District health management cycle in Malaysia

• Main Authors: C. A., Azreena, E., Azreena, W. D. S., Arinah, N., Ezy Eriyani, N., Fairuz Nadiah, Rao S., Gunenthira, Z. A., Muhammad Adil, Juni, Muhamad Hanafiah, Minhat, Halimatus Sakdiah
• Format: Article
• Language: English
• Published: Community Health Society Malaysia 2016
• Online Access: http://psasir.upm.edu.my/id/eprint/55549/1/District%20health%20management%20cycle%20in%20Malaysia.pdf; http://psasir.upm.edu.my/id/eprint/55549/; http://publichealthmy.org/ejournal/ojs2/index.php/ijphcs/article/view/289

Background: Imbalance between needs, demands and resources are commonly seen in the public sector. Management team needs to manage the available resources in the best possible way to meet the health needs. This is decided by the District Health Management Team (DHMT) in the district health. The concept of District Health Management Cycle (DHMC) was initially introduced by the World Health Organization (WHO) in its District Health Management Models as part of health sector reform initiatives. This review aim to discuss the principle and concept of DHMC in Malaysia. Methods: A literature review was conducted through online database such as Google Scholar and Pubmed to identify the current concept of DHMC. Related government documents on district health management was also identified and reviewed through official government websites. Initial keywords used are district health services and district health management. Then, combined keywords used are district health services in Malaysia and district health management in Malaysia. Finally, about 14 articles that are related were selected and reviewed. Logic framework for district management cycle and SWOT analysis was applied to highlight the internal factors (strength and weakness) and external factor (opportunity and threats) of district health management in Malaysia. Result: DHMC is a cycle involving situational analysis, planning, implementation, with continuous monitoring and eventually the evaluation. Situational analysis identified the current requirement of the district. Then district health plan will be carried out to get a clear picture of the range of inputs needed and how these inputs will be combined to achieve goals. Implementation is the process of carrying out the activity or intervention as well as using the resources without any interruption to the existing service delivery. Followed by monitoring, where it implies checking progress of District Health Plan. Finally, evaluation is a systematic way of reviewing at the implemented plan including the strengths and the shortfalls accounted during the entire process. District health management in Malaysia is not completely decentralized, therefore there are some different in its concept and principle. Conclusion: Healthcare system in Malaysia has some strength and threat. Some of the weaknesses are lack of human resources and top to down planning. The threat comes from internally such as resource constraints and externally due to social groups and political interference. District health management is the starting point of the district health service delivery. It aims to constantly balance the needs, and demands with the limited resources to improve the quality of health service.