KUALA LUMPUR, Feb 13 — A coalition of Sarawak-based civil society organisations (CSOs) has called for the Ministry of Health (MOH) to allocate dedicated funding to improve data collection, particularly for unreached and remote communities.
The Sarawak CSO-SDG Alliance Health Thematic Group, in its report “Making Healthcare Reform Work for Sarawak”, said poverty measurements must be “context-sensitive” to reflect the realities of both remote and urban areas.
“Effective allocation of funds and resources requires accurate identification of needs and inequalities, particularly among unreached populations. Unfortunately, much data collection is aggregated, obscuring disparities within different groups.
“Disaggregated data, however, can highlight the specific challenges faced by subgroups such as women, indigenous communities, persons with disabilities, and non-citizens. Without this, marginalised communities remain invisible and unreached,” the report stated.
The group highlighted shortcomings in current systems like the Household Income and Basic Amenities Survey, which often fail to capture the realities of remote areas, leading to incomplete assessments of poverty and health care access.
“Poverty measurements must be adapted to local contexts and disaggregated to ensure accurate comparisons within the country. Surveys lacking sensitivity to current living standards in Malaysia may overlook the realities of people in remote areas and the relative poverty in urban areas,” it said.
The group noted that district-level data from the 2019 Household Income and Basic Amenities Survey offers a clearer picture than state averages.
The survey found that 73.5 per cent of households in Sarawak live within 5km of a public health facility, but this figure is lower in 31 out of 40 districts. In Sebauh, a district in Bintulu, only 27.6 per cent of households meet this criterion.
Similarly, while the state average for households living more than 9km from a health facility is 15.5 per cent, this figure is higher in 29 districts, with Sebauh at 56.3 per cent.
“Twelve districts have over 30 per cent of households living more than 9km away, and five of these districts exceed 40 per cent. These figures align with the 2016 survey, which found that 43.6 per cent of rural households were more than 9km from a health centre,” the group said.
The lack of comprehensive and accessible data hampers collaboration and efforts to reduce inequalities, making it difficult for researchers and organisations to plan effective services and conduct meaningful research.
“MOH needs to enhance data collection, processing, and timely publication to facilitate a data-driven approach, especially for remote communities. Up-to-date, comprehensive data is essential for identifying gaps, monitoring progress, and ensuring efficient allocation of resources.
“Without this, evidence-based policies cannot be developed, and targeted interventions are difficult to implement, leading to inefficient use of financial resources,” the group noted.
The group said poverty, a key social determinant of health and a critical Sustainable Development Goal (SDG 1), should be prioritised, with out-of-pocket (OOP) expenses included as a significant factor in measurement.
It also called for expanding Sarawak’s digital infrastructure, emphasising that reliable internet access is essential for delivering services in rural areas.
“With most specialists concentrated at Sarawak General Hospital and the Sarawak Heart Centre, implementing a hub-and-spoke model or tele-mentoring can significantly improve access to specialised services in remote regions.
“Additionally, cloud technology facilitates the swift transfer of patient data across different levels of care, ensuring seamless communication and continuity in patient management. Innovative approaches like Project ECHO can help bridge the gap in the distribution of medical specialists,” it said.
The Sarawak CSO-SDG Alliance is a coalition of civil society organisations working to advance the UN SDGs in Sarawak. The report was prepared by their Health Thematic Group, which includes experts, non-governmental organisations (NGOs), community organisations, and advocacy groups focused on health.
