Objective: To determine the trend in incidence of preterm birth over five years and its predictors in a single centre.Design: A cross sectional study using electronic data from a Total Hospital Information System (THIS) and computerized birth registry system.Setting: A single teaching and referral hospital in the Greater Kuala Lumpur, Malaysia.Population or Sample: All livebirths delivered in the centre from January 2011 to December 2015 weighing ≥500g.Methods: Logistic regressions with backward likelihood ratio were used. Main outcome measures: Preterm live birth and live term babies.Results: 31,405 live births were included. There was almost 20% increment in the incidence of preterm births between 2011 and 2012 which then gradually decreased until 2015. Maternal age of 20-34 years (OR 0.7, 95% CI 0.7-0.8) was noted as a protective factor. The highest risk level of the pregnancy (OR 2.83, 95% CI 2.3-3.4), multiple pregnancy (OR 2.2, 95% CI 1.8-2.6), low birth weight (OR 18.7,) and male infant (OR 1.3, 95% CI 1.2-1.5) were noted as risk factors. Conclusions:The incidence showed an upward trend between 2011 and 2012 then a gradual decrease until 2015 with a similar pattern reported by national data. The predictors of preterm birth in the study centre were birth weight, risk level of the pregnancy, multiplicity of pregnancy, maternal age and infant gender. Continuum of care using the risk level coding assessment must be enhanced at the primary care level especially for appropriate referral and co-management at a referral centre (secondary or tertiary hospital).

The Quality Assurance Programme (QAP) in the public sector of the Ministry of Health (MOH) Malaysia had been in place for more than 25 years. It is an effort by the government to ensure that care provided is at par with the regional and the worldwide standards. The process toward attaining what was achieved today is neither an overnight nor an easy journey. Thus, this paper intends to share the implementation progress of QAP in the MOH government facilities for future benefits. To date, the MOH's champions in quality are well-recognized and had a strong governance structure that oversees the programme. Indicators were identified according to the needs of the activities in MOH and these measurements were used to measure the quality of the healthcare services in the government facilities. Sharing of best practices is done through local quality improvement journals and reports on the quality activities and research. Among the challenges faced is the process of gathering information.After 25 years, MOH is still collecting the information manually and hopefully, a better approach can be established.

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IntroductionProviding training on areas of known social cultural limitation such as sexual and reproductive health (SRH) is challenging and many end up with improper training. Present study aims to explore facilitators' skills and exploring feedback on the SRH program implementation. A training program was conducted based on existing module developed by Ministry of Health Malaysia. The focus of the training is on imparting essential sexual reproductive health knowledge for the teachers and instilling confidence in educating it on children and adolescents particularly those with disabilities. Methods The respondents were enrolled from a training centre for teachers trained for special needs children. The fascilitators of the program were the public health doctors in training. A case studies design was used to explore the themes. Nine focus group discussions comprising 15 participants each were conducted on teachers who had participated in the training. A semi-guided questionnaire was used to guide the discussion. Discussions were audio and video recorded with permission then transcribed verbatim. Transcriptions were analysed using thematic analysis to capture similarities and differences in views expressed by the participants. Results Eight themes were derived. Three related to the facilitators which were personality and characteristics, knowledge and skills. Five were related to the programme implementation -time, input, output, outcome and venue. Conclusion Generally, the programme received positive remarks. Programme input needs further improvement. Based on the participants' feedback, the programme managed to achieve its objectives. Facilitators were able to facilitate the training satisfactorily.

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