Page 79 - MOH Supply and Needs-Based Requirement Hyperlink 02032021

71 EXTENDED EXECUTIVE SUMMARY

The undersupply of the AMOs in meeting population healthcare needs is apparent in the
first ten years. Following a balance between supply and Need in 2026, it can be seen that
supply of AMOs will exceed population health care requirement or known as oversupply
if all parameters remain the same. The supply of AMOs will exceed (surplus) the projected
Need by 10.0% and projected Demand by 30% in 2030.

It can be seen that by 2021, there will be an oversupply of AMOs in Malaysia to fulfil
the health care demand. Nevertheless, the requirement projections do not account for
existing and future needs of rehabilitation, palliative, geriatric care services, increase
in disease burden and incidence as well as advancement in medical care. The needs
for these services are presumed to have a significant impact on AMOs requirement.

b) Scenario Task Reallocation

At present, there are many areas where AMOs and nurses have similar functions, although
technically a certain portion of tasks are handled entirely by the AMOs. This is based on the
training syllabus of the AMO diploma program. However, there was overlapping or task-sharing
along time with nurses due to HRH shortage in certain areas of service, as well as the post-
basic programs and on-job training offered to nurses. The scenario depicted here is based on
assumptions that certain areas are totally handled by either the AMOs or nurses from the year
2020 onwards. Baseline requirement based on need follows current practice at the facility level.

Currently, the boundary between the job scopes of nurses and AMOs are unclear. There
is a lot of task-sharing between these two professions whereby either one could do the
job depending on the availability of staff at a particular time. For example, nurses have
been known to be posted in the emergency department despite it being the territory of
AMOs based on formal training. Due to the overlapping roles between nurses and AMOs,
projections into their requirement are difficult to attain. Therefore, one of the way forward
is to clearly delineate their roles and streamline the job scopes. For example, services
like the emergency department, haemodialysis, outpatient department can be delegated
to AMO while services in psychiatry ward and school health are to be done by nurses.

Figure 30 shows that 52,064 AMOs are required based on the population’s needs in
2030 if the tasks mentioned above have been fully shifted to the AMOs, which is 17,659
more than what is required if there is no task shifting (reallocation). Compare that to the
nurses, and it could be observed that the requirement for nurses in 2030 is slightly less
than the requirement based on need if there is task shifting (reallocation). This indirectly
indicates that a lot of the AMOs’ job scopes are currently being covered by the nurses.

SUPPLY AND NEEDS-BASED REQUIREMENT PROJECTIONS OF MALAYSIAN HUMAN
RESOURCES FOR HEALTH USING SYSTEM DYNAMICS APPROACH 2016 - 2030