The number of people in Malaysia living with diabetes will increase to almost 25% of adults by 2020. A recent study carried out by the Ministry of Health, National Health and Morbidity, showed a significant increase in the prevalence of diabetes among economically productive Malaysian youths (aged 18–35 years) – with reported rates increasing threefold in the last 15 years alone. Diabetes already demands 16% of the country’s healthcare budget, and the need to combat increasing levels has been recognized. Mounting evidence, published by Harvard Medical School, has shown that healthier lifestyle choices prior to and during pregnancy can help prevent the incidence of Type 2 diabetes in newborns.
Maternal and child health initiative
- Jom Mama: Meaning “Let’s do it, Mama!” in Malay. This initiative, funded by Novo Nordisk, has the objective of introducing and implementing pre-pregnancy and prenatal assessment interventions to couples, to improve the health of potential and future childbearing women, and thus reduce the incidence of Type 2 diabetes amongst their children, preventing the generational transmission of this chronic disease risk. This research and development project takes the pre-pregnancy and pregnancy periods as a window of opportunity for prevention. The project aims to develop, implement and evaluate a prevention program addressing risk factors such as obesity among young couples. By improving women’s knowledge, attitudes, and behaviors regarding healthy living, it is hoped the program will demonstrate that pre-pregnancy and during-pregnancy intervention is a feasible way of improving birth outcomes and reducing incidence of diabetes.
Designed in collaboration with the Malaysian Ministry of Health, the University of Southampton (UK), the University of Witwatersrand (South Africa), World Diabetes Foundation (partners involved contribute with their own resources) and Novo Nordisk, a number of key areas of improvement were identified. These included; increasing general health literacy, support to improve physical activity, and encouraging adoption of healthy choices. The initiative has developed a health education intervention for young couples, based on extensive formative work including a needs assessment, literature reviews, and three qualitative studies exploring the priorities of the young couples, community leaders, health care professionals, and other key stakeholders.
Women and their partners are enrolled into an 18-month program to improve their health outcomes before and during pregnancy. The primary target group are young couples planning pregnancies and their offspring. Secondary target groups are healthcare professionals and managers at local and national levels within the Malaysian healthcare system. Involvement will focus on health literacy, physical activity, nutrition, psychosocial well-being, and pregnancy preparedness.
The program is currently being implemented throughout Malaysia, and it is hoped that by taking a preventative, proactive approach “Jom Mama” will sustainably tackle the country’s mounting diabetes and obesity issues. Evaluation will include analysis of behavioral outcomes, knowledge gain and reduction of risk factors identified in the mother and child.The intervention will be evaluated to determine whether and how it can be refined, scaled up within Malaysia, and disseminated to other settings and populations.
Article: Maternal and child health initiative