22
The Health | august-September, 2020
| Issue |
Vital health information
for the masses
Immense effort goes into producing the health and morbidity
survey for the benefit of the public
BY KHIRTINI K KUMARAN
The National Health and
Morbidity Survey (NHMS) by the
Ministry of Health (MoH) has
come a long way since it started
in 1986.
At that time, the survey
focussed on the health status and the
risk factors for non-communicable
diseases (NCD) and conducted once
every 10 years. The second edition was in
1996 and the third in 2006.
Since 2011, the NHMS was in
four-year cycles. The first year of each
cycle focussed on NCD and healthcare
demand (HCD) while in other years, it
concentrated on areas as determined
by the MoH and the NHMS Steering
Committee.
The NHMS is Malaysia’s national
health survey that provides communitybased
data and evidence to the MoH on
health status and risk factors. The study
is carried out by the Institute for Public
Health (IPH), a research institute under
the MoH.
Today, the NHMS has become the
report to refer to for official national
figures. The survey results are also used
to report indicators to the World Health
Organization (WHO) and the Sustainable
Development Goals (SDG) agenda.
Since 2011, the NHMS was conducted
in a series of surveys focussing, among
others, on a load of illness, health-seeking
behaviour, health services utilisation
and NCD risk factors including mental
The more technical research highlights
are created to hand out to the relevant
ministries and stakeholders. The
issues on health are not limited to the
MoH. We need other ministries and
multiple stakeholders to play their
part.”
— Dr Shubash
health. Again, the Steering Committee of
the NHMS will decide on the scope of the
studies.
A lot of work and effort goes into
producing the survey involving a big
team comprising data collectors, research
assistants, statisticians, survey experts
and many more.
NHMS 2019 operational Process
NHMS 2019, which marks the beginning of
the sixth cycle, focusses on NCD, HCD and
Health Literacy.
Director of Institute for Public Health
(IPH), Dr Noor Ani Ahmad said the NHMS
2019 survey was from July to October 2019.
“We do it for three months, and we have
teams in every State,” she shared.
The number of teams depends on the
size of the States and the accessibility and
mobility within the States.
The methodology of the survey follows
international standards.
“We are pretty careful in making sure
our methodology is accurate so that the
results are valid and accurately represents
the situation in Malaysia,” she said.
The survey involved all States
and federal territories in Malaysia
to produce data which is nationally
representative. Face-to-face interviews
were carried out by trained research
assistants, together with structured selfadministered
questionnaires, clinical and
anthropometric measurements as well as
point-of-care finger-prick blood tests.
The target population are all
members of a household. A total of 14,965
respondents (87.2 per cent response rate)
and 16,688 respondents (88.8 per cent
response rate) participated for NCD and
HCD, respectively.
“The survey will involve interviews by
the data collectors or research assistants
based on standardised questionnaires.
Some respondents will be required to fill
in self-administered questionnaires,” Dr
Noor Aini revealed.
Medical Officer of IPH Dr Shubash
Shander Ganapathy (pix), was the principal
investigator for the 2019’s NHMS survey.
He shared some behind-the-scene efforts
of the project, from data collection until
the publication of the results.
“The respondents will also undergo
simple clinical examination by MOH’s
nurses which includes weight and height
measurement, blood pressure, glucose and
cholesterol levels measurement.”
Dr Shubash notes the data collection
process has become more efficient since
they introduced tablets.
“Once the data is keyed in, it will be
submitted to the server. Thus, we can
continuously monitor the situation on the
field and the data in real-time. It has also
helped in saving time from data entry and
data cleaning.”
Health
literacy
rate still
not up to
mark
The 2019 National Health and Morbidity
Survey (NHMS) revealed that more
than 30 per cent of Malaysian adults
have relatively low healthcare literacy or
knowledge on how to manage their medical
issues and live healthy lifestyles.
Health literacy is defined by NHMS 2019
as the ability to find, understand and use
health information and services needed for
everyday health decision making.
In general, 35.1 per cent of adults have
low health literacy, 28 per cent have low
health literacy in managing medical issues,
32.3 per cent have low health literacyrelated
with disease prevention activities.
In comparison, 27 per cent have low health
literacy in health promotion and healthy
lifestyle practices.
The Principal Assistant Director (Health
Education) from the Institute for Health
Behavioural Research (IHBR), Komathi
Perialathan (pix) said: “Although Malaysians
have a high literacy level when it comes to
health literacy, they fall short.”
According to Komathi, health literacy
plays an integral part in ensuring people can
understand the risk factors.
She added: “Health literacy evaluates the
ability of that individual if they can assess
and understand the health information and
how they are going to apply the information
to make an informed decision regarding
their health.”
Health literacy also plays an essential
role in addressing the rise in noncommunicable
diseases (NCD) cases
identified by NHMS 2019.
“When health literacy is good, people will
make the right choices for their health and
their family and friends. Inevitably, they will
advocate for healthy habits and behaviour
in the community,” said Director, IHBR, Dr
Manimaran Krishnan.
The NHMS 2019 also revealed the rise
in diabetic and obesity cases in Malaysia.
Nearly one in five Malaysian adults or 18.3
per cent had diabetes, while more than 50
per cent were overweight or obese. It is a