FACULTY OF ADMINISTRATIVE SCIENCE AND PUBLIC POLICY

DIPLOMA IN PUBLIC ADMINISTRATION

(AM110)

INTRODUCTION TO MALAYSIAN PUBLIC POLICY

(PAD 104)
INFECTION, PREVENTION AND CONTROL BY MINISTRY OF HEALTH
PREPARED BY:

NAME MATRIX NUMBER

NUR ATHIRAH BINTI MARZUKI 2022450452

NUR ANIS MAISARAH BINTI AHMADIL 2022471774

HAIRI

NUR ALIA AFISHA BINTI AZELAN 2022499976

NUR ALYA IZZATI BINTI ZURAIMI 2022852742

NUR ALIA MAISARAH BINTI 2022472214

RADZHALI

GROUP:
KAM1102F (G1)

PRESENTED TO:
MADAM ANIS FARAWAHIDA BINTI MOHD KARIM
INTRODUCTION

Contagious disease is one of the main problems for Public Health in Malaysia. The
infection is the invasion and multiplication of microorganisms in a host with an associated
host response such as SARS, HIV, H1N1, Hepatitis B, Dengue, Malaria, COVID-19 and
others. The infection may be local or generalized. For example, Influenza A H1N1 found in
Mexico and started to spread in 2009. It involved 15000 individuals in Malaysia in an early
pandemic. Besides, the infection happens due to cross infection from a person to other
people. Hence, it is important for all communities, especially health staff, patients and close
people to obey the infection control policy seriously. The risk for health staff and patients are
really high due to a variety of aspects. For example, tools, cleanliness and others. The
health staff risk arises from handling large quantities of blood and body fluids without
protective clothing, handling sharps and hollow needles without gloves and others.
Furthermore, the risk of patients arises from poor word facilities and cleaning, use recycled
hollow needles and syringes and others. Realizing these risks, infection control should be
taken to protect health staff and patients from the injection. However, how to control the
spread of the infection is not an easy way by just being careful and keeping distance from
the patients. So, the Ministry of Health Malaysia issues a policy and procedures in 2019 for
health personnel used to control the infection and keep their health. “The policy under the
Ministry of Health is important to ensure standardization of infection control activities in
hospitals, but also will facilitate future monitoring and audit systems on infection control”.
Director general of the Ministry of Health, Tan Sri Dato’ Seri Dr. Noor Hisham bin Abdullah.
Moreover, injections require antibiotic treatment. So, the Antibiotic Control Committee is
formed to be in charge of antibiotic treatment. The Committee is divided into several groups:
the Hospital Infection and Antibiotic Control Committee (HIACC) and Infection Control Doctor
(ICD). HIACC is responsible for developing policies related to the usage of antibiotics in the
hospital by following the standard by the National Infection and Antibiotic Control Committee
(NIACC). Meanwhile, ICD is responsible for the day-to-day management of infection control
in Malaysia. Infection prevention and control practices are important in maintaining a safe
environment for patients by reducing the risk of the spread of disease. Studies are needed to
assess the determinants of infection control practises and behaviour promotion among
different populations of healthcare workers and to implement and evaluate the impact of the
different programmes components of multimodal programmes to promote optimal infection
control practises.
PROBLEM

A problem description is entwined with the political process throughout the

activities of issue initiation, program design, and legislative enactment; it is essential
to the creation of public policy(Rochefort & Cobb, 1993). Problem definition,
however, continues to be an immature analytical concept that has produced little
scholarship and no comprehensive framework. This assignment methodically
analyses the causes, components, and effects of tissue characterization, current
policy making trends, and anticipated future research needs in an effort to fill this
gap. By popular demands for government action, policy issues are being identified in
this way. Public sentiment will affect governmental policy in democracies. In this
sense, the public's opinion was considered to be crucial and play a big part in a
government. Hence, while making decisions about matters of public policy,
democratic representatives such as members of parliament or policy makers should
serve the interests of the people rather than necessarily adhering to their
preferences.Before the infection control policy was implemented there were various
problems involving infections caused by germs and bacteria. This problem often
occurs in medical centers, especially hospitals. This happens because the
regulations and policies about infection are applied in the medical field in Malaysia
as well as around the world. thousands of lives were also lost due to the invading
germs. When fighting with germs that cannot be seen with the naked eye, special
care and observation are necessary because they are very small and can cause a
very painful and horrible death.

The government implements an infection control program that as long as it is

followed it will have some beneficial impact. The rising death rate caused by
untreated bacterial infections is the most worrisome issue among them. through this
policy, the content can be reduced effectively. However, there are certain issues with
this policy that cannot be contained. There are still some issues that arise after the
implementation of this strategy.

One of those issues is that they don't know how to manage unforeseen
infectious infections. Medical staff did not adequately prepare to control any
infectious issues prior to the development of infectious diseases control
policies. In order to prevent epidemics and illnesses, the infection, prevention,
 and control policy was devised. These epidemics and diseases are eradicated
and controlled by the infection, prevention, and control policy, although this
policy mainly concentrates on illnesses and epidemics that have already
happened. For instance, because the H1N1 virus, sometimes known as swine
flu, has been around for a while, organizations are aware of how to control
and eradicate the disease. However, this strategy does not provide enough
information to prepare for an unexpected disease like covid 19. This is
because the covid 19 virus was a surprise occurrence that even the WHO did
not anticipate. This virus exists and is capable of making not only Malaysia
become uncontrollable but the whole world with a high mortality rate.

infectious illness transmission is also influenced by adverse environmental

conditions. While Malaysia is a sophisticated nation that is continuously growing,
certain areas are having trouble adjusting to the country's progress. This is
especially true in rural areas where there is a lack of cleanliness because people still
follow traditional customs like openly burning trash, dumping trash close to homes,
and other similar behaviors. It makes it simple for contagious illnesses to spread and
damage a settlement's environment. The policy infection, prevention, and control
department has indirectly found it more difficult to prevent the disease from
spreading. Also, it makes it hard for them to predict potential future outbreaks of
infectious illnesses.

The most common adverse outcomes in healthcare delivery (HAIs) occur

worldwide. HAIs, particularly surgical site infections, are common in areas affected
by malignancy. IPC is an essential component of providing safe, efficient and high-
quality healthcare and is essential to stopping preventable HAIs. Armed conflict and
widespread violence, however, can severely impact the quality of health care
through shortages of skilled workers, disruptions in supply chains, and attacks on
medical facilities and workers. Before the intervention, the total baseline compliance
rate for hand hygiene among healthcare workers (HCW) in inpatient services was
only 4.8%. Due to lack of access to clean water, hand sanitizer or dispensers, poor
hand hygiene practices are prevalent. Also, many sinks either don't work or leak.
HCWs do not have a thorough understanding of the 5 seconds of hand hygiene7
using the correct method. Several participants in focus group discussions identified
workload, insufficient availability of hand hygiene products, and lack of adequate
training as their biggest barriers to practicing good hand hygiene.

Next is the community's attitude of not caring about the repercussions that
may happen to them in the future makes it difficult to instill cleanliness standards as
a culture. The policy infection, prevention, and control department has engaged in a
number of initiatives to educate the public and healthcare professionals on the value
of maintaining good hygiene. Despite this, the general public and healthcare
professionals continue to disregard the significance of hygiene care, despite
community education being a standard practice in all healthcare organizations. Due
to the public's and the medical profession's attitude, which downplays the
significance and measures of health care and hygiene, this makes cleanliness and
health care measures as a culture and practice rather difficult to adopt. Since they
believe that they will not be sick or injured by infectious diseases, these disbelievers
make the process of applying the practices emphasized by the infection control
department disrupted and make it difficult to stop the spread of these infectious
diseases. Such a mindset makes it harder for the policy, infection prevention, and
control department to improve the practice and make it a community culture in this
nation.

Following that, one of every person's everyday necessities is access to the

internet. At any place and time, it's fairly common to see teens, seniors, and kids
online. People may now always acquire information or the most recent news at the
tip of their fingers because of the widespread availability of internet connections and
smartphones. However, a number of detrimental effects on the nation and society
went unrecognised. One effect is that the community has trouble determining if the
information received is accurate or not. False information in cyberspace is
particularly concerning since the general public is going to be confused about the
truth about it. The information will be simply influence to those who simply believe it.
For instance, many people disseminate erroneous information online about how to
cure covid19 and the efficacy of immunizations in preventing covid19. Without
checking the accuracy of the content, the general public who reads it will be duped.
These factors contribute to the presence of anti-vaccine groups in society. Those
who oppose vaccinations prefer to learn about Covid-19 through fake and
trustworthy sources rather than on social media. According to its minister, Khairy
Jamaluddin (azneal ishak,2021) the Malaysian Ministry of Health (KKM) filed multiple
police investigations against anti-vaccine organizations that spread false information
and threatened public safety. It is challenging for the infection, prevention, and
control policy to stop infectious illnesses from spreading and endangering the lives of
all residents. This is due to the anti-vaccine movement's refusal to adhere to the
infection, prevention, and control policy's recommended course of action.
3.MAIN OBJECTIVE
The main objective of infection control and prevention programs is to identify and
reduce the risks of infections in patients and healthcare workers. Furthermore, there
must be functioning organizations and committees to coordinate all activities related
to surveillance, prevention, and control of infections from spreading. The goal of the
infection control program must be effective to improve clinical outcomes using a
multidisciplinary team approach.
To be clear, the objective of infection control policies includes identifying the
most effective but at the same time the least expensive for providers to prevent and
control infections. Besides, their objective is also to summarize all types of
precautions such as standard precaution, contact precaution, droplet precaution and
airborne precaution. Apart from that, their goal is to review the type of precautions
required for patients especially those with tuberculosis and clostridium difficile.
Lastly, accurate infection control must be followed to prevent infection in healthcare
by the interprofessional strategies team.
4.ACTORS INVOLVED IN THE POLICY PROGRAMS/ACTIVITIES
● Infection Prevention and Control (IPC) is a practical and evidence-based approach -
designed activities,policies and procedures to prevent infection in the healthcare
community.
Actors involved:
1. Infection Control Unit
- support other units in preventing and oversee healthcare-associated
epidemics, infections and antimicrobial.
- work based on-Communicable Diseases Act (1227/2016)
- example: staff training, identify roles played by hospital members and develop
infection control outline
- scope: surveillance study, health education, orientation,isolation.
- position: interprofessional clinicians, nurses and administrators

2. National Infection and Antibiotic Control Committee (NIACC)

- is a part of the governance body that incharge of coordinating national efforts
in reducing healthcare associated infection (HCIA) and promoting judicious
use of antimicrobials.
- participate with MOH and University Hospital -University Malaya Medical
Center
- developing policies and act as a source of expertise relating to infection
control, antibiotic usage and antimicrobial resistant (AMR)
- committee: reviewed related issues and will be discussed in the National
Antimicrobial Resistant Committee, advisor for chairman of infection control.

3. State Infection and Antibiotic Control Committee (SIACC)

- governance body that is coordinating state efforts in reducing healthcare
associated infection (HCIA) as well as to control AMR by promoting judicious
use of antimicrobials.
- focuses on disciplinary participation from the State Health Department and
hospitals-providing treatment for common illness.
- provides references from the experts, identify and submit report to NIACC
and advise Infection Control Doctor (IDC)

4. Personnel
- appoint hospital epidemiologists, infection preventionists, and an infection
control committee to organize a well-structured and implemented infection
control program.
- a.epidemiologist: interact with hosp departments and administrators to
discuss about responsibility and expectation
- b.preventionist: multiple preventionist- number of beds, mix of patients
and CDC recommendations

5.0 IMPLEMENTATION OF THE POLICY

Malaysia has implemented an Infection Control Policy from the Ministry of Health in order to
control disease outbreaks from further spreading and causing death. It is one of the
important steps taken by the government to protect the welfare of the people. To keep the
policy up to date, Infection Control Unit, Malaysia and National Infection and Antibiotic
Committee are responsible for reforming and consolidating the national policies with global
standards.

5.1 Movement Control Order

Government has used several effective strategies that can be seen from the spread
of the Covid-19 virus in our country. The first case was recorded on 4th February 2020 but
there was a sudden increase in cases when there was a large religious gathering in Kuala
Lumpur. Movement Control Order or known as MCO are implemented throughout the
country including Sabah and Sarawak. There are 4 phases of MCO. The first phase of the
MCO runs from 18th March until 21st May 2020. All Malaysians are instructed to stay
indoors at all times during the MCO. Strict action will be taken against those who disobey the
instructions. The Royal Malaysian Police and the army are responsible for controlling the
border area and patrolling to ensure that everything is under control.

5.2 National Immunisation Program

In order to ensure that the probability of the people that are infected by the virus is
low, the government has taken the initiative by providing free vaccination service on a large
scale. For Covid-19 virus, there are several types of vaccines that have been prepared like
Pfizer, Sinovac and AstraZeneca. The amount of doses that need to be taken is three,
namely the first dose, the second dose and the booster dose. All Malaysians are required to
get all three types of vaccines to help the immune system to fight infections more quickly and
effectively. Besides, Covid-19 vaccine, Malaysians are also required to take the Bacillus
Calmette-Guerin (BCG) vaccine at birth to prevent diseases like Tuberculosis or TB.

5.3 Comprehensive Observation

In addition to getting a vaccine injection, observation is also important to identify

actions that can be taken next to stop the spread. Through observation we can identify the
cause, treatment and effects that will be borne in the future. This action will help in
maintaining a clean and safe environment and reducing the risks of the potential spread of
disease. For example, through observation we can find out what actions can be taken to
prevent the spread of epidemics such as quarantine. By quarantining susceptible individuals
it can helps in reducing or stopping the transmission of a contagious disease.
6.0 EVALUATION ON THE EFFECTIVENESS OF THE INFECTION CONTROL POLICY
FROM THE MINISTRY OF HEALTH (USING SWOT ANALYSIS)
 The strength(S), weakness(W), opportunities(O), threats(T). SWOT analysis method
is one of the analysis methods used for the in-depth analysis of COVID-19 epidemic
prevention and control strategies and to formulate relevant strategic planning.

Subject Criteria description

Strength 1. Ministry Health has a strong commitment to increasing patient trust and an
sharing culture

-Instead of focusing on one particular team, method, or piece of technology, it is

ideal to think of the promotion of patient safety culture as a collection of
treatments founded in leadership, teamwork, and behaviour change principles.

Weakness 1. Services too stretched for additional activities

-Burnout is a common problem among emergency medical personnel, especially

nurses. Frequent contact with angry people, task overload, a lack of clear
instructions, and the impression that one was being underpaid were the variables
that contributed to burnout.

2. Lack of knowledge of duties among personnel

-The constant underinvestment in health worker education and training in some

nations as well as the misalignment of education and employment policies with
regard to health systems and population demands are factors in the ongoing
shortages.

Opportunit 1. Technologies upgrade

y
-Technology is essential to maintaining society's functionality during the COVID-
 19 pandemic, which is characterised by lockdowns and quarantines. Beyond
COVID-19, these technologies might have a lasting effect.

Threat 1. Decreased workforces

-The ongoing high risk of infection and death, existing issues with exhaustion,
mental health, well-being, and workplace violence were made worse.

2. Confidentiality is at risk

7.0 RECOMMENDATIONS
 The Ministry of Health (MOH), health staff, patients and all individuals in
Malaysia are affected with contagious disease especially COVID-19. All of us faced
a lot of problems such as staff not being clear of their role, staff facing workload,
decreased work faced and confidentiality is at risk. Hence, there are the
recommended ways to fix the problem above.

1)Interactions between HIACC with the health system, public health and disease
specific programmes.

-Members of HIACC are well represented and have clearly defined roles and
responsibilities in the existing health system, public health and disease
specific programmes.

2)Additional education intervention and campaigns are required to improve

knowledge of health staff.

- Health staff should have adequate knowledge about clinical presentation,

general knowledge and transmission route of COVID-19 and to increase the
perception and practice of the preventive measures.

3)Provide enough healthcare personnel.

- To ensure healthcare personnel work during normal work hours

- Increase motivation

- Reduce stress, overwork and fatigue

4) Advertise the community the importance of using IT.

-For example, the impact of using AI and drones to detect COVID-19 from
individuals by emulating China.
Conclusion

In summary, the diseases that can be spread are becoming worse nowadays. So, the
effective prevention and control of healthcare associated infection (HCAI) must be
embedded into everyday practice and applied consistently. As with any risk assessment
process, prompt identification, proper recording, appropriate action and effective monitoring
are important to ensure high standards of infection control are in place.

Efforts are being made to reduce these infections, and although such aims are often
regarded as unachievable, Ministry of Health policies are always ready to pretend all the
potential of spread of infections. Otherwise, it also cares about health personnel, patients
and the community from being one of the infected people.

Consumer demands for more responsibility and openness, increased scrutiny, and
expectations for quick decreases in HAI rates all characterize this new age in healthcare
epidemiology. Infection control is responsible for preventing and lowering the risk of hospital-
acquired infections. This may be accomplished by putting in place infection control strategies
that include policies and management for surveillance, isolation, outbreak management,
environmental cleanliness, staff health, and prevention of infections.

This policy can also help develop the economic sector of a country. This is because,
with the efficiency of a country in dealing with problems involving germ-borne diseases or
dangerous infectious diseases, a country can guarantee the safety of all its citizens, with this
efficiency, it can indirectly attract tourists from various corners of the world. This can
indirectly increase the country's economy. Therefore, in addition to this policy being able to
guarantee safety and health, it can also guarantee economic growth in the country.