annual report 2016 -...

T&CM DIVISION ANNUAL REPORT | 2016

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TRADITIONAL AND COMPLEMENTARY MEDICINE DIVISION

ANNUAL REPORT 2016


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CONTENTS

Director’s Message .................................................................................................................................. 2

Organisation ............................................................................................................................................... 4

Management............................................................................................................................................... 9

Human Resource .................................................................................................................................. 9

Management of MS ISO 9001:2008 ........................................................................................... 13

Fiscal Report ....................................................................................................................................... 15

Competency Enhancement ............................................................................................................... 18

Members of the Organisation ...................................................................................................... 18

T&CM Practitioners .......................................................................................................................... 24

T&CM Governance ................................................................................................................................ 31

Enforcement of Act 775 .................................................................................................................. 31

T&CM Practitioners’ Statistics ..................................................................................................... 32

Development of Guidelines and SOPs ...................................................................................... 35

Advocacy ............................................................................................................................................... 39

Management of Complaints .......................................................................................................... 42

Services at T&CM Units .................................................................................................................. 44

Research ................................................................................................................................................... 48

Collaborations ........................................................................................................................................ 53

National ................................................................................................................................................. 53

International ....................................................................................................................................... 55

Strengthening the Direction of T&CM Division ........................................................................ 60

Editorial Board ....................................................................................................................................... 62

Article Contributors ......................................................................................................................... 62


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DIRECTOR’S MESSAGE

Salam Sihat and Salam 1 Malaysia,

The division reached a monumental milestone in 2016 with the official enforcement of the Traditional and Complementary Medicine (T&CM) Act 2016 (Act 775) on 1st August 2016 as published in the government gazette. The Act provides for the establishment of the T&CM Council to regulate the T&CM services in Malaysia as well as matters connected therewith.

The direction of T&CM Division towards enforcement of the Act became more clearly outlined after an internal restructuring process that involved the merging and consolidation of existing sections and formation of the Secretariat for the T&CM Council. The role of the secretariat is to assist the T&CM Council in carrying out its functions such as registration of practitioners, managing ethical and disciplinary issues and setting the standards for accreditation of T&CM courses.

T&CM Division was involved in the recently concluded nationwide National Health and Morbidity Survey 2015 in collaboration with the National Institutes of Health (NIH). A T&CM Module was introduced for the 2015 leg of the survey which found that close to 30% of Malaysians have used T&CM with consultation during their lifetime. The findings serve as a bolster for the continual development and improvement of T&CM in Malaysia.

International ties with India and China were further strengthened through Bilateral Technical Meetings in the field of T&CM held in November and December 2016 respectively. I am very pleased to announce that the T&CM Guideline for Varmam Therapy was successfully launched following the 4th Bilateral Technical Meeting with India and the service will begin to be offered at Hospital Sungai Buloh in 2017.

Without the constant and unwavering support from YB Datuk Seri Dr. S. Subramaniam, Minister of Health, Malaysia and the top management of Ministry of Health, the achievements of this division would have been lacklustre. I would also like to extend my heartfelt gratitude to my colleagues at the Division whose hard work and inspiring teamwork has no doubt helped to shape the Division into what it is today. May the coming years bring more triumphs for T&CM Division!

DR. GOH CHENG SOON Director Traditional and Complementary Medicine Division


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ORGANISATION


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ORGANISATION

INTRODUCTION

The T&CM Division, Ministry of Health (MOH) Malaysia was initially gazetted under the Research and Technical Support programme in February 2004 and subsequently restructured under the Medical programme on 1st March 2013. The main functions of T&CM Division are to plan, develop, regulate and expand T&CM in Malaysia based on the National Policy of T&CM 2001 (Revised 2007).

In January 2006, the Cabinet approved the MOH’s proposal to integrate T&CM into the national healthcare system. Hospital Kepala Batas, Hospital Sultan Ismail and Hospital Putrajaya were identified as the pilot hospitals for the integration of T&CM services as stated in the 9th Malaysia Plan (RMK-9). As of December 2016, T&CM services are available in 15 government healthcare facilities. To date, T&CM services have been extended to the primary healthcare level.

The T&CM Act 2016 (Act 775) was gazetted on 10th March 2016 and enforced on 1st August 2016.

VISION

T&CM Division aspires to be a centre of excellence for traditional and complementary medicine.

MISSION

T&CM Division will ensure that the practice of traditional and complementary medicine is safe and effective for the benefit of the people.


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QUALITY POLICY

T&CM Division is determined to improve the level and quality of health of the people. We are committed in complying with regulatory requirements, fulfilling the clients’ needs and implementing continuous improvements to the quality management system so that the control systems and standards for the practise of T&CM are effective and efficient.

QUALITY OBJECTIVES

The Division’s quality objectives are formulated based on the quality policy and is continuously

updated to meet current needs. The quality objectives are as below:

i. Management of Supporting Letters for Foreign T&CM Practitioners

To issue a supporting letter for foreign T&CM practitioners within 14 days upon receipt of a completed application.

ii. Management of Talks and Exhibitions

a. To obtain at least 80% satisfactory feedback from the participants' perceptions survey of the talks given by officers of T&CM Division; and

b. To obtain at least 80% satisfactory feedback obtained from exhibition’s visitors survey.

iii. Management of T&CM Unit Monitoring

To monitor the T&CM Units in government healthcare facilities in the Central Zone twice a year.

iv. Management of T&CM Division Staff Training

To ensure the staff of T&CM Division undergo training for at least seven days a year.

v. Management of Finance

To manage payment for service and inventory within 14 days upon receipt of a

complete invoice.


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RESTRUCTURING OF T&CM DIVISION

Following the enforcement of the T&CM Act 2016, an internal restructuring was done within the Division without any increment of posts. The Secretariat to T&CM Council was formed to assist the T&CM Council in carrying out its functions under this Act.

Sections in T&CM Division before and after internal restructuring are shown as below:

Policy and Development Section

Administrative and Finance Section

Practice and Registration Section

Research and Development Section

Inspectorate and Enforcement Section

Standard and Quality Section


Management and Training Section

T&CM Practice Section


Secretariat to T&CM Council

THEN

NOW


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ORGANISATIONAL CHART

DIRECTOR

Policy and Development

Section

Policy Unit

Development Unit

Management and Training Section

Training Unit

General Administration

Unit

Finance Unit

Information Technology Unit

T&CM Practice Section

Practice Development Unit

Practice Evaluation Unit

Inspectorate and Enforcement

Section

Legislative and Prosecution Unit

Complaints and Investigations Unit

Operations and Intelligence Unit

Secretariat to T&CM Council

Registration Unit

Disciplinary and Ethics Unit

Standards and Accrediation Unit


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MANAGEMENT


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MANAGEMENT

HUMAN RESOURCE

STATISTICS ON POSTS

POSTS (as of December 2016)

NUMBER OF POSTS

NUMBER OF FILLED POSTS

VACANCIES

Open Post (Grade 54)

1 1 0

Medical Officer/Pharmacist /Administration and Diplomatic Officer (UD43-54/UF41-54/M44)

1 1 0

Medical Officer/Pharmacist (UD43-54/UF41-54)

27 25 2

Pharmacist (UF41-54)

13 12 1

Information Technology Officer (F41/44)

1 1 0

Assistant Information Technology Officer (F29)

1 1 0

Assistant Administrative Officer (N27/32)

2 2 0

Administrative Assistant (Secretarial) (N17-32)

1 1 0

Administrative Assistant (Finance) (W17-22)

1 1 0

Administrative Assistant (Clerical/Operations) (N17/22)

10 10 0

General Office Assistant (N11) 1 1 0

Driver (H11) 2 2 0

TOTAL 61 57 3


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STAFFING CHANGES

In 2016, ten new staff transferred into T&CM Division, seven were transferred out and two resigned.

TRANSFERS IN

No NAME GRADE DATE OF TRANSFER IN

1 Dr. Mohd Naufal Bin Ridzuan UD48 18 January 2016

2 Dr.Tharumaningam A/L M.Mutiah UD44 15 February 2016

3 Yeoh Suang Meng UF48 18 April 2016

4 Dr. Dang Siew Bing UD54 9 May 2016

5 E Mei Hooi UF41 9 May 2016

6 Dr. Farhana Binti Abdul Aziz UD48 15 June 2016

7 Tan Kee Leong UF54 1 July 2016

8 Dr. Karena Binti Khalid UD48 5 September 2016

9 Nur Syafiqa Binti Saezan F41 20 September 2016

10 Mohd Zulkifli Bin Ismail PT(P/O)N19 8 November 2016

TRANSFERS OUT

No NAME GRADE DATE OF TRANSFER OUT

1 Rahayu Binti Shahperi UF52 4 January 2016 2 Dr. Sangeetha Sami Rajah UD48 4 January 2016 3 Dr. N. Khairiyah Shazwani Sholehudin UD48 18 April 2016 4 Wong Kuan Yeen UF48 18 April 2016 5 Balqis Binti Mohamad Zin UF44 3 May 2016 6 Dr. Koh Siew Li UD48 13 June 2016 7 Mohd Afendy Bin Baharuddin PT(P/O)

N19 31 October 2016

RESIGNATIONS

No NAME GRADE DATE OF RESIGNATION

1 Dr. Farisah Binti Saari UD52 10 June 2016 2 Wong Wei Chyi UF48 13 October 2016


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PROMOTIONS

In 2016, 11 officers received promotions.

No NAME GRADE DATE OF PROMOTION

1 Dr Dyanan A/L Puvanandran UD54 17 May 2016

2 Dr. Ali Noor Bin Hassan UD54 18 October 2016

3 Dr. Jaspal Kaur A/P Marik Singh UD52 1 October 2016

4 Dr. Adilla Nur Binti Halim UD48 20 February 2016

5 Dr. Farhana Binti Abdul Aziz UD48 14 March 2016

6 Tan Hooi Tien UF48 3 April 2016

7 Yeoh Suang Meng UF48 3 April 2016

8 Ng Angeline UF48 1 September 2016

9 Ng Suk Kuan UF48 4 September 2016

10 Lim Wai Yee UF48 9 September 2016

11 Wong Meng Xian UF48 13 September 2016


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SERVICE EXCELLENCE AWARDS, MINISTRY OF HEALTH 2015

The 2015 Service Excellence Awards Ceremony for the staff of MOH headquarters was held in Putrajaya on 29th March 2016. The ceremony was officiated by the Health Minister, YB Datuk Seri Dr. S Subramaniam. Congratulations to the five T&CM Division staff who had received Service Excellence Awards for their numerous contributions and dedication to service.

Dr. Wong Pi Ying

Principal Assistant Director UD48

Ms. Teoh Sheh Ki Principal Assistant Director

UF48

Ms. Ng Angeline Senior Assistant Director

UF44

Mdm. Noraini Binti Sulaiman

Executive Officer N27

Mr. Gunalan A/L Pachimuthu

Driver H11


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MANAGEMENT OF MS ISO 9001:2008

To facilitate the effective implementation of MS ISO 9001:2008 quality management system (QMS) in T&CM Division, two sessions of internal audit were conducted in 2016. The first audit was conducted on 27th January to 3rd February 2016 and the second was conducted on 2nd to 11th November 2016. All staff involved in the audit had given their full cooperation to the audit team and allowed the auditing process to complete smoothly.

In addition, a surveillance audit was conducted by a team of auditors from INTERTEK on 19th April 2016. The results of the audit were favourable as the QMS in T&CM Division was found to be fully effective and thus no subsequent action was needed.

Two Management Review meetings were held in 2016 to discuss issues regarding QMS and continuous organisational improvement strategies. The direction for T&CM Division towards transition from MS ISO 9001:2008 to MS ISO 9001:2015 was also deliberated upon as the current certification for MS ISO 9001:2008 would expire in April 2017.

Hence, members of the MS ISO 9001 QMS Implementation Committee were sent to ISO related courses in order to familiarise themselves with the transition from MS ISO 9001:2008 to MS ISO 9001:2015. A briefing session for other T&CM Division staff with regards to this issue was also organised.


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ACHIEVEMENT OF QUALITY OBJECTIVES


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FISCAL REPORT

The Finance Unit is responsible for managing all matters related to finance and accounts in accordance to the treasury circulars and rules set by the government. It ensures that all budget allocations from the Finance Department, MOH are sufficiently, effectively and efficiently used to ensure that each planned activity meets its objectives.

Allocation and Expenditure

In 2016, T&CM Division received a total budget of RM3,550,000.00 for operations and RM150,000.00 for development respectively. RM3,511,744.43 (99.0%) of the Operating Budget was spent on operations for T&CM Division as well as T&CM services provided in the integrated hospitals. A summary of the allocation and expenditure for the year 2016 is as shown in Table 1.

Table 1: Allocation and Expenditure of Budget in T&CM Division

Type of Allocation

Category Allocation (RM)

Expenditure (RM)

Percentage Expenditure/

Allocation

(%)

Operating Supplies and Services

3,546,000.00 3,507,744.43 99%

Assets 4,000.00 4,000.00 100%

ISO 0.00 0.00 0%

Development Training 150,000.00 119,824.71 80%

Bill Payment Performance

In line with the directives and policies from the Ministry of Finance, the Division has aimed to ensure that payments are made within 14 days upon receipt of a complete invoice and related documents.

In 2016, the Division had received a total of 744 bills. 99.9% of the bills were successfully settled in less than 14 days (Table 2). However, there was one bill that was settled after 14 days due to human error while using the e-Perolehan system.

Table 2: Bill Payment Performance in 2016

Number of Days Number of Bills Percentage (%)

Less than 7 days 737 99.06

8-14 days 6 0.81

More than 14 days 1 0.13

Total 744 100.00


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Revenue Collection

The total revenue collection for T&CM Division in 2016 in comparison to 2015 is as shown in Table 3.

Table 3: Revenue Collection in 2015 and 2016

Types of Revenue Revenue Code

Total

2015 2016

Foreign Practitioner Supporting Letter Processing Fee

72409 RM18,600.00

RM15,600.00


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COMPETENCY ENHANCEMENT


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COMPETENCY ENHANCEMENT

MEMBERS OF THE ORGANISATION

Continuing Professional Development Programme

The Continuing Professional Development (CPD) programme ensures that the staff of T&CM Division are able to equip themselves with new knowledge, skills as well as values and best practices in performing their daily activities.

CPD Sessions 2016

Date Title Speaker

7 April 2016 Transformasi Kecerdasan Emosi Dalam Pembelajaran Dan Pengajaran

Mohd Sani Bin Tuhimin

26 April 2016 Nilavembu Kudineer - A Siddha Formulation In The Treatment Of Dengue

Dr. P. Gunasekaran

27 April 2016 Kawalan Iklan Oleh Lembaga Iklan Ubat Kementerian Kesihatan Malaysia

Asniza Binti Alias

12 May 2016 Pendaftaran Dan Pengawalseliaan Produk Tradisional Di Malaysia

Azlene Binti Mat Amin

24 May 2016 An Introduction To Varmam Therapy Prof. Dr. R.S. Ramaswamy

2 June 2016 Perkongsian Pengalaman Penguatkuasaan Mohd Firdaus Bin Sanusi

9 June 2016 CPD Ramadhan - Bagaimana Puasa Nabi? Adab Dan Akhlak Berpuasa

Ustaz Mohd Zaim Juwaidi Bin Jamaluddin

16 June 2016 CPD Ramadhan - Meraih Syurga Di Bulan Ramadhan

Ustaz Zulkefli Bin Alimon

23 June 2016 CPD Ramadhan - Puasa Ibadah Bermusim Ustazah Sakdiah Binti Mohamed Nusi

30 June 2016 CPD Ramadhan - Kemuncak Ramadhan, Malam Penentuan

Ustaz Baharuddin Bin Idris

22 July 2016 Jom Diet! Fadwa Binti Ali

22 September 2016 Penggunaan Peranti Perubatan Dalam Perubatan Tradisional Dan Komplementari

Idamazura Binti Idris


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A total of 12 CPD sessions were held in 2016. Four CPD sessions were held during the month of Ramadhan which focused on Islamic teachings. The Standard and Quality Section collaborated with Inspectorate and Enforcement Section to organise CPD sessions relating to enforcement activities by Pharmacy Services Division and Medical Device Authority. A special collaboration with the Welfare and Social Club for a CPD session on healthy eating was held prior to the Hari Raya Aidilfitri Gathering 2016. A renowned Siddha medicine expert from India, Prof. R.S Ramaswamy was invited to give a talk on Varmam Therapy which is a part of Siddha medicine. Most of the participants agreed that the talks had been beneficial in increasing the level of general knowledge among the staff of T&CM Division. Moreover, the sessions allowed them to have ample opportunity to interact with the speakers. With reference to the suggestions from participants, the CPD programme in 2017 should focus on talks relating to physical exercise such as yoga, aerobics and Tai Chi as well as the art of self-defence. Additionally, there was a suggestion to invite MOH staff from surrounding facilities such as the Institute of Health Management, Bangsar Dental Clinic and Tanglin Health Clinic to participate in the programme.


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Training of Trainers (TOT)/Ecotraining Programme

The objectives of the TOT/ecotraining programme include to give the opportunity for new staff to be involved in division activities; develop presentation skills among new staff; and create a platform for them to showcase their knowledge and talent The programme facilitates better interaction among the staff of T&CM Division. Presenters include both groups of professional and supporting staff who joined T&CM Division in 2014 and 2015.

In 2016, six TOT/ecotraining sessions were held. Each session allowed three presenters who were nominated by their respective Section Heads to showcase their talent. The presenters were given 20 minutes for their presentation and 10 minutes for question and answer session. Presenters were given freedom to select any topic for his/her presentation; however, they were advised to choose a topic related to healthcare or their working experience. The presenters were allowed to present in either Bahasa Melayu or English.

A majority of participants noted that the programme was beneficial and improved their general knowledge. Many participants were pleased with the duration of the programme. The presenters felt more comfortable giving talks on their chosen topic and the programme was seen to be more flexible as presentation topics were not restricted to T&CM practices and inherent duties of the officers in T&CM Division.

Some suggestions for improvement include better time management during presentations and the topics should be tailored to the audience who are of both the professional and support groups. Another suggestion is for the Management and Training Section to organise a public speaking course for all the staff to improve their competency in delivering a presentation. In conclusion, the programme is beneficial to the staff of T&CM Division and it is hoped to be continued in years to come.


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TOT/Ecotraining Sessions in 2016

Presenter Presentation Topic

Session 1 (30 March)

Dr. Tharumaningam A/L M.Muthiah Varmam: An Ancient Wisdom Of Holistic Health

Dr. Kavitha A/P Purushotaman Understanding ADHD

Dr. Yuhin Norkamilah Binti Yusoff Blood Donation

Session 2 (21 April)

Dr. Maznah Binti Wazir Acupuncture For Post Stroke Rehabilitation

Wong Meng Xian Smoking Cessation

Session 3 (8 June)

Dr. Siti Norhidayah Binti Md Almi Gaya Hidup Sihat

Dr. Adilla Nur Binti Halim Vaksin: Mitos & Fakta

Ng Suk Kuan Paracetamol

Session 4 (30 June)

Siti Hajar Binti Mohamad Yusof Tuntutan Perjalanan Dalam Negeri

E Mei Hooi Pertussis

Lydiawati Binti Arzeni Pemuliharaan Hidupan Liar Di Malaysia

Norsalfarina Binti Ariffin Nilai dan Etika Penjawat Awam

Session 5 (27 July)

Anis Romiza Binti Sulaiman Implikasi Telefon Pintar Dalam Kehidupan

Aslida Binti Safiain @ Safian Perkhidmatan Tambah Nilai Farmasi

Aziman Bin Abdul Rahman Kebersihan Diri

Session 6 (18 August)

Anipah Binti Hj. Asikin Petua Tradisional Melayu

Dr. Muhammad Zubair Bin Zain Al-Aabideen

Tip-Tip Survival Di Hutan

Teh Teo Meng Muscular Fitness and Resistance Training


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Courses Organised by T&CM Division 2016

Organiser Date Course Title Venue Management and Training Section/ Administration and Finance Section/ Standard and Quality Section

10 – 11 August Bengkel Pengurusan Sumber Manusia Dan Sesi Semakan Buku Perkhidmatan BPTK

BM1, T&CM Division

22 – 23 August Bengkel Fail Meja BM1, T&CM Division

6 – 7 September Kursus Pengurusan Aset Alih Dan Stor Kerajaan

BM1, T&CM Division

27 October Bengkel Penggunaan Sistem Pemantauan Pengurusan Aset

BM2, T&CM Division


25 October Program Taklimat Berkenaan Akta PT&K 2016 [Akta 775]

Hospital Kuala Lumpur

27 June – 1 July

1st Workshop on the Development of Preliminary Draft for T&CM Blueprint

BM 2, T&CM Division

29 November – 1 December

2nd Workshop on the Development of Preliminary Draft for T&CM

Premiere Hotel, Klang

8 December Bengkel Perkhidmatan PT&K di Peringkat Penjagaan Kesihatan Primer

Klinik Kesihatan Masai

Secretariat to T&CM Council / Practice and Registration Section

25 – 27 May Bengkel Pembangunan Garis Panduan Terapi Varmam

BM1, T&CM Division

30 November – 2 December

Bengkel Pembangunan Modul Peningkatan Kompetensi Pengamal Perubatan Tradisional Melayu

BM1, T&CM Division


25 August Bengkel Garis Panduan Pengiklanan PT&K

RISDA Office, Shah Alam

10 – 12 November

Kursus Pemahaman Akta PT&K 2016 dan Sekyen Berkaitan Dalam Kanun Tatacara Jenayah

ILKAP, Bandar Baru Bangi

T&CM Practice Section / Research and Development Section

7 – 8 December Bengkel Penulisan Manuskrip I BM1, T&CM Division

19 – 20 December

Bengkel Penulisan Manuskrip II BM1, T&CM Division


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In-Service Training (Overseas)

Integration of Traditional Korean Medicine

Venue : Busan National University, Busan, South Korea Training period : 20 June 2016 – 1 July 2016 Participant : Dr. Jaspal Kaur A/P Marik Singh Objectives

i. To gain experience through exposure to the health care system of traditional medicine abroad to assist the management of development and evaluation of T&CM practices in Malaysia based on scientific evidence.

ii. To study the integration system of traditional medicine adopted by Korea in aspects of treatment methods, education, research, enforcement as well as laws governing foreign practitioners in Korea.

iii. To upgrade the development of practice guidelines of traditional medical practices in Malaysia by referring to the South Korean Ministry of Health on matters concerning the development of Clinical Practice Guideline (CPG) for traditional Korean medicine.

Outcome Gained good exposure to the traditional Korean medicine practice including the higher education system as well as the successful implementation of policies on the integration system of traditional medicine and modern medicine in Korea.

Group photo with the Director of Traditional Korean Medicine Hospital and

Professor of Rehabilitation Medicine

Exchange of souvenirs with the Dean of Traditional Korean Medicine, Busan

National University


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2016 China-ASEAN Traditional Medicine Training Programme and Field Study on Disease Prevention and Treatment

Venue : Guang’anmen Hospital of China Academy of Chinese Medical Sciences,

Beijing, China Training period : 20 June 2016 – 24 June 2016 Participants : Dr. Tajul Iqmal Bin Tajul Arus and Teh Teo Meng Objectives

i. To promote multilateral exchanges and cooperation among Traditional Medicine (TM) healthcare officials and professionals.

ii. To discuss subjects such as integration of Traditional Chinese Medicine (TCM) with modern medicine; personalised TM service; and role of quality TM and healthcare culture in medical tourism.

Outcome Participants were able to join field studies, round table discussions and lectures during the programme. Gained exposure and chance to communicate with Chinese experts, share practical experiences of TCM and find inspirations on management of traditional and complementary medicine in Malaysia. Additionally, cooperative opportunities among China and ASEAN member states were explored.

Other Overseas Conferences / Training Programmes / Meetings Attended by Officers of T&CM Division

No. Name of Officer

Dates Conference / Training Programme / Meeting Attended

1 Dr. Goh Cheng Soon

12 Jul 2016 – 14 Jul 2016

2nd WHO Working Group Meeting on Interaction of Herbal Medicines with other Medicines Mississippi, USA

2 Dr. Dyanan A/L Puvanandran

13 Jul 2016 – 15 Jul 2016

2nd Workshop on the Preparation of the Book Traditional Medicine Self-Care in ASEAN Bangkok, Thailand

3 Dr. Siti Norhidayah Binti Md Almi

26 Oct 2016 – 28 Oct 2016

1st China-ASEAN Cooperation Forum on Health Nanning, Guangxi, China

4 Dr. Goh Cheng Soon

8 Nov 2016 – 10 Nov 2016

9th International Regulatory Cooperation for Herbal Medicine (IRCH) New Delhi, India


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T&CM PRACTITIONERS

Competency Enhancement Module for Traditional Indian Medicine (Siddha) Practitioners

The competency enhancement module is a proposed method to assist traditional medicine practitioners who have not received formal training in their respective fields to register with the T&CM Council during the transitional period. A unique module is developed for each traditional medicine field notably traditional Chinese medicine, traditional Malay medicine and traditional Indian medicine. In 2016, the focus was to develop a competency enhancement module for traditional Indian medicine (Siddha) practitioners. A workshop was held on 23rd and 26th May 2016 for this purpose.

The module was developed in collaboration with the Central Council for Research in Siddha (CCRS), India. The traditional Indian medicine experts who were involved include Prof. Dr. R. S. Ramaswamy (Director of CCRS), Dr. P. Sathiya Rajeswaran and Dr. Gopesh Mangal, an Ayurveda specialist from India on deputation to Malaysia.

The drafted module was presented to stakeholders and representatives from the traditional Indian medicine practitioner body, Malaysian Association of Traditional Indian Medicine (PEPTIM) to obtain feedback and ensure that the module is applicable within the Malaysian context. Subsequently, the proposed module will be presented to the T&CM Council for approval.

Photo session between T&CM Division officers, delegates from India and PEPTIM representatives


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Competency Enhancement Module for Traditional Malay Medicine Practitioners Date : 30 November 2016 – 2 December 2016 Time : 8.30 a.m. – 4.30 p.m. Location : Meeting Room 1, T&CM Division The competency enhancement module was proposed as a mechanism to facilitate existing traditional medicine practitioners (Malay, Chinese and Indian) who have certain years of working experience but without formal education to register with the T&CM Council during the transitional period. It is not intended to upgrade the practitioners to any educational level in Malaysia.

Competency Enhancement Module Development Workshop for traditional Malay medicine (TMM) was held to improve the drafted module through inputs from TMM experts and stakeholders.

The invited TMM experts include Dr. Harun Bin Mat Piah, Dr. Abdul Ghani Bin Hussain and Dr Eshaifol Azam Bin Omar who have expertise in Malay literature and in particular fields of TMM such as traditional herbal medicine. In addition, representatives from higher education institutions and the TMM practitioner body known as the Federation of Traditional Malay Medicine Practitioners Associations Malaysia (GAPERA) were invited to comment on the suitability of the drafted module for existing TMM practitioners. The proposed module will be proposed to the T&CM Council for approval.


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Assessment of Private T&CM Premises for Residency Training

In 2016, Inspectorate and Enforcement (I&E) Section was assigned by the Residency Training Module Development Committee of T&CM Division to visit private T&CM premises and identify potential institutions or premises and practitioners for the purpose of residency training for T&CM graduates (requirement as in Section 22 (5), T&CM Act 2016). The visits were restricted to traditional Chinese medicine, chiropractic and homeopathy premises. This is in correspondence to the developed institutional programmes.

T&CM Act 2016 [Act 775] was partly enforced on 1st August 2016. In accordance to Section 22 (5):

“A provisionally registered practitioner shall undergo a period of residency of not less than one year with any hospital or institution in Malaysia which is approved by the T&CM Council to enable him to be fully registered.”

This activity aims to prepare a list of T&CM facilities to be recommended to the T&CM Council as premises for residency training. In order to compile a database of such training centres, I&E Section was assigned with this task and monitored through a Key Performance Index (KPI) with the indicator of not less than 70% of the T&CM premises identified as potential training centres. The list of T&CM premises was developed in accordance to the criteria set by the Residency Training Module Development Committee. The statistics of the number of T&CM premises that were visited based on location/zones are shown in Table 4. Based on the total number of premises that were visited, only 54.3% met all of the stipulated criteria (Table 5).


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Table 4: T&CM Premises Visited Based on Location

Table 5: KPI Achievement Based on Practice and Overall Suitability

Institution Location T&CM Premises

distribution based on the

T&CM premises list

Number of T&CM premises successfully visited, (%)

(Standard: not less than 70%)

T&CM Division

Kuala Lumpur 82 76 (92.7%) Selangor Negeri Sembilan Melaka

Johor T&CM Branch

Johor 28 28 (100%)

Pulau Pinang T&CM Branch

Kedah 9 6 (66.7%)

Pulau Pinang

Terengganu T&CM Branch

Terengganu 5 5 (100%)

Pahang

Perak T&CM Branch

Perak 7 6 (85.7%)

Sabah T&CM Branch

Sabah 6 5 (83.3%)

Sarawak T&CM Branch

Sarawak 16 14 (87.5%)

TOTAL

153 140 (91.5%)

Practice KPI Achievement, (%)

Overall Suitability

Suitable, (%) Not Suitable, (%)

Traditional Chinese Medicine

121 (85.8%) 61/121 (50.4%) 60/121 (49.6%)

Chiropractic 13 (162.5%) 11/13 (84.6%) 2/13 (15.4%)

Homeopathy 6 (150%) 4/6 (66.7%) 2/6 (33.3%)

TOTAL 140 (91.5%) 76/140 (54.3%) 64/140 (45.7%)


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Educational Visit to T&CM Practitioners

While conducting inspection of the premises, officers of I&E Section interviewed practitioners who work in the premises. The distribution of the number of interviewed practitioners who had received an educational explanation on the obligations of practitioners under the T&CM Act 2016 is shown in Figure 1. A total of 189 practitioners of traditional Chinese medicine, chiropractic and homeopathy had received educational visits.

Figure 1: Number of T&CM Practitioners Who Have Successfully Received An Educational Visit

93

45

11

6

7

6

21

0 10 20 30 40 50 60 70 80 90 100

T&CM Division

Johor Branch Office

Pulau Pinang Branch Office

Terengganu Branch Office

Perak Branch Office

Sabah Branch Office

Sarawak Branch Office


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T&CM GOVERNANCE


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T&CM GOVERNANCE

ENFORCEMENT OF ACT 775

Key Milestones in 2016

Note: The T&CM Act 2013 (Act 756) has been replaced by the T&CM Act 2016 (Act 775). As such, Act 756 holds no force of law.

The T&CM Act 2016 was gazetted on 10th March 2016 and was enforced on 1st August 2016 (P.W. 5450).

•A series of discussions with the Department of IslamicDevelopment Malaysia (JAKIM) to refine aspects related to theregulation of Islamic medical practice

• Internal restructuring of the T&CM Division was formalised toallow the formation of the Secretariat to the T&CM Counciland to strengthen the Inspectorate and Enforcement Section

• The enforcement plan for the T&CM Act 2016 was presentedto the Deputy Director General of Health (Medical)

January - June 2016

• The T&CM Act 2016 was enforced on 1 August 2016 (onlySections 1, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 20,42, 43, 44, 45, 46, 47, 60, 61 and subsections 63(1) and (3) ofthe Act came into operation)

• Public briefing on the T&CM Act 2016 at the Main Auditoriumof Kuala Lumpur General Hospital

• The enforcement plan for the T&CM Act 2016 was presentedto the Director General of Health and subsequently to theMinister of Health

•On-going consultations with the Legal Advisor of the Ministryof Health and the Attorney-General’s Chambers of Malaysia onthe T&CM draft regulations

• The first Secretary to the T&CM Council was appointed

July - December 2016


32

T&CM PRACTITIONERS’ STATISTICS

Local T&CM Practitioners

The Registration Unit for Local T&CM Practitioners conducts all activities relating to registration of local T&CM practitioners.

In 2004, MOH had appointed eight practitioner bodies to self-regulate existing local T&CM practitioners based on their respective practice area. A compiled database on existing local T&CM practitioners who have registered with the practitioner bodies before 1st August 2016 was handed over to T&CM Division. This database reported that a total of 17,045 T&CM practitioners have registered with practitioner bodies.

In conjunction with the enforcement of Section 20 to 28 of the T&CM Act 2016, it will be compulsory for all local T&CM practitioners who are intending to practise T&CM in any recognised practice area to register with the T&CM Council. Hence, an electronic software system termed ‘e-Pengamal’ has been developed for this purpose. The software is currently undergoing a trial process.

Figure 2: Percentage of local T&CM Practitioners Who Have Registered with Practitioner Bodies (until 1st August 2016)

Traditional Malay Medicine

12%

Traditional Chinese Medicine,

44.9%Traditional Indian Medicine, 0.1%

Homeopathy, 3.5%

Complementary Medicine, 6.5%

Islamic Medical Practice

33%


33

Application of Supporting Letter for Foreign T&CM Practitioners

Following the enforcement of the T&CM Act on 1st August 2016, amendments were made to the Application Guideline for Foreign T&CM Practitioners. The enforcement of subsection 63(1) of the Act:

“Any practitioner body who before the coming into operation of this Act undertakes or performs its functions as a governing body of a practice area, shall, on the coming into operation of this Act, cease to so undertake or perform such functions until it has been designated as a designated practitioner body under section 42.”

This resulted in the discontinuation of the following requirements:

Requirement 3.5: The practitioner (applicant) must register with one of the practitioner

bodies that is recognised by the MOH;

Requirement 4.1: Any subsequent application must provide evidence of imparting skill

and knowledge to the local T&CM practitioners.

These amendments have shortened the time taken to process applications with incomplete documents from 53 days to 23 days. This is because there was no more time lag associated with the requirements for recommendation letters and evidence for transfer of technology from the respective practitioner bodies.


34

Issuance of Supporting Letters for Foreign T&CM Practitioners

In 2016, the Registration Unit for Foreign T&CM Practitioners had received 84 applications for supporting letters and out of which 71 of them had been were approved. 55% of the approved applications were for practitioners of traditional Indian medicine mainly Ayurvedic Physicians (11%) and Ayurvedic Therapists (43%). Based on our data, the ratio of Ayurvedic Physician to Ayurvedic Therapists is 1:4.

There was a dramatic decrease in the number of approved applications for traditional Chinese medicine practitioners in 2016 (n=20) as compared to 2015 (n=44). This statistic might indicate a lower dependency on foreign traditional Chinese medicine practitioners in the Malaysian traditional Chinese medicine industry.

Figure 3: Number of Supported Applications for Foreign T&CM Practitioners Based on Modality in 2016

Table 6: Reasons for Not Supporting Application for Supporting Letter for Foreign Practitioners in 2016

No. Reasons of Not Supporting Number of Applications

1 Unrecognised qualification by country of origin 1

2 Unrelated basic qualification 1

3 Insufficient work experience 4 TOTAL 6

A total of six applications were not supported in 2016 due several reasons as listed in Table 6.

Traditional Chinese

Medicine, 20, 28%

Traditional Indian Medicine, 39,

55%

Homeopathy, 2, 3%

Complementary Medicine, 10,

14%


35

DEVELOPMENT OF GUIDELINES AND SOPS

T&CM Practice Guideline for Varmam Therapy Date : 24 – 25 May 2016 Time : 8.30 a.m. – 4.30 p.m. Location : Meeting Room 1, T&CM Division A workshop had been held to discuss the development of the T&CM Practice Guideline for Varmam Therapy. This guideline will be used as reference by the Siddha practitioner and therapist as well as MOH healthcare professionals in Hospital Sungai Buloh in 2017 when Varmam Therapy services will be offered. In addition to the invited experts listed in the table below, representatives from the Practice and Registration Section, Policy and Development Section of the T&CM Division as well as four representatives from the Traditional Indian Medicine Association of Malaysia (PEPTIM) had participated in the workshop. The following activities had been held during the workshop:

i. A talk titled “Introduction to Varmam Therapy” by Prof. Varmam therapy Dr. R.S. Ramaswamy of the Central Council of Research in Siddha (CCRS);

ii. Presentation on a working paper for the study "A Pilot Study on Varmam Therapy” by Dr. Akmal Hafizah binti Zamli (the study is planned to be carried out in Hospital Sungai Buloh);

iii. A demonstration session on Varmam Therapy to participants by Prof. Dr. R.S. Ramaswamy; and

iv. A discussion session. The views and suggestions given by members of the panel, who are experts in their respective fields, were very valuable for the development of the guideline.

Speakers/Invited Panel Experts from India Experts from Malaysia

Prof. Dr. R.S. Ramaswamy Director Central Council of Research in Siddha, India

Dato’ Dr. Zamyn Zuki Bin Mohd Zuki Head of Department Department of Orthopaedics and Traumatology, Hospital Sungai Buloh

Dr. Sathiyarajeswaran Research Officer Central Council of Research in Siddha, India

Dr. Syed Azmi Shah bin Dato’ Ahmad Shah Orthopaedic Surgeon Department of Orthopaedics and Traumatology, Hospital Sungai Buloh

Dr. Gopesh Mangal Ayurveda Physician Hospital Port Dickson /Hospital Rehabilitasi Cheras

Dr. Akmal Hafizah binti Zamli Head of Department Department of Medical Rehabilitation, Hospital Sungai Buloh


36

Prof. Dr. R.S. Ramaswamy showing the location of Varmam points to participants

Group photo of panelists with workshop participants


37

Advertisement Guideline for T&CM Practitioners

Date : 25 August 2016 Time : 8.00 a.m. – 5.00 p.m. Location : RISDA Office, Shah Alam, Selangor A workshop was held to share the draft of the Advertisement Guideline for T&CM Practitioners to participants and gather input from them. Their input could improve the guideline which is to be used as a guidance for T&CM advertisements in mass media, name cards as well as sign boards. Additionally, a list of prohibited titles and abbreviations was discussed during the workshop. 16 representatives from eight practitioner bodies together with 23 officers from T&CM Division and T&CM Branch Offices attended this workshop. Two speakers were invited to share their knowledge in this workshop. They were from the Companies Commission of Malaysia (CCM) and Malaysian Communication and Multimedia Commission (MCMC). The speaker from CCM gave important input regarding the registration of company names such as permitted and non-permitted company names as well as information related to CCM roles. On the other hand, the speaker from MCMC provided information regarding control of advertisements in social media. A talk on Guideline for Investigation and Prosecution of Offences under Section 4A of the Medicines (Advertisement and Sales) Act 1956 was delivered by Mr. Tan Kee Leong, the Head of I&E Section. The guideline will be used by officers from T&CM Division and T&CM Branch Office during the course of their work in investigation and prosecution of such cases in the future. The Advertisement Guideline for T&CM Practitioners was published on 28 September 2016 and could be accessed through the T&CM Division official website.

Workshop officiated by Director of T&CM Division


38

Enforcement Related Guidelines and Standard Operating Procedures (SOP)

A total of three guidelines and four SOPs were developed by I&E Section in 2016. These guidelines and SOPs will be used as a reference by the Authorised Officers in T&CM Division and T&CM Branch Offices.

Title Objective GUIDELINES

Guideline for Investigation and Prosecution for Offences under Section 4A, Medicines (Advertisement and Sales) Act 1956 for Investigation and Prosecution Officers in T&CM Division

To increase understanding on the important elements in investigation of cases that need to be proved during prosecution, especially those related to T&CM Advertisements that violate the related Act. To describe the process and important evidences required for investigation to achieve a prima facie case during prosecution.

Advertisement Guideline for T&CM Practitioners

To inform T&CM practitioners and service providers regarding proper advertisement based on T&CM Act 2016 as well as other related medical and pharmaceutical legislation in Malaysia.

Guideline for Closing of Investigation Cases with No Further Action

Ensure the procedure of closing of cases without further action is carried out in a proper, transparent manner and in compliance with principles of law.

SOP

SOP for Investigation Cases under Section 4A of the Medicines (Advertisement and Sales) Act 1956

This SOP explains the procedures for conducting an investigation on offences under Section 4A of the Medicines (Advertisement and Sales) Act 1956.

SOP for Website Closure This SOP explains the procedure to close a website by application to Malaysian Communications and Multimedia Commission (MCMC) on T&CM related advertisements which violate the Medicines (Advertisement and Sales) Act 1956 and T&CM Act 2016.

SOP for Stop Order and Closure Order

This SOP explains the steps to be taken by Authorised Officer under T&CM Act 2016 to stop and terminate recognised T&CM practices provided by T&CM practitioners as well as to close any premises used for providing the T&CM services for a specified period as directed by Director General of Health.

SOP for Management of Photographs and Digital Camera

This SOP explains the procedures for the use of digital images during an investigation on complaints related to T&CM practices.


39

ADVOCACY

T&CM Exhibitions

The I&E Section conducted exhibitions to educate the public regarding T&CM in Malaysia and T&CM Act 2016. The targeted locations for exhibitions in 2016 were public healthcare facilities, government agencies as well as higher learning institutions. In 2016, a total of 25 exhibitions were carried out successfully.

Date Event Location

20 January Exhibition Klinik Kesihatan Sungai Besi

3 February Exhibition Hospital Sungai Buloh

10 March Exhibition Klinik Kesihatan Batu

24 March Exhibition Klinik Kesihatan Presint 18

31 March Exhibition & CME Hospital Orang Asli Gombak

12 April Exhibition Hospital Sultan Ahmad Shah

14 April Exhibition & CME Akademi Imigresen Malaysia

22 April Exhibition Masjid Negara

28 April Exhibition & CME Kompleks Kastam Wilayah Persekutuan Kuala Lumpur

5 May Exhibition Hospital Serdang

17 May Exhibition Klinik Kesihatan Peringgit

18 May Exhibition Hospital Melaka

19 May Exhibition & CME Fakulti Farmasi, Universiti Kebangsaan Malaysia

1-3 June Exhibition Association of Private Hospitals Malaysia Exhibition, Kuala Lumpur Convention Centre

28 June Exhibition & CME Lincoln University College

3 August Exhibition Hospital Sungai Buloh

5 August Exhibition & CME Pusat Perubatan Universiti Malaya

16 August Exhibition Hospital Tuanku Ampuan Najihah, Kuala Pilah

3-4 September Exhibition 11th Asian Congress of TCM Exhibition, Genting Highlands

6 September Exhibition Klinik Kesihatan Bandar Jerantut

7 September Exhibition Hospital Raub

19 October Exhibition & CME Pejabat Tanah dan Galian Selangor

25 October Exhibition & CME Hospital Kuala Lumpur

2 December Exhibition Masjid Negara

2 December Exhibition Universiti Putra Malaysia


40

Knowledge of Exhibition Visitors on T&CM in Malaysia

A copy of the questionnaire “Knowledge of Exhibition Visitors on T&CM in Malaysia” was distributed to every visitor to the T&CM Division’s exhibition booth. The average number of visitors was reported to be 38 people per exhibition. The number of visitors increased towards the end of the year as compared to the first six months of 2016 due to the improvements made in terms of adding props such as Chinese herbs, acupuncture tools and acupuncture meridians model to attract visitors to the exhibition booth. Overall, 98% of the respondents found that exhibition activities aided in increasing their knowledge on T&CM in Malaysia.

The analytic report of the questionnaires (Figure 4), showed that:

a. Percentage of respondents who have ever received T&CM treatment: 52.2% b. Percentage of respondents who know about T&CM Division: 43.1% c. Percentage of respondents who know about T&CM Act 2016: 46.6% d. Percentage of respondents who know that T&CM practitioners must register in

accordance to the enforcement of T&CM Act 2016: 49.8% e. Percentage of respondents who know that the public can lodge a complaint about

T&CM practitioners/services: 51.0% f. Percentage of respondents who are satisfied and think that exhibition activities

increase their knowledge on T&CM: 96.8%

From the responses, it was found that the awareness of the visitors on T&CM Division and T&CM Act 2016 was low in almost all conducted exhibitions. This may be due to the lack of awareness among the public on the recent enforcement of the T&CM Act 2016.

Figure 4: Analysis on the Knowledge of Exhibition Visitors on T&CM in Malaysia

52.2

43.146.6

49.8 51.0

96.8

47.8

56.952.7

50.2 49.0

4.3

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

Perkhidmatan BPTK AKTA Pendaftaran Aduan Kepuasan

Per

cen

tage

of

Res

po

nd

ents

Ya

Tidak

Yes

No

Services T&CM Division DDivision

Act Registration Complaints Satisfaction


41

Briefing on the T&CM Act 2016 [Act 775] Date : 25 October 2016 Time : 9.00 a.m. – 1.00 p.m. Venue : Main Auditorium, Hospital Kuala Lumpur The main objective of this programme was to raise public awareness and understanding towards the T&CM Act 2016. The shared information relates to the functions of the T&CM Council, mechanism for registration with the T&CM Council and encouraging T&CM practitioners who are practising the recognised practice areas to register with the T&CM Council during the transitional period. The programme was started with a comprehensive briefing on the T&CM Act 2016 followed by a Q&A session. The programme was attended by 200 participants and 80% of them were T&CM practitioners. It was indeed a successful event with stimulating feedback from all participants.

Photographs taken during the briefing session


42

MANAGEMENT OF COMPLAINTS

Complaints and Investigations Cases

The Complaints and Investigations Unit handles complaints related to T&CM practitioners and practices in Malaysia from various sources such as the public, government and non-government agencies as well as practitioner bodies. In 2016, a total of 63 complaints from various categories were received. The highest number of complaints was for offences related to advertisement. This was possibly due to the fact that consumers were more aware of the T&CM Act 2016.

The practices involved in complaints and investigations of cases and action taken to address the complaints are summarised in Figure 5 and Figure 6 respectively.

TMM Traditional Malay Medicine TCM Traditional Chinese Medicine TIM Traditional Indian Medicine COMP Complementary Therapies HOM Homeopathy IM Islamic Medical Practice

Figure 5: Practices Involved in the Complaints and Investigations of Cases in 2016

10

12

5

23

3

1

0

5

10

15

20

25

TMM TCM TIM COMP HOM IM

No

. of

Co

mp

lain

ts


43

Figure 6: Actions Taken to Address Complaints Received in 2016

Power to Investigate under Medicines (Advertisement and Sales) Act 1956

In view of the limitations in carrying out enforcement activities on premises which are in contravention of the Medicines (Advertisement and Sales) Act 1956, T&CM Division has successfully applied to the Minister of Health via the Pharmaceutical Services Division for the power to investigate under Section 6A of this Act and to carry out investigations on advertisement offences among T&CM practitioners.

A total of 11 pharmacists, namely four officers from T&CM Division, and seven officers from T&CM Branch Offices were recently authorised as Authorised Officers under this Act.

Warning Letter, 24%

Verbal Advice, 14%

Joint Operation, 6%

Website Closure, 2%

Pending Case, 19%

Complaint Forwaded to

Relevant Agency, 13%

No Further Action (Unfounded

Complaint), 22%


44

SERVICES AT T&CM UNITS

As of December 2016, T&CM services are being offered at 14 government hospitals and one unit in 1Malaysia Low-risk Birth Centre, Majlis Agama Islam Wilayah Persekutuan (PBBR1M MAIWP), Putrajaya.

Figure 7: List of T&CM services offered in public healthcare facilities

Table 7: Number of Patients Who Received T&CM Services in T&CM Units (2014 – 2016)

Modality/Year 2014 2015 2016

Traditional Massage 18,359 20,819 21,337

Acupuncture 29,722 34,584 35,599

Herbal Therapy as an Adjunct Treatment for Cancer

3,457 5,790 7,489

Traditional Postnatal Care 5,130 5,396 6,526

Shirodhara 1,084 2,305 697

External Basti Therapy - 239 2,663

Generally, all modalities have shown an increment in the number of patients who received treatment in all T&CM units in government healthcare facilities with the exception of Shirodhara. In 2016, Herbal Therapy as an Adjunct Treatment for Cancer recorded the highest percentage increment of 29% followed by Traditional Postnatal Care (21%), Acupuncture (3%) and Traditional Massage (3%). The overall increment shows that T&CM services are gaining popularity and acceptance among Malaysians. Additionally, there is rising awareness and understanding among modern medicine practitioners on the importance of T&CM treatment as a complement to existing modern medicine treatments in the national healthcare system.

Shirodhara, had showed a 70% reduction in the number of treated patients due to the uprising demand for External Basti Therapy since its introduction in Hospital Port Dickson and Cheras Rehabilitation Hospital in 2015. The public’s encouraging response is attributed to the ongoing efforts made by the deputed Ayurvedic expert from the Republic of India and staff members of Hospital Port Dickson and Cheras Rehabilitation Hospital in promoting the services in their respective hospitals and to nearby public healthcare facilities. The excellent rapport between the Ayurvedic physician and Orthopaedic Surgeon in Hospital Port Dickson also contributed to the increment.


45

External Basti Therapy and Shirodhara in public healthcare facilities are provided by the same Ayurvedic physician and therapists. Thus, the introduction of External Basti Therapy led to the reduction of patients for Shirodhara as both services utilise the same manpower and time slots for treatment.

Despite the ongoing challenges, our heartiest congratulations and appreciation goes out to all relevant stakeholders, especially the T&CM Units in public healthcare facilities for their effort in promoting and improving existing services. It is hoped that this effort will continue to drive the mission of T&CM Division in ensuring that T&CM services continue to be of quality, safe and beneficial to the people.


0

Figure 7: List of T&CM Services Offered in Public Healthcare Facilities

Acupuncture

Hospital Sultanah Bahiyah

Hospital Sultan Ismail

Hospital Raja Perempuan Zainab II

Hospital Duchess Of Kent

Hospital Sultanah Nur Zahirah

Hospital Kepala Batas

Hospital Putrajaya

Hospital Sultanah Hajah Kalsom

Hospital Umum Sarawak

Hospital Port Dickson

Hospital Rehabilitasi Cheras

Institut Kanser Negara

Hospital Wanita dan Kanak-Kanak Sabah

Hospital Jasin

Traditional Massage







Hospital Putrajaya

Hospital Sultanah Hajah Kalsom




Hospital Wanita dan Kanak-Kanak Sabah

Hospital Jasin

Herbal Therapy as an Adjunct to

Chemotherapy in Cancer Patients



Institut Kanser Negara

Hospital Wanita dan Kanak-kanak Sabah

Traditional Postnatal Care





Hospital Putrajaya



Pusat Bersalin Berisiko Rendah MAIWP


Hospital Jasin

Shirodhara



External Basti Therapy




47

RESEARCH


48

RESEARCH

National Health and Morbidity Survey 2015

The National Health and Morbidity Survey (NHMS) is a nationally representative survey of population in Malaysia. It was first initiated in 1986 and has been an important platform for monitoring the health of the population in Malaysia. Its objectives are to supplement community-based data on the pattern of common health problems, health needs and expenditure on health in the community to enable the Ministry of Health to review priorities and activities of programmes, plan future allocation of resources and evaluate the impact of strategies. The interval of NHMS has been shortened from every 10 years to a four yearly cycle with annual data collection since 2011 to ensure accurate information is obtained for planning of health policies and programmes.

The main scopes in the NHMS 2015 were health care demands, non-communicable diseases and risk factors for non-communicable diseases. A module for T&CM was also introduced in the 2015 cycle. The objectives of the T&CM module were to:

1. Study the prevalence of T&CM practices used by the Malaysian population with consultation;

2. Describe the reasons for T&CM use; 3. Determine the place where the T&CM practices are obtained; and 4. Determine the amount of expenditure and the amount the public is willing to pay for the

services of the T&CM practices.

An estimated 29.25% of the population had ever used any T&CM practices with consultation and 21.51% of the population used T&CM within the last twelve months with consultation. Figure 8 shows the prevalence of T&CM use among Malaysians by practice area.

Figure 8: Prevalence of T&CM Use Among Malaysians by Practice Area

52.06

20.01

6.2

4.04

1.45

0.97

0 10 20 30 40 50 60

Traditional Malay Medicine

Traditional Chinese Medicine

Complementary Therapies

Islamic Medical Practice

Homeopathy

Traditional Indian Medicine

Percentage of Use %


49

T&CM practices were mainly used to maintain wellness, as shown in all the top five preferred practices; Malay massage (41.92%), Chinese herbs (13.69%), Malay herbs (10.07%), Malay cupping (6.45%) and tuina (4.49%). It was found that when T&CM was used as a treatment method, it was intended for primary and complementary treatment. The number of people who used T&CM as an alternative treatment was noted to be less than 20%. This study found that T&CM services were often used for minor ailments such as myalgia, joint and muscle ache, back pain and cough. Consumers obtained T&CM services from various facilities depending on the services offered. Traditional Chinese medicine, traditional Indian medicine, homeopathy and complementary therapy practices were services that were mainly obtained at practitioners’ premises. Traditional Malay medicine practices, in particular Malay massage and Malay herbs, were provided at practitioner’s house or the client’s own house. Although some of the respondents claimed that they had paid a higher fee compared to what they were willing to pay, the median values of out-of-pocket expenditure for the majority of T&CM practices were nearly similar to the median amount that the users were willing to pay. In conclusion,

T&CM continues to be an important presence in this country as it has made some impact

to the health of Malaysian population.

There is a need to continue providing T&CM practices to offer options for patients and for

healthy individuals especially in maintaining wellness and complementing mainstream

medical system.

Services of T&CM are obtained at various facilities depending on the practices offered.

The cost of the services for the majority of the T&CM practices is within an affordable rate.


50

Patient Satisfaction Survey at T&CM Units 2016

In 2016, a Patient Satisfaction Survey was conducted in six T&CM Units to assess the level of patient satisfaction of services provided at the T&CM Unit by the staff of the Ministry of Health and T&CM practitioners as well as the facilities available at the units. The T&CM Units involved in the study were:

Overall, it was found that over 90% of patients were satisfied with the provided services at the T&CM Units involved in the study especially in terms of service provided by MOH staff and T&CM practitioners. However, it was noted that the level of dissatisfaction regarding the duration of treatment sessions for acupuncture and traditional massage was found to be similar among all the units involved whereby patients felt that the duration of the sessions were too short. The findings from this study will serve as input for the upcoming revision of the respective practice guidelines.

Hospital Sultanah Bahiyah, Alor Star

Hospital Raja Perempuan Zainab II, Kota Bharu

Hospital Sultanah Nur Zahirah, Kuala Terengganu



Hospital Duchess of Kent, Sandakan


51

RESEARCH INITIATIVES

No. Research Title Objectives

T&CM Division Research Project

1. Traditional Malay Postnatal Practice in Kelantan, Malaysia: A Cross-Sectional Exploratory Study

To identify traditional Malay postnatal practices among traditional Malay medicine practitioners in Kelantan

Collaborative Research Projects

Psychiatry and Mental Health Department, Hospital Kuala Lumpur 1.

A Double Blind Randomized Controlled Trial To Assess Effectiveness of Acupuncture as A Complementary Therapy to Methadone Maintenance Therapy in Opioid Dependence Patients in Klang Valley, Malaysia.

To assess the effectiveness of acupuncture as a complementary therapy to Methadone Maintenance Therapy in opioid dependence patients in Klang Valley, Malaysia

Forest Research Institute Malaysia (FRIM) 2. A Comprehensive Documentation of Malay

Traditional Knowledge of Medicinal Plants in Peninsular Malaysia

To gather comprehensive documentation on Malay traditional knowledge of medicinal plants in Peninsular Malaysia

Malaysia Health Technology Assessment Section, Medical Development Division, MOH

Health Technology Assessment Report 3. The Effect Of Chinese Herbal Therapy As An

Adjunct Management Of Fatigue And Muscle Weakness In Cancer Patients Receiving Chemotherapy

To assess the effect of Chinese herbal therapy as an adjunct management of fatigue and muscle weakness in cancer patients receiving chemotherapy

Technical Reports 4. Chiropractic Therapy For Musculoskeletal

Pain

To assess the role of chiropractic therapy for musculoskeletal pain

5. Homeopathy for Rheumatoid Arthritis, Bronchial Asthma and Allergic Rhinitis

To assess the role of homeopathy in the treatment of rheumatoid arthritis, bronchial asthma and allergic rhinitis


52

COLLABORATIONS


53

COLLABORATIONS

NATIONAL

Development of T&CM Service at Primary Health Care Level The Ministry of Health (MOH) has taken a proactive approach to integrate T&CM services at the primary health care level. It is a collaborative effort between the T&CM Division, Family Health Development Division and the Johor State Health Department. Traditional postnatal services were started at Masai Health Clinic, Johor in 2012 and subsequently expanded to Meranti Health Clinic, Kelantan in November 2014 with the cooperation from the Kelantan State Health Department. Several efforts had been made to ensure the continuity of service to the public.

Expansion of Traditional Postnatal Services in Kelantan

The decision to expand traditional postnatal services to every district in Kelantan was made in a meeting held between the T&CM Division and the Kelantan State Health Department on 22nd February 2016. It was based on the positive feedback received from Meranti Health Clinic, Johor since the introduction of the service. The expansion was planned to be carried out in phases, starting from health clinics in the district of Pasir Mas and expanding to all health clinics in the state of Kelantan. As of December 2016, the service had been expanded to To’uban Health Clinic, Kangkong Health Clinic and Chekok Health Clinic in the Pasir Mas district. Currently, the Kelantan State Health Department is in the process of identifying potential health clinics for service provision.


54

Traditional Postnatal Practitioners Enhancement Programme in Kelantan

Traditional Postnatal Practitioners Enhancement Programme had been initiated in Kelantan in 2015. The aim of this programme was to standardise traditional postnatal services in Malaysia. A series of workshops for traditional postnatal practitioners had been conducted since October 2015. A total of 127 practitioners have successfully completed the programme.

Date Details

12 October 2015 Training of Trainers (TOT) Workshop for Traditional Postnatal Practitioners Enhancement Programme (Pasir Mas District)

28 – 29 October 2015 1st Session: Traditional Postnatal Practitioners Enhancement Programme (Module 1 and 2)

8 – 9 November 2015 2nd Session: Traditional Postnatal Practitioners Enhancement Programme (Module 3 and 4)

23 – 24 March 2016 TOT Workshop for Traditional Postnatal Practitioners Enhancement Programme (For every district in Kelantan)

16 May – December 2016 Traditional Postnatal Practitioners Enhancement Programme (Module 1 only) Training workshops for Module 2 to 4 will be held for traditional postnatal practitioners by the respective district health offices


55

INTERNATIONAL

WORKING VISITS

Working Visit by Dr. P. Gunasekaran, Director of King Institute of Preventive Medicine and Research, Chennai, India

Date : 26 April 2016 Time : 2.30 p.m. Location : Meeting Room 1, T&CM Division Following his engagement as a speaker at the Asia Dengue Conference 2016 held on 23-24 April 2016 at JW Marriot Hotel Kuala Lumpur, Dr. P. Gunasekaran was invited by T&CM Division to share his knowledge and experiences in a Continuous Professional Development (CPD) session. His presentation “Nilavembu Kudineer - A Siddha Formulation in the Treatment of Fever" was informative and covered new knowledge and research findings on the potential and beneficial uses of Siddha medicine in the prevention and treatment of dengue.

Group photo with Dr. P. Gunasekaran


56

Working Visit by the Delegation from Ministry of Public Health of Thailand Date : 19 September 2016 Time : 10.00 a.m. to 1.00 p.m. Location : Meeting Room 1, T&CM Division On 19th September 2016, T&CM Division received a delegation of 14 officers from the Department of Thai Traditional and Alternative Medicines, Ministry of Public Health of Thailand. It was led by Dr. Anchalee Chuttaputti, Director of the Office of International Cooperation. The purpose of the working visit was to learn about the development of T&CM in Malaysia. The Thai delegates visited the Clinical Research Centre (CRC), Institute of Medical Research (IMR) and Pasir Raja Herbal Cultivation Park, Terengganu as part of their initiative towards understanding the policies, strategies and regulations implemented under Entry Point Project 1: High-Value Herbal Products of the Economic Transformation Programme.

Group photo of T&CM Division officers with delegates from the Ministry of Public Health Thailand


57

BILATERAL TECHNICAL MEETINGS

Second Bilateral Technical Meeting on Cooperation in Traditional Medicine between the Government of Malaysia and the People’s Republic of China

Date : 10 November 2016 Time : 11.30 a.m. Location : Malaysian Medical Council Meeting Room Ministry of Health Malaysia Block C, Jalan Cenderasari Kuala Lumpur The Second Bilateral Technical Meeting on Cooperation in Traditional Medicine between the Government of Malaysia and the People’s Republic of China was successfully held on 10th November 2016 in Kuala Lumpur. The meeting was chaired by YBhg. Datuk Dr. Noor Hisham Bin Abdullah, Director General of Health Malaysia who led the Malaysian delegation. On the other hand, the five member Chinese delegation was led by Mr. Yan Shujiang, Vice Commissioner, State Administration of Traditional Chinese Medicine (SATCM). The collaborative activities discussed during the meeting relates to the development of traditional Chinese medicine (TCM) in Malaysia in terms of practice, education and training, research and development as well as regulation of herbal/traditional products. This meeting is one of the blossoming initiatives and successes of the Ministry in strengthening bilateral ties with China for the progressive development of TCM in Malaysia.

The Chinese delegation with Director General of Health Malaysia and the Ministry of Health delegation


58

Fourth Bilateral Technical Meeting on Cooperation in the Field of Traditional Systems of Medicine between the Government of Malaysia and the Republic Of India

and The Launch Ceremony of the T&CM Practice Guideline on Varmam Therapy

Date : 27 December 2016 Time : 10.00 a.m. Location : Malaysian Medical Council Meeting Room Ministry of Health Malaysia Block C, Jalan Cenderasari Kuala Lumpur The Fourth Bilateral Technical Meeting provided an excellent platform to strengthen international collaboration with the Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy (AYUSH), Government of India on areas of mutual concern regarding traditional Indian medicine (TIM). This steadfast collaboration is exemplified by the technical assistance provided by the Ministry of AYUSH in deputing skilled TIM experts to serve with the Ministry of Health Malaysia and in developing practice guidelines and competency modules. The meeting was followed by the launch ceremony of the T&CM Practice Guideline on Varmam Therapy, a collaborative effort between T&CM Division and the Central Council for Research in Siddha (CCRS), Ministry of AYUSH. The guideline will be used as a reference for the Siddha practitioner who will be deputed from India to provide Varmam therapy at Sungai Buloh Hospital. Prof. R.S. Ramaswamy, who is the Director-General of CCRS and part of the five member Indian delegation to Malaysia, conducted a short demonstration of Varmam therapy prior to the launch ceremony.

Photo session with participants of the Fourth Bilateral Technical Meeting on Cooperation in the Field of Traditional

Systems of Medicine between the Government of Malaysia and the Republic of India


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STRENGTHENING THE DIRECTION OF T&CM

DIVISION


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STRENGTHENING THE DI RECTION OF T&CM DIVISION

Workshop on the Development of the T&CM Blueprint 2018-2027 Date : First session: 27 June – 1 July 2016

Second session: 29 November – 1 December 2016 Location : First session: Various premises within the Ministry of Health Malaysia

Second session: Premiere Hotel, Klang The T&CM Blueprint is intended to serve as a guiding document for the development of T&CM industry in Malaysia for the coming ten years (2018-2027), specifically to facilitate the regulation, integration and economic development of the T&CM industry and strengthen the Malaysian healthcare delivery system, particularly in the T&CM field. The development of the T&CM Blueprint is also one of the identified action plans under the 11th Malaysia Plan (RMK-11) 2016-2020, Strategy Paper 18G: Transforming Services Sector (Private Healthcare). This plan aligns with the direction of the World Health Organization (WHO) which encourages its member states to achieve the strategic objectives specified in the WHO Traditional Medicine Strategy 2014 – 2023. A series of meetings and workshops involving various stakeholders in the T&CM industry was conducted to draft the Blueprint. Among them, two workshops were held in the presence of Prof. Narantuya Samdan, the WHO consultant who was appointed to assist the Ministry of Health, Malaysia in developing the Blueprint. She emphasized that the process of translating good policies into good practice is challenging, requiring steadfast commitment and collaboration from all stakeholders.


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EDITORIAL BOARD


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EDITORIAL BOARD

ARTICLE CONTRIBUTORS

Aslida Binti Safian@Safiain Chua Yau Li

Dr. Maznah Binti Wazir Dr. Mohd Naufal Bin Ridzuan

Dr. Sharifah Firyelhana Binti Syed Abdul Rahman Dr. Mohd Zubair Bin Zain Al Aabideen

Dinish A/L Perumal E Mei Hooi

Lim Wai Yee Ng Angeline

Ng Suk Kuan Teh Li Yin

Teh Teo Ming Yeoh Suang Meng

Dr. Adilla Nur Binti Halim

(Chief Editor)

Dr. Siti Norhidayah Binti Md Almi

Dr. Yuhin Norkamilah Binti Yusoff

Tan Hooi Tien

Wong Meng Xian

annual report 2016 -...

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