WHILE it marks a good starting point for newly minted Health Minister Dr Zaliha Mustafa to provide free sanitary pads at the ministry level, the period poverty issue is just the tip of the iceberg.
Period poverty refers to a lack of or inadequate access to menstrual products, sanitation facilities and information on menstruation – often leading to adverse health, psychological and social consequences. As highlighted by Emir Research, the Covid-19 pandemic has exposed the underlying risks of inadequate access to sanitary pads among low-income and poorer girls and women.
With shrinking income and job losses, the affected working-age women were left with few options but to go for unhygienic methods by using tattered clothes, coconut husks, old or discarded newspapers, and even banana leaves during their menstruation period.
This is just one chronic issue. The other issue is the insufficient number of medical specialists and healthcare amenities in sub-urban and rural areas. Malaysians who reside outside major cities and conurbations have to travel afar to access necessary medical treatment.
Such a phenomenon is especially acute in Sabah and Sarawak (including the Federal Territory of Labuan), which account for 60% (i.e. 198,100 sq km) of the total area of Malaysia. In 2021, Sabah, Sarawak and Labuan’s official ratio of doctors to the population were 1:776, 1:662 and 1:837, respectively, lower than the national average of 1:420.
Moreover, Sabah and Sarawak’s teacher-to-student ratios in the rural secondary schools were 1:11.75 and 1:12.61 in 2020, lower than the national average of 1:9.36. The issue of dilapidated schools in both Sabah and Sarawak has also become a hindrance for students to experience a conducive learning environment.
As of April 2020, out of 1,296 schools in Sabah, 589 of them were dilapidated (latest obtainable figure). For Sarawak, latest derived figure as of Sept 2022 shows that 476 dilapidated schools were yet to be repaired or upgraded.
Due to the limited number of Comprehensive Special Model Schools Nine (K9), which offers schooling from Year One to Form Three in the remote areas of Sabah and Sarawak, fewer children have been graduating.
As a result, only 12.7% and 13.4% of the rural workforce in Sabah and Sarawak received tertiary education qualifications in 2020.
East Malaysians with lower educational attainment can only opt for lower-skilled jobs, thus depriving them of opportunities to earn a higher income.
As 2023 marks Sabah and Sarawak’s 60th anniversary of independence and, by inclusion and extension, of the Malaysia Agreement/MA (1963), the unity government does not have much time to delay or postpone these issues.
Both newly appointed education and health ministers have to start carrying out the necessary groundwork, understand the underlying problems and develop solutions to ensure a brighter future for the next generations.
Pakatan Harapan has claimed that among the 21 issues under MA63, 17 were resolved during the tenure of its administration between May 2018 and February 2020. However, one month before the 14th Parliament was dissolved on Oct 10, 2022, former minister in the prime minister’s department (Sabah and Sarawak Affairs) Datuk Seri Dr Maximus Ongkili insisted that 15 MA63 issues remain outstanding. These include jurisdiction over health, the remaining (i.e. based on and derived from pre-existing shared list of the Federal Constitution) jurisdiction on the environment, labour and the release of land ownership rights to the federal government.
Although the current unity government aspires to resolve all MA63 issues within a month (due by this month), it remains to be seen whether the federal ministers will be able to effectively translate the political commitments into policies and laws.
Also, the federal government has to be proactive in organising frequent engagements with the state governments. This includes ensuring complete decentralisation of power from the federal to the state in the matters of health and education. However, it is currently challenging for the federal government to fully delegate them to the states as Sabah no longer has its own health and education ministries.
When the Warisan-led PH plus governed Sabah between 2018 and 2020, then chief minister Datuk Seri Shafie Apdal set up both the state level Health and People’s Well-being Ministry and the Education and Innovation Ministry.
Sarawak also followed in Sabah’s footsteps post-2021 state election. The Cabinet rebranding saw the establishment of the Education, Innovation and Talent Development Ministry as well as the Public Health, Housing and Local Government Ministry under Sarawak premier Tan Sri Abang Johari Openg.
Given that Datuk Seri Hajiji Noor remains the chief minister of Sabah (the state assembly has until Dec 9, 2025 before it has to be dissolved), he may consider having the current state local government and Housing Minister Datuk Seri Panglima Masidi Munjun holding an additional, i.e. health portfolio.
Whereas Datuk Yakub Khan, the current state science, technology and innovation minister, could be put in charge of education as well to ensure effective transition of power devolution from the federal to the Borneo territories.
When both Sabah and Sarawak have their respective ministries to manage health and education affairs, Datuk Seri Anwar Ibrahim’s administration will find the MA63 agenda a less daunting task to achieve within his first 100 days serving as prime minister (March 3).
In promoting the overall national health and education infrastructure, Emir Research has recommendations for the unity government to look into:
1. The Health Ministry should think of ways to increase the number of medical officers (MO) for permanent positions without compromising on the three-tier assessment system that is in place. The three-tier assessment comprises the Permanent Appointment Technical Committee at the medical programme level, the Permanent Appointment Selection Committee chaired by the deputy secretary-general (management) and the committee to certify the permanent appointment by making the final recommendations to the ministry’s top management. If some MO have yet to have their contract renewed after the two-year compulsory service, the ministry can work with potential employers in the private sector, i.e. including government-linked hospitals (both federal and state), to absorb them. It should also look into the working conditions of MO, such as giving them unrecorded leave and maternity leave, and financial assistance or sponsorship for post-specialist training.
2. It is highly commendable that Education Minister Fadhlina Sidek intends to bring back the National Education Advisory Council. Although she did not specify the council’s purview, it would be ideal that it comprises experts, academics and representatives from teacher and parent associations to formulate an integrated plan for post-pandemic education.
Moving forward, the Education Ministry should go ahead and implement the plan to revamp the national education system, with a stronger emphasis and focus on science, technology, reading, engineering, arts and mathematics stream, encompassing primary, secondary and university levels. In abolishing the arts and sciences streams, so that whatever subjects the students choose will still revolve around some science and engineering or technology-based subjects, they will still be exposed to a holistic education (i.e. via the introduction of liberal arts disciplines such as communications, philosophy, literature, etc. in addition to conventional subjects like history and geography, inter alia).
Essentially, the vision is to ultimately revamp the education philosophy to produce graduates who are both generalists (minoring) and specialists (majoring) in their respective streams of choice, which will boost their employability in the “new” economy. This will also facilitate the promotion of flexibility in skills needed for upskilling, reskilling and cross-skilling to adapt to the rapidly evolving economic and industrial landscape.
Nonetheless, the stream initiative has to be supported by digital devices and connectivity. Students without digital and internet accessibility cannot upgrade themselves with the relevant knowledge and practical skills, hence, diminishing their chances of securing higher-paying jobs after graduation.
The Education Ministry should also introduce education in sexual and reproductive health, moral and civic to provide a holistic framework for Malaysians from a young age (“Women’s issues are also issues that require the national or the other gender’s attention”, Emir Research, April 6, 2022).
3. Initiate discussions with the education and health ministries to allocate more teachers and doctors to be based in the rural areas of Sabah and Sarawak. Both ministries can provide training and job guarantee incentives to motivate more Sabahans and Sarawakians to contribute to their home territories through teaching and medical professions. Encouraging more Sabahans and Sarawakians to become teachers and doctors will eventually narrow the gap between the number of teachers and doctors required and the number of students and residents in a particular rural district of Sabah and Sarawak.
4. Provide full autonomy for both Sabah and Sarawak state governments to carry immediate upgrading of dilapidated health and education infrastructure or initiate development for new hospitals, clinics and schools. As part of a new era of partnership between the Peninsular and East Malaysia, the unity government should standby to provide additional funding if the Sabah and Sarawak state governments require more financial assistance.
5. Monitor the construction progress regularly to ensure that the infrastructures comply with requirements (i.e. construction industry standard by the Construction Industry Development Board, road safety audit by the Public Works Department, etc.). Also ensure that projects are completed within the specific timeframe.
Anwar’s commitment to combat wastages, leakages and graft in the public sector, including projects related to health and education infrastructure, whereby an open tender environment and culture should be the default system, has reignited fresh and renewed hope for our nation.
Let us pray that the prime minister will lead Malaysia towards promising economic growth prospects and stable governance in the next five years and beyond.
Amanda Yeo is research analyst at Emir Research, an independent think tank focused on strategic policy recommendations based on rigorous research.