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NATIONAL HEALTHCARE ESTABLISHMENTS & WORKFORCE STATISTICS 2010 HOSPITALS

CHAPTER 3 | MATERNITY SERVICES IN MALAYSIAN HOSPITALS AND MATERNITY HOMESRavichandran J1, Ravindran J2, Zaleha AM3, Sharmini DP4, Jumeah S2, Arunah C5*, Faizah A5*, Arpah A6.

1. Hospital Sultanah Aminah, Johor Bahru, 2. Hospital Kuala Lumpur 3. Universiti Kebangsaan Malaysia Medical Centre 4. Hospital Seberang Jaya 5. Clinical Research Centre, Ministry of Health 6. Medical Development Division, Ministry of Health.

* Corresponding author.

Summary: There were 315 hospitals and 22 maternity homes that delivered maternity services in 2010. These services were provided by 756 Obstetrics and Gynaecology (O&G) specialists together with a team of medical officers, O&G trainees and nurses. There was an increase in Caesarean section rates (21.9%) in 2010 when compared to 20.8% in 2009. The private sector reported a higher rate (34%) compared to the public sector (19%). Deliveries to midwife ratio in the private sector was 150:1 compared to 198:1 in the public sector. The private sector had almost 6 times more specialists per 1,000 deliveries compared to the public sector. Overall, there is maldistribution in the workforce in terms of workload between public and private hospitals and between different regions in the country.

This survey on maternity services was conducted in all inpatient establishments that receive patients and provide nursing and midwifery care for women in labour or for women immediately after childbirth. Facilities with no inpatient services that conduct deliveries such as the rural health clinics in Sabah and Sarawak were excluded in this survey.

There were a total of 315 hospitals with maternity services and 24 maternity homes in 2010. However, 2 maternity homes were excluded as these facilities did not conduct any deliveries.

The overall hospital response rate was 74.92% (100% from the public sector and 56.6% from the private sector). The response rate from the maternity home was 59.09% (13 of 22 maternity homes).

Maternity Hospitals

facilities

A total of 315 hospitals provided maternity services in Malaysia, of which 182 (57.8%) were from the private sector and 133 (42.2%) from the public sector (Table 3.1).

Wilayah Persekutuan Kuala Lumpur (WPKL) recorded the highest density of maternity services at 0.21 per 10,000 population, followed by Pulau Pinang at 0.15 per 10,000 population and Sarawak at 0.13 per 10,000 population. The lowest densities of hospitals were in Perlis, followed by Melaka and Terengganu (Table 3.1).

A total of 1,579 delivery beds were available nationwide, of which 863 (54.7%) were in the public sector and the remaining 716 (45.3%) in the private sector. This was equivalent to 2.15 delivery beds per 1,000 deliveries in the public sector and corresponds to 6.97 beds per 1,000 deliveries in the private side. The national average was 3.13 per 1,000 deliveries. In the public sector, 12 out of 15 states (80%) did not conform to this average. All private hospitals have met this national average (Table 3.2).

Nationwide, there were 81 public hospitals with operation theatre (OT) facilities, of which only 29 (35.8%) had dedicated maternity OT. This translates to 0.07 dedicated OT per 1,000 deliveries (Table 3.3).

There were a total of 139 obstetrics high dependency unit (HDU) beds, of which 106 beds (76.26%) were in the public sector. The national average of obstetrics HDU beds per 1,000 deliveries was 0.28. Kelantan had the lowest number of HDU beds (0.06 beds per 1,000 deliveries), followed by Negeri Sembilan (0.12), Sabah and WP Labuan (0.14). There were no obstetrics HDU beds available in Melaka in the public sector (Table 3.4).

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Activities

A total of 504,104 deliveries were reported from both public and private hospitals in 2010. This did not include home deliveries, maternity home deliveries and deliveries in transit. Of these, 401,398 (79.6%) deliveries were from the public sector and 102,706 (20.4%) from the private sector (Table 3.5).

Kelantan had the highest rate of deliveries at 231 per 10,000 population followed by WPKL (227) and Terengganu (200). Perak had the lowest rate of deliveries at 155 per 10,000 population. All the states registered proportionally higher delivery rates in public hospitals (Table 3.5). Of the total deliveries in Malaysia, 363,472 were spontaneous vertex deliveries (SVD). Kelantan and Sabah recorded the highest density of SVD with 894.780 deliveries per 1,000 live birth. Whereas, Selangor and Melaka had the lowest density of SVD with 532 and 566 per 1,000 deliveries, respectively (Table 3.6). There were more vaginal breech deliveries in the public (2,224) than the private (151) sector (Table 3.7).

About 5.4% of the total deliveries were instrumental, of which about 24,347 (4.83%) were conducted using the vacuum and 2,856 (0.6%) using forceps. Overall, this report showed that the number of instrumental deliveries were significantly higher in the private sector. It was also noted that the rate of vacuum deliveries in the private sector was 1.2 times higher than in the public sector (Table 3.8 and 3.9).

There were a total of 110,347 Caesarean sections (CS) in 2010. This accounted for 21.9% of all deliveries captured in this survey, slightly higher than the rate reported in the previous NHEWS 2008-2009 which was 20.8%2. Compared to the average rate across OECD countries which accounts for 25.8 per 100 live births, Malaysia had a significantly lower rate of CS at 20.7 per 100 live births1 (Table 3.10).

A total of 34,655 (33.74 per 100 deliveries) of CS were performed in the private sector and 75,692 (18.86 per 100 deliveries) CS were recorded in public hospitals. The states with the lowest proportion of CS were Terengganu at 12.2 per 100 deliveries, followed by Kelantan at 13.84 per 100 deliveries. WPKL had the highest proportions of deliveries under CS (27.02 per 100 deliveries), followed by Perak (27.0 per 100 deliveries). In the private sector, Melaka had the highest CS rate (49.98 per 100 deliveries) with Terengganu having the lowest (19.43 per 100 deliveries). In the public sector, WPKL had the highest CS proportion at 29.97 per 100 deliveries while Terengganu again recorded the lowest (12.12 per 100 deliveries) (Table 3.10).

A total of 3,735 deliveries (0.74 per 100 deliveries) were from multiple pregnancies, of which 3,131 deliveries (0.78 per 100 deliveries) were in public hospitals (Table 3.11).

There were 498 maternal complications with eclampsia, which accounted for 0.99 cases per 1,000 deliveries. A total of 7 states did not report any cases (Table 3.12).

A total of 8,998 cases of post partum haemorrhage (PPH) were reported nationwide, which accounted for 1.8% of total deliveries. Perak had the highest PPH rate of 4.3% followed by Pulau Pinang at 2.69%. The lowest rate recorded was in Melaka at 0.23%, followed by Terengganu at 0.32%. There were 295 recorded cases of Caesarean hysterectomies in this survey, which was 0.06% of total deliveries (Table 3.13).

Human Workforce

There were 756 obstetricians and gynaecologists (O&G) recorded in this survey, of whom 310 (41%) were in the public sector and 446 (59%) in the private sector. This equates to 5.49 specialists per 100,000 female population compared to the OECD standards of 26.8 specialists per female 100,000 population1. When translated into per 1,000 deliveries, the private sector had almost 6 times more specialists compared to the public sector (Table 3.14).

There were a total of 741 medical officers and 172 trainees in O&G working in the maternity services in 2010. A total of 87.18% of these were working in the public hospitals. At least 23.2% of medical officers were trainees. The majority of them were in WPKL, followed by Selangor, Sabah and Kelantan (Table 3.14).

There are 11,140 midwifery trained staff nurses presently registered with the Midwifery Board of Malaysia who are presently employed in public hospitals. However, in this report only 2,025 (18.18%) were working in the labour rooms.

The delivery to midwife ratio in the private and public sectors were 150:1 and 198:1 respectively. These figures were significantly lower than the recommended ratio of 35:13. The Private Healthcare Facilities and Services Act Regulation 147 (5) requires one midwife to take care of one patient in labour, not more than 3 patients in the antenatal ward and not more than 4 patients in the postnatal ward4. The records in this survey indicate that these regulatory requirements are not being adequately met. This survey also revealed that there were 850 clinic assistants working in the private sector (Table 3.15 and 3.16).

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Maternity Homes

There were 22 maternity homes identified in the country that collectively had 90 delivery beds, 36 medical officers and 4 specialists. All 22 maternity homes were invited to participate in this survey. However, only 13 (59.09%) responded. The maternity homes in Selangor contributed 27 beds whereas Perlis had 2 beds. A total of 2,067 deliveries were conducted in the 12 participating maternity homes. The majority of deliveries (2,033 deliveries) were spontaneous vaginal deliveries but records show that 6 breech and 21 vacuum extractions were also conducted in these maternity homes (Table 3.17 – 3.24).

Limitations

1. Misinterpretation of the variables. For example, in cases of PPH, in the absence of a data definition, some hospitals reported only primary PPH, while others reported total PPH including secondary PPH.

2. Different reporting arrangements resulted in some hospitals reporting the total number of delivery beds. However, others only reported functional delivery beds.

3. Difficulty in non specialist hospitals reporting the number of nurses in different maternity wards. It is common practice for the responsibility of labour and obstetrics wards to be shared in these hospitals.

References

1. Organisation for Economic Co-operation and Development. Health at a glance 2011, OECD indicators. Paris: OECD Publishing; 2011.

2. Clinical Research Centre. National Healthcare Establishments & Workforce Statistics (Hospital) 2008-2009. Kuala Lumpur 2011

3. Royal College of Obstetricians and Gynaecologists. High quality women’s healthcare: a proposal for change. London: RCOG Press; 2011.

4. The Private Healthcare Facilities and Services Act Regulation 147 (5)

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Table 3.1 Number, Density and Percentage of Hospitals Providing Maternity Services in Malaysia by State and Sector, 2008-2009 & 2010

STATE SECTOR

YEAR 2008-2009

YEAR 2010

TOTAL HOSPITALS PROVIDINg MATERNITY SERVICES

HOSPITALS PROVIDINg MATERNITY WITH

SPECIALISTS

NO.PER 10,000

POPuLATION

% Of fACILITIES bY SECTOR

NO.PER 10,000

POPuLATION

% Of fACILITIES bY SECTOR

NO.% PER

MATERNITY HOSPITAL

Malaysia Public 131 - 42.1 133 - 42.20 53 39.80Malaysia Private 180 - 57.9 182 - 57.80 182 100.00Malaysia Total 311 0.11 100.0 315 0.11 100.00 235 74.60Perlis Public 1 - 100.0 1 - 100.00 1 100.00Perlis Private 0 na na 0 na na 0 naPerlis Total 1 0.04 100.0 1 0.04 100.00 1 100.00Kedah Public 9 - 45.0 9 - 47.40 4 44.40Kedah Private 11 - 55.0 10 - 52.60 10 100.00Kedah Total 20 0.10 100.0 19 0.10 100.00 14 73.70Kedah & Perlis Public 10 - 47.6 10 - 50.00 5 50.00Kedah & Perlis Private 11 - 52.4 10 - 50.00 10 100.00Kedah & Perlis Total 21 0.10 100.0 20 0.09 100.00 15 75.00Pulau Pinang Public 6 - 26.1 6 - 26.10 3 50.00Pulau Pinang Private 17 - 73.9 17 - 73.90 17 100.00Pulau Pinang Total 23 0.15 100.0 23 0.15 100.00 20 87.00Perak Public 14 - 50.0 14 - 50.00 5 35.70Perak Private 14 - 50.0 14 - 50.00 14 100.00Perak Total 28 0.12 100.0 28 0.12 100.00 19 67.90Selangor & WP Putrajaya Public 11 - 20.8 12 - 21.10 8 66.70Selangor & WP Putrajaya Private 42 - 79.2 45 - 78.90 45 100.00Selangor & WP Putrajaya Total 53 0.11 100.0 57 0.10 100.00 53 93.00WP Kuala Lumpur Public 3 - 7.7 3 - 8.60 3 100.00WP Kuala Lumpur Private 36 - 92.3 32 - 91.40 32 100.00WP Kuala Lumpur Total 39 0.23 100.0 35 0.21 100.00 35 100.00Selangor & WP Putrajaya & WPKL Public 14 - 15.2 15 - 16.30 11 73.30Selangor & WP Putrajaya & WPKL Private 78 - 84.8 77 - 83.70 77 100.00Selangor & WP Putrajaya & WPKL Total 92 0.14 100.0 92 0.13 100.00 88 95.70Negeri Sembilan Public 6 - 54.5 6 - 50.00 2 33.30Negeri Sembilan Private 5 - 45.5 6 - 50.00 6 100.00Negeri Sembilan Total 11 0.11 100.0 12 0.12 100.00 8 66.70Melaka Public 3 - 50.0 3 - 50.00 1 33.30Melaka Private 3 - 50.0 3 - 50.00 3 100.00Melaka Total 6 0.08 100.0 6 0.07 100.00 4 66.70Johor Public 11 - 29.7 11 - 28.20 6 54.50Johor Private 26 - 70.3 28 - 71.80 28 100.00Johor Total 37 0.11 100.0 39 0.12 100.00 34 87.20Pahang Public 10 - 58.8 10 - 58.80 3 30.00Pahang Private 7 - 41.2 7 - 41.20 7 100.00Pahang Total 17 0.11 100.0 17 0.11 100.00 10 58.80Terengganu Public 6 - 85.7 6 - 85.70 2 33.30Terengganu Private 1 - 14.3 1 - 14.30 1 100.00Terengganu Total 7 0.07 100.0 7 0.07 100.00 3 42.90Kelantan Public 10 - 76.9 10 - 76.90 4 40.00Kelantan Private 3 - 23.1 3 - 23.10 3 100.00Kelantan Total 13 0.08 100.0 13 0.08 100.00 7 53.80Sabah & WP Labuan Public 21 - 77.8 22 - 81.50 5 22.70Sabah & WP Labuan Private 6 - 22.2 5 - 18.50 5 100.00Sabah & WP Labuan Total 27 0.08 100.0 27 0.08 100.00 10 37.00Sarawak Public 20 - 69.0 20 - 64.50 6 30.00Sarawak Private 9 - 31.0 11 - 35.50 11 100.00Sarawak Total 29 0.12 100.0 31 0.13 100.00 17 54.80

Abbreviation: na – not applicable

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Table 3.2 Number, Density and Percentage of Delivery beds, Ratio of Delivery beds to Deliveries by State and Sector, 2010

STATE SECTORDELIVERY bEDS

NO. % Of bEDS bY SECTOR

DELIVERY bEDS PER 1,000 DELIVERIES

Malaysia Public 863 54.70 2.15Malaysia Private 716 45.30 6.97Malaysia Total 1,579 100.00 3.13Perlis Public 6 100.00 1.52Perlis Private na na naPerlis Total 6 100.00 1.52Kedah Public 58 57.40 1.97Kedah Private 43 42.60 7.98Kedah Total 101 100.00 2.90Kedah & Perlis Public 64 59.80 1.92Kedah & Perlis Private 43 40.20 7.98Kedah & Perlis Total 107 100.00 2.76Pulau Pinang Public 46 41.10 3.28Pulau Pinang Private 66 58.90 5.43Pulau Pinang Total 112 100.00 4.28Perak Public 80 69.60 2.69Perak Private 35 30.40 5.25Perak Total 115 100.00 3.16Selangor & WP Putrajaya Public 103 41.00 1.69Selangor & WP Putrajaya Private 148 59.00 4.70Selangor & WP Putrajaya Total 251 100.00 2.71WP Kuala Lumpur Public 42 16.90 1.81WP Kuala Lumpur Private 207 83.10 14.04WP Kuala Lumpur Total 249 100.00 6.55Selangor & WP Putrajaya & WP KL Public 145 29.00 1.72Selangor & WP Putrajaya & WP KL Private 355 71.00 7.68Selangor & WP Putrajaya & WP KL Total 500 100.00 3.83Negeri Sembilan Public 39 62.90 2.93Negeri Sembilan Private 23 37.10 6.15Negeri Sembilan Total 62 100.00 3.64Melaka Public 23 54.80 2.17Melaka Private 19 45.20 6.07Melaka Total 42 100.00 3.06Johor Public 91 50.60 1.82Johor Private 89 49.40 7.14Johor Total 180 100.00 2.88Pahang Public 70 79.50 3.14Pahang Private 18 20.50 5.77Pahang Total 88 100.00 3.46Terengganu Public 37 92.50 1.80Terengganu Private 3 7.50 14.22Terengganu Total 40 100.00 1.93Kelantan Public 66 86.80 1.98Kelantan Private 10 13.20 4.76Kelantan Total 76 100.00 2.14Sabah & WP Labuan Public 120 80.50 2.24Sabah & WP Labuan Private 29 19.50 9.83Sabah & WP Labuan Total 149 100.00 2.63Sarawak Public 82 75.90 2.27Sarawak Private 26 24.10 5.72Sarawak Total 108 100.00 2.66


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Table 3.3 Number and Density of Public Hospitals With OT facilities and Dedicated OT in Malaysia by State, 2010

STATEOT fACILITIES DEDICATED OT

NO. Of HOSPITAL PER 1,000 DELIVERIES NO. PER 1,000 DELIVERIES

Malaysia 81 0.20 29 0.07

Perlis 1 0.25 0 0.00

Kedah 4 0.14 3 0.10

Kedah & Perlis 5 0.15 3 0.09

Pulau Pinang 3 0.21 1 0.07

Perak 5 0.17 3 0.10

Selangor & WP Putrajaya 8 0.13 5 0.08

WP Kuala Lumpur 3 0.13 3 0.13

Selangor & WP Putrajaya & WPKL 11 0.13 8 0.10

Negeri Sembilan 3 0.23 1 0.08

Melaka 1 0.09 1 0.09

Johor 6 0.12 1 0.02

Pahang 3 0.14 1 0.05

Terengganu 2 0.10 1 0.05

Kelantan 4 0.12 2 0.06

Sabah & WP Labuan 19 0.35 6 0.11

Sarawak 19 0.53 1 0.03

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Table 3.4 Number and Density of functional Obstetrics HDu beds Within O&g Departments in Malaysia by State and Sector, 2010

STATE SECTORfuNCTIONAL ObSTETRICS HDu bEDS WITHIN O&g DEPARTMENT

NO. PER 1,000 DELIVERIES

Malaysia Public 106 0.26Malaysia Private 33 0.32Malaysia Total 139 0.28Perlis Public 2 0.51Perlis Private na naPerlis Total 2 0.51Kedah Public 7 0.24Kedah Private 3 0.56Kedah Total 10 0.29Kedah & Perlis Public 9 0.27Kedah & Perlis Private 3 0.56Kedah & Perlis Total 12 0.31Pulau Pinang Public 8 0.57Pulau Pinang Private 7 0.58Pulau Pinang Total 15 0.57Perak Public 8 0.27Perak Private 0 0.00Perak Total 8 0.22Selangor & WP Putrajaya Public 13 0.21Selangor & WP Putrajaya Private 1 0.03Selangor & WP Putrajaya Total 14 0.15WP Kuala Lumpur Public 15 0.64WP Kuala Lumpur Private 11 0.75WP Kuala Lumpur Total 26 0.68Selangor & WP Putrajaya & WP KL Public 28 0.33Selangor & WP Putrajaya & WP KL Private 12 0.26Selangor & WP Putrajaya & WP KL Total 40 0.31Negeri Sembilan Public 2 0.15Negeri Sembilan Private 0 0.00Negeri Sembilan Total 2 0.12Melaka Public 0 0.00Melaka Private 5 1.60Melaka Total 5 0.36Johor Public 24 0.48Johor Private 0 0.00Johor Total 24 0.38Pahang Public 8 0.36Pahang Private 0 0.00Pahang Total 8 0.31Terengganu Public 3 0.15Terengganu Private 3 14.22Terengganu Total 6 0.29Kelantan Public 2 0.06Kelantan Private 0 0.00Kelantan Total 2 0.06Sabah & WP Labuan Public 8 0.15Sabah & WP Labuan Private 0 0.00Sabah & WP Labuan Total 8 0.14Sarawak Public 6 0.17Sarawak Private 3 0.66Sarawak Total 9 0.22


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Table 3.5 Number, Density and Percentages of Total Deliveries in Malaysia by State and Sector, 2008-2009 and 2010

STATE SECTOR

YEAR 2008-2009 YEAR 2010

NO Of DELIVERIES

PER 10,000 POPuLATION

% Of DELIVERIES bY SECTOR

NO Of DELIVERIES

PER 10,000 POPuLATION

% Of DELIVERIES bY SECTOR

Malaysia Public 392,417 - 77.7 401,398 - 79.60Malaysia Private 112,853 - 22.3 102,706 - 20.40Malaysia Total 505,270 181.13 100.0 504,104 177.91 100.00Perlis Public 4,655 - 100.0 3,949 - 100.00Perlis Private na na na na na naPerlis Total 4,655 196.41 100.0 3,949 170.58 100.00Kedah Public 30,159 - 86.3 29,397 - 84.50Kedah Private 4,770 - 13.7 5,388 - 15.50Kedah Total 34,929 179.81 100.0 34,785 178.60 100.00Kedah & Perlis Public 34,814 - 87.9 33,346 - 86.10Kedah & Perlis Private 4,770 - 12.1 5,388 - 13.90Kedah & Perlis Total 39,584 181.61 100.0 38,734 177.74 100.00Pulau Pinang Public 14,933 - 57.9 14,013 - 53.50Pulau Pinang Private 10,862 - 42.1 12,160 - 46.50Pulau Pinang Total 25,795 163.26 100.0 26,173 167.63 100.00Perak Public 31,058 - 78.1 29,741 - 81.70Perak Private 8,689 - 21.9 6,666 - 18.30Perak Total 39,747 163.73 100.0 36,407 154.75 100.00Selangor & WP Putrajaya Public 62,571 - 65.6 61,061 - 66.00Selangor & WP Putrajaya Private 32,797 - 34.4 31,479 - 34.00Selangor & WP Putrajaya Total 95,368 189.47 100.0 92,540 167.21 100.00WP Kuala Lumpur Public 18,113 - 50.8 23,260 - 61.20WP Kuala Lumpur Private 17,544 - 49.2 14,749 - 38.80WP Kuala Lumpur Total 35,657 209.37 100.0 38,009 226.97 100.00Selangor & WP Putrajaya & WPKL Public 80,684 - 61.6 84,321 - 64.60Selangor & WP Putrajaya & WPKL Private 50,341 - 38.4 46,228 - 35.40Selangor & WP Putrajaya & WPKL Total 131,025 194.50 100.0 130,549 181.09 100.00Negeri Sembilan Public 10,410 - 78.1 13,297 - 78.10Negeri Sembilan Private 2,916 - 21.9 3,738 - 21.90Negeri Sembilan Total 13,326 133.22 100.0 17,035 166.83 100.00Melaka Public 11,856 - 74.5 10,585 - 77.20Melaka Private 4,054 - 25.5 3,129 - 22.80Melaka Total 15,910 208.90 100.0 13,714 167.02 100.00Johor Public 52,804 - 73.0 50,122 - 80.10Johor Private 19,516 - 27.0 12,471 - 19.90Johor Total 72,320 221.22 100.0 62,593 186.94 100.00Pahang Public 22,621 - 87.8 22,302 - 87.70Pahang Private 3,142 - 12.2 3,120 - 12.30Pahang Total 25,763 169.86 100.0 25,422 169.39 100.00Terengganu Public 18,411 - 98.0 20,510 - 99.00Terengganu Private 375 - 2.0 211 - 1.00Terengganu Total 18,786 181.37 100.0 20,721 200.01 100.00Kelantan Public 33,301 - 92.8 33,381 - 94.10Kelantan Private 2,577 - 7.2 2,100 - 5.90Kelantan Total 35,878 218.90 100.0 35,481 230.46 100.00Sabah & WP Labuan Public 38,056 - 94.5 53,646 - 94.80Sabah & WP Labuan Private 2,218 - 5.5 2,949 - 5.20Sabah & WP Labuan Total 40,274 122.86 100.0 56,595 171.83 100.00Sarawak Public 43,469 - 92.8 36,134 - 88.80Sarawak Private 3,393 - 7.2 4,546 - 11.20Sarawak Total 46,862 189.66 100.0 40,680 164.62 100.00


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Table 3.6 Number, Density and Percentages of Spontaneous Vertex Deliveries (SVD) in Malaysia by State and Sector, 2010

STATE SECTORSPONTANEOuS VERTEx DELIVERIES (SVD)

NO. PER 100 DELIVERIES PER 1,000 LIVE bIRTHS

Malaysia Public 310,511 77.36 -Malaysia Private 52,961 51.57 -Malaysia Total 363,472 72.10 682.35Perlis Public 2,899 73.41 -Perlis Private na na naPerlis Total 2,899 73.41 662.58Kedah Public 21,677 73.74 -Kedah Private 1,958 36.34 -Kedah Total 23,635 67.95 645.47Kedah & Perlis Public 24,576 73.70 -Kedah & Perlis Private 1,958 36.34 -Kedah & Perlis Total 26,534 68.50 647.30Pulau Pinang Public 10,318 73.63 -Pulau Pinang Private 7,204 59.24 -Pulau Pinang Total 17,522 66.95 714.78Perak Public 21,608 72.65 -Perak Private 3,159 47.39 -Perak Total 24,767 68.03 662.08Selangor & WP Putrajaya Public 44,150 72.30 -Selangor & WP Putrajaya Private 16,909 53.72 -Selangor & WP Putrajaya Total 61,059 65.98 532.97WP Kuala Lumpur Public 15,171 65.22 -WP Kuala Lumpur Private 6,487 43.98 -WP Kuala Lumpur Total 21,658 56.98 769.84Selangor & WP Putrajaya & WP KL Public 59,321 70.35 -Selangor & WP Putrajaya & WP KL Private 23,396 50.61 -Selangor & WP Putrajaya & WP KL Total 82,717 63.36 579.67Negeri Sembilan Public 10,086 75.85 -Negeri Sembilan Private 2,052 54.90 -Negeri Sembilan Total 12,138 71.25 646.04Melaka Public 8,027 75.83 -Melaka Private 989 31.61 -Melaka Total 9,016 65.74 566.00Johor Public 39,698 79.20 -Johor Private 6,419 51.47 -Johor Total 46,117 73.68 744.50Pahang Public 17,041 76.41 -Pahang Private 2,336 74.87 -Pahang Total 19,377 76.22 721.29Terengganu Public 17,672 86.16 -Terengganu Private 156 73.93 -Terengganu Total 17,828 86.04 771.68Kelantan Public 28,344 84.91 -Kelantan Private 1,753 83.48 -Kelantan Total 30,097 84.83 849.94Sabah & WP Labuan Public 44,678 83.28 -Sabah & WP Labuan Private 1,202 40.76 -Sabah & WP Labuan Total 45,880 81.07 780.85Sarawak Public 29,142 80.65 -Sarawak Private 2,337 51.41 -Sarawak Total 31,479 77.38 681.22


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Table 3.7 Number, Density and Percentages of Vaginal breech Deliveries in Malaysia by State and Sector, 2010

STATE SECTORVAgINAL bREECH DELIVERIES


Malaysia Public 2,224 0.55 -Malaysia Private 151 0.15 -Malaysia Total 2,375 0.47 4.46Perlis Public 22 0.56 -Perlis Private na na naPerlis Total 22 0.56 5.03Kedah Public 174 0.59 -Kedah Private 17 0.32 -Kedah Total 191 0.55 5.22Kedah & Perlis Public 196 0.59 -Kedah & Perlis Private 17 0.32 -Kedah & Perlis Total 213 0.55 5.20Pulau Pinang Public 65 0.46 -Pulau Pinang Private 18 0.15 -Pulau Pinang Total 83 0.32 3.39Perak Public 163 0.55 -Perak Private 3 0.05 -Perak Total 166 0.46 4.44Selangor & WP Putrajaya Public 292 0.48 -Selangor & WP Putrajaya Private 22 0.07 -Selangor & WP Putrajaya Total 314 0.34 2.74WP Kuala Lumpur Public 201 0.86 -WP Kuala Lumpur Private 37 0.25 -WP Kuala Lumpur Total 238 0.63 8.46Selangor & WP Putrajaya & WP KL Public 493 0.58 -Selangor & WP Putrajaya & WP KL Private 59 0.13 -Selangor & WP Putrajaya & WP KL Total 552 0.42 3.87Negeri Sembilan Public 137 1.03 -Negeri Sembilan Private 3 0.08 -Negeri Sembilan Total 140 0.82 7.45Melaka Public 46 0.43 -Melaka Private 1 0.03 -Melaka Total 47 0.34 2.95Johor Public 324 0.65 -Johor Private 43 0.34 -Johor Total 367 0.59 5.93Pahang Public 100 0.45 -Pahang Private 3 0.10 -Pahang Total 103 0.41 3.83Terengganu Public 87 0.42 -Terengganu Private 1 0.47 -Terengganu Total 88 0.42 3.81Kelantan Public 218 0.65 -Kelantan Private 2 0.10 -Kelantan Total 220 0.62 6.21Sabah & WP Labuan Public 227 0.42 -Sabah & WP Labuan Private 0 0.00 -Sabah & WP Labuan Total 227 0.40 3.86Sarawak Public 168 0.46 -Sarawak Private 1 0.02 -Sarawak Total 169 0.42 3.66


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Table 3.8 Number, Density and Percentages of Instrumental Deliveries using Vacuum in Malaysia by State and Sector, 2010

STATE SECTORINSTRuMENTAL DELIVERIES uSINg VACuuM

NO. PER 100 DELIVERIES PER 1,000 LIVE bIRTH

Malaysia Public 11,185 2.79 -Malaysia Private 13,162 12.82 -Malaysia Total 24,347 4.83 45.71Perlis Public 149 3.77 -Perlis Private na na naPerlis Total 149 3.77 34.05Kedah Public 1,174 3.99 -Kedah Private 1,192 22.12 -Kedah Total 2,366 6.80 64.62Kedah & Perlis Public 1,323 3.97 -Kedah & Perlis Private 1,192 22.12 -Kedah & Perlis Total 2,515 6.49 61.35Pulau Pinang Public 243 1.73 -Pulau Pinang Private 1,561 12.84 -Pulau Pinang Total 1,804 6.89 73.59Perak Public 351 1.18 -Perak Private 905 13.58 -Perak Total 1,256 3.45 33.58Selangor & WP Putrajaya Public 2,332 3.82 -Selangor & WP Putrajaya Private 4,266 13.55 -Selangor & WP Putrajaya Total 6,598 7.13 57.59WP Kuala Lumpur Public 851 3.66 -WP Kuala Lumpur Private 2,058 13.95 -WP Kuala Lumpur Total 2,909 7.65 103.40Selangor & WP Putrajaya & WP KL Public 3,183 3.78 -Selangor & WP Putrajaya & WP KL Private 6,324 13.68 -Selangor & WP Putrajaya & WP KL Total 9,507 7.28 66.62Negeri Sembilan Public 402 3.02 -Negeri Sembilan Private 650 17.39 -Negeri Sembilan Total 1,052 6.18 55.99Melaka Public 432 4.08 -Melaka Private 363 11.60 -Melaka Total 795 5.80 49.91Johor Public 1,846 3.68 -Johor Private 1,397 11.20 -Johor Total 3,243 5.18 52.35Pahang Public 790 3.54 -Pahang Private 100 3.21 -Pahang Total 890 3.50 33.13Terengganu Public 177 0.86 -Terengganu Private 4 1.91 -Terengganu Total 181 0.87 7.84Kelantan Public 271 0.81 -Kelantan Private 85 4.05 -Kelantan Total 356 1.00 10.05Sabah & WP Labuan Public 1,211 2.26 -Sabah & WP Labuan Private 375 12.72 -Sabah & WP Labuan Total 1,586 2.80 26.99Sarawak Public 956 2.65 -Sarawak Private 206 4.53 -Sarawak Total 1,162 2.86 25.15


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Table 3.9 Number, Density and Percentages of Instrumental Deliveries using forceps in Malaysia by State and Sector, 2010

STATE SECTORINSTRuMENTAL DELIVERIES uSINg fORCEPS


Malaysia Public 1,454 0.36 -Malaysia Private 1,402 1.37 -Malaysia Total 2,856 0.57 5.36Perlis Public 9 0.23 -Perlis Private na na naPerlis Total 9 0.23 2.06Kedah Public 76 0.26 -Kedah Private 196 3.64 -Kedah Total 272 0.78 7.43Kedah & Perlis Public 85 0.25 -Kedah & Perlis Private 196 3.64 -Kedah & Perlis Total 281 0.73 6.86Pulau Pinang Public 28 0.20 -Pulau Pinang Private 38 0.31 -Pulau Pinang Total 66 0.25 2.69Perak Public 79 0.27 -Perak Private 181 2.72 -Perak Total 260 0.71 6.95Selangor & WP Putrajaya Public 597 0.98 -Selangor & WP Putrajaya Private 392 1.25 -Selangor & WP Putrajaya Total 989 1.07 8.63WP Kuala Lumpur Public 76 0.33 -WP Kuala Lumpur Private 210 1.42 -WP Kuala Lumpur Total 286 0.75 10.17Selangor & WP Putrajaya & WP KL Public 673 0.80 -Selangor & WP Putrajaya & WP KL Private 602 1.30 -Selangor & WP Putrajaya & WP KL Total 1,275 0.98 8.94Negeri Sembilan Public 85 0.64 -Negeri Sembilan Private 29 0.78 -Negeri Sembilan Total 114 0.67 6.07Melaka Public 39 0.37 -Melaka Private 27 0.86 -Melaka Total 66 0.48 4.14Johor Public 172 0.34 -Johor Private 89 0.71 -Johor Total 261 0.42 4.21Pahang Public 9 0.04 -Pahang Private 70 2.24 -Pahang Total 79 0.31 2.94Terengganu Public 35 0.17 -Terengganu Private 9 4.27 -Terengganu Total 44 0.21 1.91Kelantan Public 118 0.35 -Kelantan Private 4 0.19 -Kelantan Total 122 0.34 3.45Sabah & WP Labuan Public 51 0.10 -Sabah & WP Labuan Private 15 0.51 -Sabah & WP Labuan Total 66 0.12 1.12Sarawak Public 80 0.22 -Sarawak Private 142 3.12 -Sarawak Total 222 0.55 4.80


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Table 3.10 Number, Density and Percentages of Caesarean Section Deliveries in Malaysia by State and Sector, 2010

STATE SECTORCAESAREAN SECTION DELIVERIES

NO. PER 100 DELIVERIES PER 1,000 LIVE bIRTH

Malaysia Public 75,692 18.86 -Malaysia Private 34,655 33.74 -Malaysia Total 110,347 21.89 207.15Perlis Public 870 22.03 -Perlis Private na na naPerlis Total 870 22.03 198.84Kedah Public 6,454 21.95 -Kedah Private 2,024 37.56 -Kedah Total 8,478 24.37 231.53Kedah & Perlis Public 7,324 21.96 -Kedah & Perlis Private 2,024 37.56 -Kedah & Perlis Total 9,348 24.13 228.04Pulau Pinang Public 3,516 25.09 -Pulau Pinang Private 3,325 27.34 -Pulau Pinang Total 6,841 26.14 279.07Perak Public 7,541 25.36 -Perak Private 2,296 34.44 -Perak Total 9,837 27.02 262.97Selangor & WP Putrajaya Public 13,602 22.28 -Selangor & WP Putrajaya Private 9,643 30.63 -Selangor & WP Putrajaya Total 23,245 25.12 202.90WP Kuala Lumpur Public 6,972 29.97 -WP Kuala Lumpur Private 5,951 40.35 -WP Kuala Lumpur Total 12,923 34.00 459.35Selangor & WP Putrajaya & WP KL Public 20,574 24.40 -Selangor & WP Putrajaya & WP KL Private 15,594 33.73 -Selangor & WP Putrajaya & WP KL Total 36,168 27.70 253.46Negeri Sembilan Public 2,543 19.12 -Negeri Sembilan Private 1,005 26.89 -Negeri Sembilan Total 3,548 20.83 188.84Melaka Public 2,087 19.72 -Melaka Private 1,564 49.98 -Melaka Total 3,651 26.62 229.20Johor Public 7,868 15.70 -Johor Private 4,512 36.18 -Johor Total 12,380 19.78 199.86Pahang Public 4,362 19.56 -Pahang Private 611 19.58 -Pahang Total 4,973 19.56 185.12Terengganu Public 2,486 12.12 -Terengganu Private 41 19.43 -Terengganu Total 2,527 12.20 109.38Kelantan Public 4,483 13.43 -Kelantan Private 428 20.38 -Kelantan Total 4,911 13.84 138.69Sabah & WP Labuan Public 7,209 13.44 -Sabah & WP Labuan Private 1,380 46.80 -Sabah & WP Labuan Total 8,589 15.18 146.18Sarawak Public 5,699 15.77 -Sarawak Private 1,875 41.25 -Sarawak Total 7,574 18.62 163.91


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Table 3.11 Number and Density of Multiple Pregnancies Delivered in Malaysia by State and Sector, 2010

STATE SECTORMuLTIPLE PREgNANCIES DELIVERED

NO. MuLTIPLE PREgNANCIES PER 100 DELIVERIES

Malaysia Public 3,131 0.78Malaysia Private 604 0.59Malaysia Total 3,735 0.74Perlis Public 23 0.58Perlis Private na naPerlis Total 23 0.58Kedah Public 247 0.84Kedah Private 25 0.46Kedah Total 272 0.78Kedah & Perlis Public 270 0.81Kedah & Perlis Private 25 0.46Kedah & Perlis Total 295 0.76Pulau Pinang Public 101 0.72Pulau Pinang Private 106 0.87Pulau Pinang Total 207 0.79Perak Public 208 0.70Perak Private 23 0.35Perak Total 231 0.63Selangor & WP Putrajaya Public 514 0.84Selangor & WP Putrajaya Private 182 0.58Selangor & WP Putrajaya Total 696 0.75WP Kuala Lumpur Public 289 1.24WP Kuala Lumpur Private 91 0.62WP Kuala Lumpur Total 380 1.00Selangor & WP Putrajaya & WP KL Public 803 0.95Selangor & WP Putrajaya & WP KL Private 273 0.59Selangor & WP Putrajaya & WP KL Total 1,076 0.82Negeri Sembilan Public 102 0.77Negeri Sembilan Private 18 0.48Negeri Sembilan Total 120 0.70Melaka Public 92 0.87Melaka Private 24 0.77Melaka Total 116 0.85Johor Public 329 0.66Johor Private 66 0.53Johor Total 395 0.63Pahang Public 155 0.70Pahang Private 17 0.54Pahang Total 172 0.68Terengganu Public 123 0.60Terengganu Private 0 0.00Terengganu Total 123 0.59Kelantan Public 289 0.87Kelantan Private 7 0.33Kelantan Total 296 0.83Sabah & WP Labuan Public 457 0.85Sabah & WP Labuan Private 13 0.44Sabah & WP Labuan Total 470 0.83Sarawak Public 202 0.56Sarawak Private 32 0.70Sarawak Total 234 0.58


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Table 3.12 Number and Density of Eclampsia in Malaysia by State and Sector, 2010

STATE SECTORECLAMPSIA

NO. Of ECLAMPSIA PER 1,000 DELIVERIES

Malaysia Public 391 0.97Malaysia Private 107 1.04Malaysia Total 498 0.99Perlis Public 5 1.27Perlis Private na naPerlis Total 5 1.27Kedah Public 21 0.71Kedah Private 6 1.11Kedah Total 27 0.78Kedah & Perlis Public 26 0.78Kedah & Perlis Private 6 1.11Kedah & Perlis Total 32 0.83Pulau Pinang Public 4 0.29Pulau Pinang Private 9 0.74Pulau Pinang Total 13 0.50Perak Public 12 0.40Perak Private 0 0.00Perak Total 12 0.33Selangor & WP Putrajaya Public 79 1.29Selangor & WP Putrajaya Private 44 1.40Selangor & WP Putrajaya Total 123 1.33WP Kuala Lumpur Public 9 0.39WP Kuala Lumpur Private 29 1.97WP Kuala Lumpur Total 38 1.00Selangor & WP Putrajaya & WP KL Public 88 1.04Selangor & WP Putrajaya & WP KL Private 73 1.58Selangor & WP Putrajaya & WP KL Total 161 1.23Negeri Sembilan Public 7 0.53Negeri Sembilan Private 0 0.00Negeri Sembilan Total 7 0.41Melaka Public 4 0.38Melaka Private 4 1.28Melaka Total 8 0.58Johor Public 42 0.84Johor Private 0 0.00Johor Total 42 0.67Pahang Public 17 0.76Pahang Private 6 1.92Pahang Total 23 0.91Terengganu Public 21 1.02Terengganu Private 0 0.00Terengganu Total 21 1.01Kelantan Public 19 0.57Kelantan Private 0 0.00Kelantan Total 19 0.54Sabah & WP Labuan Public 118 2.20Sabah & WP Labuan Private 0 0.00Sabah & WP Labuan Total 118 2.09Sarawak Public 33 0.91Sarawak Private 9 1.98Sarawak Total 42 1.03


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Table 3.13 Number, Density and Percentages of Post Partum Haemorrhage (PPH) and Caesarean Hysterectomies Performed in Malaysia by State and Sector, 2010

STATE SECTORPOST PARTuM HAEMORRHAgE CAESAREAN HYSTERECTOMIES

NO. Of DELIVERIES

PER 1,000 DELIVERIES

NO. Of DELIVERIES

PER 1,000 DELIVERIES

Malaysia Public 8,045 20.04 233 0.58Malaysia Private 953 9.28 62 0.60Malaysia Total 8,998 17.85 295 0.59Perlis Public 39 9.88 1 0.25Perlis Private na na na naPerlis Total 39 9.88 1 0.25Kedah Public 253 8.61 21 0.71Kedah Private 54 10.02 4 0.74Kedah Total 307 8.83 25 0.72Kedah & Perlis Public 292 8.76 22 0.66Kedah & Perlis Private 54 10.02 4 0.74Kedah & Perlis Total 346 8.93 26 0.67Pulau Pinang Public 568 40.53 13 0.93Pulau Pinang Private 136 11.18 5 0.41Pulau Pinang Total 704 26.90 18 0.69Perak Public 1,497 50.33 27 0.91Perak Private 83 12.45 2 0.30Perak Total 1,580 43.40 29 0.80Selangor & WP Putrajaya Public 1,662 27.22 37 0.61Selangor & WP Putrajaya Private 271 8.61 12 0.38Selangor & WP Putrajaya Total 1,933 20.89 49 0.53WP Kuala Lumpur Public 515 22.14 12 0.52WP Kuala Lumpur Private 60 4.07 32 2.17WP Kuala Lumpur Total 575 15.13 44 1.16Selangor & WP Putrajaya & WP KL Public 2,177 25.82 49 0.58Selangor & WP Putrajaya & WP KL Private 331 7.16 44 0.95Selangor & WP Putrajaya & WP KL Total 2,508 19.21 93 0.71Negeri Sembilan Public 57 4.29 9 0.68Negeri Sembilan Private 73 19.53 2 0.54Negeri Sembilan Total 130 7.63 11 0.65Melaka Public 26 2.46 2 0.19Melaka Private 6 1.92 2 0.64Melaka Total 32 2.33 4 0.29Johor Public 993 19.81 19 0.38Johor Private 98 7.86 0 0.00Johor Total 1,091 17.43 19 0.30Pahang Public 355 15.92 8 0.36Pahang Private 19 6.09 2 0.64Pahang Total 374 14.71 10 0.39Terengganu Public 67 3.27 15 0.73Terengganu Private 0 0.00 0 0.00Terengganu Total 67 3.23 15 0.72Kelantan Public 853 25.55 6 0.18Kelantan Private 6 2.86 1 0.48Kelantan Total 859 24.21 7 0.20Sabah & WP Labuan Public 984 18.34 41 0.76Sabah & WP Labuan Private 5 1.70 0 0.00Sabah & WP Labuan Total 989 17.48 41 0.72Sarawak Public 176 4.87 22 0.61Sarawak Private 142 31.24 0 0.00Sarawak Total 318 7.82 22 0.54


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Table 3.14 Number and Density of Medical Officers, Obstetrics Specialists & Obstetrics Trainees in Malaysia by State & Sector, 2010

STATE SECTORMEDICAL OffICERS O&g SPECIALISTS O&g TRAINEES

NO.PER 100,000

fEMALENO.

PER 100,000 fEMALE

NO.PER 100,000

fEMALEMalaysia Public 646 - 310 - 172 -Malaysia Private 95 - 446 - 0 -Malaysia Total 741 5.38 756 5.49 172 1.25Perlis Public 8 - 5 - 0 -Perlis Private na na na na na naPerlis Total 8 6.80 5 4.25 0 0.00Kedah Public 41 - 22 - 3 -Kedah Private 3 - 16 - 0 -Kedah Total 44 4.57 38 3.95 3 0.31Kedah & Perlis Public 49 - 27 - 3 -Kedah & Perlis Private 3 - 16 - 0 -Kedah & Perlis Total 52 4.81 43 3.98 3 0.28Pulau Pinang Public 39 - 14 - 12 -Pulau Pinang Private 7 - 48 - 0 -Pulau Pinang Total 46 5.90 62 7.96 12 1.54Perak Public 51 - 24 - 11 -Perak Private 0 - 42 - 0 -Perak Total 51 4.38 66 5.66 11 0.94Selangor & WP Putrajaya Public 108 - 64 - 25 -Selangor & WP Putrajaya Private 34 - 119 - 0 -Selangor & WP Putrajaya Total 142 5.31 183 6.84 25 0.93WP Kuala Lumpur Public 91 - 44 - 47 -WP Kuala Lumpur Private 34 - 98 - 0 -WP Kuala Lumpur Total 125 15.20 142 17.26 47 5.71Selangor & WP Putrajaya & WPKL Public 199 - 108 - 72 -Selangor & WP Putrajaya & WPKL Private 68 - 217 - 0 -Selangor & WP Putrajaya & WPKL Total 267 7.63 325 9.29 72 2.06Negeri Sembilan Public 28 - 10 - 8 -Negeri Sembilan Private 0 - 18 - 0 -Negeri Sembilan Total 28 5.69 28 5.69 8 1.63Melaka Public 31 - 9 - 5 -Melaka Private 0 - 18 - 0 -Melaka Total 31 7.59 27 6.61 5 1.22Johor Public 57 - 27 - 5 -Johor Private 2 - 36 - 0 -Johor Total 59 3.73 63 3.99 5 0.32Pahang Public 27 - 15 - 5 -Pahang Private 10 - 7 - 0 -Pahang Total 37 5.25 22 3.12 5 0.71Terengganu Public 17 - 10 - 6 -Terengganu Private 2 - 1 - 0 -Terengganu Total 19 3.74 11 2.17 6 1.18Kelantan Public 44 - 22 - 19 -Kelantan Private 3 - 6 - 0 -Kelantan Total 47 6.14 28 3.66 19 2.48Sabah & WP Labuan Public 55 - 23 - 18 -Sabah & WP Labuan Private 0 - 13 - 0 -Sabah & WP Labuan Total 55 3.46 36 2.26 18 1.13Sarawak Public 49 - 21 - 8 -Sarawak Private 0 - 24 - 0 -Sarawak Total 49 4.09 45 3.76 8 0.67


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Table 3.15 Number and Density of Nurses in Obstetric and Labour Wards in Malaysia by State and Sector, 2010

STATE SECTORSTAff NuRSES COMMuNITY NuRSES CLINIC ASSISTANTS

NO.PER 100,000

fEMALENO.

PER 100,000 fEMALE

NO.PER 100,000

fEMALEMalaysia Public 3,919 - 2,540 - - -Malaysia Private 1,216 - 260 - 850 -Malaysia Total 5,135 37.29 2,800 20.33 850 6.17Perlis Public 31 - 18 - - -Perlis Private na na na na na naPerlis Total 31 26.34 18 15.29 0 0.00Kedah Public 370 - 193 - - -Kedah Private 54 - 17 - 68 -Kedah Total 424 44.06 210 21.82 68 7.07Kedah & Perlis Public 401 - 211 - - -Kedah & Perlis Private 54 - 17 - 68 -Kedah & Perlis Total 455 42.13 228 21.11 68 6.30Pulau Pinang Public 178 - 102 - - -Pulau Pinang Private 136 - 49 - 126 --Pulau Pinang Total 314 40.29 151 19.38 126 16.17Perak Public 283 - 178 - - -Perak Private 59 - 18 - 42 -Perak Total 342 29.34 196 16.81 42 3.60Selangor & WP Putrajaya Public 505 - 455 - - -Selangor & WP Putrajaya Private 328 - 56 - 181 -Selangor & WP Putrajaya Total 833 31.13 511 19.10 181 6.76WP Kuala Lumpur Public 325 - 76 - - -WP Kuala Lumpur Private 225 - 16 - 135 -WP Kuala Lumpur Total 550 66.87 92 11.19 135 16.41Selangor & WP Putrajaya & WPKL Public 830 - 531 - - -Selangor & WP Putrajaya & WPKL Private 553 - 72 - 316 -Selangor & WP Putrajaya & WPKL Total 1,383 39.53 603 17.24 316 9.03Negeri Sembilan Public 124 - 49 - - -Negeri Sembilan Private 45 - 3 - 26 -Negeri Sembilan Total 169 34.34 52 10.57 26 5.28Melaka Public 104 - 73 - - -Melaka Private 59 - 4 - 27 -Melaka Total 163 39.88 77 18.84 27 6.61Johor Public 473 - 258 - - -Johor Private 201 - 37 - 121 -Johor Total 674 42.64 295 18.66 121 7.65Pahang Public 291 - 215 - - -Pahang Private 27 - 9 - 41 -Pahang Total 318 45.14 224 31.80 41 5.82Terengganu Public 224 - 157 - - -Terengganu Private 5 - 3 - 7 -Terengganu Total 229 45.12 160 31.53 7 1.38Kelantan Public 352 - 137 - - -Kelantan Private 14 - 6 - 16 -Kelantan Total 366 47.79 143 18.67 16 2.09Sabah & WP Labuan Public 357 - 315 - - -Sabah & WP Labuan Private 24 - 8 - 16 -Sabah & WP Labuan Total 381 23.95 323 20.31 16 1.01Sarawak Public 302 - 314 - - -Sarawak Private 39 - 34 - 44 -Sarawak Total 341 28.46 348 29.05 44 3.67


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Table 3.16 Number and Density of Nurses With Midwifery in Obstetric and Labour Wards in Malaysia by State and Sector, 2010

STATE SECTORSTAff NuRSES ObSTETRIC WARD NuRSES LAbOuR WARD NuRSES

NO.PER 100,000

fEMALENO.

PER 100,000 fEMALE

NO.PER 100,000

fEMALEMalaysia Public 3,919 - 2,743 - 2,025 -Malaysia Private 1,216 - 552 - 685 -Malaysia Total 5,135 37.29 3,295 23.93 2,710 19.68Perlis Public 31 - 27 - 20 -Perlis Private na na na na na naPerlis Total 31 26.34 27 22.94 20 16.99Kedah Public 370 - 201 - 199 -Kedah Private 54 - 19 - 29 -Kedah Total 424 44.06 220 22.86 228 23.69Kedah & Perlis Public 401 - 228 - 219 -Kedah & Perlis Private 54 - 19 - 29 -Kedah & Perlis Total 455 42.13 247 22.87 248 22.96Pulau Pinang Public 178 - 115 - 102 -Pulau Pinang Private 136 - 115 - 115 -Pulau Pinang Total 314 40.29 230 29.51 217 27.85Perak Public 283 - 331 - 192 -Perak Private 59 - 37 - 37 -Perak Total 342 29.34 368 31.57 229 19.64Selangor & WP Putrajaya Public 505 - 236 - 228 -Selangor & WP Putrajaya Private 328 - 67 - 132 -Selangor & WP Putrajaya Total 833 31.13 303 11.32 360 13.45WP Kuala Lumpur Public 325 - 299 - 111 -WP Kuala Lumpur Private 225 - 87 - 127 -WP Kuala Lumpur Total 550 66.87 386 46.93 238 28.94Selangor & WP Putrajaya & WPKL Public 830 - 535 - 339 -Selangor & WP Putrajaya & WPKL Private 553 - 154 - 259 -Selangor & WP Putrajaya & WPKL Total 1,383 39.53 689 19.69 598 17.09Negeri Sembilan Public 124 - 104 - 60 -Negeri Sembilan Private 45 - 8 - 32 -Negeri Sembilan Total 169 34.34 112 22.76 92 18.70Melaka Public 104 - 105 - 54 -Melaka Private 59 - 29 - 28 -Melaka Total 163 39.88 134 32.79 82 20.06Johor Public 473 - 221 - 233 -Johor Private 201 - 97 - 75 -Johor Total 674 42.64 318 20.12 308 19.48Pahang Public 291 - 205 - 141 -Pahang Private 27 - 15 - 18 -Pahang Total 318 45.14 220 31.23 159 22.57Terengganu Public 224 - 187 - 128 -Terengganu Private 5 - 3 - 6 -Terengganu Total 229 45.12 190 37.44 134 26.40Kelantan Public 352 - 180 - 148 -Kelantan Private 14 - 6 - 7 -Kelantan Total 366 47.79 186 24.29 155 20.24Sabah & WP Labuan Public 357 - 313 - 231 -Sabah & WP Labuan Private 24 - 13 - 17 -Sabah & WP Labuan Total 381 23.95 326 20.50 248 15.59Sarawak Public 302 - 219 - 178 -Sarawak Private 39 - 56 - 62 -Sarawak Total 341 28.46 275 22.95 240 20.03


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Table 3.17 Number of Maternity Homes Providing Maternity Services in Malaysia by State, 2010

STATE MATERNITY HOMES

Malaysia 22

Perlis 1

Kedah 0

Kedah & Perlis 1

Pulau Pinang 1

Perak 0

Selangor & WP Putrajaya 7

WP Kuala Lumpur 3

Selangor & WP Putrajaya & WPKL 10

Negeri Sembilan 1

Melaka 1

Johor 1

Pahang 1

Terengganu 2

Kelantan 2

Sabah & WP Labuan 1

Sarawak 22

Table 3.18 Number of Delivery beds in Maternity Homes in Malaysia by State, 2010

STATE DELIVERY bEDS

Malaysia 90

Perlis 2

Kedah 0

Kedah & Perlis 2

Pulau Pinang 1

Perak 0


WP Kuala Lumpur 15


Negeri Sembilan 2

Melaka 6

Johor 7

Pahang 10

Terengganu 10

Kelantan 4

Sabah & WP Labuan 4

Sarawak 2

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Table 3.19 Number of Medical Officers and Obstetrics Specialists in Maternity Homes in Malaysia by State, 2010

STATE MEDICAL OffICERS O&g SPECIALISTS

Malaysia 36 4

Perlis 1 0

Kedah 0 0

Kedah & Perlis 1 0

Pulau Pinang 2 1

Perak 0 0

Selangor & WP Putrajaya 8 1

WP Kuala Lumpur 7 1

Selangor & WP Putrajaya & WPKL 15 2

Negeri Sembilan 1 1

Melaka 1 0

Johor 3 0

Pahang 1 0

Terengganu 7 0

Kelantan 3 0

Sabah & WP Labuan 1 0

Sarawak 1 0

Table 3.20 Number of Deliveries in Maternity Homes in Malaysia by State, 2010

STATE NO. Of DELIVERIES

Malaysia 2067

Perlis 0

Kedah 0

Kedah & Perlis 0

Pulau Pinang 80

Perak 0


WP Kuala Lumpur 131


Negeri Sembilan 10

Melaka 0

Johor 0

Pahang 0

Terengganu 885

Kelantan 294

Sabah & WP Labuan 233

Sarawak 0

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Table 3.21 Number of Spontaneous Vertex Deliveries (SVD), breech & Vacuum Deliveries in Maternity Homes in Malaysia by State, 2010

STATE SPONTANEOuS VERTEx DELIVERIES (SVD) bREECH VACuuM

Malaysia 2033 6 21

Perlis 0 0 0

Kedah 0 0 0

Kedah & Perlis 0 0 0

Pulau Pinang 80 0 0

Perak 0 0 0

Selangor & WP Putrajaya 413 5 16

WP Kuala Lumpur 119 0 5

Selangor & WP Putrajaya & WPKL 532 5 21

Negeri Sembilan 10 0 0

Melaka 0 0 0

Johor 0 0 0

Pahang 0 0 0

Terengganu 885 0 0

Kelantan 294 1 0

Sabah & WP Labuan 232 0 0

Sarawak 0 0 0

Table 3.22 Number of Eclampsia and Post Partum Haemorrhage (PPH) in Maternity Homes Deliveries in Malaysia by State, 2010

STATE ECLAMPSIA POST PARTuM HAEMORRHAgE (PPH)

Malaysia 20 11

Perlis 0 0

Kedah 0 0

Kedah & Perlis 0 0

Pulau Pinang 0 2

Perak 0 0


WP Kuala Lumpur 0 0


Negeri Sembilan 0 0

Melaka 0 0

Johor 0 0

Pahang 0 0

Terengganu 20 7

Kelantan 0 2


Sarawak 0 0

45


Table 3.23 Number of Newborns Delivered & Newborns Admitted to Paediatrics, NICu & SCN in Maternity Homes in Malaysia by State, 2010

STATE NEWbORNS DELIVERED NEWbORNS ADMITTED TO PAEDIATRICS, NICu & SCN

Malaysia 2068 38

Perlis 0 0

Kedah 0 0

Kedah & Perlis 0 0

Pulau Pinang 80 2

Perak 0 0


WP Kuala Lumpur 132 12


Negeri Sembilan 10 0

Melaka 0 0

Johor 0 0

Pahang 0 0

Terengganu 885 19

Kelantan 294 2


Sarawak 0 0

Table 3.24 Number of Staff Nurses, Community Nurses, Clinic Assistants and Nurses with Midwifery Training in Maternity Homes in Malaysia by State, 2010

STATE STAff NuRSES COMMuNITY NuRSES CLINIC ASSISTANTS NuRSES WITH MIDWIfERY TRAININg

Malaysia 27 59 7 31

Perlis 0 0 0 0

Kedah 0 0 0 0

Kedah & Perlis 0 0 0 0

Pulau Pinang 1 4 0 3

Perak 0 0 0 0

Selangor & WP Putrajaya 8 13 4 10

WP Kuala Lumpur 6 16 1 8

Selangor & WP Putrajaya & WPKL 14 29 5 18

Negeri Sembilan 1 2 0 1

Melaka 0 0 0 0

Johor 0 0 0 0

Pahang 0 0 0 0

Terengganu 8 21 0 4

Kelantan 1 0 0 2

Sabah & WP Labuan 2 3 2 3

Sarawak 0 0 0 0

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