Affordable, accessible health care gets results: financial protection and people-centred care in Malaysia

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As a community nurse and midwife, Ismaziah Binti Ibrahim understands the importance of accessible maternal health care. The clinic where she works, Klinik Desa Broga in the Malaysian state of Selangor, is often the first point of contact between local pregnant women and the health system.

“In this village clinic, we provide services for mothers and children,” explains Ismaziah. “We perform urine checks, blood pressure checks and other necessary tests. If we encounter something difficult, we refer patients to doctors and hospitals.”

For some women, however, visiting a health centre can be difficult. “Sometimes, when mothers do go to the clinic, they don't talk, they feel shy,” she says. “New mothers also often face challenges because of the distance to health centres,” she says. For many, the cost of transport is a major barrier and if a partner or relative brings the mother to the clinic, it means missing out on work. 

That’s why Ismaziah and a team of other nurse-midwives visit new mothers in their own homes. “When we go to their homes, it’s more personal. We know our patients and they are more comfortable and willing to talk to us,” she explains. In these familiar surroundings, the nurse-midwives counsel the mothers on nutrition, cleanliness and breastfeeding, and encourage mothers to create healthy environments for their newborns.

The cost for this government healthcare is minimal and home visits remove other costs such as transport and lost work. "In Malaysia, healthcare costs in the government health care services are the most affordable,” explains Ismaziah. “Patients tell us that they prefer government health care."

These home postnatal care visits are a great example of health care that puts patients and their specific needs at the centre of care. And this approach gets results. By providing accessible, affordable postnatal care, Malaysia has achieved the Sustainable Development Goal related to maternal and child mortality.

Unfortunately, however, for many families in the World Health Organization (WHO) Western Pacific Region accessing health care comes at a high cost. A new WHO report finds that 1 in 5 – or 385 million people – in the Western Pacific face financial hardship when seeking care. People are defined as facing financial hardship when more than 10% of a household’s income is spent on out-of-pocket health care costs. In a concerning trend, the number of people experiencing financial hardship has doubled over the last two decades.

That’s why, on Universal Health Coverage (UHC) Day, WHO calls for leaders to invest in universal health coverage with a focus on ensuring financial protection for all.

UHC is fundamental for realizing the For the Future vision to make the Western Pacific the world’s safest and healthiest region. But without strong and effective financial protection, this cannot be achieved.

WHO is working with Member States in the Western Pacific to develop health financing policies that reduce financial hardship. As these efforts progress, more people will have access to affordable care. For Ismaziah, this is something to be celebrated. “I feel proud to be a community nurse and midwife,” she shares. “In the future, we will strive to be better than before and make a positive impact on others. My hope is for the people of Malaysia to be healthy and safe.”