Kasmani

Kasmani et al.
et al. MAEHJournal
MAEH Journal of
of Environmental
Environmental Health Vol.Vol.
Health 3, No.
3, 1No.
(2021) 1-8 1-8
1 (2021)

The Delivery of Environmental Health Services in Malaysia: The Current

Status and The Way Forward
Norasmah Kasmania, Fathin Shakira Abd Azhara, Syarifah Mazidah Syed Badrula, Aaina Afrina Abd Manafa,
Muhammad Aiman Abd Jalila, Farah Ayuni Shafiea,b* Subramaniam Karuppannanb, Samsudin Zawawic,
Murugan Subramaniamd, Syazwan Aizat Ismaile, Arshad Abdul Majidf, Khairul Anam Mokhtarg, Noramirul
Nizam Kamisg, Siti Naszila Abu Talibh
a
Centre of Environmental Health and Safety, Faculty of Health Sciences, Universiti Teknologi MARA Puncak Alam, Selangor, Malaysia
b
Malaysian Association of Environmental Health
c
Universiti Teknologi MARA Sarawak, Kota Samarahan, Sarawak
d
Sek. Keb. Sungai Tinggi, Trong, Perak
e
Institut Latihan Kementerian Kesihatan Malaysia Sungai Buloh, Selangor
f
Hospital Queen Elizabeth, Kota Kinabalu, Sabah
g
Majlis Bandaraya Melaka Bersejarah, Graha Makmur, Ayer Keroh, Melaka
h
Pejabat Kesihatan Daerah Kuala Selangor, Selangor

*Corresponding author: farahayuni@uitm.edu.my

2021 MAEH Research Centre.
All rights reserved

INTRODUCTION

Environmental health comprises of the effect of human man-made

hazard or natural hazard towards the environment and human health
which include identification of the impact of those hazards, the source
and preventive measures that is needed to be taken into consideration.
According to WHO, environmental health addresses all the physical,
chemical, and biological factors which is external to a person, and all
the related factors impacting towards behaviour. It includes the
assessment and control of these environmental factors that can
potentially affect health (Rinkesh, 2017).

It is targeted towards preventing diseases and creating a

health-supportive environment. Rapid urbanisation is the major cause
of environmental health hazards in many countries. It includes
contamination of air, water, and soil. Sprawling urban areas contribute
to traffic congestion, with is associated to air pollution, noise and long
commuting times affecting public health and productivity across the
world (Vardoulakis et al., 2016). There is a significant environmental
impact of urban activities towards the environment and human (Ofori
et al., 2000). The main types of environmental impact are global
warming, abiotic depletion, human toxicity and reduction of ozone
layer (Tukker et al. 2006).

Figure 1 is the list of most concerning environmental issue in

Malaysia according to Malaysian citizens (Müller, 2019). It shows
that respondents believe that global warming or climate changes are
the most concerning environmental issues that need to be more
seriously approached. Environmental impacts have direct effects on
health, both in the short term and long-term periods.
Figure 1: Most concerning environmental issues according to
citizens across Malaysia in 2019

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A few years ago, Malaysia had faced major environmental Table 1: Roles and Responsibilities of Stakeholders
problems that lead to negative impacts towards environment and
human health. In 2019, the whole country was shocked with Kim Kim Category of Agencies/ Function
river water pollution that led to the dispersal of dangerous chemical Stakeholder Institutions
towards Pasir Gudang community. Moreover in 2019, Malaysia
experienced haze episodes which were caused from agricultural open Federal Ministry of ● Implement Health Policies
burning that consequently gave rise to the Air Pollutant Index (API) in Level Health (MOH) and Planning.
many states. Recently, the emergence of COVID-19 virus world ● Involved in Public Health
pandemic caused global lockdown because of the spread of the virus Activities for managing
infection towards human health. All these environmental health issues Communicable Disease and
have been managed by the environmental health officers, known as Non-Communicable Disease.
the frontline workers. They were the first to implement the plans and ● Implement regulation and
carry out corrective actions to minimise the impact towards enforcement
environment and human population. Strategically, in order to deliver ● Planning for Health
environmental health services effectively, it had been categorised into Guidelines and Standards
preventive, treatment, education and operational research measures. In Department of ● Prevent, eliminate, control
these categories different healthcare professionals whether Environment pollution to enjoy a better
government agencies or private sector such industrial and (DOE) environment and comply
Non-Governmental Agencies (NGOs) were involved in delivering with the Environmental
environmental health services. Quality Act 1974 and related
regulations.
One of the plans included in the environmental framework in
Malaysia is the National Environmental Health Action Plan Department of ● Collect and analyse
(NEHAP). NEHAP presents the strategies that can be implemented to Irrigation and hydrological data for the
improve the environmental health within the country and also address Drainage development and
the roles played by all major stakeholders. This national framework management of water
will provide the basis of the government’s approach in the direction of resources.
sustainable development, socio-monetary development, protection of ● Implement the plans for
the environment, and promoting and protection of human health. development and
Hashim, (2019) mentioned that NEHAP Malaysia had come out with management of water
Priority List of Environmental Health Issues in Malaysia (towards resources.
2030) that need to be looked into, which are: ● Provide hydrological plan
strategies in case of flood or
1. Children environmental health (birth cohort study, impact of draught.
indoor environment). Department of ● Promote safe and healthy
2. Vector borne diseases such as dengue and malaria Occupational workers at workplace.
3. Contamination of drinking water sources and emerging water Safety and ● Conduct research to reduce
pollutants such as endocrine disrupting chemicals (EDCs), Health (DOSH) accident, injuries or
pharmaceutical drugs (antiseptics, antimicrobials) occupational diseases at
4. Urban health issues such as poor housing and sanitation, Crime workplace.
rate, security and many more. Ministry of ● Responsible for issues
5. Climate change Environment & involving climate change and
6. Food safety and contamination such as incomplete food Water (MEWA) biosafety and spearhead the
labelling, untrained food handlers especially among foreigners growth of the green economy.
and non-compliance for food standards. ● Strengthen the management
7. Pesticides contamination of the water ecosystem.
8. Human exposure to environmental chemicals from industrial Ministry of ● Responsible for urban related
and daily products. Housing and issue, town and country
9. Zoonotic diseases such as rabies and leptospirosis. Local planning, fire and rescue
10. Exposure to ionizing and non-ionizing radiation. Government authority, local government,
solid waste and landscape.
Therefore, these are the challenges awaiting healthcare State Level Health ● Improve public health
professionals or stakeholders in delivering and implementing Department through the control of
environmental health framework. The following section will discuss infectious and vector borne
on the current roles and responsibilities of the Environment Health diseases.
Stakeholders in Malaysia. ● Enhance the involvement of
residents and other parties in
ENVIRONMENTAL HEALTH STAKEHOLDERS IN maintaining public health.
MALAYSIA Water Resources ● Manage licensing and
Management monitoring of the water
Stakeholders are a group of people in an organization where their Authority services industry.
involvements, actions and decisions influence in the environmental
Local Kuala Lumpur ● Provide public health
health delivery. The stakeholders in Malaysian Environmental Health
Authorities City Hall services and control
are listed in Table 1. The table summarizes the general functions of
(DBKL) pollution.
the listed stakeholders.
● Plan and control urban
development.

City Council ● Provide services such as

such as Majlis roads, traffic planning,

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Bandaraya housing, economic and Environmental Education (EE) can be defined “as a process aimed at
Petaling Jaya community development, developing a world population that is aware of and concerned about
(MBPJ) environment, recreation and the total environment and its associated problems, and which has
amenity services knowledge, attitudes, motivations, commitments and skills to work
Private Waste ● Provide waste management individually and collectively towards solutions of current problems
sector Management services such as recycling, and the prevention of new ones” (Lateh and Muniandy, 2010). The
Concessions waste storage and waste basic concept of EE is education on the environment, for the sake of
(e.g. Alam Flora disposal. the environment by using the environment.
Sdn. Bhd
/KDEB/E-idama Ministry of Education of Malaysia has taken drastic action to
n) include environmental education (EE) into the school curricula of
Industries ● Involved in food Malaysia to promote sustainable development and improving the
manufacturing, food supply capacity of people to address environmental and developmental
chain, hospitality, issues. Others government agencies that are involved in promoting
construction, plantations, environmental education are the Department of Environment (DOE),
farms, etc the Department of Wildlife and National Parks (DWNP), municipals
NGOs Malaysian ● Promote and share councils and non-government agencies (NGOs) such as the Malaysian
Association for knowledge about Nature Society (MNS), the World Wide Fund for Nature (WWF),
Environmental environmental health. Treat Every Environment Special (TrEES) and Wetlands International.
Health (MAEH) ● To encourage interest for the An example of EE programs conducted is the School Nature Clubs or
Profession of Environmental Kelab Pencipta Alam (KPA). KPA is an example of EE-related clubs
Health Practitioners. active in schools and supported by the Ministry of Education. The
Association of ● Increase professionalism club’s objectives are to promote interest and understanding as well as
Environmental to promote student involvement in any sort of conservation of
among members
Health Officer environment activities as the introduction to environmental health
● Gather personnel who are should be introduced as early as primary schools. However, absence
(EHOM)
involved in environmental of specific environmental education syllabus in schools makes it
health. difficult for teachers alone to address environmental health without
● Provide association to assistance from the experts (Loubser et al., 2014). Information and
agencies which are involved guidance from environmental health specialist can be a great help to
improve the current content of environmental health education.
in environmental health.
Sungai Kim-kim episode highlights the importance of our school
health program to be continuously conducted and not only looking
into the school canteens. The holistic nature of public health risk
The stakeholder’s views on environmental health are very vital for assessment process should be the primary concern, especially in the
the improvement and enforcement of laws, policies, prevention public interest areas.
control and effective management of public health. The support from
the government and all related stakeholders are pertinent to deliver an
effective environmental health services. Meanwhile, environmental health professionals are dedicated to
conserve the environment to lower the risk of human disease, as well
CHALLENGES IN DELIVERING IN ENVIRONMENTAL as improving human health and well-being. The quantity and quality
HEALTH SERVICES of the environmental health professionals have been an issue (Walker
et al., 2018; Massoudi et al., 2012). Knechtges and Kelly (2015) in
Crisis, Rumours And Communication their paper had focused on the issue of educating environmental
health professionals. However, it is important to know the difference
When a crisis occurs in a country, the most valuable thing is the between training and education. In simpler words, training is the
availability of information. There is a need to distinguish between the "Know-How" and education is the "Know Why". When practicing
real news or rumours especially with the emergence of information environmental health, it is not enough to rely on "Know-How" alone.
sharing by social media that can be spread by seconds. The roles of "Know Why" also plays an important role in understanding the
stakeholders are vital to control the information sharing whether underlying reasons behind a procedure or standard. This distinguishes
among the stakeholders themselves or to the public. The inconsistency professionals from technicians. Environmental Health professionals
of report by stakeholders causing confusion among the authorities to with proper education and training will be able to develop solutions to
take immediate action. Public also experiencing difficulty due to unprecedented problems that may not be routinely procedural. New
ineffective communication and updates regarding the major issues independent regulatory board or body (Malaysian Allied Health
from the government through media. This led to a rumour going Profession Council-MAHPC, 2020) established according to the
driving into unnecessary panic. Allied Health Professional Act 774 will certify the graduates to
become competent personnel and also contribute towards the reasons
Some important issues that can be looked into from any tragedies why environmental health practitioners will be involved in the
are the role of media in providing timely and useful information decision-making process as well as raising the standard of the allied
during the critical time (Leask et al., 2010). Information sharing health profession. This independent regulatory body is important to
between agencies also needs to be strengthened. For example, in assess the training or courses that has been completed by the
handling toxic waste arriving at the port, the first agency involved is graduates and are sufficient to ensure the graduates to become a
the Royal Malaysian Customs Department (RMCD). The RMCD will competent person and able to conduct their work effectively.
need to share detailed information on hazardous chemicals with all
stakeholders such as the Department of Environment, Ministry of Many Environmental Health Science (EHS) academic programs
Health Malaysia, local authorities, and others. This step needs to be in colleges and universities are facing budget reduction due to the low
continued in every user chain until the toxic substance becomes waste number of students enrolled each year. The reasons behind this may
and sent to a licensed disposal site for appropriate action. be due to fewer job opportunities and poorly defined career
Barriers to Effective Education opportunities for environmental health degree holders within the
government and private sector. The rising number of online courses
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and degree programs also poses significant challenges to EHS policies in delivering environmental health services and solve all the
academic programs. Higher education institutions should also conduct environmental issues (Chin et al., 2019).
knowledge sharing sessions with the field practitioners and the
industry more frequently to share the new available information from Other challenges that can disrupt the success of an environmental
the research that had been conducted by the experts as well as getting health delivery system are the lack of training of Environmental
inputs or feedbacks from the industry on how the situations may differ Health Officials on how to assist or respond to environmental
in the field. problems in an integrated and comprehensive way. With only a small
number of them who have been trained to predict and prevent the
Besides environmental health professionals, other health pollution to occur or make effective use of the reduction tools beyond
professionals and clinicians should also involve or take part in an the command-and-control regulations. Some challenges in
environmental health education program to take care of the workers environmental training are to promote “competent person” to all
and the public. Mujuru and Niezen (2004) stated that due to the Department of Environment (DOE) staff, industries, consultants and
limitation on including environmental health course in nurse's services providers, promoting the accumulation of CPD hours and
education curriculum may lead them to fail to provide sufficient promoting the transformation of command and control of enforcement
emergency care during the threats of environmental exposures are approach into guided self-regulation. There is also lack of
expected as they do not consider the environmental exposure while Environmental Health Surveillance System to enable EH
tracking a patient's history. Education department should collaborate professionals to make risk decision-making process easier, which will
with environmental expertise when constructing or planning the cause many EH issues being neglected and not being pursued by EH
environmental health syllabus in schools and higher education levels. professionals and might be taken up by other professionals. Many EH
professionals in Malaysia were trained as reactive professionals rather
The success of environmental education is challenged by a few than proactive professionals, they generally proceed with current and
barriers such as conceptual barriers, logistical barriers, and lack of prediction and forecasting skills. They were trained but not
educational barriers. Conceptual barriers are when there is a lack of officially certified by any regulatory body and perform work on the
agreement on the scope and content or syllabus of the EE. The basis of attachment. Regulatory body who governs the
shortage of attachment and training has failed to prepare the students professionalism, ethics and competency should be made available to
or future environmental health practitioners for the environmental and ensure the professionalism of the profession.
public health workforce, ensuring them to be capable of coordinating
and come out with alternative approaches to EH problems. Logistical Solving Methods by Stakeholders
barriers mean there is a lack of time, financial support, and resources.
Cooperation between government and non-government agencies in Solving methods or decision-making process are vital to have an
providing funds and resources to prepare a suitable comprehensive effective environmental health delivery. The authorities usually allow
syllabus can be a great help in promoting environmental education the law makers and the stakeholders to implement and enforce the law
among environmental health professionals (Tewksbury and Harris, needed to work together effectively with limited resources.
1982). For instance, Sanitary Survey activities should utilise the Participants in stakeholder processes have a variety of
Department of Environmental (DOE) database on the river quality problem-solving options, each of which has strengths and limitations.
monitoring system and water quality index. Teachers or trainers with Number of, facilitators, and participants have not made effective use
wide knowledge and experiences on environmental health will be a of, knowledge and practices developed over time. For example, in the
great help to solve educational barriers in environmental education as issue of Sungai Kim Kim pollution, it has had been timely reported
they can share their experiences and will be able to expose the reality but there is no significant action taken by the authorities
of environmental health in Malaysia. However, this strong EH (Keshavarzifard et al., 2018). The scientific monitoring data is needed
collaborative partnership should make the ministries able to work to treat it with high importance and governing bodies should be
without border especially in terms of data sharing which is more working closely with those researchers for the benefits of public,
economical for environmental monitoring activities. especially in air and water related work (Yap et al., 2019).

Chamhuri (2005) stated that the lack of coordination between The conflicting role of the federal and state governments can be
NGOs, governments, and media agencies has caused a delay in problematic in dealing with environmental issues when the state and
assistance and the distribution of aid during the Asian tsunami disaster federal governments are of different political backgrounds. Take for
back in 2004. Absence on early system warning on this kind of natural example the Integrated River Basin Management (IRBM) issue. The
disaster also contributes to this massive destruction. Cooperation framework adopted is still less effective in addressing rivers and water
between media and government agencies can also help to educate the management issues in Malaysia (Chuan et al., 2013). There are too
public on this natural disaster besides distributing the information in many government agencies involved in various aspects of river
all stages before, during, and after more accurately and quickly. Many management, with no single agency directly responsible. The issue of
studies have proved that public awareness, public concern for the federal and state government disputes over water supply is one
environment and the readiness to bear the cost of the adverse impacts example of non-integrated management. According to Chan (2012),
of human activities are the major factors that can help to overcome the rivers and urban drainage must be managed well before achieving
fright of natural disaster which in this case was the tsunami which is a good water quality in order to maintain water resource sustainability.
whole new thing to us. Japan is a good example on how they manage Poor understanding and change of top management staff have led to
the risk, educate, and create awareness among citizens during natural delays in the Integrated Urban Water Management System (IUWM)
disasters. Environmental experts also highlighted how the information which requires alignment of urban development and basin
is being delivered to the public (Ramírez et al., 2019). For example, management to achieve sustainable economic, social and
during the current air pollution risk communication, the use API or environmental goals (Bahri, 2012).
Air Pollutant Index is used to monitor the situation. When the API
result comes out, stakeholders cannot assume that the public can DELIVERY OF ENVIRONMENTAL HEALTH: THE WAY
understand the meaning behind it. Another technical barrier to the FORWARD
successful delivery of environmental health is the language. Most
sources are available in English and some of it come in Bahasa The Environmental Health service in Malaysia encompasses a wide
Malaysia, but not in spoken languages in Malaysia such as Mandarin range of public health institutions from government, private and
and Tamil. Public awareness and support for environmental protection non-governmental organizations (NGOs) who provide health services
play an important role in the success of government efforts and through prevention, control and law enforcement. Despite the
challenges faced today on issues of globalization and sustainable
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development, the delivery of Environmental Health services has been mitigation plans. One of the neglected duties will be the post-disaster
a major step in the face of challenges and concerns in maintaining the mitigation actions and strategies; EH professionals should be
strength of the current public health system. The rapid development of equipped with a group of professional in qualitative research, to
high-tech physical and industrial as well as technological understand the thematic, perception and text analytics, in the context
advancements in the field of public health requires increased of understanding needs or improvement needed, in the event of
knowledge and skills in the field of Environmental Health to address upcoming disaster.
new emerging issues. These developments affect the roles and
responsibilities of public health including environmental health The failure rate in collaborations especially in communication
delivery system that needs to be expanded, and streamlined. process for information sharing is a major concern (Marek et al.,
2015). According to Eide et al. (2014), cross-agency collaboration is
Environmental Health Groups have an identifiable 'stake' in the complex and difficult to manage because each of the agency possess
future with a set of goals and measurable criteria or indicators. The different skills, procedure, knowledge and competencies. Hence, the
potential future of Environmental Health delivery system, must key challenges of collaboration can be categorized into efficient
consider the accessibility of information technology and which is communication across agencies, establishing and maintaining shared
associated with decentralization of decision-making in large situational awareness and achieving adequate organizational
institutions; increased transparency of organizations whose decisions understanding. By defining the core competencies required for
have an impact on environmental quality; enhanced capacity of successful environmental health at the local level and beginning to
communities to participate in stakeholder processes; and policy find consensus about their adoption, the Environmental Health system
commitments made by government agencies to improve stakeholder can be strengthened, and the programs' capacity building can be
engagement. developed. A robust system to monitor environmental quality trends
and information used to mitigate potential health concerns, resource
Enabling Information Technology Knowledge Sharing planning, risk analysis and decision-making should be provided by the
environmental health surveillance system. The environmental health
Environmental Health is a public health field that addresses a variety surveillance system is not fully being implemented by Environmental
of factors around us that affect our physical and mental well-being. Health officers, no absolute system under Environmental Health
Malaysia's challenge in delivering Environmental Health services in fields, most coming from the other programs. Environmental Health
the future need to be more realistic. Effective delivery of surveillance systems such as using of software available within the
environmental health services includes partnerships collaboration agency to conduct research, save the record, communication, analysis
between agencies in maximizing the use of data and information to and interpretation of data, and tasks to be reported in environmental
generate new knowledge that can be exchanged, shared and agents that is needed to be considered by the Environmental Health
incorporated with other agencies (Erwin et al., 2019). Like other practitioners. At the same time, the opportunity to use Information
developing countries, Malaysia needs to have a comprehensive Technology for the development of Environmental Health services.
community of Environmental Health (EH data base) systems as well Environmental health surveillance system (record, analyse, and
as a cohort exposed to environmental agents so that environmental predict) environmental agents need to be considered.
epidemiological methods, modelling techniques as well as forecasts of
exposure risk and health impacts can be evaluated either in the short Quality Decision Making Processes by Stakeholder Engagement
and long term. For example, the use of Pasir Gudang community data
exposed to health threats from water and air pollution is used in the Effective delivery of environmental health services includes strategic
assessment of exposure based on scientifically and systematically alliances and collaborations between academic institutions and health
planned methods. In addition, other than conducting cross-sectional departments to promote evidence-based decision-making (Brooks et
epidemiological studies and case studies, retrospective and al., 2019). To tackle local issues and improve resilience,
prospective cohort studies should also be carried out in the Environmental Health practitioners should broaden and enhance
communities involved so that we can identify hazards or mitigation in current relationships by working together with other public health
the community at risk for preventive measures to be identified in the disciplines such as laboratories, epidemiologists, community health
early stages before the issue becomes more serious. educators), NGOs and universities. Environmental health practitioners
are important collaborators in optimizing the value of translational
During the Crisis and Disaster Management, the objective of the research. It is important to establish new strategic partnerships
Environment Health professionals is to prevent and reduce any between academic and government researchers and Environmental
possible misfortunes from risks and hazards, guarantee instant and Health practitioners in the environmental health field.
provide suitable help to the survivors of the disaster. The
Environment Health Professional aims to accomplish quick and According to (Wisner and Adams, 2003), the involvement of
effective recovery affect from the disaster. Besides that, even though various parties in the Environmental Health issue is necessary to
the fact of the information, data and resource sharing can improve the rectify the deficiencies in the management of sectoral nature. This
standard of operating procedure of Crisis and Disaster Management, indicates that consensus as a result of the agreement of all
there might be apparent gap in government joint effort and stakeholders in addressing environmental issues can improve the
coordination between different stakeholders in solving the quality of environmental management in Malaysia. Strategic
environment issues (Dahlan et al., 2013). According to Maidin et al. collaborations between higher learning institutions and health
(2015), the lack of collaboration and exchange of information through departments will promote evidence-based decision-making in local
agencies will complicate solutions to environmental issues. Each health services (Erwin et al., 2019). This is reflected in the
organization has a propensity to keep information relevant. Research involvement of various ministries, agencies, educational institutions
carried out has identified the challenges of cross-agency collaboration and the public in dealing with the ever-discussed dengue outbreak.
in information sharing (Othman et al., 2014). This is reflected in the Establishment of a National Dengue Special Task Force aimed at
high commitment given by Environmental Health practitioners in all mobilizing agencies and communities in the prevention and control of
government agencies, private and foreign agencies and NGOs that dengue. The task force includes ministries from the Ministry of Health
have been working hard to monitor, manage and evaluate the ongoing (MOH), the Ministry of Housing and Local Government, the Ministry
COVID-19 outbreak to address and help the community. The of Human Resources, the Ministry of Education, the Ministry of
‘frontline troops’ in the public health to prevent disease are the local Higher Education, the Ministry of Defense, the Ministry of Works and
Environmental Health practitioners. However, there are some specific the Ministry of Communications & Multimedia, including the Local
suggestions that can be applied to improve the management system to Authorities (PBT). All partners have their own jurisdiction outside the
be more efficient, systematic and effective for a long-term community
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health sector to implement strategies in the fight against dengue Participation of Structured Stakeholders' in Operational
infections. Guideline Production.

There is a strong need to prepare Environmental Health The preparedness of Environmental Health practitioners in the face of
practitioners to address the challenges and environmental health future challenges, especially in relation to environmental issues, must
problems facing the country in the next century. The value of be mobilized. According to Linzalone et al. (2019), local authorities
competency is required by every Environmental Health practitioner to and government agencies should have compact and precise
ensure they are able to attend important meetings and operational guidelines to provide case-related health information in
decision-making processes. Environmental Health practitioners must reports. The involvement of Environmental Health Practitioners is
have a certification system. A proposal for members under the crucial in the implementation of tasks facing the risk of infection to
Malaysian Allied Health Profession Council (MAHPC) to set up a investigate, screen and isolate at-risk individuals in law enforcement.
certification of competency body and renewal practising abilities Enforcement of the Public Health Law in Malaysia includes
specifically for the field of Environmental Health (e.g. Environmental legislation such as the Prevention and Control of the Infectious
Health Legislation, Environmental Health Risk Assessment, Diseases Act 1988 (Act 342), Destruction of Disease-Bearing Insects
Environmental Health Epidemiology, Drinking Water Quality, Food Act 1975 (Act 154), Food Act 1983 (Act 281) and Food Regulation
Quality and Safety, Vector Control, International Health Control, 1985, Food Hygiene Regulation 2009, Tobacco Product Control
Industrial Hygiene in workplaces) to strengthen and maintain Regulations 2004 and the Hydrogen Cyanide Act (Fumigation) 1953
life-cycle competencies. In addition, with the establishment of this and etc. For example, the power given under the Prevention and
competency body, the Environmental Health profession can determine Control of the Infectious Diseases Act 1988 (Act 342) allows District
the appropriate qualifications of each of its members. These Health Officers and Public Health Physicians in a supervisory role of
professional bodies can also focus and supervise matters relating to Environmental Health Officers to prosecute individuals who have
Environmental Health Professions which include training, made or violated legal instructions order to protect the public from
competency and professional development. From this qualification, health hazards.
Evaluation Committee for Expert will verify and recommend to
Council for Expert Registration and certification. Examples of recent Court actions are often initiated against individuals who refuse to
work on competencies in this field that were implemented in United pay a compound imposed on other notices that could be compounded
States include The Public Health Functions Workgroup Project, by statute. For offenses that cannot be compounded, prosecution in
Competency-Based Curriculum Work Group, The National Public court is carried out from time to time by an authorized officer.
Health Performance Standards Program, The Crossroads Colloquium: Enforcement of public health laws aims to raise awareness among the
An Examination of the Educational Needs for Environmental Health public. The role of the Environmental Health Officer in providing
and Protection, The Public Health Faculty/Agency Forum and information and awareness to the public to understand that a lack of
Committee of National Environmental Health Association (NEHA) on health can have a negative impact on them and ultimately be at risk.
the Future of Environmental Health (Tobergte and Curtis, 2013). In addition, public enforcement activities include the issuance of
notice and merger of offenses such as mosquito breeding, smoking in
The disaster and outbreak management body can achieve their non-smoking areas that are gazetted and notices of closure of
target during the join venture of interagency collaboration, vertical premises. This shows the scope of the environmental health field in
and horizontal integration. The definition of vertical integration is the law enforcement is very challenging. The challenges and risks that
collaboration between a single organization such as the local Environmental Health Officers face are increasing with new emerging
government between two different levels. Horizontal integration is the issues. Risk assessments need to be carried out as health threats
integration among different disaster management organization. For remain.
example, the incorporation in management and organize the
development between the government body, private sector and other Municipal issues such as population density and economic sector
stakeholders in disaster management such as the participation from growth and increased migration are seen to cause various infections.
the Fire and Rescue Department Malaysia (HAZMAT Team), This threat is a serious concern for the involvement of Environmental
National Disaster Management Agency (NADMA), Ministry of Health practitioners in Malaysia as evidenced by the recent
Health Malaysia (MOH), Royal Malaysian Police and Ministry of COVID-19 pandemic. The Malaysian government's action in
Defence Malaysia (MinDef). Stakeholders should engage with implementing the Movement Control Order (MCO) has led to a
Environmental Health practitioners in line with the decision that they decrease in the number of daily COVID-19 infections. In the early
need to establish. According to Menya et al. (2016), the collaboration stages of confusion among the public and enforcement agencies on
efforts bring a lot of benefits to the disaster and outbreak management roles and jurisdictions in implementation, the challenge of obtaining
as it can boost the process of decision making among government and compliance from the public for movement control measures was not
stakeholders. Among them, Research and Development (R&D) effectively disseminated. For Environmental Health Officers the
between stakeholders' especially Ministry of Science, Technology and challenge in tracking contacts and obtaining movement history
Innovation who are involved in innovation and intervention study in information properly is very critical. Therefore, short and long-term
overcoming environmental health problems. During the Malaria preparation in the face of any infection is necessary. In addition, the
outbreak, Environmental Health practitioners will investigate, survey threat of infectious diseases such as dengue and tuberculosis are a
and control the disease. Environmental Health practitioners will major concern. For emerging diseases, strategies to strengthen the
collaborate with laboratories for sending the sample, survey and workforce's ability to detect new syndromes or new disease patterns
control will involve public and local agencies. Besides that, Bryson et are needed. Monitoring through case investigations and outbreaks will
al., (2010) also had stated that this collaboration contributes a lot to prompt early detection of new pathogens and enable the development
improve the way of the service delivery and solving complicated of control and prevention methods. As a precursor to disease control
problems. In addition, the Epidemic Intelligence Program (EIP) and prevention activities, there is a need to strengthen the surveillance
should be included as the key element in the Environmental Health system in preparation for the new emergence of infections. All of
domain. It aims to strengthen the practice of applied epidemiology for these require a certain level of responsiveness by the Environmental
enhancing public health surveillance and outbreak investigation. Health practitioner. Steps must be taken to ensure proper control and
Therefore, the development of competencies in surveillance and rapid prevention activities such as contact tracking, case investigation and
response, and conduct of study projects will contribute directly to the enforcement procedures. Most importantly, standard guidelines and
enhancement of public health surveillance. protocols are provided to every manpower in providing
Environmental Health services. Periodic training for an

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Environmental Health practitioner is another important step in CONTRIBUTION STATEMENT

ensuring preparedness in all situations.
MAEH Focus Group Discussion 2020 was held via teleconference
The competency of policy development implies that an from 25 June - 25 July 2020. NK, FSAA, SMSB, AAAM, MAAJ, and
Environmental Health practitioner should be able to go to the FAS conceived the forum and drafted the first version of the
Malaysian Allied Health Profession Council (MAHPC) and argue for discussion. SK, SZ, MS, SAI, AAM, KAM, NNK, and SNAT
a specific policy. This task may not be relevant to the starting analyzed the topic. All participants produced the article and approved
position. While these tasks are very important to work effectively, the final version.
they also represent a basic part of job knowledge rather than
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