Evaluation of the Impact of Enhanced Primary Health Care Intervention Programme in Malaysia: A Repeat Cross-sectional Pre-Post Quasi Experimental Study Introduction Non-communicable diseases (NCD) lead to substantial mortality and morbidity worldwide. Malaysia is currently experiencing an epidemic of NCDs. This paper aims to evaluate the effectiveness of the Enhanced Primary Health Care (EnPHC) intervention in reducing the prevalence of undiagnosed diabetes, undiagnosed hypertension, and undiagnosed hypercholesterolemia as well as NCD risk factors in the population after about one year of intervention. Methodology This is a repeat cross-sectional pre-post quasi-experimental study comparing intervention and control groups. The target population included adults aged 30 years and above living within the 40 selected clinics' catchment areas for at least six months. Data were collected using face-to-face interviews and clinical assessments. A difference-in-difference (DID) analysis was used to determine the effect of the EnPHC intervention. Results The percentage of the population screened for diabetes mellitus, hypertension, and hypercholesterolemia increased from the baseline status by 8.7%, 9.9%, and 9.2%, respectively. The prevalence of undiagnosed diabetes mellitus and hypercholesterolemia decreased from the baseline status by 17.6% and 13.7% compared to the control group. However, the EnPHC intervention did not affect the prevalence of overweight, obesity and smoking. Conclusion The EnPHC intervention contributed to the reduction in the prevalence of undiagnosed NCDs. A more extended period of intervention would be required to show the effect on NCD risk factors. Further strengthening of the intervention would be needed for implementation in other localities

Food insecurity affects food intake, and it could prevent an individual from consuming enough nutritious food to support and maintain health. The aim of this paper is to determine the prevalence and factors influencing food insecurity among Malaysian households. In 2014, the Malaysian Adult Nutrition Survey (MANS) was carried out, and one of the components measured was food insecurity. Six out of sixteen questions from the food security core-module questionnaire were adopted and answered by 2962 adults. The results showed that about 25.0% adult experienced food quantity insufficiency, 25.5% had food variety insufficiency, 21.9% practised reduced size of the meal, and 15.2% skipped main meal due to lack of money to spend on. For the parents, 23.7% only rely on cheap food to feed children, and 20.8% could not afford to purchase various foods to feed their children. Location, strata, race, level of education, working status and household income shows significant difference while none of the nutritional status components found to be difference in all six parameters of food insecurity measured. Logistic regression with adjusted odds ratios discovered race, education level and household income were related to risk to all six parameters of food insecurity. In conclusion, food insecurity can be a serious problem in Malaysia. An effective and comprehensive effort by the government in terms of policy solution is required to increase education level and ensure an adequate income for every household. Therefore, future research should focus on some of those promising policy solutions and at the same time, study the other possible underlying factors that may lead to food insecurity.
Food Insecurity ; Malaysia ; Adult ; Nutrition Survey