Country Overview: Malaysia

I Demographics
In 2010, the population of Malaysia was estimated to be 28,250,500. Malaysia is a multiracial country consisting of Malays, Chinese, Indians and other ethnic groups. In 2010, an estimated 2,473,700 non-Malaysians were living in the country. It has a young population, with 7,690,500 (27.2%) below the age of 15 years, while those aged 15-64 years account for 19,230,100 (68.1%) and those 65 years or older for about 1,329,800 (4.7 %).

Life expectancy at birth for both sexes has increased over the years, rising from 56 years for males and 58 for females in 1957 to 71.7 years for males and 76.6 years for females in 2010. Over the same period, the crude death rate fell from 12.4 per 1000 to 4.9.

II Political Structure
Malaysia practices parliamentary democracy based on the federal system of government. The country is a constitutional monarchy with three branches of government: the legislative, judiciary and executive. The constitutional monarch is the Yang Di-Pertuan Agung (Paramount Ruler), who is elected from among and by the sultans (hereditary rulers) of the nine states for a five-year term. The Yang Di-Pertuan Agung is empowered to safeguard the customs and traditions of the Malays. Islam, the official religion of the country, is safeguarded by Yang Di-Pertuan Agung and the sultans of the respective states. The monarch is also the Commander-in-Chief of the Federation’s Armed Forces. Since early 2007, the Yang Di-Pertuan Agung has been Sultan Mizan Zainal Abidin, the Sultan of Terengganu. The head of government is the Prime Minister, who appoints the Cabinet from among the members of Parliament with the consent of the Yang Di-Pertuan Agung. The current Prime Minister is Y.A.B Dato’ Seri Mohd Najib Tun Razak.

III Socioeconomic Conditions
Malaysia’s aspiration to become a developed and high-income economy was laid out in the 2010 budget with the introduction of the New Economic Model (NEM) and the Tenth Malaysia Plan (10MP). The National Transformation Programme is further strengthened in the 2011 budget through revitalized private investment, strengthened human capital development and improved productivity, including the well-being of the people. The four pillars of the National Transformation Programme are the ‘1Malaysia: People First, Performance Now’ concept, the Government Transformation Programme (GTP), the Economic Transformation Programme (ETP) and 10th Malaysia Plan (2011-2015).

The country was rated 0.7 on the Human Development Index in 2010. In 2007, the poverty rate declined to 0.7%, compared with 6.9% in 1985, while the percentage of the population below the poverty line in 2007 fell to 3.6%, compared with 32.1% in 1980.  In an effort to increase income and raise living standards, the 2010 Budget, among other measures, continued to provide resources to eradicate extreme and urban poverty; assist the poor and vulnerable groups; increase home ownership; expand public health facilities; and enhance the social safety net. It is hoped that human capital expenditure directed towards the community will stimulate economic growth and eventually reduce the poverty rate.

IV Major National Health Issues
Malaysia is at an epidemiological transition stage, with communicable and noncommunicable diseases both presenting as disease burdens. As in most developed nations, the top five diseases are dominated by noncommunicable diseases. Diabetes, hypertension and obesity are growing problems. However, some communicable diseases persist along with the rising incidence of noncommunicable disease, including tuberculosis, dengue fever and HIV. Viral hepatitis is still a public health problem in Malaysia, and cholera and typhoid fever are among the five foodborne and waterborne diseases occurring in the country. Mental illness has also become an increasing problem.

From the most recent National Cancer Registry (NCR) for new cases diagnosed in 2007 and reported to the NCR, the age-standardized incidence rates for all cancers in 2007 were 85.1/100 000 for males and 94.4/100 000 for females, while the cumulative rate to age 75 was 10.1 for males and 10.5 for females. The cumulative risk of developing cancer before the age of 75, in the absence of other causes of death, was 9.6 for males and 9.9 for females. Cancer occurs at all ages and increases with age. The incidence rate in males exceeded the incidence rate in females after the age of 60 years.

The Ministry of Health has introduced a harm-reduction strategy as a new initiative to curb the spread of HIV among drug users. This strategy consists of two components: the Needle and Syringe Exchange Programme and drug substitution therapy.

V Maternal and Child Health
Socioeconomic development, together with efforts to promote health, has resulted in a decline in maternal mortality. The total fertility rate among Malaysian women is also declining and was estimated to be 2.4 per woman aged 15 to 49 years in 2010. Urbanization, late marriage and increased access to education and health care services, as well as more employment opportunities and family planning programmes, have contributed significantly to the decline in fertility.

The national maternal mortality ratio showed a reduction from 280 per 100 000 live birth in 1957 to 27.3 in 2008. There has also been gradual improvement in the infant mortality rate (from 13.1 per 1000 live births in 1990 to 6.2 in 2008), the perinatal mortality rate (from 13.0 per 1000 births in 1990 to 7.3 in 2008) and the toddler mortality rate (from 0.9 per 1000 population aged 1-4 years in 1990 to 0.4 in 2008).

VI National Health System
The Ministry of Health’s Vision for Health is of a nation working together for better health. The Mission of the Ministry is to build partnerships for health to facilitate and support the people to attain their full potential in health and to motivate them to appreciate health as a valuable asset and take positive action to improve further and sustain their health status to enjoy a better quality of life. The Malaysian population is served by both public and private health sectors, which complement each other. While the Ministry of Health continues to play a pivotal role as the main provider of health services, there is a need to harness the collective involvement of all stakeholders in health to improve the health of the nation. With growth, development and maturity, it is expected that greater demands will be made on the health system.

The Malaysian population is served by both public and private health sectors, which complement each other. While the Ministry of Health continues to play a pivotal role as the main provider of health services, there is a need to harness the collective involvement of all stakeholders in health to improve the health of the nation. With growth, development and maturity, it is expected that greater demands will be made on the health system. To enable the nation to deliver and meet heightened expectations, greater commitment and cooperation between the public and private sectors is required.

The health system consists of various stakeholders: the Ministry of Health, local government, the academic community, professional organizations, the private sector and others. The Ministry works very closely with all stakeholders to strengthen its health priority areas. Effective collaboration and coordination minimizes the gaps between agencies.

Realizing the major issues and challenges, and to ensure that national health care provision meets required international standards, the Ministry of Health strongly advocates the implementation of various quality assurance initiatives. Guided by the Vision for Health, the Mission of the Ministry of Health and the 1Malaysia concept, Malaysia is striving to achieve a healthy and developed nation.