HEALTH SITUATION Malaysia is a federal constitutional monarchy, located in South-East Asia. As a multicultural country, Malaysia is home to Malays, Chinese, Indians, Ibans, Kadazans and other ethnic groups. In 2016, 0.4% of the population was below the national poverty l ine, having reduced significantly from 8.6% in 1999, although there remain persistent inequalities for indigenous people and the bottom 40%. The Malaysian health system delivers a comprehensive range of services through public and private providers. Malaysia has one of the lowest incidences of catastrophic health expenditure in middle-income countries. The country has had success in reducing maternal mortality, infant and under-5 mortality . Even though immunization rates are good, there are periodic measles outbreaks, most recently in 2011–2012. Dengue remains a challenge. The service coverage for HIV and TB lags behind national targets. NCDs account for 73% of deaths in Malaysia, including 35% of deaths among people under 60 years. The prevalence of key NCD risk factors is significant in the population, and many are undiagnosed. Mental health problems are increasingly prevalent in adults and children. An increasingly wide range of complex environmental health issues is an ongoing challenge including air and water pollution and activities related to extractive industries. HEALTH POLICIES AND SYSTEMS Malaysia aims to become a high-income country by 2020 through Vision 2020 and implementation of the Eleventh Malaysia Plan 2016–2020. This plan provides the overarching framework for Malaysia's development and health is identified as a key component. Four national strategies identified for the health sector: 1) Enhancing targeted support, particularly for underserved communities. 2) Improving system delivery for better health outcomes, 3) Expanding capacity to increase accessibility, 4) Intensifying collaboration with private sector and NGOs to increase health awareness. In support of this, the Ministry of Health Strategic Plan 2016–2020 identifies a vision of a “nation working together for better health”, with five strategic objectives (outcomes). COOPERATION FOR HEALTH Malaysia generally does not receive significant bilateral aid for health. TheHIV/AIDS grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria focuses on supporting civil society activities. There is no United Nations Development Assistance Framework for Malaysia, but a United Nations strategic partnership framework for 2017–2020 has been developed to support implementation of the Sustainable Development Goals (SDGs) and the Eleventh Malaysia Plan 2016–2020. Though WHO is the primary partner in health, other UN agencies also provide health- related support. These include UNAIDS, the UNDP, UNFPA, UNICEF, UNHCR, and the UN University International Institute for Global Health. Malaysia http:// www.who.int/countries/en/ WHO region Western Pacific World Bank Income group Upper-middle- income Child health Infants exclusively breastfed for the first six months of life (%) (2009) 14.5% Diphtheria tetanus toxoid and pertussis (DTP3) immunization coverage among 1-year-olds (%) (2016) 98.0 Demographic and socioeconomic statistics Life expectancy at birth (years) (2016) 77.2 (Female) 72.5 (Male) 74.7 (Both sexes) Population (in thousands) total (2016) 31661 % Population under 15 (2016) 24.5 % Population over 60 (2016) 9.5 Poverty headcount ratio at $1.25 a day (PPP) (% of population) (2009) 0 Literacy rate among adults aged >= 15 years (%) (2015) 94.6 Gender Inequality Index rank (2015) 59 Human Development Index rank (2015) 59 Health systems Total expenditure on health as a percentage of gross domestic product (2016) 4.21 Private expenditure on health as a percentage of total expenditure on health (2016) 48.5% General government expenditure on health as a percentage of total government expenditure (2016) 6.99 Physicians density (per 1000 population) (2015) 1.533 Nursing and midwifery personnel density (per 1000 population) (2015) 4.124 Mortality and global health estimates Neonatal mortality rate (per 1000 live births) (2016) 4.2 Under-five mortality rate (probability of dying by age 5 per 1000 live births) (2016) 8.1 Maternal mortality ratio (per 100 000 live births) (2016) 29.1 n Births attended by skilled health personnel (%) (2014) 99.0 Public health and environment Population using improved drinking water sources (%) (2015) 100.0 (Urban) 98.2 (Total) 93.0 (Rural) Population using improved sanitation facilities (%) (2015) 96.1 (Urban) 96.0 (Total) 95.9 (Rural) Sources of data: Global Health Observatory May 2017 http://apps.who.int/gho/data/node.cco WHO COUNTRY COOPERATION STRATEGIC AGENDA (2016–2020) Strategic Priorities Main Focus Areas for WHO Cooperation STRATEGIC PRIORITY 1: Facilitate multisectoral collaboration and support coordination for health. 1. Enhancing disaster risk reduction, preparedness, response and recovery including through coordination of and information sharing on humanitarian action with partners as part of the United Nations Humanitarian Country Team. 2. Strengthening the engagement and collaboration of communities, state and non-state actors beyond the health sector, to achieve national priorities, such as NCDs, and work towards achievement of the SDGs. 3. “One Health” approaches to emerging disease surveillance and response, antimicrobial resistance (AMR), urban health, injuries, water safety, disabilities, environmental health and health promotion. STRATEGIC PRIORITY 2: Strengthen policies and capacities to build a more resilient, sustainable and responsive health system that moves even further towards universal health coverage. 1. Governance, organizational arrangements and financing to sustainably and equitably meet future health needs, including for an ageing population. 2. Integrated, responsive and equitable delivery of quality health services, including human resource planning and management, and the effective regulation and oversight of health technologies and service delivery. 3. The availability, quality, management, analysis and use of disaggregated data to support performance monitoring and improved service delivery, monitoring of equity, health risk management, and reporting on national priorities and the SDGs or other regional/global commitments. STRATEGIC PRIORITY 3: Strengthen policies and capacities for assessing, preventing, managing, mitigating and monitoring health risks and chronic conditions. 1. The prevention and management of NCDs and conditions and their risk factors, including mental health, injuries and disabilities, and enable individual and community empowerment and mobilization for health. 2. Environmental health, including strengthening the use of health impact assessments and similar tools to be able to assess, advise, manage and respond to an increasingly diverse range of environmental health issues and concerns. 3. Risk management, including strengthening the role and engagement of the health sector with national and state systems and organizations responsible for disaster risk management, ensuring sufficient ongoing IHR (2005) capacities and effective systems, monitoring and managing risks related to food safety and AMR, and increasing the effectiveness of risk communication. STRATEGIC PRIORITY 4: Facilitate the use of Malaysian expertise and sharing of experiences in regional or global settings and events and to provide expert advice to other countries. 1. Supporting Malaysia’s increasing role in sharing expertise and experience for the benefit of other countries as well as to support the development of global and regional public health policies, strategies and action plans, the sharing of experiences, and capacity-building. 2. Complementing Malaysia’s role in mechanisms such as ASEAN and the OIC. 3. Facilitating participation of Malaysia’s WHO collaborating centres in continuing to provide significant contributions to the regional and global work of WHO. Please note that the 3rd generation CCS 2014-20g finalize © W orld Health Organization 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. This publication does not necessarily represent the decisions or policies of WHO. WHO/CCU/18.02/Malaysia Updated May 2018
HEALTH SITUATION Malaysia is a federal constitutional monarchy, located in South-East Asia. As a multicultural country, Malaysia is home to Malays, Chinese, Indians, Ibans, Kadazans and other ethnic groups. In 2016, 0.4% of the population was below the national poverty l ine, having reduced significantly from 8.6% in 1999, although there remain persistent inequalities for indigenous people and the bottom 40%. The Malaysian health system delivers a comprehensive range of services through public and private providers. Malaysia has one of the lowest incidences of catastrophic health expenditure in middle-income countries. The country has had success in reducing maternal mortality, infant and under-5 mortality . Even though immunization rates are good, there are periodic measles outbreaks, most recently in 2011–2012. Dengue remains a challenge. The service coverage for HIV and TB lags behind national targets. NCDs account for 73% of deaths in Malaysia, including 35% of deaths among people under 60 years. The prevalence of key NCD risk factors is significant in the population, and many are undiagnosed. Mental health problems are increasingly prevalent in adults and children. An increasingly wide range of complex environmental health issues is an ongoing challenge including air and water pollution and activities related to extractive industries. HEALTH POLICIES AND SYSTEMS Malaysia aims to become a high-income country by 2020 through Vision 2020 and implementation of the Eleventh Malaysia Plan 2016–2020. This plan provides the overarching framework for Malaysia's development and health is identified as a key component. Four national strategies identified for the health sector: 1) Enhancing targeted support, particularly for underserved communities. 2) Improving system delivery for better health outcomes, 3) Expanding capacity to increase accessibility, 4) Intensifying collaboration with private sector and NGOs to increase health awareness. In support of this, the Ministry of Health Strategic Plan 2016–2020 identifies a vision of a “nation working together for better health”, with five strategic objectives (outcomes). COOPERATION FOR HEALTH Malaysia generally does not receive significant bilateral aid for health. TheHIV/AIDS grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria focuses on supporting civil society activities. There is no United Nations Development Assistance Framework for Malaysia, but a United Nations strategic partnership framework for 2017–2020 has been developed to support implementation of the Sustainable Development Goals (SDGs) and the Eleventh Malaysia Plan 2016–2020. Though WHO is the primary partner in health, other UN agencies also provide health- related support. These include UNAIDS, the UNDP, UNFPA, UNICEF, UNHCR, and the UN University International Institute for Global Health. Malaysia http:// www.who.int/countries/en/ WHO region Western Pacific World Bank Income group Upper-middle- income Child health Infants exclusively breastfed for the first six months of life (%) (2009) 14.5% Diphtheria tetanus toxoid and pertussis (DTP3) immunization coverage among 1-year-olds (%) (2016) 98.0 Demographic and socioeconomic statistics Life expectancy at birth (years) (2016) 77.2 (Female) 72.5 (Male) 74.7 (Both sexes) Population (in thousands) total (2016) 31661 % Population under 15 (2016) 24.5 % Population over 60 (2016) 9.5 Poverty headcount ratio at $1.25 a day (PPP) (% of population) (2009) 0 Literacy rate among adults aged >= 15 years (%) (2015) 94.6 Gender Inequality Index rank (2015) 59 Human Development Index rank (2015) 59 Health systems Total expenditure on health as a percentage of gross domestic product (2016) 4.21 Private expenditure on health as a percentage of total expenditure on health (2016) 48.5% General government expenditure on health as a percentage of total government expenditure (2016) 6.99 Physicians density (per 1000 population) (2015) 1.533 Nursing and midwifery personnel density (per 1000 population) (2015) 4.124 Mortality and global health estimates Neonatal mortality rate (per 1000 live births) (2016) 4.2 Under-five mortality rate (probability of dying by age 5 per 1000 live births) (2016) 8.1 Maternal mortality ratio (per 100 000 live births) (2016) 29.1 n Births attended by skilled health personnel (%) (2014) 99.0 Public health and environment Population using improved drinking water sources (%) (2015) 100.0 (Urban) 98.2 (Total) 93.0 (Rural) Population using improved sanitation facilities (%) (2015) 96.1 (Urban) 96.0 (Total) 95.9 (Rural) Sources of data: Global Health Observatory May 2017 http://apps.who.int/gho/data/node.cco WHO COUNTRY COOPERATION STRATEGIC AGENDA (2016–2020) Strategic Priorities Main Focus Areas for WHO Cooperation STRATEGIC PRIORITY 1: Facilitate multisectoral collaboration and support coordination for health. 1. Enhancing disaster risk reduction, preparedness, response and recovery including through coordination of and information sharing on humanitarian action with partners as part of the United Nations Humanitarian Country Team. 2. Strengthening the engagement and collaboration of communities, state and non-state actors beyond the health sector, to achieve national priorities, such as NCDs, and work towards achievement of the SDGs. 3. “One Health” approaches to emerging disease surveillance and response, antimicrobial resistance (AMR), urban health, injuries, water safety, disabilities, environmental health and health promotion. STRATEGIC PRIORITY 2: Strengthen policies and capacities to build a more resilient, sustainable and responsive health system that moves even further towards universal health coverage. 1. Governance, organizational arrangements and financing to sustainably and equitably meet future health needs, including for an ageing population. 2. Integrated, responsive and equitable delivery of quality health services, including human resource planning and management, and the effective regulation and oversight of health technologies and service delivery. 3. The availability, quality, management, analysis and use of disaggregated data to support performance monitoring and improved service delivery, monitoring of equity, health risk management, and reporting on national priorities and the SDGs or other regional/global commitments. STRATEGIC PRIORITY 3: Strengthen policies and capacities for assessing, preventing, managing, mitigating and monitoring health risks and chronic conditions. 1. The prevention and management of NCDs and conditions and their risk factors, including mental health, injuries and disabilities, and enable individual and community empowerment and mobilization for health. 2. Environmental health, including strengthening the use of health impact assessments and similar tools to be able to assess, advise, manage and respond to an increasingly diverse range of environmental health issues and concerns. 3. Risk management, including strengthening the role and engagement of the health sector with national and state systems and organizations responsible for disaster risk management, ensuring sufficient ongoing IHR (2005) capacities and effective systems, monitoring and managing risks related to food safety and AMR, and increasing the effectiveness of risk communication. STRATEGIC PRIORITY 4: Facilitate the use of Malaysian expertise and sharing of experiences in regional or global settings and events and to provide expert advice to other countries. 1. Supporting Malaysia’s increasing role in sharing expertise and experience for the benefit of other countries as well as to support the development of global and regional public health policies, strategies and action plans, the sharing of experiences, and capacity-building. 2. Complementing Malaysia’s role in mechanisms such as ASEAN and the OIC. 3. Facilitating participation of Malaysia’s WHO collaborating centres in continuing to provide significant contributions to the regional and global work of WHO. Please note that the 3rd generation CCS 2014-20g finalize © W orld Health Organization 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. This publication does not necessarily represent the decisions or policies of WHO. WHO/CCU/18.02/Malaysia Updated May 2018