Challenges of implementing occupational health services (OHS) in Malaysia -perspective of occupational health doctors

Mortality estimation due to work-related illness has reached up to 2.4 million each year. The current coverage of occupational health services (OHS) in Malaysia is still low. Occupational health doctors (OHDs) are one of the essential personnel to ensure proper execution of OHS. This study was conducted to explore the experiences and views of OHDs on the challenges in implementing OHS in Malaysia. Four focus group discussions were conducted with OHDs (N = 23) from four different states in Malaysia in 2016. Another five OHDs participated in in-depth interviews to implement the identified codes or themes. The discussions were recorded and transcribed verbatim. NVivo version 11.0 was used to facilitate data analysis. The data were analysed following the thematic analysis guidelines. Three themes were identified from the discussions: difficulties in diagnosing occupational diseases and poisoning; poor practices, attitudes, and commitment by both workers and employers; and non-compliance with laws and regulations related to the industries. The common challenges discussed by the participants were the lack of knowledge and skills among OHDs, and the shortage of standard procedures, leading to difficulties to screen occupational diseases. The poor cooperation and behaviour from the industries also hindered OHDs when performing their services. This study suggests better training and provision of standard tools or guideline to assist OHDs in making occupational disease diagnoses, increasing OHS awareness among the industries, and enacting OHS as part of the laws and regulations with adequate enforcement