Background: Since December 2019, COVID-19 pandemic has continued to grow it spread and has currently affected more than 200 countries and for the last four months, healthcare workers (HCW) has worked performed their duties endlessly, more than the norms at their respective health care facility. Therefore this review paper aims to describe healthcare workers issues in managing the current COVID-19 pandemic Materials and Methods: Articles were chosen using a structured search via three electronic databases, namely PubMed, Scopus, and Direct Science coupled with a combination of keywords namely "healthcare workers" OR "health staff" AND "COVID19". Other inclusion criteria include full accessible, original studies in English language, published in peer-reviewed journals from December 2019 till 30th April 2020. Result and Discussion: A total of 17 articles were chosen to be reviewed which can be further broadly categorised into three domains which are; physical effects, psychological effects and socioeconomic effects. COVID-19 infection among healthcare workers is not uncommon as they represent the essential human resources in managing the pandemic. Of the three effects, mental health burden ranging from anxiety to burnout was studied along with its risk and protective factors discussed. Socioeconomic factors describe how prevention and control measures adopted has given a toll to this vulnerable group. Conclusion: Health-related effects and unforeseen factors has impacted healthcare workers such as the direct effect of the infection, issues related to the use of personal protective equipment, the spectrum of mental health burden as well as the socio-economic effects as a result of the demands faced by them in responding and providing healthcare needs.

Background: Since December 2019, COVID-19 pandemic has continued to grow it spread and has currently affected more than 200 countries and for the last four months, workers (HCW) has worked performed their duties endlessly, more than the norms at their respective care facility. Therefore this review paper aims to describe workers issues in managing the current COVID-19 pandemic Materials and Methods: Articles were chosen using a structured search via three electronic databases, namely PubMed, Scopus, and Direct Science coupled with a combination of keywords namely healthcare workersOR health staffAND COVID19. Other inclusion criteria include full accessible, original studies in English language, published in peer-reviewed journals from December 2019 till 30th April 2020. Result and Discussion: A total of 17 articles were chosen to be reviewed which can be further broadly categorised into three domains which are; physical effects, psychological effects and socioeconomic effects. COVID-19 infection among workers is not uncommon as they represent the essential human resources in managing the pandemic. Of the three effects, mental burden ranging from anxiety to burnout was studied along with its risk and protective factors discussed. Socioeconomic factors describe how prevention and control measures adopted has given a toll to this vulnerable group. Conclusion: Health-related effects and unforeseen factors has impacted workers such as the direct effect of the infection, issues related to the use of personal protective equipment, the spectrum of mental burden as well as the socio-economic effects as a result of the demands faced by them in responding and providing needs.

Introduction: Knowledge on under-five childhood immunization has been identified as a key factor in determining understanding and compliance to the schedule. Understanding the current levels of knowledge and introducing a health intervention to improve the level will benefit the population to be healthier and reduce morbidity. Materials and Method: A quasi-experimental study was conducted in nurseries in Putrajaya and Cyberjaya, Malaysia from January 2016 to January 2018. 98 respondents from Putrajaya were given the technology based intervention and 98 from Cyberjaya were the wait-listed control group. Respondents answered a validated, self-administered questionnaire at baseline, immediate post-intervention and 3 months post-intervention that were specifically targeted to examine their levels of knowledge on under five childhood intervention. Results: Data was analysed using Statistical Package for Social Science (SPSS) Version 23. The level of knowledge at baseline was 58.9% for the intervention group and 61.7% for the control group with no significant difference between both groups (p=0.651). Immediate post intervention showed a significant difference (p<0.001) between the intervention group (97.7%) and control group (54.9%). As for 3 months post-intervention the intervention group was 95.5% and the control was at 85.1% (p<0.001). Conclusion: The level of knowledge improved after receiving the health intervention module and was effective in the increasing of knowledge among the respondents. However, there are still gaps in research that must be addressed in future studies to help further improve knowledge on under-five childhood immunization schedule.

Solid waste management is a growing challenge to many countries.The implications of poorly managed waste on health are numerous.Improper waste management serve as the breeding places for many vectors resulting in proliferation of vector-borne diseases.This article highlights the impact of improper solid waste management on the public health and the increase risk of vector-borne diseases.

Background: Knowledge on under-five childhood immunization has been identified as a key factor in determining understanding and compliance to the schedule.Understanding the current levels of knowledge and introducing a health intervention to improve the level will benefit the population to be healthier and reduce morbidity.Methods: A quasi-experimental study was conducted in nurseries in Putrajaya and Cyberjaya from January 2016 to January 2018.98 respondents from Putrajaya were the intervention group and 98 from Cyberjaya were the wait-listed control group.The intervention was a technology based health education module.Intervention groups received the intervention through the messaging service of Whatsapp at pre-determined intervals.Respondents answered a validated, self-administered questionnaire at baseline, immediately post-intervention and 3 months post-intervention that were specifically targeted to examine their levels of knowledge.Results: Data was analyzed using Statistical Package for Social Science (SPSS) Version 23.The level of knowledge at baseline was 58.9% for the intervention group and 61.7% for the control group with no significant difference between both groups.At 3 months post-intervention the intervention group was 95.5% and the control was at 85.1%.Immediate post intervention showed a big gap between both groups.Conclusion: The level of knowledge improved after receiving the health intervention module and was effective in the increasing of knowledge among the respondents.However, there are still gaps in research that must be addressed in future studies to help further improve knowledge on under-five childhood immunization schedule.

ABSTRACT Technology based health intervention has seen an increase in use in multiple health programs. Improving non-adherence days ensures that children achieve maximum benefits of the immunization program. Determining the cost-effectiveness of the intervention to improve non-adherence days to the under-five childhood immunization schedule will be beneficial to policy and decision makers. A quasi-experimental study was conducted in nurseries in Putrajaya and Cyberjaya from January 2016 to January 2018. The sample size were 196 respondents with Putrajaya as the intervention group and Cyberjaya as the wait-listed control group. The intervention was a technology based health education module. Intervention groups received the intervention through the messaging service of Whatsapp at pre-determined intervals. Respondents answered a validated, self-administered questionnaire at baseline, immediately post-intervention and 3 months post-intervention. The costs of this program was then calculated to determine its cost-effectiveness. Data was analysed using Statistical Package for Social Science (SPSS) Version 23. The mean non-adherence days were 10 at baseline with no significant difference between both groups. The cost-effectiveness analysis showed that the intervention was cost effective with the cost-effectiveness ratio being less than 1.  The technology based health intervention module was cost-effective in improving non-adherence days. The ability to improve non-adherence will greatly benefit children who receive the under-five childhood immunizations and the costs reduction may help policy makers to determine future plans of action. Keywords Under-Five Childhood Immunization Schedule, Adherence, Cost-Effectiveness of Health Intervention and Technology based Health Education Module.

Introduction: Automotive workers are exposed to high level of noise as part of their daily work routine. Determining the predictors of knowledge, attitude and practice of noise induced hearing loss (NIHL) among automotive is important because it may help prevent a serious irreversible disease known as noise induced hearing loss. Methods: A cross sectional study in an automotive plant in Shah Alam, Selangor was conducted from January 2015 to May 2015 among 550 workers with response rate of 83%. Respondents were workers from the operational divisions, selected based on simple random sampling using validated, published (1) and reliable self-administered questionnaire that focused on knowledge, attitude and practice towards NIHL. Results: Logistic Regression was used to determine predictors and the predictors for satisfactory knowledge on noise induced hearing loss were perceived noise exposure as harmful noise (AOR=0.54, 95%CI = 1.02 - 3.41), years in service for more than 10 years (AOR=2.79, 95%CI = 1.71 – 4.56) and had received training on safety (AOR=1.94, 95%CI = 1.12 – 3.36). For satisfactory attitude the predictors were perceived noise exposure as harmful noise (AOR=3.79, 95%CI = 2.36 – 6.10), years in service for more than 10 years (AOR=0.56, 95%CI = 0.34 – 0.83) and tertiary level of education (AOR=3.61, 95%CI = 1.67 - 7.81). As for satisfactory practice the predictors were more than 10 years in service (AOR=2.16, 95%CI = 1.24 – 3.75) and had received training on safety (AOR=1.94, 95%CI = 1.26 – 2.99). Conclusions: The results from this study may be used to set appropriate measures and identify workers who are at risk of developing noise induced hearing loss.

ABSTRACT The demand for high quality primary care services has been constantly increasing and it is likely to keep growing in the foreseeable future. Assessing efficiency of primary care services is crucial. The pursuit of efficiency in health systems should, therefore, be a central objective of decision makers and health managers. Measuring efficiency across institutions and across time is a critical element for improving the performance of health systems. The data for efficiency tool outlines key data categories and indicators necessary for assessing efficiency in the use of resource inputs, provides guidance on sources for these data and calculation of indicators. Applying this tool, managers will be better prepared to defend their budget requests providing evidence of internal efficiency while ensuring effective and efficient spending of monies that are allocated. There are a few methods that can be used for economic evaluation in assessing efficiency of primary care services. Economic efficiency of a service can be analyzed using non-parametric method (Data Envelopment Analysis) or parametric method - Stochastic Model (Frontier Approach).It can also analyzed based on production function – Cobb-Douglas Model or Trans Log Model. Using General Additive Model (GAM) where additive modelling techniques are the impact of the predictive variables. These methodologies come with several issues, whether the methods are suitable or not to be used in assessing efficiency of primary care services. This article will disclose the issues and the application of the economic efficiency methods used in primary care services. Keywords: Efficiency, Primary Care Services, Health, Methodologies, Issues.

Flood has been one of the most recurring disasters in Malaysia since the early 1920’s. Previously it was limited to the city centre with flash floods occurring at various intervals. With the major development and expansion of the country as a whole, various states especially those located in the eastern coastal regions have been badly affected over the recent years. The capital Kuala Lumpur has also not been spared. Various agencies play a role in the mitigation and preparedness in the event of a flood disaster and this article aims to look at the strategic planning and also assess the Malaysian disaster preparedness as a whole. They are however very limited papers and research done on the disaster preparedness in Malaysia, and the majority of the paper has used guidelines, Acts and Laws, reports and also direct Ministerial regulations to help assess the disaster preparedness plan in Malaysia. The paper found that there are many areas of assessment and key agencies involved. The disaster plan in Malaysia at present is not perfect and there is much room for improvement and upgrading.

ABSTRACT Background: Adherence on under-five childhood immunization schedule has been an area of study that has seldom been explored. Adherence has been the subject of focus in determine if the results of outbreaks and vaccine preventable disease is related to the adherence of the parents to the vaccine schedule. Materials and Methods: A systematic review of articles on the factors of adherence on under-five childhood immunization schedule was performed using various keywords utilizing multiple databases (Medline, PubMed, Science Direct and CINAHL). Studies conducted between 2000 to present, English language and were either observational or qualitative designs were included. Result: Of 45 articles identified, 13 studies were eligible for inclusion . The studies showed that the majority of factors were divided into modifiable and non-modifiable factors. These factors were then further classified into various groups according to its relevance. The modifiable factors were identified as knowledge, vaccine, awareness and perception towards childhood immunization. Whereas non-modifiable factors were sociodemographic factors of parent and child, logistic factors and administration factors. Conclusion: There were many factors identified significantly to be associated with adherence among parents on under-five childhood immunization schedule. Keywords: Factors of adherence, childhood immunization schedule, vaccine schedule.

ABSTRACT Background: Healthcare financing has been on the global agenda for many countries to elevate the health status of the citizens at the same time aim for a lean and sustainable health system. Singapore in particular has demonstrated progressive leaps in health care financing through various reforms. Materials and Methods: A systematic review of articles related to health care financing in Singapore was compiled using a series of keyword search in various databases (Medline, CINAHL, and PubMed ). Studies that were conducted from 1981 to 2015, written in English and used either a quantitative or qualitative design that focus on health care reform in Singapore were included in this study. Result: Most of the studies revealed that the most innovative factor in the health care financing in Singapore was the structure and the comprehensive health insurance systems that are in place but it was not necessarily deemed beneficial or affordable to its citizens. The systematic review yielded over 125 results, only 7 of which were relevant to this study after examining in full text. A purposeful approach was then pursued. Snowballing on bibliographic references and undertaking key author and grey-literature searches proved as an effective complimentary approach to the original review and was reverted to in addition to the original search. This method brought the full-text results up to 5. Conclusion: Healthcare financing have a direct influence on the citizens of Singapore and although comprehensive, it also has deficiencies and issues that still need to be addressed. Keywords: Health care, Reform, Financing, Singapore, systematic review

ABSTRACT Background: Adherence on under-five childhood immunization schedule has been an area of study that has seldom been explored. Adherence has been the subject of focus in determine if the results of outbreaks and vaccine preventable disease is related to the adherence of the parents to the vaccine schedule. Materials and Methods: A systematic review of articles on the factors of adherence on under-five childhood immunization schedule was performed using various keywords utilizing multiple databases (Medline, PubMed, Science Direct and CINAHL). Studies conducted between 2000 to present, English language and were either observational or qualitative designs were included. Result: Of 45 articles identified, 13 studies were eligible for inclusion . The studies showed that the majority of factors were divided into modifiable and non-modifiable factors. These factors were then further classified into various groups according to its relevance. The modifiable factors were identified as knowledge, vaccine, awareness and perception towards childhood immunization. Whereas non-modifiable factors were sociodemographic factors of parent and child, logistic factors and administration factors. Conclusion: There were many factors identified significantly to be associated with adherence among parents on under-five childhood immunization schedule. Keywords: Factors of adherence, childhood immunization schedule, vaccine schedule.

ABSTRACT Background: Excessive exposure to noise can cause a serious irreversible disease known as noise induced hearing loss. In all workplaces there is always risk of exposure to occupational noise but some workers are more susceptible to a higher exposure of workplace noise in comparison to others. This study was to determine the satisfactory knowledge and attitude of automotive workers towards noise induced hearing loss. Materials and Methods: A cross sectional study was conducted from January 2015 to May 2015 in an automotive company in Selangor. There were 457 respondents that were selected based on simple random sampling method, using validated and reliable self-administered questionnaire. The dependent variables were knowledge and attitude on noise induced hearing loss and the independent variables were age, gender, ethnicity, level of education, perceived noise exposure, years of service and training on safety. Data was analysed using SPSS version 22. Result: Response rate was 83.1%. 21.7% had satisfactory knowledge and 39.8% had satisfactory attitude towards noise induced hearing loss. For knowledge the significant association were between age group and ( X 2 =17.831; df 3; p <0.001), perceived noise exposure ( X 2 =6.237; df 2; p =0.044), years in service ( X 2 =618.588; df 3; p <0.001) and training on safety ( X 2 =9.129; df 1; p =0.001) with noise induced hearing loss. As for attitude they were significant association between level of education ( X 2 =20.934; df 3; p <0.001), perceived noise exposure ( X 2 =54.560; df 2; p <0.001) and years in service ( X 2 =19.464; df 3; p <0.001) with noise induced hearing loss. Conclusion: The satisfactory level of knowledge and attitude is low. Heath intervention focussing on knowledge on noise induced hearing loss is needed. The results from this study may be used to set appropriate measures and identify workers who are at risk of developing noise induced hearing loss. Keywords: Knowledge on Noise Induced Hearing Loss, Attitude on Noise Induced Hearing Loss, Automotive Company and Workers.