Healthcare system’s resilience needs strengthening


MALAYSIA needs to increase the resilience of its health system to protect the population from current and future health challenges, Khazanah Research Institute (KRI) said.

According to its latest publication titled “Health and Social Protection: Continuing Universal Health Coverage”, there is a need for health protection as part of a comprehensive social protection system as every individual face potential unexpected loss of health such as illness, disability or death.

The paper also noted that aside from the direct consequences of poor health, unexpected health loss can translate into economic vulnerabilities for both individuals and households, thus a major risk factor for impoverishment.

KRI research associates Nazihah Muhamad Noor and Ilyana Syafiqa Mukhriz Mudaris shared in a webinar session recently that the chronic underinvestment in the public healthcare sector has left the overall healthcare system vulnerable and thus leaving the Malaysian population vulnerable.

They noted that through the highly-subsidised public healthcare sector, Malaysia has been able to provide universal health coverage for the population, producing significant improvements in health outcomes such as higher life expectancies and low child and maternal mortality rates.

As such, Nazihah and Ilyana Syafiqa have proposed three policy considerations to address some of the challenges in Malaysia’s healthcare system.

One of them being continued commitment to public funding for public health which ensures the largest possible financial pooling mechanism that focuses on the entire population rather than groups of contributing individuals.

“Malaysia’s health spending is modest by international standards, even compared to countries at a similar stage of economic development.

“Our country’s total health expenditure as a percentage of GDP ranks in seventh place among the Asean countries, indicating room for greater spending on health, especially considering that public spending in Malaysia is only half of total health spending,” they stated.

They also believe that tax-based financing should remain as the dominant form of health financing to ensure the provision of universal health coverage through the public healthcare sector.

Meanwhile, Nazihah and Ilyana Syafiqa noted that the country needs to focus on the implementation of a comprehensive national electronic health record (EHR) to facilitate person-centred continuity of care and promote preventive care services.

“The government has already committed to realising an EHR system under the 12th Malaysia Plan to leverage technology to improve the healthcare subsector.

“An EHR system would allow seamless sharing of information between healthcare providers, following a patient as they interact with not only large hospitals but also primary care facilities.

“This would help to realise the government’s goal of creating a lifetime health record for the Malaysian population, as well as serve as an important foundation for further adoption of digital health technologies such as telemedicine or e-prescriptions,” they said.

Furthermore, Nazihah and Ilyana Syafiqa suggested that it is also crucial to apply health in all policies approach to address social determinants of health, taking into consideration the health impact of all social policies.

They highlighted that it has been estimated that between 45% and 60% of variations in health outcomes are due to social, economic and environmental factors.

They also added that while ensuring access to quality healthcare is necessary, the healthcare system on its own is insufficient to optimise the health of the population and reduce inequities in health.

“There is a need to recognise that socioeconomic inequalities can have an outsized effect on population health, with the potential to create a vicious cycle of poverty and poor health.

“Left unchecked, resources will continue to accumulate within groups with more power and privilege, and the lived experiences between the highest and lowest wealth portions of the population will continue to diverge,” they said.

Therefore, they noted that understanding and addressing growing inequities will be crucial for addressing the role and allocation of social determinants in improving population health.