Abstract-The increasing cases of HIV/AIDs among the women and infants transmitted from the drug abuser through sharing of needles and unsafe sex had forced the Ministry of Health to initiate harm reduction programmes. A group of researchers from Universiti Sains Malaysia (USM) administered two harm reduction programmes: needle & syringe exchange programme (NSEP) and the methadone maintenance programme (MMT). The two programmes were conducted for patients at a local NGO and a public hospital in Kota Bharu, Kelantan.The efforts were not received favourably by many people because it involves the use of public funds. As accounting professionals, the first three authors were invited by USM researchers to review of the costs effectiveness of the programmes. Basically, the drug users who participated in these programmes are mostly youths and young adults who are at their prime age. In this paper the authors discuss the cost effectiveness of the NSEP and MMT intervention programmes. The paper also looks into the quality of life of the clients/patients.
Abstract-Total Quality Management has been applied widely in the business sector in particular to assess the impact of continuous quality in the day to day operation. The emphasis was more on preventive than cure. Many government sectors in Malaysia are moving towards adopting this concept to ensure that quality product and services are delivered to their customers. In this paper, the researcher introduces the concept of TQM to cost drug intervention programme in particular the Needle and Syringe Exchange Programme (NSEP), conducted in Kota Bharu, Kelantan, Malaysia. The paper also measures the effectiveness of the activities using the concept of 4Cs. The framework has never been used before to cost and at the same time determine the effectiveness of harm reduction programme. The result demonstrated that the NSEP is cost effective in preventing the spreading of HIV virus through needle-syringe sharing. It also reveals the importance of creating awareness among the public about the programme and the benefits of such programme. The research findings will better promote the programme to the government so that a larger investment would be made to prevent the spreading of HIV virus in the country.Index terms-4Cs, harm reduction, NSEP, total quality management.
I. INTRODUCTIONIn the past, cost effectiveness on the harm reduction programmes were conducted through the eyes of non-management accountant. These work mostly involved classifying and quantifying the costs of harm reduction, as evident by some literatures. Any costs that relates to detecting and treating of diseases were classified as direct costs whereas costs that relates to any production lost as a result of premature mortality, morbidity and the use of health care services were classified as indirect costs [1].The intervention costs have also been classified as financial costs and economic costs [2]. In measuring the effectiveness of the activities, productivity costs were also introduced which described some indirect costs associated to intervention activities [3]. The harm reduction has also been identified as annual costs of methadone substitution; additional counselling and program support costs as well as annual health costs [4].In this paper the authors will costs the activities relating to harm reduction using the total quality management by introducing the 4Cs. Manuscript
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