nhms_2019.pdf

Type: Document | Status: ready

Non-Communicable Diseases: Risk Factors and other Health Problems 001 MOH/S/IKU/144.20(TR)-e

National Health and Morbidity Survey 2019 Technical Report − Volume I 002

Non-Communicable Diseases: Risk Factors and other Health Problems 001 NATIONAL HEALTH AND MORBIDITY SURVEY 2019: NON-COMMUNICABLE DISEASES, HEALTHCARE DEMAND AND HEALTH LITERACY Volume I: NCDs – Non-Communicable Diseases: Risk Factors and other Health Problems NMRR-18-3085-44207 The following persons had contributed in the proposal, planning, logistics, analysis, write-up, discussion, conclusions and/or drawing recommendations for this report. Core Team Members Dr Shubash Shander Ganapathy, Dr Hj Tahir Hj Aris, Dr Noor Ani Ahmad, Dr Nor Izzah Hj Ahmad Shauki, Dr Manimaran Krishnan Kaundan, Nazirah Alias, Dr Muhammad Fadhli Mohd Yusoff, Suhana Jawahir, Komathi Perialathan, Dr Mohd Shaiful Azlan Kassim, Wan Shakira Rodzlan Hasani, Dr Fathullah Iqbal Ab Rahim, Dr Halizah Mat Rifin, Dr LeeAnn Tan, Norzawati Yeop, Dr Mohd Azahadi Omar, Norazizah Ibrahim Wong, Ruhaya Salleh, Lim Kuang Kuay, Dr Rajini Sooryanarayana, Hasimah Ismail, Norhafizah Sahril, Chan Ying Ying, Ahmad Ali Zainuddin, Andy Mustaming Editors Chan Ying Ying, Norzawati Yeop, Dr Muhammad Solihin Rezali, Dr Jane Ling Miaw Yn, Dr Noor Aliza Lodz, Syafinaz Mohd Sallehuddin, Dr Chong Zhuo Lin, Dr Thamil Arasu Saminathan, Cheong Siew Man, Lalitha Palanivello, Dr Fazila Haryati Ahmad, Dr Tania Gayle Robert Lourdes, Mohd Hatta Abdul Mutalib, Jayvikramjit Singh Manjit Singh Produced and Distributed by Institute for Public Health, Ministry of Health, Malaysia The National Health and Morbidity Survey 2019: Non-Communicable Diseases, Healthcare Demand and Health Literacy Institute for Public Health National Institutes of Health Ministry of Health Block B5 & B6, Kompleks NIH No 1, Jln Setia Murni U13/52 Seksyen U13, Bandar Setia Alam 40170 Shah Alam, Selangor Darul Ehsan Tel: +603-3362 7800 Fax: +603-3362 7801 / 7802 Any enquiries or comments on this report should be directed to The Principal Investigator, The National Health and Morbidity Survey 2019 Institute for Public Health, National Institutes of Health, Ministry of Health, Block B5 & B6, Kompleks NIH No 1, Jln Setia Murni U13/52 Seksyen U13, Bandar Setia Alam 40170 Shah Alam, Selangor Darul Ehsan Tel: +603-3362 7800 Fax: +603-3362 7801 / 7802 Published by the Institute for Public Health, National Institutes of Health (NIH), Ministry of Health, Malaysia

National Health and Morbidity Survey 2019 Technical Report − Volume I 002 This report comprises of two volumes, as follows: i. Volume I: NCDs – Non-Communicable Diseases: Risk Factors and other Health Problems ii. Volume II: Healthcare Demand ©2020, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia. Selangor. ISBN: e978-967-18159-2-2 Suggested citation: Institute for Public Health (IPH), National Institutes of Health, Ministry of Health Malaysia. 2020. National Health and Morbidity Survey (NHMS) 2019: Vol. I: NCDs – Non-Communicable Diseases: Risk Factors and other Health Problems Disclaimer The views expressed in this report are those of the authors alone and do not necessarily represent the opinions of other investigators participating in the survey, nor the views or policy of the Ministry of Health. National Health and Morbidity Survey 2019 Technical Report − Volume I 002

Non-Communicable Diseases: Risk Factors and other Health Problems 003 Message from the Director General of Health Malaysia The National Health and Morbidity Survey (NHMS) was first carried out by the Ministry of Health Malaysia in 1986 and subsequently in ten-yearly intervals, i.e. in 1996 and 2006, to obtain local data on the nation’s population health. However, given the growing importance of ‘time-context’ data to effectively respond to the healthcare needs in Malaysia, the NHMS is now carried out every year since 2011, with a regular four-yearly interval survey on Non-Communicable Diseases (NCDs). The significance of the NHMS goes beyond providing up- to-date epidemiological data on the key diseases and NCDs risk factors. An understanding of disease trends and their risk factors will supplement and aid the country in planning for the healthcare needs of the people in Malaysia. Thus, the information gained from the NHMS will unequivocally facilitate the process of benchmarking our progress towards global commitments and strategically prioritise our nation to achieve Universal Health Coverage (UHC) and the Sustainable Developmental Goals (SDG). The alarming rise of NCDs in Malaysia over the years is of grave concern as we approach an ageing nation status. In 2016, the Ministry of Health developed the National Strategic Plan on Non-Communicable Diseases (NSP-NCD) to tackle the growing burden of NCDs in Malaysia. The analysis obtained from this survey will provide the Ministry of Health the tools towards monitoring and evaluating the formulated health policies and strategies to strengthen healthcare delivery to the nation continuously. This latest NHMS aimed to provide community-based data to determine the prevalence of NCDs, the prevalence of risk factors of NCDs, and relevant critical areas of concern. The diseases and risk factors studied in each NHMS is overseen by the NHMS Steering Committee, which consists of Ministry of Health policymakers as well as state representatives and experts from local universities. Each topic studied in the survey is critically evaluated to ensure appropriate and meaningful data collection. The NHMS 2019 was carried out between July and October 2019, simultaneously across all 13 states and three Federal Territories in Malaysia. A total of 70 research teams of over 300 personnel, consisting of field supervisors, research assistants and nurses were mobilised for data collection. In addition, dozens of experts from the Ministry of Health and local universities from various fields were involved in the analysis and preparation of this report. The success of this nation-wide survey is owed to the gracious support from all the state health departments in carrying out scouting activities, providing nurses, and assisting the research teams. I wish to express my gratitude to all State Health Directors and their team members for their immense contribution. My commendation also goes to the survey team from the Institute for Public Health, Institute for Health Systems Research, and Institute for Health Behavioural Research for the successful completion of this important survey. Thank you to all the agencies involved for their support and cooperation throughout the process. Last but not least, I also thank all the respondents who had taken the time to participate in this survey and urge everyone to join hands towards creating a healthy Malaysia. This survey has highlighted several areas of concern that will be addressed by the Ministry of Health as we continue to improve the health status and health delivery in the country. Datuk Dr Noor Hisham bin Abdullah Director General of Health Malaysia Chairman of NHMS Steering Committee Ministry of Health Malaysia Non-Communicable Diseases: Risk Factors and other Health Problems 003

National Health and Morbidity Survey 2019 Technical Report − Volume I 004 Acknowledgements The authors would like to thank the Director General of Health Malaysia for his enduring support and guidance during the conduct of this survey and for his permission to publish this report. Our sincere appreciation to the Deputy Director General (Research and Technical Support), our beloved Directors of the Institute for Public Health, Institute for Health Systems Research and Institute for Health Behavioural Research, for their unwavering support, guidance and technical advice throughout the various stages of the survey that led this project to fruition. The National Health and Morbidity Survey 2019, was accomplished with funding supported by the National Institutes of Health, Ministry of Health Malaysia. Technical advice was from the Advisory Panel and Steering Committee, consisting of executives and experts from both inside and outside the Ministry of Health. The authors would like to express our sincere thanks to them. Our sincere gratitude also goes to the Department of Statistics Malaysia for their assistance in the sampling and preparation of data collection. The authors thank all the State Health Directors, all State Liaison Officers and District Health Officers who have been instrumental in mobilising resources during the scouting and data collection phase. We also extend our gratitude to all personnel in Institute for Public Health, Institute for Health Systems Research, and Institute for Health Behavioural Research for their support in carrying out this survey. The authors also thank all parties who assisted in the implementation of the survey, from the Central Committee Team, Field Supervisors, Team Leaders, Data Collectors and Drivers, without whom the survey would not have been a success. Finally, our sincere appreciation is extended to all respondents who had participated in and contributed their valuable time and precious information towards the survey. It is our hope that these findings will help program leaders and policy makers to better run the various health programs and other services available to the people of Malaysia. National Health and Morbidity Survey 2019 Technical Report − Volume I 004

Non-Communicable Diseases: Risk Factors and other Health Problems 005 Table of Contents Acknowledgement 004 Executive Summary 010 1.0 Introduction 1.1 Background 1.2 Objectives 014 014 014 2.0 Methodology 2.1 Target Population 2.2 Sampling Frame 2.3 Sample Size Determination 2.4 Sampling Design 2.5 Ethical Considerations 2.6 Questionnaire and Other Survey Material 2.7 Field Preparation and Logistic Support 2.8 Training 2.9 Publicity 2.10 Data Collection 2.11 Data Management and Monitoring During Data Collection 2.12 Data Analysis 016 016 016 016 016 017 017 018 019 019 019 020 020 3.0 General Findings 3.1 Sample Coverage 3.2 Sociodemographic Characteristics 3.3 Sample Representativeness 022 022 022 024 4.0 Non-Communicable Diseases: Diabetes, Hypertension and Hypercholesterolaemia 4.1 Diabetes 4.2 Hypertension 4.3 Hypercholesterolaemia 026 026 028 029 5.0 Physical Activity 070 6.0 Tobacco Use 6.1 Smoking 6.2 Exposure to Secondhand Smoke 6.3 Smoking Cessation Behaviour 6.4 Awareness of Anti-Smoking Campaign 6.5 Awareness of Cigarette Advertising and Promotion 080 081 081 082 082 082 7.0 Dietary Practices 7.1 Intake of Commercially Packed Ready to Drink Beverages/ Premixed/ Sugar Added Self-Prepared Drinks and The Consumption of Sugar 7.2 Dietary Practices 104 104 107 8.0 Health Screening 8.1 Medical Check-Up / Health Screenings 8.2 Breast Cancer
8.3 Cervical Cancer 8.4 Faecal Occult Blood Test for Colorectal Cancer Screening 132 133 133 134 134 9.0 Alcohol Consumption 9.1 Alcohol Consumption Among Those Aged 18 Years and Above 9.2 Alcohol Consumption Among Those Aged 13 Years Old and Above 9.3 Binge Drinking Among Those Aged 18 Years and Above 9.4 Heavy Episodic Drinkers Among Those Aged 18 Years and Above 9.5 AUDIT Risk Stratification Related to Pattern of Drinking 146 147 147 147 147 147 10.0 Substance Abuse 156 11.0 Benign Prostatic Hyperplasia (BPH) 162 12.0 Erectile Dysfunction (ED) 168 13.0 Anaemia 174 14.0 Nutritional Status of Adults 184 15.0 Nutritional Status of Children 15.1 Nutritional Status of Children Below 5 Years Old 15.2 Nutritional Status Among Children 5 To 17 Years Old 206 206 207 16.0 Mental Health Problems of Children 226 17.0 Disability 236 18.0 Child Functioning 248 19.0 Epilepsy 252 20.0 Depression 256 21.0 Health Literacy 21.1 Overall Health Literacy 21.2 Health Literacy in Health Care, Disease Prevention and Health Promotion Domains 260 261 262

National Health and Morbidity Survey 2019 Technical Report − Volume I 006 List of Tables Table 2.1: Distribution of Sample by State, NHMS 2019 Table 2.2: Questionnaire Used for NCD Component, NHMS 2019 017 018 Table 3.1: Response Rate by Living Quarters and Individual by State, NHMS 2019 Table 3.2: Socio-Demographic Characteristics of Sample, NHMS 2019 022 023 Table 4.1: Non-Communicable Diseases Trend in Malaysia Table 4.2: Prevalence of Overall Raised Blood Glucose Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 4.3: Prevalence of Known Diabetes Among Adults Aged 18 Years and Above in Malaysia by Socio- Demographic Characteristics Table 4.4: Prevalence of Raised Blood Glucose Amongst Those Not Known to Have Diabetes Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 4.5: Prevalence of Overall Raised Blood Pressure Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 4.6: Prevalence of Known Hypertension Among Adults Aged 18 Years and Above in Malaysia by Socio- Demographic Characteristics Table 4.7: Prevalence of Raised Blood Pressure Amongst Those Not Known to Have Hypertension Among Adults Aged 18 Years and Above in Malaysia by Socio- Demographic Characteristics Table 4.8: Prevalence of Overall Raised Blood Cholesterol Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 4.9: Prevalence of Known Hypercholesterolemia Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 4.10: Prevalence of Raised Total Cholesterol Amongst Those Not Known to Have Hypercholesterolemia Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics 031 032 036 040 044 048 052 056 060 064 Table 5.1: Physical Inactivity Trend in Malaysia Table 5.2: Prevalence of Physically Inactivity Among Respondents Aged 16 Years and Above in Malaysia by Socio-Demographic Characteristics Table 5.3: Prevalence of Physical Inactivity in Travel
Domain Among Respondents Aged 16 Years and Above in Malaysia by Socio-Demographic Characteristics 071 072 073 Table 5.4: Prevalence of Exposure to Physical Activity Information Disseminated Through Various Mass Media Channels Among Respondents Aged 16 Years and Above in Malaysia by Socio-Demographic Characteristics 074 Table 6.1: Smoking Trend in Malaysia Table 6.2: Prevalence of Smokers Among Respondents Aged 15 Years and Above in Malaysia by Socio- Demographic Characteristics Table 6.3: Prevalence of Smokeless Tobacco and E-cigarettes / Vape Use Among Respondents Aged 15 Years and Above in Malaysia by Socio-Demographic Characteristics Table 6.4: Prevalence of Any Tobacco Product Use Among Respondents Aged 15 Years and Above in Malaysia by Socio-Demographic Characteristics Table 6.5: Cigarettes Smoked Per Day Among Daily Cigarette Smokers Among Respondents Aged 15 Years and Above in Malaysia by Socio-Demographic Characteristics Table 6.6: Prevalence of Exposure to Secondhand Smoke at Home and Work Among Respondents Aged 15 Years and Above in Malaysia by Socio-Demographic Characteristics Table 6.7: Prevalence of Exposure to Secondhand Smoke at Eateries Among Respondents Aged 15 Years and Above in Malaysia by Socio-Demographic Characteristics Table 6.8: Current Smokers Who Made a Quit Attempt in The Past 12 Months Among Respondents Aged 15 Years and Above in Malaysia by Socio-Demographic Characteristics Table 6.9: Prevalence of Noticing Anti-Cigarette Information in Newspapers/Magazines and Television in The Past 30 days Among Respondents Aged 15 Years and Above in Malaysia by Socio-Demographic Characteristics Table 6.10: Prevalence of Noticing Cigarette Advertisement and Promotion Among Respondents Aged 15 Years and Above in Malaysia 083 084 086 088 090 094 096 098 099 101 Table 7 .1: Inadequate Fruit and / or Vegetable Intake Trend in Malaysia Table 7 .2: Prevalence of at Least Once in A Week Intake of Commercially Packed Ready to Drink (CPRD) Beverages, Proportion of Daily Intake of at Least One Type of CPRD Beverages and The Amount of Sugar Intake Per Day Among the Respondents Consuming CPRD Beverages Daily Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 7 .3: Prevalence of at Least Once in A Week Intake of Premixed Drinks, Proportion of Daily Intake of at Least One Type of Premixed Beverages and The Amount of Sugar Intake Per Day Among the Respondents Consuming Premixed Beverages Daily Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics 109 110 114 Non-Communicable Diseases: Risk Factors and other Health Problems 007 Table 7 .4: Prevalence of at Least Once in A Week Intake of Sugar Added Self-Prepared Beverages, Proportion of Daily Intake of at Least One Type of Self-Prepared Beverages and The Amount of Sugar Intake Per Day Among the Respondents Consuming Self-Prepared Beverages Daily Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 7 .5: Prevalence of Inadequate Intake of Fruit, Vegetable and Fruit and / or Vegetable Among Adults Aged 18 Years and Above in Malaysia by Socio- Demographic Characteristics Table 7 .6: Prevalence of Adequate and Inadequate Plain Water Intake in A Day Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 7 .7: Prevalence of Awareness of Healthy Plate Concept Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 7 .8: Prevalence of Adequate Knowledge and Practice of Healthy Plate Concept Among Those with Awareness Among Adults Aged 18 Years and Above in Malaysia 118 122 126 128 129 Table 8.1: Prevalence of Undergoing Any Health Screening / Medical Check Up in The Past 12 Months Among Adults Aged 18 Years and Above in Malaysia by Socio- Demographic Characteristics Table 8.2: Prevalence of Breast Self-Examination in The Past 12 Months Among Females Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 8.3: Prevalence of Mammogram Examination (In The Past 3 Years and Ever Done) Among Females Aged 40 Years and Above in Malaysia by Socio-Demographic Characteristics Table 8.4: Prevalence of Pap Smear Examination in The Last 3 Years and, Awareness and Interest to Use Self- Sampling Screening (HPV Screening) Among Female Aged 20 Years and Above in Malaysia by Socio-Demographic Characteristics Table 8.5: Prevalence of Faecal Occult Blood Test Among Adults Aged 50 Years and Above in Malaysia by Socio- Demographic Characteristics 136 137 138 140 144 Table 9.1: Harmful Alcohol Consumption Trend in Malaysia Table 9.2: Prevalence of Current Drinkers Among Adults Aged 18 Years and Above in Malaysia by Socio- Demographic Characteristics Table 9.3: Prevalence of Current Drinkers Among Respondents Aged 13 Years and Above in Malaysia by Socio-Demographic Characteristics Table 9.4: Proportion of Binge Drinkers Among Current Drinkers Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics 148 149 150 151 Table 9.5: Proportion of Heavy Episodic Drinkers Among Current Drinkers Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 9.6: Proportion of AUDIT Risk Stratification Score Among Current Drinkers Aged 18 Years and Above in Malaysia 152 153 Table 10.1: Prevalence of Ever and Current Drug Use Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 10.2: Prevalence of Drug Use by Types Among Adults Aged 18 Years and Above in Malaysia Table 10.3: Proportion of Age of Initiation and Types of First Started Drug by Respondents with Ever Drug Use Among Adults Aged 18 Years and Above in Malaysia Table 10.4: Proportion of Sources of Obtaining Drugs by Respondents with Current Drug Use Among Adults Aged 18 Years and Above in Malaysia 158 159 159 159 Table 11.1: Prevalence of Probable Benign Prostatic Hyperplasia (BPH) Among Males Aged 40 Years and Above in Malaysia by Socio-Demographic Characteristics Table 11.2: Association Between BPH Status and Quality of Life (QoL) Due to Urinary Symptom Among Males Aged 40 Years and Above in Malaysia 164 165 Table 12.1: Prevalence of Probable Erectile Dysfunction (ED) Among Sexually Active Males Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics 170 Table 13.1: Anaemia Trend in Malaysia Table 13.2: Prevalence of Anaemia Among Respondents Aged 15 Years and Above in Malaysia by Socio- Demographic Characteristics Table 13.3: Prevalence of Anaemia Level Among Respondents Aged 15 Years and Above in Malaysia by Socio-Demographic Characteristics Table 13.4: Prevalence of Anaemia Among Women of Reproductive Age Group (15-49 years) in Malaysia by Socio-Demographic Characteristics Table 13.5: Prevalence of Anaemia Level Among Women of Reproductive Age Group (15-49 years) in Malaysia by Socio-Demographic Characteristics 175 176 177 179 180 Table 14.1: Nutritional Status (Adults) Trend in Malaysia Table 14.2: Prevalence of Underweight Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 14.3: Prevalence of Normal BMI Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 14.4: Prevalence of Overweight Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics 186 187 188 190 National Health and Morbidity Survey 2019 Technical Report − Volume I 008 Table 14.5: Prevalence of Obesity Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 14.6: Prevalence of Obesity I to III (WHO 1998) Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 14.7: Prevalence of Obesity I to III (CPG 2004) Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 14.8: Prevalence of Abdominal Obesity (WHO 2000) Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 14.9: Mean Weight by BMI Category Among Adults Aged 18 Years and Above in Malaysia 192 194 198 202 203 Table 15.1: Nutritional Status (Children Under 5 Years of Age) Trend in Malaysia Table 15.2: Nutritional Status (Children 5 – 17 Years of Age) Trend in Malaysia Table 15.3: Prevalence of Nutritional Status Among Children Below 5 Years Old in Malaysia Table 15.4: Prevalence of Nutritional Status Among Children Aged 5-17 Years Old in Malaysia Table 15.5: Prevalence of Weight-for-Age Among Children Below 5 Years Old in Malaysia by Socio-Demographic Characteristics Table 15.6: Prevalence of Height-for-Age Among Children Below 5 Years Old in Malaysia by Socio-Demographic Characteristics Table 15.7: Prevalence of Weight-for-Height Among Children Below 5 Years Old in Malaysia by Socio- Demographic Characteristics Table 15.8: Prevalence of BMI-for-Age Among Children Below 5 Years Old in Malaysia by Socio-Demographic Characteristics Table 15.9: Prevalence of Weight-for-Age Among Children Aged 5-10 Years Old in Malaysia by Socio-Demographic Characteristics Table 15.10: Prevalence of Height-for-Age Among Children Aged 5-17 Years Old in Malaysia by Socio-Demographic Characteristics Table 15.11: Prevalence of BMI-for-Age Among Children Aged 5-17 Years Old in Malaysia by Socio-Demographic Characteristics 207 209 209 210 210 212 214 216 218 220 222 Table 16.1: Mental Health (Children) Trend in Malaysia Table 16.2: Prevalence of Mental Health Problems Among Children Aged 5 - 15 Years in Malaysia by Socio- Demographic Characteristics Table 16.3: Prevalence of Emotional Health Problems Among Children Aged 5 - 15 Years in Malaysia by Socio- Demographic Characteristics 227 228 229 Table 16.4: Prevalence of Conduct Problems Among Children Aged 5 - 15 Years in Malaysia by Socio- Demographic Characteristics Table 16.5: Prevalence of Hyperactivity Problems Among Children Aged 5 -15 years in Malaysia by Socio- Demographic Characteristics Table 16.6: Prevalence of Peer Problems Among Children Aged 5 - 15 Years in Malaysia by Socio-Demographic Characteristics Table 16.7: Prevalence of Pro-Social Skills Among Children Aged 5 - 15 Years in Malaysia by Socio-Demographic Characteristics 230 231 232 233 Table 17 .1: Disability (Adult) Trend in Malaysia Table 17 .2: Prevalence of Overall Difficulty Among Adults Aged 18 Years and Above in Malaysia by Socio- Demographic Characteristics Table 17 .3: Prevalence of Difficulty by Domains Among Adults Aged 18 Years and Above in Malaysia by Socio- Demographic Characteristics Table 17 .4: Prevalence of Overall Disability Among Adults Aged 18 Years and Above in Malaysia by Socio- Demographic Characteristics Table 17 .5: Use of Assistive Device Among Adults with Overall Difficulty Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics 238 239 240 244 245 Table 18.1: Prevalence of Overall Functional Difficulty (At Least One Domain) Among Children Aged 2-17 Years in Malaysia by Socio-Demographic Characteristics Table 18.2: Prevalence of Use of Assistive Devices Among Children Aged 2-17 Years in Malaysia 250 250 Table 19.1: Prevalence of Suspected Epilepsy (Preliminary Results Based on Initial Screening) in Malaysia by Socio- Demographic Characteristics 254 Table 20.1: Prevalence of Depression Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics 258 Table 21.1: Prevalence of Total Health Literacy Level Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 21.2: Prevalence of Health Literacy Level for Healthcare Domain Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 21.3: Prevalence of Health Literacy Level for Disease Prevention Domain Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics Table 21.4: Prevalence of Health Literacy Level for Health Promotion Domain Among Adults Aged 18 Years and Above in Malaysia by Socio-Demographic Characteristics 264 268 272 276 Non-Communicable Diseases: Risk Factors and other Health Problems 009 List of Figures Figure 3.1: Population Pyramid Comparing Estimated Population of NHMS 2019 and Projected Population of Malaysia for 2019 by Age and Sex 024 List of Appendices APPENDIX 1: Members of Steering Committee, NHMS 2019-2022 282 APPENDIX 2: Members of NHMS 2019 Central Coordinating Team (CCT) 282 APPENDIX 3: List of Research Team Members 282 APPENIDX 4: List of Liaison Officers (Other Research Members) 284 APPENDIX 5: List of Research Assistants in Central Team 285 APPENDIX 6: State Data Collection Teams 285 APPENDIX 7: Questionnaire 290 APPENDIX 8: Code Book 364 APPENDIX 9: Summary of Publicity Activities and Samples of Publicity Materials 381

Page 1 of 74