BackgroundThis cross-sectional study assesses factors that contribute to discontinuing breastfeeding among employed mothers in Malaysia.MethodsA structured questionnaire was used in conducting this study involving all government health clinics in Petaling district between July and September 2006. Respondents were Malaysian women with children between the ages of six to twelve months who were formally employed. Factors studied were selected socio-demographic and work-related characteristics.ResultsFrom a total of 290 respondents, 51% discontinued breastfeeding. The majority (54%) of mothers who discontinued breastfeeding had breastfed their babies for less than three months. Compared to Malay mothers, the risk of breastfeeding discontinuation were higher among Chinese (AOR 3.7, 95% CI: 1.7, 7.8) and Indian mothers (AOR 7.3, 95% CI 1.9, 27.4). Not having adequate breastfeeding facilities at the workplace was also a risk factor for breastfeeding discontinuation (AOR 1.8, 95% CI: 1.05, 3.1).ConclusionIt is important that workplaces provide adequate breastfeeding facilities such as a room in which to express breast milk and a refrigerator, and allow mothers flexible time to express breast milk.

P.A.); aziahkb@usm.my (A.D.); drkamarul@usm.my (K.I.M.); na.hamid@usm.my (N.A.A.H.); shaifulb@usm.my (S.B.I.)Abstract: Background: Men's health in Malaysia is slowly gaining more attention, but minimal research has examined how Malaysian men behave and seek treatment. While few studies have investigated men's treatment-seeking behavior (TSB), those that have been conducted seem to be inconclusive and tend to yield contradictory findings. Objectives: This paper aims to determine the proportion of inappropriate TSB and to explore in-depth treatment-seeking behavior among male civil servants in northeastern Malaysia. Methods: This paper adopted a mixed-methods approach, specifically a concurrent parallel study design. A quantitative study using a self-administered questionnaire was performed to identify the proportion of appropriate and inappropriate TSB among male civil servants in northeastern Malaysia. Concurrently, a qualitative study was conducted involving six focus group discussion sessions, and the results of both parts were integrated to provide a detailed explanation of TSB among the participants. Results: A total of 381 participants were involved in the quantitative study, yielding a response rate of 94.8%; 246 (64.6%) engaged in inappropriate TSB. Some of the reported morbidities among the participants were hypertension (26.5%) and diabetes mellitus (26.2%). From the qualitative study, a main theme related to TSB emerged with several sub-themes, which were health literacy, stage of seeking treatment, preference for alternative treatment, perceived threat of illness, self-treatment, and the influence of family members and others. Conclusions: TSB among male civil servants in northeastern Malaysia is poor, and the factors contributing to it are multidimensional. This study has provided new valuable evidence on men's TSB in northeastern Malaysia. The findings can be used to facilitate and improve current policies and the implementation of men's health services throughout the country.

Breast cancer is the most common cancer affecting  women globally. Several ways of breast cancer screening tools are available. This study aims to evaluate Malaysia's breast cancer screening program using the national database based on participation and performance indicators for the past five years. A retrospective cumulative analysis of clinical breast examination and mammogram screening services were performed using the national dataset of 2016-2020 obtained from the Health Informatics Centres, Ministry of Health Malaysia. The performance indicator represents the percentage of breast abnormality detected during clinical breast examination and the proportion of confirmed cancer through mammogram screening.  A reduction in the participation rate for clinical breast examination was noted from 2016 (25.8%) to 2020(25.1%). However, a high participation rate in 2019 (29.1%) was noted following active health promotion intervention. The rate of high-risk women who underwent mammogram screening fluctuated by years according to active breast awareness campaign. The average rate of confirmed breast cancer annually was 0.7% and was noted highest in 2020 (1.17%).  Improving early diagnosis is an eminent strategy for cancer control in all settings, including strengthening health systems and providing universal health coverage. Successful breast cancer prevention and control programs require intersectoral planning and active community participation. Ensuring sustainability and accessibility of breast cancer screening programs is highly needed. Fostering good collaborative multiagency partnership and community participation for the cancer control program urges an innovative approach through a policy formulation.

Inadequate men’s engagement with health services may be influenced by unmet needs and demands of the local men’s community. This study aimed to explore men’s experiences with primary health services and their expectations of the characteristics of friendly primary health services, from the perspective of men in Kelantan, Malaysia. A qualitative study using in-depth interviews was conducted with 15 men from six primary health facilities in Kelantan, Malaysia, who were selected based on maximum variation sampling. The data were transcribed and analyzed using the thematic analysis method. The study found that experiences with the existing primary health services were categorized into four subthemes: provision of health services, health promotion delivery, attributes of healthcare providers, and the physical environment of the health facilities. Meanwhile, the expectations of the characteristics of friendly primary health services were categorized into four subthemes: meeting the needs of men in primary health services, approaching men through effective health promotion strategies, standards of a healthcare provider from the viewpoint of men, and a comfortable physical environment for men. Prior experiences hugely influenced men’s expectations of friendly primary health services. Men want these health service characteristics customized to meet their needs, allowing them to use health services with confidence and comfort. Thus, to strengthen primary health services for men, it is essential to comprehend their prior experiences with and expectations of the services.

Background and context: Cervical cancer remains a major burden to many countries worldwide particularly in underdeveloped and developing countries. It continues to have a huge impact on women not only physically but also socially and sexually. However, the good news, because of its slow progression and cytologic identifiable precursors and provided it is detected early and managed effectively, it is herald as one of the preventable and treatable forms of cancer. Despite the decades of awareness campaigns and progress in technology, the coverage and uptake remains low, more so among the younger and high risk women. Sadly too of those diagnosed, more than 76% were at stage II and above when intensive and invasive treatment will be required. Conventional Papanicolaou test is the only primary screening tool available since 1969 and it is considered the most successful cancer screening program to date. Nevertheless, cytology has its limitations especially technical limitations regarding sampling and laboratory errors in screening and interpretation. Noticing the laggardness of a single approach, Malaysia doubles up her strategy by introducing primary prevention using the HPV immunization to hasten reduction of cervical cancer. While Pap smear remain as a strategy, improving the quality of the laboratory services is paramount to ensure effective early detection of precancerous lesion. In 2015 the Ministry of Health introduced the liquid-based cytology in a phased implementation starting with Kelantan, Johor, Negeri Sembilan and Selangor gradually the whole country. Does HPV DNA testing be available soon to further enhance diagnosis? The topic has a fair share of several rounds of discussions. Aim: To share the latest challenge, gap, strategy and the way forward for the transformation of the cervical cancer prevention and control program comprehensively taking into consideration of HPV DNA test as a screening tool. Strategy/Tactics: The milestone of the Papanicolaou test program was analyzed to see the gap and the options of the improvement. The performances of Papanicolaou test services were analyzed through the annual data and report of Papanicolaou test services from all the states. Later, we also map the analysis with the latest incidence of cervical cancer in Malaysia to see the impact of the program. Program/Policy process: The planning process involved several discussions at ministry level, series of workshop to develop the important documents for the implementation, being collaborative partner in organizing HPV workshop and effective discussions with VCS, Australia. Outcomes: Mandate of the way forward of comprehensive strategy for cervical cancer control program being approved. What was learned: Malaysia is optimistic that cervical cancer reduction program remain a high-profile agenda in the country and therefore we are ready for the change to give a better impact of the program.