04 Nov Geography as Strategy: How Malaysia Transformed National Health Care

In the remote villages of Sarawak, on the island of Borneo, health workers move from house to house, administering medication and recording progress on their tablets. Two thousand kilometers away, just south of Kuala Lumpur in Putrajaya, government officials track that progress on dashboards—seeing a map of how and where they are fighting disease.

This is Malaysia’s health-care transformation in action. The Ministry of Health has shifted from reactive reporting to proactive intervention by weaving advanced mapping technology into the very fabric of its health programs. It’s a national model of how a geographic approach can drive better health outcomes—efficiently, equitably, and at scale.

“When you have a map laid out in front of you, you know exactly where the gaps are and where conditions are most severe,” said Dr. Hammad Fahli bin Sidek, senior assistant director at the Ministry of Health Malaysia.

Meeting the Challenge of Geography and Resource Allocation

Malaysia is literally split in two: Peninsular Malaysia, connected by highway systems along its east and west coasts, and East Malaysia—the states of Sabah and Sarawak—situated on the island of Borneo. This geography creates complex demands for delivering medical care across vast distances to nearly 36 million people who speak 137 languages.

Precision and foresight are a must.

Health care is the nation’s second-largest budget allocation yet spending averages just RM 1259 ($268) per person annually. That makes efficiency essential.

Rather than seeing geography and resources as barriers, Malaysia embraced geographic information system (GIS) technology for managing assets, planning services, and delivering care. Using GIS, the nation has built one of the world’s most comprehensive health intelligence platforms, the Malaysian Health Data Warehouse (see sidebar). Led by Dr. Mohamad Fadli Kharie, senior principal assistant director at the Ministry of Health Malaysia, MyHDW’s GIS capabilities enable health planners to move beyond asking how many to understanding where and why.

Fighting Disease, Door to Door

Health workers in Malaysia are now using GIS technology to help eradicate filariasis, a parasitic disease that can cause severe limb swelling and disability. When one person in a village is affected by the disease, the entire community receives preventive medication to break the transmission cycle.

Previously, the process was a logistical challenge. Health inspectors would manually survey villages, distribute medications, and compile paper-based reports to convey progress. Distribution could take several months. Following distribution, it could take another month to gather statistics.

Today, field teams use a GIS survey app on tablets to collect household data and sync it to GIS dashboards automatically each day. “We can see the progress by the end of the night,” Kharie said. “We managed to reduce the medication distribution timeline from six months down to just two months because of the improved reporting.”

The impact goes beyond efficiency.

Officials at headquarters can verify that medications are being administered, confirm the geographic distribution of interventions, and monitor coverage rates in near real time. Instead of waiting for summary tables or paper reports, they can monitor and guide the nation’s public health strategy on maps and dashboards, house by house, village by village.

For all stakeholders, the visualization tools deliver a new level of awareness and inspire strategic problem-solving. “The main point of the dashboard isn’t just reporting numbers and statistics,” Kharie said. “It’s about initiating discussions. When bosses and stakeholders realize the situation through maps, they want to think and discuss solutions.”

COVID-19: When Preparation Met Crisis

Malaysia’s health technology infrastructure proved its value during the COVID-19 pandemic. Months before the first cases appeared in Malaysia, the team had conducted a disaster management exercise that connected health facilities and offices via GIS.

“A few months after an exercise with the World Health Organization, we had the first few cases reported in Malaysia,” Sidek said. The team quickly created dashboards that integrated multiple data sources—not just Malaysian health data, but international travel information and global case tracking. “Instead of just reporting numbers, stakeholders could see where COVID-19 was happening,” Kharie said.

The transformation wasn’t just technical; it was cultural. Leaders and the public began relying on maps to understand and respond to the crisis.

A Model for Global Health

A geographic approach underpins Malaysia’s long-term health strategy. The country maintains a comprehensive inventory of health-care assets, from high-value equipment like PET-CT scanners and mammogram machines to a health facility master list, including the locations of specialized cancer centers and women’s hospitals.

This inventory is dynamic, integrated with population projections and disease incidence data. “We look at cancer incidence based on our registry data and do projection exercises for population growth,” Sidek said. “We forecast breast cancer estimates all the way to 2040—the number of cases we expect and how to procure assets and where to place them.”

Malaysia, like much of the world, is experiencing declining fertility rates and an aging population. The country is adapting its services to make the most of both public and private facilities. Rather than automatically purchasing expensive equipment for every hospital or opening new facilities, officials use spatial analysis to prioritize investments and identify public-private partnerships.

Malaysia’s success offers lessons for other countries struggling to optimize health-care delivery with limited resources and shifting public health needs. They’ve shown that GIS for health isn’t just about technology—it’s about empowering high-level decision-makers and local teams to see patterns and identify solutions.