Background: The demand for healthcare in Southeast Asia is growing sustained by demographic diseases transition and rising incomes due to economic growth and globalization. Structure of the healthcare market has effect on competition and efficiency. Materials and Methods: Scoping review method adopted with articles identified using Scopus, Google Scholar, PubMed and ScienceDirect databases via the keywords "healthcare market", "Southeast Asia", "market structure" and/or "competition". Final 15 articles were reviewed of those published only in English in the last 15 years. Results and Discussion: Majority Southeast Asia countries are striving to provide universal healthcare coverage straining resources and affecting quality. Forces in the market has pushed demand for higher quality care. General share of private healthcare expenditure, 55% of the total healthcare expenditure, is higher than that of public. Healthcare systems are moving from a publicly dominant health service provision towards greater private sector involvement. The public and private financing among the SEA countries health systems are dynamic and diverse where national health insurance (NHI) with various social security schemes exists to provide basic access to healthcare. Private health insurance is also growing. Differences in healthcare financing is driven by the growing demand for higher quality healthcare. Changing lifestyles, an aging population, and rising income have led to increased prevalence of noncommunicable diseases. Increasing educational levels and aging populations led to increase health demand which affects the market and competition. Market failures in healthcare has pushed for more government intervention and growing effect of globalization has contributed to high care cost. Health systems have to adapt to rapid transformation of the market. Conclusion: The health system in SEA countries consists of the public and private sector working together in the provision of health service delivery with bigger private market share. Epidemiological transition of disease, an aging population and increase demand for high quality care pushes the competition in the healthcare market.

Background: Dengue vaccine can assist in controlling the rise of dengue. Highly effective cost of dengue vaccine in Malaysia is estimated to be between RM50 to RM200 per dose. It is important to know the willingness to pay (WTP) for the vaccine to assist in policy-making decisions for future dengue vaccine programme. The aim of study was to determine willingness to pay for dengue vaccine among healthcare workers (HCW) in Petaling Health District. Materials and Methods: A cross-sectional study was conducted among HCWs of Petaling Health District, Selangor from September to July 2018 via simple random sampling according to proportion of HCWs in specific facilities. A self-administered questionnaire using the contingent valuation method was used to estimate WTP. Factors associated with WTP for dengue vaccine were assessed and associations measured using Chi-square test with significance level at 0.05. Results and Discussion: Response rate was 92.2%. Majority of the respondents were female (72.3%), presently married (73.4%) with 93.6% aged 40 years or less, having at least college or matriculation education (54.3%). For monthly household income, 51.1% was between RM 3001 to RM 9000. Only 17.0% had history of dengue with 43.1% having family history of dengue. The median WTP for dengue vaccine was RM 20 per dose ranging between RM1 to RM500. Among the HCWs, 51.1% had a high WTP for dengue vaccine defined as at or above the median WTP. Factors significantly associated with WTP for dengue vaccine were monthly household income (χ2=11.974, p=0.003), dengue preventive practice (χ2=4.715, p=0.03), knowledge of dengue vaccine (χ2=3.062, p=0.05) and perception towards vaccination (χ2=5.593, p=0.02). Conclusion: The study revealed that the range of WTP for dengue vaccine among healthcare workers was RM 1 to RM 500; with 51.1% of HCWs of Petaling Health District having high WTP for dengue vaccine. The predictors for WTP for dengue vaccine were monthly household income, knowledge regarding dengue vaccine, dengue preventive practice and perception towards vaccination.

Background: Governance in health is a process whereby important decisions are made and determining who is accountable. Good health system governance (HSG) can ensure optimal functioning of the health system influenced by transparent rules and governed by effective oversight. Assessment of governance can influence the health outcome of the population when subsequent improvement is made for better policy input. The aim of this review is to understand the methodological research approaches used in the assessment of HSG. Methodology: A review was directed from a collection of articles obtained from Pubmed, ScienceDirect and CINAHL databases that summarises relevant prior publication on methodological approaches that have been used in HSG research describing study design, methods of data collection and analysis. Only original articles of the past ten years (2009 to 2019) published in English language is included. Data was extracted base on a preconstructed matrix. Results and Discussion: Findings revealed different research methods for the qualitative, quantitative and mixed-methods design. Similarities between the three are in terms of how research questions direct the choice of study design and the use of a governance framework or recommendation of indictors to guide the study. There were differences in terms of the nature of study, the methods used, and type of information gathered. Each study design has its own strengths and limitations. Lessons learned include research going beyond descriptions, tailoring approaches to fit study objectives, the importance of communicating findings and being clear in giving recommendations for policymaking. Conclusion: The qualitative design is contextual yet difficult to generalize, the quantitative design is generalizable yet very explicit to certain indicators specified while the mixed methods design is comprehensive but requires more resources to carry out.