compliance to physicians’ treatment and deterioration in overall disease management. A cross-sectional comparative study was carried out from September till October 2008 to determine population satisfaction with health services provided by the public health clinics in Selangor. A total of 3840 respondents from the urban Health Clinics (HCs) and 4768 respondents from rural HCs were selected applying multi-stage random sampling from 54 HCs in nine districts from Selangor. Self-administrated questionnaires formulated by adopting SERVQUAL method based on modified five dimensions plus four dimensions of Clinics Corporation were used . Results showed the proportion of satisfaction among the population towards services provided by the public HCs was high at 86.1%. From X2 bivariate analysis; satisfied respondents were significantly from Indian and Chinese ethnic community more than the Malays, more among the less educated, the older age category (more than 33 years old) and males’ were slightly more satisfied than females. Patients who visited HCs more than three times were more satisfied than one time visitors. Occupation, marital status and HCs urban-rural locality were not significantly associated with customers’ satisfaction level. All dimensions showed high satisfaction level especially on treatment outcome, except on health care workers (HCWs) caring and professionalism domains. Working as a team was slightly higher in the urban areas compared to rural area. Overall, the SERVQUAL score of all dimensions were higher among the urban respondents albeit not significant. Clients’ perceptions were generally higher than expectations reflecting the high satisfactions among clients at 86.1%. Much improvement needs to be put into training HCWs to be more caring and adapting a professional attitude towards clients. Clients’ satisfactions in the urban and rural HCs were almost equal and did not reflect a decrease of health services priority in the rural areas.

The extensive and intensive use of pesticides in agricultural practices has exposed farmers to various hazards resulting in varying degrees of health outcomes. We conducted a cross-sectional study among paddy farmers in Sabak Bernam district, Malaysia. The objective of this study was to gather baseline information on chlorpyrifos blood level and its relationship with pesticides exposure symptoms. We detected chlorpyrifos in farmers’ blood in 7 percent of the respondents, with mean 7.29 nanogram per millilitre blood (sd 5.84 nanogram per millilitre). The percentage of farmers who experienced at least one pesticide exposure symptoms was 75 percent. However, we found no significant association between chlorpyrifos blood level and its exposure symptoms. The farmers had low scores on safe practice of pesticide use even though they have high marks on knowledge and attitude. We found no significant association between the scores on knowledge, attitude and practice on pesticide use and the chlorpyrifos blood level. The presence of pesticide exposure symptoms proved that most of the farmers were exposed to hazardous effects of pesticides. Specific trainings on safe use and handling of pesticides should be given on regular basis to these farmers to ensure they are protected from hazardous effects of pesticides exposure.
Chlorpyrifos ; Pesticides ; Hazardous Substances

Introduction Thalassemia disease is a serious health problem as it gives psychosocial burden not only to the patients but also to the patients’ ecosystem. Among the difficulties faced by patients are psychosocial problems, especially in the process patients’ growth and development. Therefore, this study examines what factors can influenced the psychosocial of Thalassemic patients.. Methods A cross-sectional study was carried out among 161 of Thalasemia Major children at Women and Children Hospital, Likas and Keningau District Hospital, Sabah from February to April 2013. The validated PedsQL 4.0 Generic Core Scale and Social Support questionnaire has been used. Results The results showed that the overall psychosocial score was 68.50 (SP 15.18) with the lowest average school psychosocial score of 58.38 (SP 17.82). Only gender factor showed a significant relationship with psychosocial score of emotional function. There is no significant relationship noted between other sociodemographic factors with overall psychosocial scores or with the psychosocial scores of each function. In relation to subscale social support factors, there was a significant relationship between the psychosocial scores of each function and overall with social support factors of parents, close friends, classmates and teachers. The results of linear regression multivariate analysis suggest that social support factors from classmates is a significant factor in the psychosocial impact of Thalassemia Major pediatric patients. Conclusions In conclusion, social support factors primarily from peers are very important in influencing the psychosocial of Thalassemia Major children in overcoming their life's functionality like other normal children

The purpose of this study was to determine the prevalence of defaulters of immunization, and their associated risk factors among children age 12 to 24 months. Materials and Methods: A cross-sectional study was conducted in all government's maternal child health clinics in District of Kota Kinabalu, Sabah. Data was collected using a standardised questionnaire from July to November 2006. Results: The prevalence rate for defaulting immunization was 16.8% from the 315 respondents. Bivariable analysis showed various significant factors associated with defaulters such as mother’s employment status, family mobility, transportation and cost. Nonetheless, multivariable analysis showed only mother’s age, mother employment status and family size were the significant predictors for defaulting immunization. Immunization that had the highest rate of defaulters was DPT–OPV booster dose (56.6%), followed by MMR immunization (43.4 %) and DPT-Hib/OPV and Hep B third dose (37.7%).Conclusion: Employed mothers with bigger family size should be more closely monitored and advised to reduce the chance of defaulting on the immunization. Health promotion activities also should focus to these groups of mothers.

Objective: Truancy is a disciplinary problem, which frequently occurs among school students and it has many contributory as well as inter-related factors. It is a growing problem in this country and it often becomes a prelude to other delinquent behaviours. The study objective is to determine the prevalence of truancy as well as factors related to it including psycho-behavioural factors. Methods: A cross-sectional study involving 556 Malay student’s selected using multi-stage sampling was conducted. Results: The overall prevalence of truancy is 30.2%. The predictors to truancy are age, students who frequenting entertainment centre, students who have not completed Quran recital, coping strategies using problems solving methods and time spent watching television/video. There is a significant association between truancy and psycho-behaviour such as watching video/internet pornography, frequenting entertainment centre, smoking, motorcycle racing and dating a special friend. Conclusion: Truancy is a social issue, which must be given serious attention by all concerned components of the society.

A cross-sectional study was conducted from December 2009 till May 2010 to determine the quality of life and factors influencing it among physically disabled teenagers. Data were collected from 59 physically disabled teenagers using guided questionnaire Short Form 36 (SF-36) and General Health Questionnaires 12 (GHQ 12). Quality of life among physically disabled teenagers is low for most domains of SF-36 as compared to the general Malaysian population. There was significant difference in quality of life among different races (mental health domain) and among different educational level and type of disability (physical functioning domain). There was no significant association between general health domain and other variables. Higher satisfaction in house, school and recreational environment showed a better quality of life. Higher stress level had a lower quality of life. Lack of disabled friendly environment at home, school and recreational places probably contribute to their quality of life. Schools and public places should have more disabled friendly facilities to improve independency and accessibility. Better education and training will increase their independence and enhance self-confidence. More attention and support at this age is important for them to develop interpersonal skills and character for their future.

Health care services are not often accessible and available for all people in one country due to multiple reasons such asthe geographical barrier, affordability, etc. The aim of this study was to analyse willingness to pay (WTP) for healthcareservices user fees among Malaysian population and determine its’ influencing factors. Structured interviews wereconducted involving 774 households in 4 states represents Peninsular Malaysia. Validated questionnaires with openended, followed by bidding games were applied to elicit maximum amount of WTP. The study was analysed descriptivelyand with multivariate regression method to adjust for potential confounding factors. More than half of respondents WTPmore than current fee for the government clinic outpatient registration fee with mean MYR3.76 (SD2.71). Majority ofrespondents 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 wereincome and having health insurance. Community willing to pay for healthcare services user fees and charges but atcertain amount. The healthcare services user fees and charges can be increased up to community WTP level to avoidfrom catastrophic expenditure.

Background: The availability of obesity specific quality of life measurement tool is limited. The Malay version of Impact of Weight on Quality of Life-Lite is an obesity specific quality of life questionnaire which has been translated for use in Malaysia. The aim of this study is to evaluate the validity and reliability of this tool to measure quality of life among different body mass index (BMI) groups.Methods: One hundred and twenty subjects with different BMI categories attending an outpatient government clinic participated in this study. The translated Malay version of IWQOL-Lite was used for assessment. The validity of this questionnaire was examined using content validity, criterion validity and construct validity. Reliability analyses used in this study were internal consistencies and test-retest reliability. Results: The Malay version of IWQOL-Lite showed good psychometric properties whereby the content validity was sufficient as measured by expert panels. The mean score of all IWQOL-Lite domains were able to discriminate between different BMI groups. Good internal consistency was demonstrated by Cronbach alpha of 0.936. Test-retest reliability ranged from 0.828 to 0.932. The physical function score (IWQOL-Lite) correlated positively with Physical Component Summary of Short Form-36 questionnaire. Exploratory factor analysis found that the questions loaded on five domains. Conclusion: The results suggest that the Malay version of IWQOL-Lite is a valid and reliable tool to measure quality of life among obese and overweight subjects in Malaysia.