| 4. In which ways is the initiative creative and innovative?
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In the implementation of these initiatives, SOCSO employs a range of innovative approaches to maximize visibility and utilization of programs.
[Embracing Technology]
The HSP Program is conducted using an online system which enables seamless doctor-patient consultations and allows SOCSO to perform further analyses. The Disability Management Program uses technology for predictive modeling and employs data centric measures for efficient Disability Management services. In prevention, SOCSO leverages on digital and electronic media to raise public awareness by producing TV series, a rare medium used for safety promotion activities.
[Individualized Support]
SOCSO’s Disability Management Program embeds individual support through its Disability Managers to facilitate each worker to return to work to the same employer or secure another job. The prevention and health promotion program provides for innovative measures by providing extensive support to companies with high risk of accidents or diseases through support and compliance programs.
[Bringing everyone on board]
The HSP is the first free mass health screening program in the country. With the HSP, SOCSO brought health screening to vulnerable groups with free consultations on their health and disease prevention. The RTW is also the only disability management program focusing on workers with disabilities in a structured and systematic manner.
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| 5. Who implemented the initiative and what is the size of the population affected by this initiative?
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On a yearly basis, SOCSO organizes 400 road safety advocacy programs in the targeted workplaces; distributes more than 10,000 helmets, road safety vests, and stickers; and has supported 400 workplace safety programs conducted by Non-Governmental Organizations (NGOs). Annually, SOCSO reaches out to over 20,000 workers through the Workplace & Commuting Safety Program; and 5,450 workers trained in 218 defensive driving and safe riding programs.
SOCSO has also developed fourteen workplace and commuting safety videos and conducted annual academic research on safety and health in collaboration with international and national universities.
The Disability Management Program has benefitted 23,850 workers with injuries or illnesses, who have been given physical and vocational rehabilitation interventions. From this number, 75% have been successfully rehabilitated and have returned to and retained at the workplace, assisted by SOCSO Disability Managers. The SOCSO Rehabilitation Centre has so far assisted 1,266 workers with comprehensive rehabilitation through a one-stop integrated rehabilitation center which aim to improve their quality of life, functional improvements as well as enabling return to work. The PIMS, on the other hand, has efficiently distributed 35,000 items to workers with injuries or illnesses throughout Malaysia.
The HSP program specifically covers men and women above 40 years of age, who are potentially at risk of NCDs whereas the Disability Management Program covers workers with injuries or illnesses. The Workplace & Commuting Safety Program covers all workers, employers and the general public where this preventive efforts are focused at minimizing premature deaths due to NCDs as well as preventing disabilities due to injuries or illnesses. Some 2.4 million users are eligible for the HSP Program.
On the whole, these initiatives cover 16 million registered workers and close to 1 million employers who contribute to the social security system under SOCSO.
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| 6. How was the strategy implemented and what resources were mobilized?
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The rollout started with the prevention activities in 2009, followed by the nationwide implementation of the disability management program in 2010 and the health screening program in 2013. All three (3) initiatives, which is are funded entirely by SOCSO, had similar strategies in their implementations namely the design of policy and framework, capacity and infrastructure building, pilot projects, awareness campaign, implementation, governance and evaluation of the program.
[Tripartite engagement between government, trade unions and employers federation]
In line with the national social security strategic plan of the Ministry of Human Resources of Malaysia and SOCSO’s strategic plan in the area of prevention and rehabilitation, plenty of discussions and involvement with all key stakeholders were held. Discussions with trade unions and employers federation on each of the initiatives, its scopes, objectives and expected outcomes are presented to this group prior to implementation.
[Pilot projects with evaluation reporting to the board]
Both prevention and rehabilitation initiatives commenced with a pilot project on a smaller scale at the beginning. When the outcome yielded positive results, and after reporting to the SOCSO board and at the ministerial level, programs were expanded nationwide covering a larger target market while enhancing its capacity building through human resources and infrastructure. Prevention activities took on a paradigm shift in 2009 by implementing more sophisticated and active preventive program where today, it spearheads prevention together with the Royal Malaysian Police and many NGOs as well as other stakeholders. Meanwhile, the Disability Management Program commenced with a pilot project with 5 Case Managers and 1 Job Placement Officer. With regular reporting and program enhancement, it expanded progressively and in 2016, the program was driven by 40 Case Managers and 10 Job Placement Officers. The program now is not only one of SOCSO’s primary KPI but also a ministerial KPI where the outcome and success of the project is made available to the general public.
[ICT System – automation in service delivery ]
The HSP and the Disability Management ICT system was developed in-house with a very minimal cost. This system connects not only doctors but also service providers which can be centrally monitored by SOCSO. Technology has further strengthened all initiatives not only through practice but also by allowing SOCSO to capitalize on a lot of data which has been gathered since 2010, by using predictive modeling to make more informed decisions. The generous amount of data generated through this system has made it possible for a lot of R&D to be conducted with international and national academic institutions.
[Capacity Building and Professional Certification]
Parallel to the enhancement of service delivery, enhancement of the professionalism of the human resource aspect is also given key consideration by SOCSO’s top management. Since 2010, SOCSO established a partnership with the National Institute of Disability Management and Research, Canada to provide Disability Management Certification and Return to Work Coordinator Certification to all practicing prevention and rehabilitation services related employees. SOCSO employees are also sent for formal safety and health training courses locally and abroad to become leaders and experts in this field. This is the focus in SOCSO’s strategic plan on the human resource development potential.
[Financial Resources]
Since these initiatives were implemented, approximately USD2.2 million a year was allocated for prevention, USD9.4 million a year for disability management and USD45 million allocated to kick start the HSP program. These programs were funded entirely by SOCSO.
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| 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
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All initiatives involved engagements with relevant stakeholders such as SOCSO’s Board, Malaysian Employers Federation, Malaysian Trades Union Congress, Ministry of Health, Ministry of Human Resources, Ministry of Finance, Malaysian Medical Association, National Council of Safety and Health, National Council for Persons with Disabilities, academic institutions, various NGOs and the public.
This broad range of stakeholders has a legitimate interest in prevention, rehabilitation and health promotion interventions in the workplace. Respective stakeholders were involved from the beginning of discussions until the evaluation process was completed.
Apart from regular discussions, the HSP Program has established a steering committee to formulate policies and procedures of the program including in determining screening parameters, health screening charges as well as program delivery methods. The committee comprises representatives from the Ministry of Health, Malaysia Medical Association and Malaysia Laboratory Services. SOCSO has also collaborated with the Ministry of Health to ensure the scope of the program is relevant and medical evidence based.
The proposals for all prevention programs are based on inputs from stakeholders, which are then endorsed by SOCSO Accident Prevention Committee. The implementation of the approved prevention program will then be carried out by the SOCSO in collaboration with relevant accident prevention stakeholders. The outcome is then reviewed by this same committee for the planning and improvement of future programs.
The design of the Disability Management Program on the other hand was discussed with key stakeholders including the trade union and the employers’ federation, Ministry of Health, Ministry of Human Resources and various NGOs besides SOCSO Board Members. The Ministry of Human Resources also played an integral role in monitoring of this program during the infancy stage.
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| 8. What were the most successful outputs and why was the initiative effective?
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The unemployment among workers with disabilities contributes to the loss of valuable manpower to the economy. Since the start of the pilot project, SOCSO has assisted 15,479 workers with injuries or illnesses to return to and retain at work. With their inclusion into the workforce, they play an integral role as part of the nation’s human resources, enabling ‘decent work and economic growth’. The inclusion of persons with disabilities (PWDs) into the workforce also promotes diversity and encourages equality as per the recommendations by the United Nations Conventions on the Rights of Persons with Disabilities (UNCRPD). This program is effective because it also applies a holistic, biopsychosocial and multidisciplinary approach. These are facilitated by Case Managers who work with various parties including clinical services, workplace involvement, social and community support while looking into the spiritual aspects.
By returning them to work, the ‘reduction of poverty among workers with disabilities’ can be achieved. By being employed, workers with disabilities are able to meet their families’ expenses, make purchases, save and invest, thus strengthening their social and economic independence.
‘A large number of people are able to undergo health screening’. This will support the government’s agenda in reducing premature mortality from NCD by one-third through the promotion of good health, wellbeing and quality of life for workers as indicated in the SDG.
Road traffic and workplace safety promotion program
had ‘halted the continuous exponential rise of in the number of injured workers’ in the country including those commuting to work. This outcome is most relevant in reducing global death rate due to road traffic injury.
These initiatives are also in line with the strengthening of partnership and institutional coherence. ‘The transformation initiatives capitalize on existing and new international collaborations between SOCSO and other global players’. Close linkage with international players is formed through partnerships with the International Labour Organisation (ILO), the International Social Security Organisation (ISSA) and the ASEAN Social Security Organisation (ASSA) in the involvement in various technical committees and advisory roles, in the areas of prevention, compliance, disability management and specific guidelines. These initiatives are regularly featured on the global level through these organizations. The linkage also allows SOCSO to assist other developing countries to implement similar initiatives such as Disability Management Program which has been introduced Namibia, Botswana, Singapore and Indonesia.
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| 9. What were the main obstacles encountered and how were they overcome?
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There are several obstacles encountered in the implementation of the programs under the transformation initiative. The first being lack of awareness towards safety and healthy lifestyle promotions, hence the response from employees in the country is a challenge.
The second major obstacle is the readiness and buy-in from the employers into the implementation of the programs, which is essential to ensure the success of the advocated intervention programs.
In order to overcome these, SOCSO embarked on multi-pronged strategies. Promotional activities were conducted in various ways including breakthrough media approaches such as television series, short films and utilization of social media. Mass campaigns for workplace and road safety, health campaigns and job fairs specifically targeting the disabled were carried out to raise public awareness on the available facilities and programs. In order to enhance employer participation, direct engagement with employers was conducted through workplace and road safety advocacy programs, mobile-health screening programs and workplace RTW coordinator programs.
Adequate number of service providers is needed for all the initiatives either to reach out to the target workers or to meet the needs of the workers involved. To draw support from service providers, SOCSO conducted initial discussions and then engagement of third party providers so that they were able to fulfil demands throughout the country. This has facilitated easy access of workers to the services of panel clinics and rehabilitation providers, improved efficiency and in the case of RTW program, reduced the disability period. Now, the initiatives had drawn support from 3,500 clinic, 258 laboratories, 126 mammogram centers, and 122 rehabilitation centers to provide services throughout the whole nation.
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