Abstract
BackgroundMalaysia has committed to the global call to achieve universal health coverage, and with the adoption of Sustainable Development Goals, is further strengthening the health system through the primary health care services, particularly the family doctor concept. The Enhanced Primary Health Care (EnPHC) initiative was implemented to address the worrying upward trend of non-communicable disease prevalence, and incorporates the Family Health Team (FHT) concept. The aim of this paper is to describe the implementation of the FHT as part of the EnPHC intervention.MethodsIn-depth interviews and focus group discussions were conducted with the intervention design team, healthcare providers and patients in two rounds during the implementation period. A total of 121 individuals in the two rounds, split into different groups, where some of the participants of the FGD were also interviewed individually. Data were analysed using a thematic analysis, with codes being organised into larger themes.ResultsThemes that emerged from the data were around the process of FHT implementation and the advantages of the FHT, which included continuity of health care and improved quality of care. Patients and health care providers were receptive to the FHT concept, and took the effort to adapt the concept in the local settings.ConclusionsThe FHT concept implemented at 20 public primary health clinics has benefits appreciated by health care providers and patients. Addressing the viable shortcomings would better prepare the current primary healthcare system to scale up the FHT concept nationwide and enhance its feasibility and sustainability.Trial registrationThe study is registered with the National Medical Research Register, Ministry of Health Malaysia (NMRR-17-295-34711).
Highlights
Malaysia has committed to the global call to achieve universal health coverage, and with the adoption of Sustainable Development Goals, is further strengthening the health system through the primary health care services, the family doctor concept
This paper aims to describe the implementation of the Family Health Team (FHT) as part of the Enhanced Primary Health Care (EnPHC) intervention
The study is important to ensure the pilot project of EnPHC can be scaled up at a national level after taking into consideration existing facilitators and barriers. Study design This was a qualitative study which explored the experiences of the FHT members during implementation of the EnPHC intervention, as well as the experiences of patients 10 months into the intervention at the 20 clinics
Summary
Malaysia has committed to the global call to achieve universal health coverage, and with the adoption of Sustainable Development Goals, is further strengthening the health system through the primary health care services, the family doctor concept. Goal 3 of the SDG is about “ensuring healthy lives and promoting the well-being for all at all ages”, and to “achieve universal health coverage, Mohd Hanafiah et al BMC Family Practice (2020) 21:162 spotlight to ensure that UHC and betterment of population health are achieved [3] Malaysia, in her pledge towards UHC, emphasised on efforts to improve the existing PHC system by strengthening the family medicine services in the public sector. In Malaysia, AMOs are medical assistants or physician assistants who are not doctors
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