The population in 2019 was estimated to be 32 million people (0.41% of the world’s population)1
In 2018 the most common cancers were breast (17.3%), colorectal (14%) and lung (10.7%) cancers.2
On average there are over 26 000 cancer related deaths per year and around 44 000 new cancer cases each year.3
In 2019 the principal causes of death in Malaysia were ischaemic heart diseases followed by pneumonia (11.8%), cerebrovascular diseases (7.8%), transport accidents (3.7%) and chronic lower respiratory diseases (2.6%).4
Healthcare System Overview5
Malaysia has a two-tiered health care system, comprising of public and private health care.
The Ministry of Health (MoH) provides public health services to the Malay population. The services include health promotion, disease prevention, curative and rehabilitative care delivered through clinics and hospitals, while special institutions provide long-term care. In addition, several other government ministries provide health-related services.
The public system covers 82% of inpatient care and 35% of ambulatory care while the private sector provides about 18% of inpatient care and 62% of ambulatory care.
The private health sector provides curative and diagnostic health services mostly in urban areas however there is a desire to reach more rural areas.
Private practitioners, private dental clinics, retail pharmacies, and private hospitals deliver most of the primary care.
Private health care expanded its reach in the 1990’s but is accessible to only those who can afford it.
The MoH has policy goals to retain doctors in the public sector and to promote medical tourism. The government launched the Malaysia Health Care Travel Council in 2009 with members from both public and private sectors.
The Malaysian government collects data on population health, health care expenditure and health services
The Ministry of Health Informatics Centre gathers data on mortality and morbidity and service activity and collects data from clinical data registries, such as the National Cancer Registry, most of the data is from the public sector.
The MoH aims to promote the delivery of telehealth although widespread uptake has been problematic due to lack of continuity across country planning. Successes of the Telemedicine Act to date includes an interface with the national registration card (MyKad) for registration of patient cases.
Health Costs and Funders6,7
In 2017 health expenditure was 384 billion USD, approximately $1139 per person and 3.86% of GDP,
Public sector health services in Malaysia are centrally administered and funded by the MoH through its central, state and district offices. Other government departments also provide health services to specific populations
Public health care facilities provide services with minimal out of pocket costs. Private health care services are supported by patient out of pocket payments and private health care services, supported by personal health insurance and direct employer contracting with panel doctors
Domestic general government expenditure accounted for 50%, and private health expenditure 48% of overall health expenditure in 2017.
Within public and private health (predominantly private) the out of pocket expenditure relative to health expenditure was 38% in 2017.
Major Challenges
Malaysia has pockets of persistent poverty, traditional rural poverty, and urban poverty- low socioeconomic status is a key driver of poor health and lack of access to health care resources.8
Public facilities can be overcrowded and understaffed- primarily servicing the financially disadvantaged. Private services are available to wealthier individuals.9
The two tired system of public and private health funding causes disparity in the provision of health care between the wealthy and the poor.10
The forecasted economic deficit for 2021 is RM84.8 billion, or 5.4% of GDP and the federal Government debt is expected to increase by RM81.3 billion in 202011 placing constraints of funding of the health needs of the population.
In the most recent budget, Budget 2021 the allocation for cancer treatment was reduced by 58.49 % from that in 2020. The allocation of funding was similarly reduced in many chronic conditions.11
Sources:
World Bank Open Data, https://data.worldbank.org/ used in reporting of figures and calculation of percentages.
Health at a Glance 2019: OECD Indicators: DOI:https://doi.org/10.1787/4dd50c09-en
Shahar, S., Lau, H., Puteh, S.E.W. et al. Health, access and nutritional issues among low-income population in Malaysia: introductory note. BMC Public Health 19, 552 (2019). https://doi.org/10.1186/s12889-019-6852-8
