Management of diabetes in malaysia, istanbul 2013[final]
Upcoming SlideShare
Loading in...5
×
 

Like this? Share it with your network

Share

Management of diabetes in malaysia, istanbul 2013[final]

on

  • 842 views

Management of Diabetes in Malaysia. Plenary paper presented by Dato' Sri Dr Hilmi Yahaya, Deputy Minister of Health Malaysia at the International Diabetes Leadership Forum. 15 November 2013. Istanbul, ...

Management of Diabetes in Malaysia. Plenary paper presented by Dato' Sri Dr Hilmi Yahaya, Deputy Minister of Health Malaysia at the International Diabetes Leadership Forum. 15 November 2013. Istanbul, Turkey. Paper was prepared by Dr Zainal Ariffin Omar and myself

Statistics

Views

Total Views
842
Views on SlideShare
841
Embed Views
1

Actions

Likes
1
Downloads
43
Comments
0

1 Embed 1

http://www.linkedin.com 1

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • [Salutations] <br />
  • In 2008, based on the results of the National Health and Morbidity Survey or NHMS I (1986), NHMS II (1996), NHMS III (2006), we projected that by year 2020, the prevalence of diabetes would be 15.3%. <br /> This translates to 3.2 million adult Malaysians age 18 years and above with diabetes. <br /> Unfortunately, the results of NHMS 2011 have shown that we have reached the same prevalence 9 years earlier than initially projected. The prevalence of diabetes in 2011 was already 15.2%. <br /> Based on our revised projections done in early 2011, by year 2020, the prevalence of diabetes will be 21.6%, with an estimated 4.5 million Malaysians age 18 years and above. <br /> This will be a huge burden to our country. <br />
  • To further strengthen the NCD prevention and control program in Malaysia, we developed and published the National Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2010-2014. <br /> This Plan was presented and approved by the Cabinet on 17 December 2010. <br /> It contains seven main strategies, and requires the “whole-of-government” and “whole-of-society” approach in its implementation. <br /> Diabetes and obesity are used as the entry points for implementation of the NSP-NCD <br /> It contains seven strategies which are: <br /> Prevention and Promotion <br /> Clinical Management <br /> Increasing Patient Compliance <br /> Action with NGOs, Professional Bodies & Other Stakeholders <br /> Monitoring, Research and Surveillance <br /> Capacity Building <br /> Policy and Regulatory interventions <br />
  • We have continued to strengthen chronic disease management at the primary care level to cater for the increasing number of patients with diabetes. <br /> Since the year 2000, we have: <br /> Establish Diabetes Teams in clinics with high diabetes patients attendances. These teams are multi-disciplinary, consisting of Family medicine specialists, diabetes educators, dietitians, nutritionists; <br /> Providing post-basic training for nurses and assistant medical officers; <br /> Publication of various clinical practice guidelines, for example for diabetes and hypertension; <br /> Strengthened the existing Quality Assurance Program, and have introduced the National Diabetes clinical audit in 2009; <br /> Increased the coverage of Teleprimary Care (TPC) which is an electronic health record system in MOH health clinics, and have also introduced the National Diabetes Registry starting in January 2011; <br /> Increasing the number of Diabetes resource centres, to increase patient empowerment; <br /> Supporting community empowerment initiatives, e.g. peer support groups. <br />
  • In Malaysia we have established the National Diabetes Registry (or NDR), which went live as a web-based application on 1 January 2011. <br /> This application is currently being used in all MOH health clinics providing services to diabetes patients throughout the country. <br /> In addition to being a disease register, NDR also supports the implementation of the annual “Diabetes Clinical Audit” and the “Diabetes Quality Assurance Programme” amongst Type 2 Diabetes patients in MOH Health Clinics. <br /> The first report was published in August 2013, and the report is available on the MOH website. <br />
  • In summary, the prevalence of diabetes continues to increase in Malaysia, mostly contributed by the undiagnosed. The increase in prevalence is also seen to occur across all age-groups. <br /> The increasing challenge for us would be in providing satisfactory quality of care to patients with diabetes since over 80% of patients seek treatment at MOH healthcare facilities. <br /> The number of patients in MOH health clinics will continue to increase. <br /> Referrals for specialists management will also continue to increase due to late diagnosis and sub-optimal control. <br /> And lastly, there is an urgent need to address “patient-related factors” i.e. patient empowerment. <br />
  • Although we have the main building blocks for NCD prevention and control in place, Malaysia is still faced with immense challenges: <br /> Specifically for the prevention of NCD, I can see that the main challenge will be getting active involvement and support of other ministries and stakeholders outside of the health sector; <br /> And thus MOH needs to continue to play a strong leadership role as well as advocacy role; <br /> The argument that health issues only belong to the MOH is not tenable. We need to identify a win-win solution that will also benefit the other stakeholders; <br /> When embarking on any new initiatives, we need to strongly consider economic and political concerns. <br /> The health sector as a whole will need to play a strong advocacy role – we ourselves need to be champions for NCDs and behavioural change. <br />

Management of diabetes in malaysia, istanbul 2013[final] Presentation Transcript

  • 1. Ministry of Health Malaysia Management of Diabetes in Malaysia: Issues & Challenges Hilmi Yahaya Deputy Minister of Health, Malaysia International Diabetes Leadership Forum 15 November 2013 Istanbul, Turkey]
  • 2. Population of Malaysia • 2000: 23.3 mil • 2010: 28.3 mil • Life expectancy: • Total pop : 70.83 (2000), 73.79 (2011). • Male: 71.05 • Female: 76.73 • Average annual population growth • 1996 to 2000: 2.65% • 2000 to2010: 2.0% • Fertility rate : • 2000: 3% • 2010: 2.6% 2
  • 3. Burden of Diabetes in Malaysia: Trends & Projections by 2020 (Adults age 18 years and above) 3 Sources: NHMS I (1986), NHMS II (1996), NHMS III (2006) and NHMS 2011
  • 4. Seven Strategies: 1. 2. 3. 4. National Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2010-2014 • • • • Prevention and Promotion Clinical Management Increasing Patient Compliance Action with NGOs, Professional Bodies & Other Stakeholders 5. Monitoring, Research and Surveillance 6. Capacity Building 7. Policy and Regulatory interventions Presented and approved by the Cabinet on 17 December 2010. Provides the framework for strengthening NCD prevention & control program in Malaysia. Adopts the “whole-of-government” and “whole-of-society approach”. Diabetes & obesity are used as the entry points. 4
  • 5. Strengthening Chronic Disease Management at the primary care level 5
  • 6. MANAGEMENT OF NCD (Including Diabetes): 7 BASIC PRINCIPLES TO BE INTRODUCED AT THE COMMUNITY LEVELS (KOSPEN with KEMAS) 1. 2. 3. 4. 5. 6. 7. SCREENING REGISTER CLINICAL MANAGEMENT COMPLICATIONS REHABILITATION DEFAULTER TRACING SELFCARE – Patient’s empowerment 6
  • 7. Initiatives to Improve Clinical Outcome: • The formation of Diabetes Team which consists of Diabetic Educator, Medical Officer, Family Medicine Specialist (FMS), Nutritionist and Pharmacist in every clinic as appropriate to their burden of diabetes patients. • FMS or senior Medical Officer in the clinic to do regular audits on green book. • Intensify and more frequent supervision especially by FMS of clinical staff to ensure compliance to CPGs and related guidelines. • Regular training and CMEs on diabetes care for all clinic staffs, and the state office to monitor the numbers of training sessions conducted. • Availability of module for health education for patients and a set of pre- and post-test for patients, as published by Disease Control Division, MOH. • The usage of the Diabetes Conversation Map. • Further development of a Peer Support Group. • Personalized care by Medical Officer in clinics with low to moderate burden of loads, as appropriate in the individual clinic settings. 7
  • 8. National Diabetes Registry • Web-based application. • Went live on 1 January 2011. • Supports the implementation of the annual “Diabetes Clinical Audit” and the “Diabetes Quality Assurance Programme” amongst Type 2 Diabetes patients in MOH Health Clinics. • First report, “NDR Report, Volume 1, 20092012” was published in August 2013, available at the MOH website http:// www.moh.gov.my/v/NCDs. 8
  • 9. Challenges: 1. The prevalence of diabetes has increased 31.0% in 5 years, from 11.6% in 2006 to the current 15.2%. • • Mostly contributed by increase of “undiagnosed”. Increase in prevalence occurring across all age-groups. 2. Increasing challenge in providing satisfactory quality of care to patients with diabetes. • • • Number of patients in MOH health clinics will continue to increase. Referrals for specialists management will also continue to increase due to late diagnosis and sub-optimal control. Need to address “patient-related factors” i.e. patient empowerment. 9
  • 10. Challenges for Malaysia 3. The main challenge in policy and regulatory interventions remain that they are mostly under the responsibilities of ministries and departments other than Ministry of Health • • • • • Ministry of Health needs to take leadership role. Need to find a win-win solution – “mutuality of interest”. Economic and “political” consideration remains paramount and needs to be acknowledged. For Malaysia, the establishment of the Cabinet Committee was an important initial step to achieve the “whole-of-government approach”. The health sector needs to play a strong advocacy role. 10
  • 11. Thank you 11