HEALTHOPINION

Budget 2023: Building for the Future of Our Children

The Budget 2023 is due to be tabled in parliament soon. In the 33-page 2023 Pre-Budget Statement released by the Ministry of Finance (MOF), children are only mentioned twice, both in the context of childcare services. The budget states that it aims to be a “Whole-of-Nation approach” but the needs of children appear to be poorly focused on.

To be meaningful, a national budget should not focus just on economic development but also on the critical areas that affect society, especially children. These include Education, Health, Protection, Environment and the Social Determinants that marginalise and exclude children – the conditions that keep them in poverty and hold them back from being who they truly can be.

In line with our Prime Minister, Dato’ Sri Ismail Sabri Yaakob, expressed desire to support our children, “the best interest of the child shall be a primary consideration” (UN Convention on the Rights of the Child 1989, UNCRC and the Child Act 2001), kindly allow us to bring attention to some areas that require an urgent focus.

  1. Reviving and Supporting our Early Childhood Services

Many early childhood services are still struggling, with an estimated 25% having closed during the COVID-19 pandemic. Most early childhood services, especially those catering for the middle and low income families, have small profit margins, limited access to cash reserves and lack the capacity to withstand any drop in revenue. Early intervention programmes (EIPs) for children with disabilities are even worse off as they are non-commercial and are struggling due to loss of community funding. These early childhood services are critical to the development of our children and as a source of childcare and support for parents. The child care sector for children under 4 years, the preschool sector for 5-6 year olds and the care sector for children aged 4 to 18 years (Pusat Jagaan) have all been severely affected.

We urge the Government to allocate budgetary provisions to cover half the operating costs of centres catering for middle and low income families (especially staff remuneration and running charges), as well as for early intervention programmes delivered by CSOs, for the next two years, to keep vital services alive for children with disabilities, covering both pre-school and older children with disabilities. We encourage working with the National Early Childhood Intervention Council (NECIC) and National Associations of Early Childhood Education, to identify preschools and child care services in need of support and provide them financial incentives for the next 1 to 2 years.

  1. Supporting the Education of Children in Standard 1 and 2

The COVID-19 pandemic has highlighted the education disparities in our nation, with many children being left behind. Malaysia has had one of the highest learning losses among Asian developing nations and currently faces a national education emergency. During the pandemic, many students, especially those from rural Sabah and Sarawak were sent back from residential schools to villages; due to limited transport and internet, they lost a significant amount of school time.

More than 40% of children entering Standard 1 are not school ready, i.e. they do not have the reading and writing skills necessary to cope. It is estimated that 30% of preschool children have communication / learning related issues, many unrecognised. A significant proportion of children currently in Standard 1 and 2 did not receive pre-school education, including those with learning disabilities who did not benefit from early intervention. In addition, our teachers require support for this education emergency.

It is vital that Budget 2023 allocates the resources required to address this crisis. This should include harnessing additional human resources for the next 1 to 2 years to support children who did not receive adequate pre-school education or have a learning disability. There should be one extra teacher in all Primary 1 and 2 classes in every school. We can secure additional human resources by hiring retired teachers, unemployed university graduates, and upper secondary school leavers. The type of human resources to be mobilised would depend on the location and type of school; for example, rural schools in the interiors may opt to hire local school leavers given their availability, need for employment opportunities/work experience and ability to relate better to the children’s culture and context.

  1. Strengthening Primary Healthcare Nursing Human Resource

The COVID-19 pandemic has brought to the attention of the public how vital primary healthcare is and how under-funded and neglected it is locally. The 2023 Pre-Budget Statement by MOF speaks about “strengthening resilience of public health” but may not recognise where the strength of primary healthcare is located. The pillar, the strength and the execution of primary healthcare are our nurses. Without our nurses there is no primary healthcare. While we have heard much about the needs of doctors, and somewhat the needs of pharmacists, we have neglected to advocate for our nurses. Nursing is sadly no longer perceived as a respected and valued profession in our country.

It is critical that Budget 2023 address the growth and development of primary healthcare by addressing the needs of nurses. We need to triple the primary healthcare nursing human resource posts (not by taking from hospital posts) and then work concertedly to get the bodies required. We need to increase the pay scheme for nurses to attract more to join this vital profession; instead of allowing other countries to poach our nursing staff. It is not infrastructure or technology that will make primary healthcare work, it is nurses.

  1. Revamp and Strengthen the Welfare Department

Child protection services in Malaysia are weak and inadequate. Only the minority of abused children are detected and even those identified receive suboptimal care and support, despite good legislation (Child Act). One major reason for this is that the majority of our Social Welfare Officers are not trained Social Workers but are trained in other basic disciplines, often with no relevance to child protection. Hence, they lack the expertise required in child protection. In addition, staffing numbers are poor.

We urge the government to use Budget 2023 to revamp and strengthen the Welfare Department by the allocation of one to two thousand posts for trained social workers. This will encourage the development of the profession locally and offer employment to those with the training. All directors of Jabatan Kebajikan Masyarakat at district, state and national levels must have Social Work background. These steps may help reform child protection in Malaysia and bring it into the 21st century.

  1. Dramatically Improving Conditions for all Children in Detention

On 21 April 2021, the Alternatives to Detention (ATD) Pilot was approved by the Ministerial Cabinet, with 14 February 2022 set as the official start date of the ATD Pilot, for a duration of one year. The ATD Pilot aims to provide temporary shelter for unaccompanied and separated children under detention, and acknowledges the serious harm that children face in immigration detention. It focuses on prioritising the physical and mental health development of children. However, as of 12 July 2022, there were 1,764 children held in immigration detention facilities, many unaccompanied or separated from family, and the ATD Pilot has yet to commence. This is despite Malaysia’s position as an elected member of the United Nations Human Rights Council (UNHRC) for the 2022-2024 term, in which they pledged to conduct the ATD Pilot and “ensure that children grow and achieve their full potential in a family environment, instead of being placed in institutions.”

Conditions in detention centres remain extremely poor, with no access to education and severely limited access to health, nutrition and protection. Recent government statistics show at least 7 deaths of children in detention, with 4 deaths happening in the last year alone, an indictment to our services. In addition, we have thousands of children being held in prison. There is great harm caused to children by placing them in any such detention facilities.

We urge the government to use Budget 2023 to push through the implementation and upscaling of the ATD Pilot, prioritising the best interests of the child. We urgently need to move children out of detention centres into community-based, and family-based care where they can have access to meaningful education, healthcare and protection.

Additionally, in line with the UNCRC, all children, regardless of status, should have universal access to affordable health services, including hospitalisation, treatment of illness and rehabilitation of health. Routine, free primary health care and immunisation should be provided to all children in Malaysia, regardless of their status.

  1. Addressing Childhood Poverty

The revision of our poverty line income and the Merdeka Center October 2020 report suggest that 3-4 million children live in poverty or relative poverty. This is borne out by the National Health and Morbidity Surveys that show stunting in children is worsening, that 10% of children come to school without breakfast and another 60% have irregular breakfast. This has worsened with the COVID-19 pandemic. Poverty reduction requires many initiatives, one of which is a supplementary food programme.

We ask that the government use Budget 2023 to institute a universal school breakfast programme for all children as a means to support adequate nutrition. Such a programme is critical for these children with poor food security but will benefit many more students. It will have a significant impact on the long-term height growth and mental abilities of our children.

  1. Form a Children’s Ministry

No budget can solve all the nation’s problems. But budgets must be a beginning, a path to improving the situation of the most vulnerable, our children. If we want to be serious about meeting the needs of children, ensuring their rights, and having a true ‘Keluarga Malaysia’, then we need a ministry dedicated to children, with manpower and financial resources to enable them to effectively plan, coordinate and implement at all levels.

We sincerely request the government to make Budget 2023 a landmark budget, where children are given the focus they deserve, by initiating the establishment of a Children’s Ministry.

We hope the government will note that what we need to build, using Budget 2023, is the human resources of our nation, more than infrastructure development. If we do not build back better into the lives of our children, then we will pay the price economically and socially in the decades to come.

On this symbolic day, our Malaysia Day, we implore the government of the day to listen to and meet the critical needs of all our children.

Signatories

  1.   Dato’ Dr. Amar-Singh HSS, Consultant Paediatrician and Advisor Nation Early Childhood Intervention Council
  2.   Aimee Chan, Hon. Secretary, Persatuan Kebajikan Sri Eden Selangor dan Kuala Lumpur
  3.   Aisha Zanariah Abdullah, President, Montessori Association Malaysia
  4.   Dr Amelia Alias, Independent Researcher, Childline Foundation
  5.   Amy Bala, Vice President, Malaysian Association of Social Workers
  6.   Ananti Rajasingam, CEO, Yayasan Chow Kit
  7.   Anderson Selvasegaram, Executive Director, SUKA Society
  8.   Dr Angie Garet, President, Sarawak Women for Women Society
  9.   Angie Heng, Executive Director, Kiwanis Down Syndrome Foundation
  10. Anisa Ahmad, President Persatuan Pengasuh Berdaftar Malaysia
  11. Asha Singh, Child Advocate, Family Frontiers
  12. Azira Aziz, Lawyer, Liga Rakyat Demokratik
  13. Bina Ramanand, Lead Co-ordinator, Family Frontiers
  14. Brian Law, Co-Founder Study Hub Asia
  15. Brittocia Franklin, Executive Director, Global Shepherds
  16. Cathryn Anila, Founder & President, Vanguards4Change
  17. Chan Saw Si, Executive Director, Wings Melaka
  18. Chew Siok Cheng, Methodist Care Centre, Sibu, Sarawak
  19. Dr. Chin Saw Sian, Paediatrician, National Early Childhood Intervention Council
  20. Chun Wah Hoo, Managing Director, NGOhub
  21. David Ngu Tai Giin, President, Sibu Autistic Association
  22. Dato Dr. Hartini Zainudin, child activist, Yayasan Chow Kit
  23. Dr Easwary Ramulu, SAWO President
  24. Irene Xavier, Executive Director, Persatuan Sahabat Wanita Selangor
  25. Jayasingh Rajiah, ex-Director, Bethany Home
  26. Jeannie Low, Chief Operations Director, Play Unlimited
  27. Associate Prof Dr. Kamal Kenny, Chairman of Federation of Reproductive Health Associations Malaysia
  28. Kelvin Lim, Director, Change Your World
  29. Khor Ai-Na, CEO Asia Community Service
  30. Kong Lan Lee, Director, Persatuan Kanak-Kanak Istimewa Kajang Selangor
  31. Lai Sau Theng, Chairperson, New Horizons Society
  32. Lam Mary, Chairperson, Pertubuhan Perkhidmatan Intervensi Awal, Johor
  33. Lim Mei Yek, President, KATSN
  34. Ling Sii Ying, Methodist Care Centre , Kuching, Sarawak
  35. Loh Cheng Kooi, Executive Director, Women’s Centre for Change Penang
  36. Margaret Loy, Chief Executive Officer, Community Transformation Initiative Bhd
  37. Lu Chieng Hoong President Perpikat Bintulu
  38. Meera Samanther, Committee Member, Association of Women Lawyers
  39. Melissa Akhir, Access to Justice Consultant, Kemban Kolektif
  40. Melissa Ngiam, CEO, Yayasan Generasi Gemilang
  41. Nadiah Hanim Abdul Latif, President Malaysian Rare Disorders Society
  42. Ng Lai-Thin, Project Officer, National Early Childhood Intervention Council
  43. Ng Lee Boon, President of Persatuan Pengasuh Kanak-Kanak Berdaftar Sarawak
  44. Prof Dato Noor Aziah Mohd Awal, SUHAKAM
  45. Ong Puay Hoon, Founder and ex-President, Dyslexia Association of Sarawak and Chairperson, Tunaz Mutiara Consultancy
  46. Pam Guneratnam, Founder, HumanKind
  47. Pauline Wong, Director, Siloam House
  48. Datuk Dr Raj Karim, President, Majlis Kebajikan Kanak-kanak Malaysia
  49. Dato Dr Ramanathan, Persatuan pemulihan Sultan Azlan Shah,Bercham, Ipoh
  50. RD Ramesh Patel, Chairman Pertubuhan Kebajikan Vivekananda Rembau NS
  51. Roland Edward, Engagement and Partnership Manager, Be My Protector
  52. Dr Ruwinah Abdul Karim, President of Persatuan Kanak- Kanak Autism Johor
  53. Dr. Selva Kumar, Consultant Paediatrician and President Malaysian Paediatric Association
  54. Simon Hoo Hock Chwee, Chairman, SPICES Early Intervention Centre
  55. Siti Aishah Hassan Hasri, SPOT Community Project
  56. Srividhya Ganapathy, Co-chairperson, CRIB Foundation
  57. Stella Chia, Director, Pusat Jagaan Kanak-Kanak Ceria Murni
  58. Dr. Tan Liok Ee, President, BOLD Association for Children with Special Needs, Penang
  59. Teo Kun Yong, Director, Pusat Pendidikan Kanak-Kanak Istimewa Harmoni Cheras Selangor
  60. Tham Swee Keng, president and Cheong Kam Wah, Administrator, Persatuan Kanak-Kanak Istimewa Hulu Langat Selangor
  61. Thulasi Munisamy, Advocacy and Partnerships Director, Protect and Save the Children
  62. Prof. Dr Toh Teck Hock, Vice President, National Early Childhood Intervention Council
  63. Vivienne Chew, Asia Pacific Regional Coordinator, International Detention Coalition
  64. Wong Hui Min, President, National Early Childhood Intervention Council
  65. Datin PH Wong, Director, Childline Foundation
  66. Dr. Wong Woan Yiing, Consultant Paediatrician, committee member, NETWORK for the needs of children with disabilities Perak
  67. Yap Sook Yee, Founder, Persatuan WeCareJourney
  68. Yuenwah San, Project Lead, OKURightsMatter Project
  69. Zipsy Kamalr Malar, Principal, Society for Persons with Learning Difficulties, Dayspring Selangor
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