The implementation of the Electronic Medical Record in public hospitals and clinics will also be expanded nationwide to ensure seamless sharing of medical records . An action plan for the Malaysian Health Data Warehouse data migration to MyGOVCloud will be developed to enable data sharing across government agencies . The MyCHAMPION registration system will be upgraded for better organisation of content and activities of health volunteers in providing awareness on NCDs .

• Strengthening healthcare programmes for older persons Efforts will be undertaken to integrate care services between health clinics and hospitals to better serve the older persons in preparation for Malaysia becoming an aged nation . The Private Aged Healthcare Facilities and Services Act 2018 [ Act 802 ] will be enforced to ensure compliance with the safety and standards requirements . In addition , new geriatric care centres will be established to provide long-term healthcare services in improving the quality of life for older persons .

BROADENING HEALTH FINANCING OPTIONS

• Strengthening health protection and healthcare financing

Health protection coverage for targeted groups will be expanded through the implementation of Skim Perubatan MADANI . This healthcare Big Bold initiative will cater the needs of patients with limited financial capability in seeking private healthcare services , thus reducing congestion at public healthcare facilities . Meanwhile , a new model to finance health facilities will be explored to improve accessibility to healthcare services in ensuring no one is left behind . Greater investment in developing and providing healthcare services will also be promoted .

• Leasing of medical equipment Efforts will be undertaken in ensuring the availability of best medical equipment for the people through leasing option . This is part of the healthcare Big Bold initiative that will address the issue of high cost of procurement , maintenance and replacement of medical equipment due to rapid advancement in technology . This new financing option will provide better financial flexibility to acquire medical equipment with the latest technology for the benefit of the people .

• Advanced healthcare Malaysians enjoy accessible and affordable healthcare services of the highest quality . Digitalisation and artificial intelligence ( AI ) -powered techniques are leveraged to improve the efficiency of healthcare services for the people .

The threats of communicable diseases and NCDs have reduced substantially , generating a healthier and productive

• Reversal effects of Covid-19 pandemic on health status of the people

• Increase in the incidence of doubleburden diseases

• Fragmented health information systems

• Low awareness , knowledge and understanding of the basic health information

• High costs and limited care services facilities for the elderly

• Unsustainable healthcare financing

• Resource constraint to fund new healthcare infrastructure

nation and lowering healthcare expenditures .

Meanwhile , mental health issues are addressed comprehensively without discrimination , stigma or neglect . The presence of these combined vital factors enhances the quality of life of the people .

• Productive ageing Malaysians enjoy better health and longevity . Older persons contribute productively towards the socioeconomic development of the country based on their capabilities . The ecosystem , including housing , working conditions , healthcare and social protection are age-friendly for older persons .

Community support enables productive and active ageing . In addition , lifelong learning is well promoted for older persons to engage in activities and acquire new knowledge and skills , supported by digitalisation , technology and innovation .

• A decent standard of living Malaysians lead more comfortable lives as economic benefits trickle down and are spread equitably . Living in an advanced nation , we possess stronger purchasing power , attributed to higher incomes , effective price and exchange rate management as well as stable supply of essential goods and services .

Quality homes are made affordable for all income groups and can withstand the forces of nature . Most importantly , these homes are designed to accommodate the number of individuals in households .

Furthermore , high-quality utilities , public infrastructure and facilities , such as transportation networks , educational institutions , healthcare facilities and recreational amenities are not only adequately provided but also properly maintained . – The Health

POPULATION ageing is a global phenomenon in which older persons constitute a high percentage of the total population . Following the demarcation adopted by the United Nations World Assembly on Ageing in Vienna 1982 , older persons are defined as individuals aged 60 years and above .

Based on this definition , Malaysia will become an aged nation in 2030 when the share of older persons reaches 15 per cent of the total population . Meanwhile , the United Nations defines the ageing level of a nation into three categories , namely as an ageing nation when the population aged 65 and above reaches seven per cent of the total population , an aged nation at 14 per cent , and a super-aged nation at 20 per cent . Based on this definition , Malaysia became an ageing nation in 2021 and is expected to become an aged nation by 2044 ( World Bank , 2023 ).

The transition period of 23 years towards an aged nation for Malaysia is faster if compared with most Organisation for Economic Co-operation and Development ( OECD ) countries , which took about 50 to over 100 years . However , the transition period is similar to the People ’ s Republic of China , Japan and Republic of Korea .

In moving towards an aged nation , Malaysia is expected to face several challenges such as slower economic growth , declining labour force participation , lower productivity , insufficient retirement savings , higher fiscal commitment , rise in NCDs and impact on LTC and social protection .

The economic and fiscal implications are :

• Declining labour force participation

The total fertility rate ( TFR ) decreased from 4.9 births per woman in 1970 to 1.61 in 2022 and is expected to reduce further in the future . Meanwhile , the proportion of those below the working-age population declined from 45 per cent to 23 per cent in the same period , which may influence economic and productivity growth . The declining working-age population will increase demand from industries to hire foreign labour .

• Insufficient retirement savings

Sufficient retirement savings are crucial for older persons to sustain theirquality of life and well-being . Older persons with insufficient savings arevulnerable and face difficulties to obtain essential services , such as utilities , healthcare and LTC .

In addition , higher cost of living and lack of family support increase the probability of older persons falling into poverty . The savings during the working years will enable the older persons to draw down it for consumption at retirement

age . In 2022 , about 52 per cent of Employees ’ Provident Fund ( EPF ) members have savings of less than RM10,000 , whereas 22 per cent have less than RM1,000 .

Meanwhile , out of 15.7 million members , only 8.4 million have active accounts . This low savings level indicates that most Malaysians will be vulnerable at an older age .

• Impact on the healthcare system

The well-being of the rakyat has improved as a result of advancements in healthcare and medical innovation . However , the rapid increase in NCDs such as diabetes , heart disease and cancer , poses a challenge to the healthcare system , particularly on NCD prevention and management among older people .

In addition , there are also new challenges in meeting the specific needs of older people , such as dementia , palliative care , frailty and mental health . Without healthcare reforms , an increasing older population will significantly pressure the healthcare system .

IMPACT ON LONG-TERM CARE

A rising share of older people and smaller family size will increase the need to expand the formal aged LTC system . As the number of young workers and women participating in the labour force increases , providing informal care for the elderly becomes challenging , which may lead to older persons living alone or being abandoned .

In addition , limited public financing , inadequate human resources , as unclear standards for attracting , retaining , and incentivising professionals and care workers create a stumbling block to a sustainable LTC system .

• Inadequate coverage of social protection

The need to provide adequate social protection for the people continues to be a challenge as the population ages and life expectancy increases . These include the challenges of reducing the inclusion and exclusion errors in social assistance disbursement and expanding the coverage of contributory for retirement income , especially for women and informal workers , including unpaid carers . Insufficient retirement savings and inefficient financial management will affect income security , which may increase the probability of older people falling into poverty .

• Preparing towards an aged nation

In addressing the risks and challenges of population ageing , a national ageing blueprint will be developed to mitigate risks and capitalise on potential opportunities . The blueprint will outline policies , strategies and action plans for a healthy , productive and inclusive aged nation .