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Health Seeking Behaviour towards Communicable Diseases among Foreign Workers in Industrial Agriculture Sectors of Selected Districts in Perak, Malaysia
Figure 3. Work process of the interview or self-administered questionnaire
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Health Seeking Behaviour towards Communicable Diseases among Foreign Workers in Industrial Agriculture Sectors of Selected Districts in Perak, Malaysia
3.4 Variables Variables
Operational Definition Scale of Measurement
District The district of the respondent’s
work place Hulu Perak Kuala Kangsar
Kinta
Sector Job nature of the respondent
at the time of interview. Agriculture: plantation area
estates other agricultural activities. Industrial: factory or
construction sites. Others: other than these 2 sectors
Agricultural Industrial Others
Distance to nearest health
service Distance from respondent’s
residence to the nearest health service as assessed by the
interviewer Kilometres
Nationality Country of origin of respondent
as obtained from respondent to a direct question
Thai Indonesian Bangladeshi Nepali Myanmar Vietnamese
Others
Age Age in completed years as
obtained from respondent to a direct question
Years Gender
Gender of respondent Male Female
Figure 4. Health behaviour assessment questions
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Health Seeking Behaviour towards Communicable Diseases among Foreign Workers in Industrial Agriculture Sectors of Selected Districts in Perak, Malaysia
Variables Operational Definition
Scale of Measurement
Legal status Ability of respondent to
produce a legal working permit Yes No
Education level Highest level of education as
obtained from respondent to a direct question
Tertiary Secondary Primary No formal education
Fluency in Malay or
English Ability of respondents to
communicate verbally in Malay or English
Yes No
Length of stay in Malaysia
The length of time the respondent has been staying in
Malaysia Years and months
Experience of serious illness
Experiencing serious illness in the past 1 year as defined as
any hospitalisation or inability to work for 3 or more days
excluding injuries Yes No
Experience of illness
Experiencing any illness in the past 2 weeks while staying in
Malaysia excluding injuries Yes No
Seeking treatment
for mild and serious illness
Respondent’s utilisation of health service for illness
Yes No
Health facilities sought for mild
and serious illness
Health facilities sought by the respondent for illness
Government clinichospital Private or panel clinichospital
Traditionalcomplementary medicine centre
Hospital admission
Admission to hospital for mild and serious illness
Yes No Importance
of health care provider
The importance of the health care provider to the respondent
Government clinichospital Private or panel clinichospital
Traditionalcomplementary medicine centre
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Health Seeking Behaviour towards Communicable Diseases among Foreign Workers in Industrial Agriculture Sectors of Selected Districts in Perak, Malaysia
Variables Operational Definition
Scale of Measurement
Reasons for the choice of
health care provider
Respondent’s reason for choosing the particular health
care provider to seek treatment for illness
Nearby to resident or workplace Easily reached
from resident or workplace Encouraged by family friends
Confident with healthcare treatment or medication given
Satisfied with attitude and behaviour of healthcare staff
Others
Payment mode of treatment
fees Respondent’s mode of payment
of treatment fees for illness Employer paying out of pocket
Own money Panel clinic doctor Health insurance
Others
Affordable Respondents opinion on the
affordability of treatment fees Yes No
Mode of transport to
health care facilities
Methods of transportation used by the respondent
Own transport Public transport Companyemployer
transport Walking Others
Expectation towards
healthcare services
Respondent’s expectation on healthcare services currently
available in Malaysia Good Average Poor Not
sure
Action taken if did not seek
treatment Action taken by the respondent
if they did not seek treatment for illness
Self care do nothing
Reason for not seeking
treatment Respondent’s reason for not
choosing to seek treatment for illness at any health care
provider Too far Too expensive Poor
employer support Mild illness Prefer self care Not confident
with treatment or medicine given Not satisfied attitude
and behaviour of health care staff Afraid of painful
treatment or side effect Others
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Health Seeking Behaviour towards Communicable Diseases among Foreign Workers in Industrial Agriculture Sectors of Selected Districts in Perak, Malaysia
Variables Operational Definition
Scale of Measurement
Availability Respondent’s opinion on
the availability of health care service at workingresidential
area Yes No
Connecting road
The type of road that connects the respondent’s resident to the
nearest health service Tar road Non-tar road Others
Accessibility Respondent’s opinion on the
accessibility of health services Yes No
Travelling permit
The type of travelling permit of the respondent
Working Permit Tourist Visa Student Visa Nothing
Personal monthly
income Based on respondent’s monthly
salary as per reported verbally Ringgit Malaysia
3.5 Sample size and sampling method
The sample size was calculated using the EpiCalc 2000 software by setting the proportion at 7 and precision level at 3. This was based on the National Health
and Morbidity Survey of 1996, which stated that 7 of the population admitted in the period of 1 year had serious illness. The minimum sample size in each study
population of both the agriculture and industrial sectors is 277 respectively. The total sample size was targeted at 300 workers from the agricultural and 300 workers
from the industrial sector.
The sampling frame in this study consisted of foreign workers working in the agriculture sector of Hulu Perak and Kuala Kangsar districts and the industrial sector
of Kinta district. An estimated number of foreign workers in each study district are obtained from the vector control unit from the respective district health offices. The
vector unit statistics was chosen because they included both the legal and illegal foreign workers working in the areas.
From this sampling frame, respondents were then enrolled for study using a 2-staged random stratified sampling method for the villages, plantation sites or factory and
convenient quota sampling within the random sampling frame according to the worker’s nationality. In the first stage, the villages, plantation sites and manufacturing
plants were selected using simple random sampling method according to the list from the statistics obtained from the vector units of the district health offices. In the
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Health Seeking Behaviour towards Communicable Diseases among Foreign Workers in Industrial Agriculture Sectors of Selected Districts in Perak, Malaysia
second stage, adequate representative numbers of foreign workers from different nationalities in each sector were enrolled via convenient sampling method.
The 3 highest proportions of foreign workers in terms of their nationality were enrolled from the agriculture sector, i.e. 100 Indonesian, 100 Thai, and 100
Bangladeshi agriculture workers from the Hulu Perak and Kuala Kangsar districts. The 4 highest proportions of foreign workers in terms of their nationality were enrolled
from the industrial sector; i.e. 75 Indonesians, 75 Bangladeshis, 75 Nepalese, and 75 Vietnamese from the Kinta district. This sampling method was designed in such a
way to ensure that the health seeking behaviour of each nationality was included in the study, and allowed subsequent comparisons in terms of nationalities, legal
status, and other socio-demographics.
3.5.1 Inclusion criteria
All foreign workers working in the agriculture sector of Hulu Perak and Kuala Kangsar districts and the industrial sector of Kinta district who agree
to participate in the study.
3.5.2 Exclusion criteria
1. Foreign workers from developed countries with high socioeconomic
status. 2.
Foreign workers with permanent resident status. 3.
Foreign workers who are illiterate and with inadequate language ability for interview purpose.
4. Foreign workers working in other sectors maids, constructions,
service.
3.6 Data collection techniques
One health inspector, one assistant health inspector, and 5 community nurses from Grik Health District Office were trained for 2 sessions in administering the
questionnaire and were subsequently directly involved in data collection process. Literate foreign workers were encouraged to self-administer the questionnaire on
the spot with assistance from the interviewer. The questionnaires were prepared in 5 languages, i.e. English, Malay, Bangladesh, Nepali, and Vietnam languages.
Interviewers directed themselves to the pre-defined areas where the foreign workers stay or work in casual attire to prevent anxiety to the person being interviewed.
Eligible subjects were approached in the streets or at the door of their homes or at the entrance of their common meeting places. The respondents were approached
for interviews irrespective of their nationality or gender. Interviews were conducted from early morning until late at night from July to October 2008. An average of 3-4
visits was needed to accumulate the required sample size for the study.
