Sunday, April 11, 2010


Let’s recall RNM...

Introduction :
As a follow-up to the First NHMS, the Second Health and Morbidity Survey (NHMS II) was conducted 10 years later in 1996 with the main objective of providing community-based data and information for the MOH to review health priorities, programme strategies and activities, and planning for the allocation of resources. It adopted the scope and approach of the NHMS I so as to enable comparison between the findings of NHMS I and NHMS II. In addition, the NHMS II was extended to Sabah and Sarawak to provide information on health and morbidity status of the whole country.
The Second National Health and Morbidity Survey found that more than half (57.6%) of the households consisted of “adults” and “young” household members and two percent (2.5%) of the households were occupied by only members of aged 6 years and above. It was observed that Sabah, Kelantan and Terengganu had relatively higher percentage of young age group, in contrast to Wilayah Persekutuan Kuala Lumpur and Penang. The survey has shown that the prevalence of the overall possible hypertension (> 30 years old) is 29.9%, Diabetic Mellitus (> 30 years old) is 8.3%, Asthma 4.2%, Acute Respiratory Infections among children (<>18 years old) is 11.6%, Obesity in adults (>18 years old) is 4.4%, current smoker (>18 years old) is 24.8%, alcohol consumption (current drinker) among non-muslim is 23%. For Breast feeding, ever breast fed (children <> 20 years old) are 3.7% for mammography, 34.2% for breast self examination and 46.9% for any method of examination. The survey has also shown that the prevalence for pap’s smear examination (women aged >20 years old) is 26.0%.
Ten years on, the Third National Health and Morbidity Survey (NHMS III) is planned and conducted in 2006. This survey retained as much as possible the important aspects of the NHMS II and will also focus on other currently important health issues faced by the community.

Objective of the Study
General objective :
To provide health related community–based data and information for the Ministry of Health to review health priorities, programme strategies and activities and planning for allocation of resources.

Specific objectives :
1. To determine the load of illness in the population as well as the impact of these illnesses on the community.
2. To determine the pattern of utilization of health care services (government, private, traditional & self-medication)
3. To determine the household consumption cost of health & medical care and the proportion of the population covered by different sources of payment for medical and health care
4. To determine the prevalence of specific health behaviors (infant feeding practice, physical activity and exercise, pap smear test, breast examination, sexual practice, smoking and alcohol consumption)
5. For selected health problems (hypertension, IHD, diabetes, asthma, acute diarrhoeal disease, ARI, accidents, and disability) to determine:
6. The state and national level prevalence rates of these health problems
7. The socio-demographic pattern of distribution of these health problems
8. The health seeking behaviour in relation to these health problems
9. To compare the morbidity and health services utilization pattern in 2006 with that in 1996


1 Scope of The Study
• The issue/problem is current or has potential of high prevalence
• The issue/problem is focused on disease/disorders associated with affluence, lifestyle, environment and demographic changes.
• The issue/problem is causing physical, mental or social disability
• The issue/problem has important economic implications
• It is feasible to implement interventions to reduce the problem
• The information related to the issue/problem is not available through the routine monitoring system or other sources.
• The information is more appropriately obtained through a nation-wide community survey, and
• It is feasible to obtain through a nation-wide community-based survey.

2 Sampling Design and Sample Size

2.1 Sampling Frame

2.2 Sampling Design

2.3 Sample Size
a.Expected Prevalence Rate
b.Response Rate of the NHMS II
c.Margin of Error and Design Effect

3 Preparation of Field Areas and Logistic Support

4 The Questionnaire, Household Interview and Examination Procedure
4.1 The questionnaire
4.2 The interview
4.3 Clinical Examination
a.Blood pressure measurement
b. Anthropometrics measurement

4.4 Blood investigation
a.Blood glucose level.
b.Blood cholesterol level

5 Instrumentation
a. The questionnaires
i) Face to Face Interview Questionnaire
ii)Self Administrated Questionnaire

6 Field Preparations
6.1 Pilot Study
6.2 Training of Data Collection Teams

7 Quality Control

8 Data Management
8.1Data Screening
8.2 Data Entry
8.3 Data Analysis

Read More : (The Third National Health & Morbidity Survey)

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