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EMPOWERING HEALTH AMONG MIDDLE- AND LOW- INCOME EARNERS IN PENANG, MALAYSIA A REPORT ON A SMART PARTNERSHIP APPROACH BETWEEN UNIVERSITY AND COMMUNITY Report compiled and edited by: Associate Professor Dr. Mohamed Azmi Ahmad Hassali Dr. Imran Masood Ms. Gin Nie Chua Dr. Jayabalan Thambyappa Mr. Muhammad Sharrieffuddin bin Mohd. Jaki Associate Professor Dr. Asrul Akmal Shafie Mr. Fahad Saleem Professor Dr. Syed Azhar Syed Sulaiman Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia

Empowering Health among Middle- and Low-Income Earners in Penang, Malaysia: A Report on a Smart Partnership

Approach between University and Community

Empowering Health among Middle and Low Income Earners in Penang, Malaysia: A Report on a Smart Partnership

Approach between University and Community

Associate Professor Dr. Mohamed Azmi Ahmad Hassali Dr. Imran Masood Ms. Gin Nie Chua

Dr. Jayabalan Thambyappa Mr. Muhammad Sharrieffuddin bin Mohd. Jaki

Associate Professor Dr. Asrul Akmal Shafie Mr. Fahad Saleem

Professor Dr. Syed Azhar Syed Sulaiman

Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences,

Universiti Sains Malaysia

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Copyright © Discipline of Social and Administrative Pharmacy (DSAP), School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), 2012 All rights are reserved. No part of this publication may be copied or reproduced, stored in a retrieval system or transmitted in any form without the prior written permission of the authors/publisher & Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 2012 Empowering Health among Middle and Low Income Earners in Penang, Malaysia: A Report on a Smart Partnership Approach between University and Community ISBN: 978-983-44596-7-3

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Preface This report is designed to showcase health promotional activities conducted among urban poor communities within the state of Penang, Malaysia through a smart partnership programme between Universiti Sains Malaysia (USM) and civil society organizations (CSOs). The aim is to give the reader a flavour of the excitement of carrying out health campaigns and a basic appreciation of the range of activities being held at the community level in the state of Penang, Malaysia. In the present era, the higher cost of healthcare provokes the need to find the most effective and efficient methods of modifying health behaviours. One approach which has generated much interest is the employment of health promotion campaigns promoting health awareness and lifestyle adaptations among members of a community. In Malaysia, health promotion and self-care have long been adopted as part of the National Health Programme. Within this context, educational institutes in Malaysia are working to promote and improve health activities by creating health-conducive working, learning and living environments, thus influencing crucial determinants of health among the society and its members. Health is a central issue in people’s lives and, as such, must be the target of policies and effective actions essential to meet appropriate levels of development and prosperity. “To ensure a sustainable tomorrow”, USM, as a leading higher education institution in the country, is actively championing the concept of sustainable living. Within the institute, the School of Pharmaceutical Sciences, in collaboration with various CSOs, is enthusiastically engaged in promoting health awareness and offers health-related activities especially for those communities who are underprivileged. The objective of engaging society in health awareness is neither simply to change lifestyles nor to provide mere information. It encompasses providing services that improve the health of individuals and communities, and empowering people to have increased control over and to improve their health. It is hoped that this publication will raise awareness among the general public, policy makers and donors of the initiatives of the School of Pharmaceutical Sciences, USM and local CSOs in promoting health awareness and improving health-related knowledge among low-income communities in Penang. Team of Authors

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Acknowledgements The authors acknowledge the help of Prof. Dato' Susie See Ching Mey, Deputy Vice Chancellor for Division of Industry and Community Network, USM, in providing the assistance and grant to conduct the activities mentioned in this publication. These projects are conducted via the Division of Industry and Community Network Grant (1002-JJIM-ARSE-1001). The authors would also like to acknowledge the support given by donors for these projects as listed below:

1. Kotra Pharma (M) Sdn. Bhd. 2. Novo Nordisk (M) Sdn. Bhd. 3. Farmasi Sihat, Batu Pahat, Johor 4. Farmasi Metro, Alor Setar, Kedah 5. Farmasi Nazifa, Sungai Petani, Kedah 6. Farmasi Watan, Baling, Kedah 7. Farmasi Tanjung Malim, Tanjung Malim, Perak 8. City Pharmacy, Taiping, Perak 9. Shiv Pharmacy, Masai, Johor 10. Forever Pharmacy, Permatang Pauh, Penang 11. Mrs. Sharifah Nor Sazlin bt. Syed Zainuddin, Temerloh, Pahang

The authors express their appreciation to the following individuals for their help in making this publication a success:

1. Dato' Abdul Rashid b. Ismail - President, Yayasan Bina Ilmu, Penang, Malaysia 2. Haji Mohd. Farook b. Sk. Mohd. - Chairman, Jalan Makloom 1Malaysia Community,

Penang, Malaysia 3. Mr. Bakar b. Ismail - Vice President, Yayasan Bina Ilmu, Penang, Malaysia 4. Mr. Arshad b. Mohd. Sultan - Committee Member, Yayasan Bina Ilmu, Penang,

Malaysia 5. Associate Professor Dr. Zuraidah Mohd Yusoff - Deputy Dean, Division of Industrial

and Community Network, School of Pharmaceutical Sciences, USM, Penang, Malaysia

6. Ms. Lee She Wei - Postgraduate Student, Discipline of Social and Administrative Pharmacy, USM, Penang, Malaysia

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Introduction In the current context of healthcare delivery, many nations around the world have adopted the concepts of health promotion, self-care and community participation in their national health agenda documents and policies.1 Health promotion, through investment and action, has a marked impact on the determinants of health. It creates the greatest health gain for people, contributes significantly to the reduction of inequities in health, advances human rights, and builds social capital.2 The ultimate goal is to increase health expectancy, and to narrow the gaps in health expectancy between countries and groups. The concepts of health promotion, self-care and community participation emerged during the 1970s, primarily out of concerns about the limitations of professional health systems and rising cost of healthcare.3,4 Since then, there has been rapid growth in these areas in both developed and developing countries around the world due to positive evidence of the effectiveness of such interventions.1,4 In Malaysia, the concepts of health promotion and self-care are part of the national health agenda and there is a window of opportunity for promoting self-care and community participation for the betterment of population health.5 In order to effectively implement the concepts of health promotion and self-care, both healthcare workers and the community need to collaborate so that pertinent health-related messages relayed by the healthcare workers can be translated into sustainable action by the communities at large.6,7

However, one of the great challenges in developing and executing an effective health promotion programme is the lack of manpower support from volunteers and partnerships with the private sector.6,7 As the available healthcare resources are limited, there is a real need to engage and nurture the learned society, especially from the higher educational institutes, to be actively involved in community volunteerism activities. Within this context, USM as a leading higher education institution in the country is currently championing the concept of sustainable living. Together with the help of various public and private partners, USM aims to realize the concept of “health for all” by engaging herself in a number of health promotional campaigns and activities.

Project Main Objective

The main aim of this project is to empower underprivileged communities through the concept of sustainable healthy living. Besides that, this project will complement USM's agenda for fostering relationships between the university and communities through a smart partnership approach. Project Overview This project is a collaborative venture between the School of Pharmaceutical Sciences, USM and Yayasan Bina Ilmu (YBI), a prominent local CSO in the state of Penang, Malaysia. A total of 3 communities have benefited from the project since its inception in July 2011. Reports on the various project activities are provided in this publication.

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A Glimpse of the Community Living Environment

Photos taken by Ms. Lee She Wei during the initial visit to Kampung Medan Tunku, Jelutong district (one of the sites engaged in the project)

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Yayasan Bina Ilmu (YBI) First Volunteer Clinic and Health Talk

Date : 27th July 2011 Time : 5:30 pm – 8:00 pm Venue : YBI clinic, Kampung Medan Tunku, Jelutong Agenda : Health talk and counselling Health Education Associate Professor Dr. Mohamed Azmi Ahmad Hassali, an expert from the Discipline of Social and Administrative Pharmacy (DSAP), School of Pharmaceutical Sciences, USM, delivered a talk entitled “Kenali Ubat Anda (Know Your Medicines).” The second talk for the day was delivered by a pharmacist Ms. Ezazaya Othman. She spoke on proper usage of medication by Muslims during the fasting month of Ramadan. Besides that, it was announced that physiotherapy services would henceforth be provided in the YBI clinic by Mr. Siva. The health presentations were followed by a question-and-answer session. A total of 25 residents from Kampung Medan Tunku, Jelutong district attended this event. YBI Clinic The clinic operates from 7 pm until 8 pm. The medical doctor in charge for the day was Dr. Jayabalan (Honorary Lecturer for the DSAP). Ten patients were attended to, and counselling on rational use of medicines was provided by Ms. Gin Nie Chua, a lecturer from DSAP. Report Prepared by:

1. Associate Professor Dr. Mohamed Azmi Ahmad Hassali, Lecturer, DSAP, School of Pharmaceutical Sciences, USM

2. Dr. Imran Masood, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 3. Ms. Gin Nie Chua, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 4. Ms. Kalyhani Nagappa, 3rd Year Pharmacy Student, School of Pharmaceutical

Sciences, USM

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Project team members having a discussion before the start of the session Arrival of guest of honour, Dato’ Abdul Rashid b. Ismail

A public talk titled “Know Your Medicines” Talk by Associate Professor Dr. Mohamed Azmi Ahmad Hassali on “Know

Your Medicines”

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Talk by Ms. Ezazaya Othman, pharmacist from Hospital Sg Bakap, on “Proper Usage of Medication During the Fasting Month”

Participants listening to the health promotion talks

Dato’ Abdul Rashid b. Ismail, the chief guest, interacting with the participants Participants of the event with the speakers and organizers

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YBI Clinic for the Month of September 2011

Date : 28th September 2011 Time : 5:30 pm – 7:00 pm Venue : YBI clinic, Kampung Medan Tunku, Jelutong Agenda : Health talk The programme for the day began at 5:30 pm. Before the programme started, there was a short briefing for all the volunteers who were present. The day’s talk, given by Ms. Koo Hooi Chin, was on “Healthy Diet for Diabetic Patients”. There were 30 participants from the surrounding villages who attended this health talk. Ms. Koo, who is a dietician from Hospital Sungai Bakap, Penang, described proper eating habits according to the caloric chart. The talk was followed by a question-and-answer session. In his closing speech, guest of honour Dato’ Abdul Rashid b. Ismail thanked everyone who was present for their support and commitment. He also conveyed his hope that this programme would be expanded to include residents from the neighbouring villages as well. The health talk ended at 7 pm. The next date for the clinic was fixed for the 18th of October 2011. Report Prepared by:

1. Associate Professor Dr. Mohamed Azmi Ahmad Hassali, Lecturer, DSAP, School of Pharmaceutical Sciences, USM

2. Dr. Imran Masood, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 3. Ms. Gin Nie Chua, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 4. Ms. Kalyhani Nagappa, 3rd Year Pharmacy Student, School of Pharmaceutical

Sciences, USM

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Ms. Koo Hooi Chin, dietician from Hospital Sg Bakap, delivering her talk entitled “Healthy Diet for Diabetic Patients” Ms. Koo Hooi Chin answering a question raised by one of the participants

Participants listening to the talk with keen interest Participants of the health promotion campaign

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Ms. Gin Nie Chua thanking Ms. Koo Hooi Chin for her presentation Dato’ Abdul Rashid b. Ismail, the chief guest, interacting with participants

Dato’ Abdul Rashid b. Ismail, the chief guest, presenting a token of appreciation to Ms. Koo Hooi Chin

Ms. Koo Hooi Chin in a dietary counselling session with participants

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YBI Health Education for the Month of October 2011

Date : 19th October 2011 Time : 5:30 pm – 7:30 pm Venue : YBI clinic, Kampung Medan Tunku, Jelutong Agenda : Health talk and screening This health education programme was conducted on the 19th of October 2011 for the residents of Jelutong district. A total of 30 people attended the talk, with 9 volunteers offering their services to help conduct the health session. The talk, given by Dr Asrul Akmal Shafie from DSAP, School of Pharmaceutical Sciences, USM, was on the topic of “Ubat Herba Menjadi Kawan atau Lawan (Herbal Medications – Boon or Bane).” In this session, the public was educated on herbal medications, the misuses and their interaction with conventional medications. At the end of the talk, the audience got involved by raising questions. The session was followed by health screening and medical check-up by Dr. Jayabalan. Additional services such as blood pressure monitoring, cholesterol and blood glucose tests were also offered on the particular day. Physiotherapy services were also provided. The whole session ended at 7:30 pm and the next date for the upcoming clinic was yet to be decided. Report Prepared by:

1. Associate Professor Dr. Mohamed Azmi Ahmad Hassali, Lecturer, DSAP, School of Pharmaceutical Sciences, USM

2. Dr. Imran Masood, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 3. Ms. Gin Nie Chua, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 4. Ms. Kalyhani Nagappa, 3rd Year Pharmacy Student, School of Pharmaceutical

Sciences, USM

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Participants in the session Associate Professor Dr. Asrul Akmal Shafie delivering a talk titled “Ubat Herba Menjadi Kawan atau Lawan”

Participants of the health campaign Some of the participants from a local religious school

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Mr. Farook, a community leader in Jelutong, posing a question to the speaker A participant during the question-and-answer session

Associate Professor Dr. Mohamed Azmi Ahmad Hassali elaborating on some points in response to a question raised by one of the participants

Dato’ Abdul Rashid b. Ismail, the chief guest, presenting a token of appreciation to Associate Prof. Dr. Asrul Akmal Shafie

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Community Wellness Programme “Towards Healthy Living”

Date : 4th December 2011 Venue : An-Nur Mosque Compound, Titi Teras, Balik Pulau, Penang, Malaysia Time : 9:00 am – 12:00 pm Agenda : Health talk, screening, poster exhibition and medication compounding

demonstration A Community Wellness Programme was held on the 4th of December 2011 in Titi Teras village, Balik Pulau, Penang, Malaysia. Based on the theme “Towards Healthy Living”, the programme was conceived by the village community and was organized in collaboration with the DSAP, Department of Clinical Pharmacy, School of Pharmaceutical Sciences, USM and Penang Family Health and Development Association. Among the activities held on the day were colouring competition for the children, cooking competition for the adults, basic health screening such as blood pressure, glucose and cholesterol checks, medication counselling, pap smear and breast examination, voluntary HIV testing and counselling. In addition, a group of 30 pharmacy undergraduates gave a medication compounding demonstration and put up posters on common non-communicable diseases to promote awareness among the villagers. During the event, villagers who were less affluent received aid in the form of cash and basic necessities such as school uniforms and food from Sunway Group Sdn. Bhd. The event unfolded successfully and drew the participation of over 100 villagers. Report Prepared by:

1. Associate Professor Dr. Mohamed Azmi Ahmad Hassali, Lecturer, DSAP, School of Pharmaceutical Sciences, USM

2. Ms. Gin Nie Chua, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 3. Dr. Imran Masood, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 4. Ms. Nor Izreen Fazlinda Binti Idris, 3rd Year Pharmacy Student, School of

Pharmaceutical Sciences, USM

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Event organizers finalizing the arrangements and layout plan of the activity at Titi Teras, Balik Pulau

Event organizers finalizing the arrangements and layout plan of the activity at Titi Teras, Balik Pulau

Pharmacy students demonstrating how to make simple pharmaceutical preparations

Health promotion poster exhibition

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Health screening activity undertaken by USM staff Health Assessment Survey undertaken by Ms. Gin Nie Chua

Staff and postgraduate students from USM at the event Dato’ Seri Abdul Rahman Maidin, patron for the event, giving the opening

speech

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Community Wellness Programme

Co-organized by School of Pharmaceutical Sciences (USM), Lebuh Makloom 1Malaysia Community and Yayasan Bina Ilmu (YBI) with assistance from Wellness Centre (USM)

Date : 18th December 2011 Venue : 1Malaysia Community Hall, Lebuh Makloom, Jelutong, Penang Time : 9:00 am – 2:00 pm Agenda : Health talk, screening, poster exhibition and medication compounding

demonstration On the 18th of December 2011, the School of Pharmaceutical Sciences, USM in collaboration with the Wellness Centre, USM and YBI organized a community service programme at Lebuh Makloom, Jelutong, Penang, Malaysia. A group of lecturers, pharmacists, nurses and student volunteers led the activities for the day. The event took off with an educational talk on “What You Should Know About Your Medicines” by Associate Professor Dr. Mohamed Azmi Ahmad Hassali. Free screening for body fat analysis, blood pressure monitoring, glucose and cholesterol measurement as well as medication counselling were offered for free to over 100 residents at Lebuh Makloom who participated in the half-day programme. In addition, medicine compounding demonstrations by pharmacy undergraduate students from USM shed light on what goes into medicine making. Other activities at the event included poster presentations on common non-communicable diseases, a short video show on rational use of medicines, health quiz for the public and giveaways for early bird participants. The event came to a successful conclusion at 2:00 pm and wrapped up the community service efforts for the year 2011. Report Prepared by:

1. Associate Professor Dr. Mohamed Azmi Ahmad Hassali, Lecturer, DSAP, School of Pharmaceutical Sciences, USM

2. Ms. Gin Nie Chua, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 3. Dr. Imran Masood, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 4. Ms. Nor Izreen Fazlinda Binti Idris, 3rd Year Pharmacy Student, School of

Pharmaceutical Sciences, USM

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Community Hall at Lebuh Makloom, Jelutong, Penang The project team discussing the programme arrangements with Mr. Mohd.

Farook SK Mohd., the Head of ‘Komuniti 1Malaysia’, Lebuh Makloom

Programme banner displayed at the entrance of the Community Hall Project team and student volunteers getting ready for the programme

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Dr. Hamidah, dentist from USM, examining a young participant of the programme

Participants for the health screening programme

Residents of the area listening attentively to the health talk Associate Professor Dr. Mohamed Azmi Hassali receiving a token of

appreciation from Mr. Ahmad Ismail Amin, the Deputy Chairman for Komuniti 1Malaysia

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Community Wellness Programme “Mai Kita Sepakat Jaga Kesihatan”

Co-organized by School of Pharmaceutical Sciences (USM), Yayasan Bina Ilmu (YBI) and

Gabungan Pelajar Melayu Semenanjung (GPMS) Sungai Pinang

Date : 8th April 2012 Venue : Sungai Pinang Community Hall, Georgetown, Penang, Malaysia Time : 9:00 am – 2:00 pm Agenda : Health talk, screening, dental check-up, poster exhibition and medication

compounding demonstration On the 8th of April 2012, a joint community health programme was organized by the School of Pharmaceutical Sciences, USM along with YBI and Gabungan Pelajar Melayu Semenanjung (GPMS) for the community of Sungai Pinang in Penang, Malaysia. A total of 40 volunteers worked together to ensure the success of the programme. Apart from free health screening provided by the School of Pharmaceutical Sciences, USM, free dental check-ups were also provided by the staff from the USM Wellness Centre. The programme involved children from the community kindergarten by arranging a healthy eating colouring contest. A total of 50 children participated in the colouring contest. The following activities were carried out during the programme:

• Talk by Associate Professor Dr. Mohamed Azmi Ahmad Hassali entitled “What You

Should Know About Your Medicines” • Talk by Dr. Baharudin Ibrahim on “Diabetes and Healthy Diet” • Health screening (blood pressure, blood glucose, cholesterol, BMI measurement) • Dental check-up • Counselling session by registered pharmacists • Health poster exhibition • Medicine compounding demonstration • Video presentation on rational use of medicines

Report Prepared by:

1. Associate Professor Dr. Mohamed Azmi Ahmad Hassali, Lecturer, DSAP, School of Pharmaceutical Sciences, USM

2. Ms. Kalyhani Nagappa, 3rd Year Pharmacy Student, School of Pharmaceutical Sciences, USM

3. Ms. Gin Nie Chua, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 4. Dr. Imran Masood, Lecturer, DSAP, School of Pharmaceutical Sciences, USM 5. Muhammad Sharrieffuddin b. Mohd. Jaki, Research Officer, DSAP, School of

Pharmaceutical Sciences, USM

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Associate Professor Dr. Mohamed Azmi Ahmad Hassali presenting his talk on “What You Should Know About Your Medicines”

Participants listening to the presentation on “What You Should Know About Your Medicines” by Associate Professor Dr. Mohamed Azmi Ahmad Hassali

Dr. Baharudin Ibrahim giving a talk on “Diabetes and Healthy Diet” Participants listening to the presentation on “Diabetes and Healthy Diet” by Dr. Baharudin Ibrahim

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Enrolment of participants prior to medical check-up A snapshot of various devices used during the medical check-up

Volunteer pharmacy students at the community wellness programme Participants for the health screening programme

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Youngsters from the Sungai Pinang community getting ready to participate in the colouring competition Youngsters participating in the colouring competition

Children and their creations And the winner is.....: Prize distribution ceremony at the health campaign

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References

1. WHO (2007). Sixtieth World Health Assembly. Geneva 14–23 May 2007. Resolutions and Decision Annexes. WHA 60.24. Health Promotion in a Globalized World, 90-91.

2. Baranowski T, Perry CL, Parcel GS (1996). How individuals, environments, and health behavior interact. Health Behavior and Health Education: Theory, Research, and Practice (ed. by Glanz K, Lewis FM, Rimer BK), pp. 153-78.

3. WHO/UNICEF (1978). Declaration of Alma Ata. Geneva: WHO.

4. WHO (1986). Ottawa Charter for Health Promotion. Geneva: WHO.

5. Merican MI, Rohaizat Y, Haniza S (2004). Developing the Malaysian health system to meet the challenges of the future. Medical Journal of Malaysia, 59(1):84-93.

6. Altman DG, Endres J, Linzer J, Lorig K, Howard-Pitney B, Rogers T (1991). Obstacles to and future goals of ten comprehensive community health promotion projects. Journal of Community Health, 16:299-314.

7. Roussos ST, Fawcett SB (2000). A review of collaborative partnerships as a strategy for improving community health. Annual Review of Public Health, 21:369-402.

Discipline of Social & Administrative Pharmacy School of Pharmaceutical Sciences Universiti Sains Malaysia 11800 Penang, Malaysia. Phone: 0060-4-6534085 Fax: 0060-4-6570017