Saturday, February 19, 2011

Health Infrastructures

*      Health System in Kedah is under the purview of State Health Department.

*      The infrastructure is divided into Hospital System and Health System.

*      Hospital system is managed by the government hospitals such as Hospital Sultanah Bahiyah, Hospital Sultan Abdul Halim and many more; which function to provide treatment for those in need.

*      Health system is under the District Health Offices at all 9 districts in Kedah, which function as prevention and control of diseases.




*      The Distric Health Officer (Medical Officer of Health 1) of Kota Setar DHO:
Dr.Abu Hashim b.Ahmad

*      Deputy District Health Officer (Medical Officer of Health 2):
Dr.Mohd.Hisham b.Ahmad Kusairi



Departments under the purview of District Health Office (DHO)

Ø  Family Health
Ø  Communicable Disease Control Unit
Ø  Non-Communicable Disease Control Unit
Ø  Food Quality Control
Ø  BAKAS (Bekalan Air & Kebersihan Alam Sekitar)
Ø  KPAS (Kesihatan Pekerjaan & Alam Sekitar)

Health personnel and their roles
Administrative Department
Medical Officer of Health 1 & 2
Director and Deputy Director of the DHO

Administrative Clerks
Works in the office for documentation of data.

Health Clinics
Family Medicine Specialist

Consultant, provide treatment and counseling.
Medical Officers

Perform examination, order for investigation and provide treatment.
Medical Assistants

Provide treatment for minor illness, does dressing, attends school health program.
Nurses

Assist in the treatment process, checks vital signs and blood sugar level, provide vaccination injections at MCH clinic.
Nutritionist
 (Pegawai Zat Makanan-PZM)

Provide advice on the proper diet especially for diabetic, hypertensive, geriatric patients and mal-nourished children. Manages Food Basket program.
Health Education Officer
(Pegawai Pendidikan Kesihatan)

Conduct health promotion campaigns, gives health education talks and seminars, in-charge of health education materials (posters and pamphlets).
Attendants
(Pembantu Perawatan Kesihatan)

Assist the patients to move within different units in the clinics, helps with the functions of other health personnel.
Inspectorate Unit
Health Inspector
(Ketua Penolong Pegawai Kesihatan Persekitaran-KPPKP)

Plans and conducts the surveillance program based on cases and disease outbreaks. Monitors progress of those program.
Assistant Health Inspector
(Penolong Pegawai Kesihatan Persekitaran-PPKP)
Conducts surveillance, supervisor the field visit programs.
Pembantu Kesihatan Awam-PKA

Participates in the surveillance program, collect larvae sample for control of communicable disease.
Pekerja Rendah Awam-PRA

Involved in fogging activity and larvaciding.





Health care services provided

Klinik Kesihatan (KK)

·         Out-patient department (OPD), Diabetic clinic, Routine check-up
·         Maternal & Child health (MCH) – pre-pregnancy care, ante-natal care, post-natal care, child immunization, family planning.
·         Nutrition – advice on diet, demonstrate proper cooking methods, provide Food Basket containing nutritious food.
·         Program Bakul Satu AZAM (under Kementerian Pembangunan Wanita, Keluarga & Masyarakat)  - given to poor families with income < RM 2,000
·         Medical camps, Health talks, Screening program
·         Disease surveillance – e.g.: if number of cases of URTI is increasing, KK will do surveillance whether all the cases of from the same area. Then refer to KPAS (Kesihatan Pekerjaan & Alam Sekitar) to detect the source of infection and prevent further spreading.
·         Defaulter tracing – if a patient do not turn up for the scheduled follow-up (especially diabetic patient and children),  KK will call them to find out the reason for their absence and inform them another date to come for follow-up.
·         Organize community programs:
o   Kelab Warga Emas – for senior citizen
o   Combi (Communication Behavioral Impact)
o   Prostar & Kelab Doktor Muda – for teenagers
o   Home Visits - for mentally ill patients and for those who are not fit to move out from their home to the clinics.



 Klinik Desa (KD)
·         It is managed by 2 community nurses.
·         Service provided mainly for pregnant mothers and children.
·         Offer vaccination for children.
·         Can prescribe over-the-counter (OTC) drugs such as Paracetamol for simple fever.
·         Can do simple dressing for wounds.
·         Home visits and defaulter tracing.

Klinik 1 Malaysia
·          It was started last year by the initiative of our current Prime Minister Datuk Seri Najib Tun Razak .
·         Started in Kuala Lumpur with 3 staffs only: 1 medical assistant and 2 nurse.
·         It is found mainly in towns, not in rural area.
·         Provides out-patient services only for 12 hours per day (10am – 10pm).
·         The main purpose of forming these clinics is to divert patients with minor illness from busy clinics.
·         Medical assistants are allowed to drugs for simple illness but prescribe only for 3days. Antibiotics are prescribed only for 5days.
·         When it was initiated, antibiotic was not prescribed. Started giving antibiotics from last month.
·         In Kedah state, there are 5 clinics:  Kota Setar, Kuala Muda, Baling, Kubang Pasu, and Kulim.
·         Tentatively planning to open one more clinic at Kota Setar town by end of this year.
·         Improvements to be made in future is, if possible try to place a Medical Officer in these clinics.


Budget allocation for health infrastructures

Ø  Main allocation for staff salary (approx. RM 2 million/year)
Ø  For operating/treating patients / radiology department / laboratory reagent
Ø  For prevention & control (to purchase poisons for fogging / equipment maintenance)
Ø  Health promotion, medical camp, pamphlets, posters, banners, gifts
Ø  For training health personnel
Ø  Development of infrastructure (renovation, new buildings)


Strategies for improvement of health infrastructure

Ø  Building new Klinik Kesihatan – in Kota Setar, the 10th KK will be opened on 24.2.11
Ø  Renovating old buildings
Ø  Purchasing new equipments
Ø  Providing special care services – geriatric clinic started in 2011, diabetic clinic
Ø  Making health services more accessible to remote areas – home visits
Ø  Plans of posting more Medical Officers to peripheral health care centers and Klinik 1 Malaysia.

by D.S.Kisheaan




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