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SEMESTER 3: 2006/2007




Tan Gi Ni 130542
Mohd Khir A. Shukor 133833
Marina Binti Hussin 131479
Hayatul Naimah Mohd Khairuddin 131859
Munirah Mohd AriI Kor

LECTURERS : Dr. Nor AIiah Mohd ZulkeIli
Dr. Anisah Baharum


1.1 Agency background
1.2 Package
1.3 Background inIormation
1.4 Objectives
1.5 Target population and place
1.6 Risk Iactors oI teenage pregnancy
1.6.1 Teenagers
1.6.2 Family
1.6.3 Friends / peers
1.6.4 Environment

2.1 DeIinition oI teenage pregnancy
2.2 How does pregnancy occur?
2.3 Prevention oI teenage pregnancy
2.3.1 Abstinence : no sexual intercourse
2.3.2 II the teenager decides to have sex, what should they do?
2.3.3 Victim oI teenage pregnancy : rape and incest
2.4 How do you know you are pregnant?
2.4.1 Early symptoms
2.4.2 Home pregnancy test
2.4.3 Visit doctor
2.5 What should you do iI you are pregnant?
2.6 Options in teenage pregnancy
2.7 Impact oI sexual intercourse
2.8 Impact oI teenage pregnancy
2.8.1 Teenagers
2.8.2 Child
2.8.3 Family
2.8.4 Society
2.9 Antenatal care oI pregnant teenage
2.9.1 Medical care
2.9.2 LiIestyle changes
2.9.3 Nutrition
2.9.4 Exercise
2.9.5 Stress management
2.9.6 Prenatal classes
2.9.7 Preparing Ior new responsibilities

3.1 Place and time
3.2 Objectives
3.3 Program schedules : Activities
3.4 Budget
3.5 Sponsors



Our agency consists oI a team oI second year medical students Irom the Faculty oI
Medicine and Health Sciences, Universiti Putra Malaysia. We are here to present and
propose our health promotion programme on Teenage Pregnancy.


We have prepared a slide presentation along with our proposal Ior the programme
mentioned above.


We chose to do a programme on this current social problem because it is a global
incidence. The developed and developing countries have diIIerent rates oI incidence
on teenage pregnancy. Commonly, in developed regions such as North America and
Western Europe, teen parents tend to be unmarried and adolescent pregnancy is
considered a social issue. But in developing countries, teen parents are oIten married
and their pregnancy may be welcome by Iamily and society. The problem is very
alarming as proven by a report by Save The Children which shows that 13 million
children are born to women under the age oI 20 worldwide with 90 oI the cases
occurred in developing countries. AIrica has the highest incidence oI teenage
pregnancy worldwide with 143 per 1000 girls aged 15 to 19. As Ior Asia, premarital
sex is uncommon but early marriages in certain cultures sometimes promote
adolescent pregnancy. Incidence is commonly higher in rural regions than in
urbanized areas. In South Korea and Singapore, marriage beIore age 20 has all but
disappeared, and although the occurrence oI sexual intercourse beIore marriage has
risen, rates oI adolescent childbearing are low at 4 to 8 per 1000. The rate oI early
pregnancy has decreased sharply in Indonesia and Malaysia also. However, it remains
high in comparison to the rest oI Asia.


Our aims Ior this programme are to promote sexual education among our target
population, to decrease the Irequency oI teenage pregnancy, a serious social problem
and also to provide support Ior teenage mothers with counselling.


Our target population is the high risks teenagers (which will be chosen by teachers) in
secondary schools in Malaysia.


There are several Iactors that inIluence teen pregnancies. These Iactors include the
teenagers themselves, Iamily, Iriends and environment (community and culture).
1.6.1 Teenagers
Lack oI emotional maturity can be one oI the causes oI teenage pregnancy. Teenagers
become sexually mature (and Iertile) approximately 4-5 years beIore they reach
emotional maturity. They are also more likely to become pregnant iI they have low-
selI esteem, pooI perIormance in school, drop out Irom school and engaging in high
risk behaviour such as smoking, alcohol use and drug abuse.
Some teenage girls become pregnant while involved in long-term dating relationships.
The girl intends to spend her liIe with her partner. They become closer emotionally
and physically. The girl Ieels compelled to invest her body to maintain the
relationship and that is where the problems oI becoming pregnant begin.
Inadequate education or awareness regarding reproductive health, responsible sexual
behaviour, contraceptives and consequences oI sexual intercourse (including
pregnancy, sexually transmitted disease and psychosocial eIIects) are most oIten the
causes oI teenage pregnancy. Besides, they also may lack oI knowledge oI, or access
to, conventional methods oI preventing pregnancy, perhaps because they are too
embarrassed to seek it. In other cases, contraception is used, but proves to be
inadequate. This is because inexperienced teenagers may used condom incorrectly or
Iorget to take oral contraceptives. Other teenagers are knowledgeable but choose to
take sexual risks.
1.6.2 Family
Family is also a strong indicator oI the likelihood oI teenage pregnancy. Typically,
teenagers who come Irom poor, less educated, single-parent Iamilies, Iamily situation
with regular conIlicts between members are at a greater risk Ior pregnancy. Teenagers
whose mother or sister gave birth as a teen are also more likely to become pregnant
during their teenage years.

In Iact, the reason most teenage girls become pregnant is because they do not get
enough love and attention. They are sometimes neglected all the time because their
parents are out working to support the Iamily. Lack oI trust and communication
between parents and teenagers is another important cause oI unwanted teenage
pregnancy. Parental attitude towards their teenaged children and amongst themselves
inIluence their children`s behaviour and thoughts. II parents are unable to
communicate with their children regarding issues relating to sex, then the teenagers
resort to acquiring inIormation regarding sex through other sources which may not be
reliable. These other sources are generally magazines and Iriends who are extremely
unreliable sources oI inIormation and can mislead the them into Iorming incorrect
ideas about sex.

1.6.3 Friends / Peers
Without a parent to direct the teenager and set limits, a teenager might be unable to
distinguish right Irom wrong. This is where peer pressure takes hold. Teenagers who
are part oI the wrong crowd oI people who smoke, drink alcohol, take drugs and have
sex might be pressured by their peers to Iollow their routines. Consequently, this will
lead to unintended pregnancy among teenagers.

1.6.4 Environment

There is a strong correlation between teenage pregnancy and the neighbourhood in
which the teenagers live. Teenagers that live in neighbourhoods with high levels oI
poverty, low levels oI education and high residential turnover are at higher risk Ior
teen pregnancy. Lack oI community coordinated programs Ior youth and policies that
deal with social support, and positive educational and recreational activities can also
contribute to this problem. In some societies, early marriage and traditional gender
roles are important Iactors in the incidence oI teenage pregnancy.
In addition, teenagers today are growing up in a culture in which media such as
television, movies, music and magazines oIten transmit either covert or overt
messages that unmarried sexual relationships (speciIically those involving teenagers)
are common, accepted and expected behaviours. As a result, this can lead to
irresponsible sexual behaviour and thus, cause teenage pregnancy.

Teenage pregnancy is deIined as pregnancy occurring in girls aged 10-19.

During ovulation, one oI the woman's ovaries releases a tiny egg that begins to travel
down the Iallopian tube. During sexual intercourse, a man ejaculates millions oI
sperm that travel up the vagina, through the uterus and into the Iallopian tube where
the egg meets the sperm. When the egg and sperm Iuse, it is called Iertilization.
In a normal pregnancy, the Iertilized egg travels down the Iallopian tube. On about the
third day oI travel, the Iertilized egg arrives in the woman's uterus. AIter 2 or 3 days
in the uterus, the Iertilized egg begins to implant in the uterine lining. Upon
implantation, pregnancy occurs. II the lining is rich enough with maternal blood, it
will continue to grow there and will become an embryo, then a Ioetus. AIter
approximately 38 weeks, the Ioetus is ready to be born.


2.3.1 Abstinence

The most eIIective method oI prevention is abstinence, which means no sexual
intercourse. Abstinence is the only way that teenagers can be 100 sure they will not
have to deal with pregnancy or sexual transmitted diseases.

Teenagers are responsible Ior their actions and liIe. ThereIore, they should not let
anyone pressure them into having sex. There are a lot oI good reasons to say "No, not
yet". Protecting their health and Ieelings is one oI the examples. Their partner who
really loves and respects them will not ask Ior sex beIore marriage.
Teenagers should avoid Irom taking alcohol or drugs that can impair their judgement
about sex. Teenagers also need to choose the right Iriends because peer pressure can
inIluence their behaviours and decision to have sexual intercourse.
Teenagers should improve their knowledge about sexuality. They need to be made
aware oI the consequences and impacts oI sexual activities on their lives, such as
pregnancy and sexually transmitted disease.

2.3.2 Use contraception method

II the teenagers have decided to have sex, they must also take responsibility to protect
themselves Irom unplanned pregnancy and sexually transmitted diseases because sex
has consequences. For couples who do choose to have sex, there are many eIIective
birth control methods to choose, Ior examples; condom and oral contraceptive pill
(OCP) which will suppress the ovulation process by combined actions oI estrogens
and progesterone.
2.3.3 Rape and incest
However, even the teenagers not decide to have sex, they may be a victim oI teenage
pregnancy, Ior examples; rape and incest.
Rape means sexual assault on a Iemale by a male in which the penis oI the assailant is
introduced into the vagina or anus oI a non consenting victim oI any age by threat or

While, incest is sexual relations between persons who are so closely related that their
marriage is illegal or Iorbidden by custom, Ior examples; between teenager and their
parents, siblings, uncles, and grandparents etc. Incest is now recognized as a common
type oI sexual abuse. It is potentially damaging to physical, mental and social well

To prevent the sexual abuse or sexual assault, teenage should choose their Iriends
careIully, be modest in their behaviours and dressing, try to avoid peers who engage
in risky behaviours and inappropriate social activities, always inIorm their parents
about where they are going out to and with whom, do not take liIts Irom strangers,
also do not take drinks or open canned drinks Irom strangers / new Iriends and do not
take money or giIts given to you without a good reason. The teenage must avoid
loitering at night and in a lonely, quiet area and must diIIerentiate between
appropriate touch and inappropriate touch (Iondling breast, thigh or buttocks).

2.4.1 Early symptoms
Pregnancy symptoms most oIten do not occur until they have missed their period Ior
about 2 weeks, but this varies Irom woman to woman. Symptoms can occur earlier Ior
some women (sometimes a week aIter a missed period).
N Delayed period (amenorrhoea): Menses are delayed more than 10 days beyond
the due date, with previous periods being regular and have been sexually
N "Morning sickness" (nausea): Ieeling sick, or vomiting in the morning
N Breast changes: Fullness, prickling sensations and heaviness in breasts.
Breasts may Ieel painIul to touch.
N Increased vaginal discharge.
N Urination problems: Ieeling like urinating more oIten.
N Tiredness (Iatigue): Ieeling unusually tired and lethargic.
N Mood swings
N Change in appetite

2.4.2 Home pregnancy test
Pregnancy test kit can be done in the privacy at home. All home pregnancy testing
devices use monoclonal antibodies to detect a hormone known as human chorionic
gonadotropin (hCG). hCG is produced by the developing placenta beginning the day
on which the embryo implants in the uterine wall.
How to use home pregnancy test? Remove as many test cards Irom the pouches.
Then, lay the test cards on a clean Ilat surIace. Add 6 drops oI urine to the test card
using the dropper provided. Results are then read in 5 minutes.

2.4.3 Visit doctor
A woman may Ieel certain changes in body (early symptoms oI pregnancy) and may
have done a home test to Iind out whether they are pregnant or not. However, it is
good to consult a doctor to be sure. There are various subtle changes in your body in
pregnancy, which can be assessed beIore there are obvious physical changes.
General Examination:
N Pulse rate goes up by 10 15 beats / minute.
N Blood pressure tends to go low.
N Skin pigmentation increases. Darker colour "butterIly" distribution rash on the
Iace (chloasma) may be appear.
Breasts :
N Darker pigmentation oI the areola (area around nipple) and oI the nipples.
N Congestion oI breasts and dilated veins seen over the breast.
Genital tract :
N Increased vaginal discharge (leucorrhoea) is common.
N Dark, bluish discoloration oI vagina and cervix due to congestion.
N The cervix and uterus Ieel soIt.
N The uterus gradually starts increasing in size as pregnancy advances.
Confirmatory test
AIter examining, doctor may Ieel that certain tests need to be done. In particular, Ior
early pregnancy woman may be advised to do the Iollowing tests:
N Urine hCG test
N Serum beta hCG : to conIirm the pregnancy iI urine testing is not conclusive,
or help to decide the Iurther treatment in case oI complications (such as
presence oI bleeding / spotting in early pregnancy)
N Abdominal sonography


First, they should go to the nearest doctor or health clinic Ior antenatal care or check
up. Early antenatal check up is important to monitor the well-being oI the mother and
the baby. For an unmarried teenager, they can seek help or talk to their parents, school
teacher, school counsellor, doctor and health care provider and social welIare oIIicer
at the nearest District WelIare department. Deciding what to do about an unplanned
pregnancy can be diIIicult. Options Irom adults and counsellors can help teenagers
with this decision.

Teenage should not put themselves in a dangerous situation by keeping their
pregnancy as a secret or going Ior an illegal abortion.

There are several support groups available in Malaysia.

i) Woman's Aid Organization, email:
ii) Women's Centre Ior Change, (WCC) Penang, email:
iii) All Women's Action Society (AWAM), email:
iv) Sisters in Islam, email:


There are only two options Ior teenage pregnancy, either to maintain or terminate
their pregnancy. II they decide to maintain their pregnancy, they have to take care oI
the baby by themselves or live with their parents. Being a mother, having a baby will
mean that the teenagers have to get used to a new way oI liIe. This decision will cause
a big change in the teenager`s liIe. It needs hard work and costs a lot oI money. The
teenagers should think about what they want to do in the next Iew years. They have to
make another decision whether to Iinish school, get job or get an own place to live. It
is also important Ior the teenage to get prenatal health care.

The teenagers also can maintain their pregnancy and then arrange their baby to Ioster
parent care (Jabatan Kebajikan Masyarakat). In Ioster parent care, the baby is cared
by another person while the mother gets ready to raise the baby permanently. In cases
where teenagers cannot take care oI their baby, they can arrange their baby Ior a
Iormal adoption to Jabatan Kebajikan Masyarakat.

Child abandonment is a Iorm oI child neglect. It is an oIIence and is punishable by the
law. The Malaysian law states that abandoned children will be protected and cared
Ior. In Malaysian Criminal laws, as in the Penal Code states, those who abandon
babies shall be punished with imprisonment Ior 20 years.

II teenagers decide to terminate their pregnancy, it they have decided to undergo
abortion. This decision oIten jeopardizes their saIety and health by selI-inducing
abortion or seeking a dangerous illegal procedures. BeIore teenagers decide to abort,
they should think careIully about why their baby needs the same opportunity oI liIe
that they have. Abortions are illegal in Malaysia!


Sexual intercourse in teenage pregnancy is best avoided and abstinence is encouraged
due to several reasons. The main reason is that teenagers are at increased risk oI
getting sexually transmitted diseases and can seriously jeopardize the mother and the
baby signiIicantly. Pregnant teens are also more likely to have complications in
pregnancy and thereIore, sexual intercourse is not encouraged. II they still wish to do
so, their health care provider should be consulted Ior advice whether sex is saIe Ior
them or not.



Teenage pregnancy can have various impacts on adolescents and can have devastating
eIIects in their liIe. Health or medical, education, socioeconomic and psychological
impacts are impacts oI pregnancy and parenthood in teens. LiIe outcomes oI teenage
mothers and their children vary with other Iactors such as poverty and social support
which may be more important than the age oI the mother at birth. Health / Medical

Among teens that are pregnant or parenting, maternal and prenatal health is very
important. Pregnant teens are less likely to receive prenatal care, oIten seeking it to
the third trimester iI they do. Many pregnant teens also can be prone to nutritional
deIiciencies Irom poor eating habits common in adolescents, including attempts to
lose weight through dieting, skipping meals, Iaddism, snacking, skipping meals and
consumption Iast Iood. In developing countries, inadequate nutrition during
pregnancy is an even more marked problem among teenagers.

Not only that, teenagers has a signiIicantly higher complication rate both during
pregnancy and delivery. An estimation oI 70,000 teen girls in developing countries
has complication in pregnancies which results in death each year. Girls 14 years or
younger have greater risks oI medical complications, as an underdeveloped pelvis can
lead to diIIiculties in childbirth. An obstructed labour can be dealt with by Caesarean
section in developed nations. However, in less developed regions, these medical
services might not be available. This can lead to eclampsia, obstetric Iistula, inIant
mortality or maternal death. Education

Being a young mother can eIIect one`s education. Teen mothers are more likely to
drop out in high school. The Iailure to complete their education will reduce career
opportunities Ior them greatly. They will most likely bring up their child in poverty. Socioeconomic

Teenage parents are most likely to be single parents. With the low level oI education
due to the Iailure to complete it, lack oI job skills will cause Iinancial problems and
increases poverty. Their socioeconomic level will be low. However, it is diIIerent in
cases where they receive support Irom Iamily members or so. Psychological

The changing oI the role oI the teenager Irom a single young girl with their normal
daily activities to a parent Iull with many responsibilities can aIIect the teenager
psychologically. They have to understand that they can no longer do the things they
used to do beIore and have to concentrate on the baby`s care. Furthermore, teenage
mothers have 3 times more the rate oI post-natal depression compared to other older
mothers. They might also experience alienation Irom their peers and Iamily and it will
be though Ior them without support.

2.8.2 ON THE CHILD Before and At Birth

Premature birth and low weight oI the baby is more common among adolescent
mothers. This can contribute to childhood health problems (death, blindness, deaIness,
mental retardation, chronic respiratory problems) and hospitalization. Furthermore,
the inIant mortality rate Ior babies to teenage mothers is 60 per cent higher than Ior
babies born to older mothers. Teenage mothers are also more likely to smoke during
pregnancy which has negative consequences Ior the baby. Later in Life

Young people can be competent parents. However, all evidence shows that children
born to teenagers are more likely to experience a range oI negative outcomes later in

Children oI teenage parents are generally at increased risk oI poverty, low educational
attainment, poor housing and health, and have low rates oI economic activity in adult
liIe. Teenage mothers are also less likely to breastIeed which is also not good Ior the

Early motherhood can also aIIect the psychosocial development oI the inIant. The
occurrence oI developmental stabilities and behavioral issues is increased in children
born to teen mothers. This maybe because adolescent mothers are less likely to
stimulate their inIant through aIIectionate behaviors such as touch, verbal
communication and smiling or to be sensitive to the inIant`s needs.

Children oI teenage mothers are also more likely to have poor academic perIormance.
Most importantly, children born to teenage parents are much more likely, in time, to
become teenage parents themselves.

2.8.3 FAMILY

The news oI the adolescent being pregnant can be both shocking and disturbing news
Ior their Iamily. This issue might be considered a taboo by the Iamily and they might
deny and reject their child`s problem thereby leaving the pregnant teenager on her
own. The Iamily might not be able to accept this issue and they might be reluctant to
give any support to their child. On the other hand, some Iamilies might be able to
accept it and will give their Iull support to the teenager. This will relieve the
teenager`s burden and the teenager might be able to cope better with their problems.
However, providing Iinancial support Ior the baby might increase the burden oI the
Iamily and some might not be able to aIIord it.


Teenage pregnancy is a serious social problem. Society may look at this problem as a
taboo and people will discriminate these teenagers who are in need oI help and


2.9.1 Medical care

At Iirst prenatal visit, teenagers will probably be given a Iull physical exam including
blood and urine tests and screen the teenage Ior sexually transmitted diseases. The
health care provider also will discuss:
N schedule oI prenatal visits
N what she may be Ieeling physically and emotionally
N what changes she can expect with her body
N how to deal with some oI the uncomIortable side eIIects oI pregnancy such as
nausea and vomiting
Knowing what to expect can help alleviate some oI the Iears that teenagers may have
about being pregnant. The health care provider will probably prescribe a daily
prenatal vitamin to make sure the teenage mother gets enough Iolic acid, iron, and
calcium. Folic acid is especially important during the early weeks oI pregnancy, when
it plays a role in the healthy development oI the neural tube (the structure that
develops into the brain and spinal cord).
2.9.2 Lifestyle changes
The teenager`s health care provider will talk about the liIestyle changes she will have
to make Ior the health oI the baby including:
N No smoking (smoking while pregnant increases the risk oI miscarriage, stillbirth,
low birth weight, and sudden inIant death syndrome)
N No drinking (alcohol causes mental and physical birth deIects)
N No using drugs (drugs are associated with pregnancy complications and Ietal
N Avoiding excess caIIeine (too much caIIeine has been linked to an increased risk
oI miscarriage)
N Avoiding risky sexual behaviours (such as having unsaIe sex)
N Getting enough rest
II the teenagers smokes or uses alcohol or other drugs, the health care provider can
oIIer ways to help her quit.
2.9.3 Nutrition
The teenage mother should eat well which can greatly increase the teenager`s chances
oI having healthy baby. Encourage the teenager to maintain well-balanced diets that
include plenty oI Iruits, vegetables, and whole-grain breads. As a revision, the teen
can use Food Guide Pyramid as a basic guide.
The important nutrients that the teen should take are proteins, calcium, iron and Iolic
Drinking a lot oI water is essential too Ior the teenage mother and they are strictly
advised not to go on a diet. When pregnant, some teens might be tempted to counter
normal pregnancy weight gain by cutting calories or exercising excessively. Both oI
these methods can seriously harm the babies. II it is believed that the teenager has an
unhealthy preoccupation with her weight, talk to the health care provider.
2.9.4 Exercise
II the teenager was physically Iit beIore getting pregnant and not experiencing any
pregnancy complication, the health care provider will probably encourage the
teenager to continue exercising. Do the low-impact exercises such as swimming and
walking. Discuss the exercise plan with the health care provider early on.
2.9.5 Stress management
Most teenagers enter parenthood unprepared Ior the stress a new baby brings, and
many experience Irustration, resentment, and even anger toward their newborns. This
can explain why teen parents are at higher risk Ior abusing and neglecting their
babies. Have a talk with the teenager's doctor to discuss ways that can help the teen
manage her stress levels so that she can better cope with changes in her liIe. She also
may want to spend some time with other people who have babies to get a better sense
oI what caring Ior a newborn involves.
2.9.6 Prenatal classes
The teenager's health care provider will probably recommend that she take classes on
pregnancy, giving birth, and parenting. These classes (some oI which are held just Ior
teenagers) can help prepare her Ior the practical side oI parenthood by teaching skills
such as Ieeding, diapering, child saIety, and other basic baby care techniques.
2.9.7 Preparing for new responsibilities
Some teenagers raise their child alone, some have the involvement oI the baby's
Iather, and some rely on their Iamilies Ior support. As a parent, they need to think
about their own level oI involvement and commitment and discuss it with the
teenager. How much support than can they provide? (such as Iinancial and place). II
at all possible, it is best Ior teenagers that are pregnant to Iinish school so they can get
better jobs and create a better liIe Ior themselves and their babies. This is no easy task.
60 to 70 oI all pregnant teens drop out oI school. Going back aIter quitting is
especially hard.
The teenager should be given support that she needs to stay in school, so both she and
the baby will beneIit. Check Ior school and community programs that oIIer special
services Ior teenager mothers such as child care, rides or tutoring.
Teenagers also must understand that as rewarding as having a child is, it is not always
Iun. Caring Ior a baby is a huge responsibility and a liIelong commitment. The
teenager has to Iace the reality that she would not have as much time Ior the things
she used to do. Her liIe will change and the baby will take priority.



We have planned a programme which consists oI many activities. The theme oI this
programme is Have a Control over Your LiIe! Sex has Consequences. Prevent
Teenage Pregnancy. This programme will be held at Awana Kijal Resort, Terengganu
on the 1-3 December 2006.


The main objective oI this programme is to provide the teenager with sexual
education which is consists oI:
N Practice saIe sex
N Reproductive health
N Consequences oI sexual intercourse : pregnancy, sexual transmitted disease and
on psychosocial
N Responsible sexual behaviour : consequences oI unintended pregnancy


There will be several activities to be done during the programme. This includes :

1) Talk about :
N Introduction to sexual education by Dr Tan Gi Ni
N SaIe sex by Dr Munirah MohdAriI Kor
N Prevention is better than abortion by Dr Marina binti Hussin
2) Video session on impact oI teenage pregnancy to teenagers themselves, child,
Iamily and society.
3) Interactions in groups.
4) Personal counselling.


Costs (RM)
1) Promotions
2) Speakers
3) Accommodation
4) Transportation
5) Foods
6) Others
- stationary
- souvenirs
Total : RM7650.00
3.5 Sponsors

We have planned to get sponsorship in terms oI cash and giIts Irom the Ministry oI
Health and also Irom Kotex (Malaysia) Sdn. Bhd.


1. Alan Cribb, Peter Duncan, Health Promotion and ProIessional Ethnics,
Blackwell Publishing

2. Joan Arnold, S.G. Sherri, Health Promotion Handbook, Mosby


4. www.mademmedicallibrary.htm

5. www.wikipedia.htm

6. www.intelihealth.htm

7. www.who.htm