Strengthening the health systems through gaps identification is necessary to ensure sustainable improvements especially in facing a debilitating outbreak such as COVID-19. This study aims to explore public perspective on health systems’ response towards COVID-19, and to identify gaps for health systems strengthening by leveraging on WHO health systems’ building blocks. A qualitative study was conducted using open-ended questions survey among public followed by in-depth interviews with key informants. Opinions on Malaysia’s health systems response towards COVID-19 were gathered. Data were exported to NVIVO version 12 and analysed using content analysis approach. The study identified various issues on health systems’ response towards COVID-19, which were then mapped into health systems’ building blocks. The study showed the gaps were embedded among complex interactions between the health systems building blocks. The leadership and governance building block had cross-cutting effects, and all building blocks influenced service deliveries. Understanding the complexities in fostering whole-systems strengthening through a holistic measure in facing an outbreak was paramount. Applying systems thinking in addressing gaps could help addressing the complexity at a macro level, including consideration of how an action implicates other building blocks and approaching the governance effort in a more adaptive manner to develop resilient systems.

Introduction: The prevalence of psychological distress is increasing worldwide.Stressful working environments and high expectations in medical practice put doctors at high risk of depression, anxiety, and stress, especially among medical interns.Effective coping strategies may reduce psychological distress in the clinical setting.This study aimed to determine the prevalence of psychological distress and its association with coping strategies among medical interns in Malaysia.Method: A total of 431 medical interns at 26 Malaysian Ministry of Health hospitals participated in this cross-sectional study in 2017. Self-administered questionnaires consisting of sociodemographic characteristics, items from DASS and BRIEF COPE were used. Descriptive analysis was done followed by further analysis with chisquare and Spearman correlation tests. Results:The prevalence of stress, anxiety, and depression was 29.7%, 39.9%, and 26.2%, with a significantly higher prevalence among female and younger interns.Three-quarters of them (73.1%) applied problem-focused strategies as the main coping mechanism. Emotion-focused coping strategies showed a significant but weak correlation with anxiety and stress whereas avoidance-based coping strategies were significantly correlated with depression, anxiety, and stress.Discussion: Medical internship is a highly grueling period. Besides emphasizing clinical competency, internship training should also impart the practice of healthy coping mechanisms. The vulnerable groups of females and younger interns should be taught positive coping skills so that they are empowered to handle any stressors on their

Physician burnout has been recognized as a public health crisis. However, there is a paucity of burnout studies in the context of medical internship. We assessed the prevalence and relationship between various training characteristics, personal variables, resilience, and coping with burnout in a cross-sectional study involving 837 interns from ten hospitals across Malaysian healthcare system. The instrument package included demographic questions, the Connor–Davidson Resilience Scale, Brief COPE and the Copenhagen Burnout Inventory. A total of 754 (90.1%) interns completed the inventories. We found a high prevalence of personal-related (73.3%), work-related (69.1%), and patient-related (43.4%) burnout among Malaysian interns. Multivariable analysis showed female gender (odds ratio (OR):1.50; 95% confidence interval (CI): 1.02–2.20), prior work experience (OR: 1.56; 95% CI: 1.05–2.30), and irregular spirituality routines (OR: 1.97; 95% CI: 1.30–2.99) were associated with increased odds of personal-related burnout. Irregular spirituality routines (OR: 2.24; 95% CI: 1.49–3.37) were associated with work-related burnout, while living with other people (OR: 1.77; 95% CI: 1.15–2.73) was associated with patient-related burnout. Lower resilience levels and avoidant copings were associated with personal-, work-, and patient-related burnout. Burnout prevalence among interns is high. The findings support the value of individual-targeted alongside organizational-targeted intervention in burnout reduction. As burnout is prevalent in both years of internship training, ongoing burnout prevention and wellbeing measures are deemed necessary.

Introduction: Ministry of Health (MOH) Malaysia colleges, offer diploma and advanced diploma programmes for nursing, assistant medical officer and other allied health personnel. As academic institutions, the trainers are encouraged to participate and enhance the colleges' research productivity. The aim of this study is to explore the perceived barriers and motivation factors for research in MOH colleges. Method: A qualitative research design was conducted among MOH colleges trainers. Semi structured questions were used in 11 Focus Group Discussion (FGD) and 13 In-Depth Interview (IDI) among 98 respondents from seven MOH colleges. Thematic analysis was used to identify emerging themes from the interviews. Results: Three institutional factors motivate engagement in research: key performance indicator, research support and research skills. Majority of respondents were aware of the importance of research, but their research productivity is low due to perceived barriers related to human resource, research material, technical and funding support. Conclusion: The findings are useful in understanding research motivation as well as ascertain barriers that can be overcome through better support and recognition. Such understanding will help improve the policy for research across the colleges.

In 2016, the Ministry of Health (MOH) Malaysia has introduced a new programme to prevent and reduce the occurrence of non-communicable diseases (NCDs) as well as related risk factors in the work place environment known as KOSPEN Plus. This study aims to evaluate the awareness and perception of KOSPEN Plus programme after 3 years of implementation in MOH health facilities, government and private agencies in Malaysia. A cross sectional study design was employed in the study. All health facilities, government and private agencies which had implemented KOSPEN Plus programme between 2016 and 31 December 2018 in all states in Malaysia were invited to participate in the study. The computer assisted self-interview (CASI) using the pre-tested self-administered questionnaire in the electronic form was used. A total of 362 health facilities, government and private agencies which had implemented KOSPEN Plus programme was involved in this study. Overall, more than 80% of facilities/agencies in this study implemented six out of the eight scopes of KOSPEN Plus. The survey was planned with the goal of obtaining data to support the Ministry of Health in reviewing the present health activities related to workers health in Malaysia and make necessary improvement to the programme.