Malaysia
Muslim-majority, middle-income, with a national specialty credentialing structure. The case where recognition ran ahead of coverage.
8 domains reviewed · 8 high-confidence · 3 dated estimates · 8 material gaps
WHO region: Western Pacific. World Bank income group: Income group not yet retrieved.
- Domains reviewed
- 8 of 9
- Hospice: 4 of 4
- Backed by a primary document
- 0 of 9
- Open questions
- 11
- Sources behind this dossier
- 14
- Newest source 2026
Lessons from Malaysia
- Headline opioid growth can hide falling pain relief. In Malaysia most of the rise was methadone for addiction while morphine fell. Morphine for pain should be tracked separately from total opioid figures.70
- Oral morphine stocked in nearly every public hospital did not mean a palliative service existed in most of them. Stock is necessary but services and trained prescribers turn it into relief.151
- A Muslim-majority, middle-income country built public hospital and primary care palliative services while leaving community care to donor-funded NGOs. That split leaves rural East Malaysia far from any service.47
- Free NGO hospice home care that depends on private donors has run for decades in Kuala Lumpur, and its authors judge national expansion hard without a public financing mechanism.47
- Family caregivers can safely give anticipatory subcutaneous medicines at home when a community team trains them and offers phone support, though their distress needs attention.301
- A national audit of every public hospital can track oral morphine availability alongside palliative service development using a simple scoring matrix.151
Palliative care
Is morphine available in Malaysia?
Opioid supply. Is a therapeutic opioid physically available in the wards that need it? Every country on this question
- 96.40 percentSOURCE-CHECKED
Ministry of Health hospitals with oral morphine available, Malaysia, 2023151
Last checked 2026-09-24.
135 of 140 hospitals.
Cite this figure: - 24 percentSOURCE-CHECKED
Cancer pain patients receiving regular opioid analgesia, Malaysia, 2008150
Last checked 2026-09-24.
From government survey data cited in 2008; the survey year is not stated.
Cite this figure:
Malaysia's large rise in strong opioid consumption was almost entirely methadone for addiction treatment; morphine for pain fell over the same decade, and fentanyl led pain use. Oral morphine is nonetheless stocked in nearly every Ministry of Health hospital.70,151,150
What is consumption of opioid analgesics for pain after 2014?
Help answer it:Search PubMedHow does Malaysia regulate opioids for pain?
Narcotics regulation. What licensing regime governs stocking and dispensing, and when did it last change? Every country on this question
What do the Dangerous Drugs Act and its hospital exemption order require for stocking and dispensing?
Help answer it:Search PubMedWho can prescribe morphine in Malaysia?
Prescriber authority. Who is legally allowed to prescribe, and can that group be widened? Every country on this question
Hospital palliative care is led by resident or visiting palliative physicians or trained medical officers, and domiciliary teams of nurses and medical assistants work under a family health physician. Community doctors often lack access to opioids.47
Is opioid prescribing legally restricted to registered medical practitioners, and is it tied to the specialty credential?
Help answer it:Search PubMedHow does palliative care reach patients in Malaysia?
Service delivery. Through what structure does care actually reach a patient at home? Every country on this question
- 7 hospitalsSOURCE-CHECKED · 2019 DATA
Ministry of Health hospitals with a resident palliative medicine specialist, Malaysia, 201946
Last checked 2026-09-22.
Cite this figure: - 4 hospitalsSOURCE-CHECKED · 2019 DATA
Ministry of Health hospitals with an inpatient palliative care unit, Malaysia, 201946
Last checked 2026-09-22.
Cite this figure: - 29 teamsSOURCE-CHECKED
Registered community-based palliative care teams, Malaysia, 202447
Last checked 2026-09-22.
Twenty-five registered under the Malaysian Hospice Council, four under other organisations.
Cite this figure: - 25.80 percentSOURCE-CHECKED
Ministry of Health hospitals with a formal palliative care service, Malaysia, 2023151
Last checked 2026-09-24.
Cite this figure:
The 2019 national policy review also counted four public teaching hospitals and five private hospitals with specialist services. Access is uneven: palliative services are close at hand in the central peninsula but far away in East Malaysia.46,47,151
Who pays for palliative care in Malaysia?
Financing. Who pays for the drug, the visit and the workforce? Every country on this question
Hospital and primary care palliative services are funded through the subsidised public system. Community palliative care is free to patients but delivered by NGOs dependent on donations.47
What budget does the 2019 to 2030 national palliative care strategy commit?
Help answer it:Search PubMedHow are palliative care clinicians trained in Malaysia?
Training and recognition. What credential exists, who awards it, and does anyone recognize it? Every country on this question
- 1,991 yearSOURCE-CHECKED
Year the field began in Malaysia, Malaysia, 202146
Last checked 2026-09-22.
Cite this figure:
Palliative medicine is a recognised subspecialty on the National Specialist Register, entered through basic specialist training in internal medicine.45,46
In what year was the subspecialty formally recognised? No gazette notice was located.
Help answer it:Search PubMedHow does Malaysia prevent opioid misuse without blocking pain relief?
Opioid safeguards. How are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief? Every country on this question
A national audit found oral morphine available in 135 of 140 (96.4%) Ministry of Health hospitals. Malaysia had the highest strong opioid consumption of five Southeast Asian countries in 2005 to 2014 (11.2 DDD/1000 inhabitants/day), mainly methadone, and methadone maintenance therapy has been offered nationally since 2005.151,70,657
Does Malaysia operate an opioid prescription monitoring program, and can families or outreach workers obtain naloxone?
Help answer it:Search PubMedHow do children get palliative care in Malaysia?
Children's palliative care. How do children with life-limiting conditions get palliative care and the medicines they need? Every country on this question
Of 8907 child deaths in Ministry of Health hospitals in 2012 to 2014, 3958 (44.4%) were children with life-limiting illness, and 63.9% of those were neonates. Paediatric palliative care developed later than adult care, first through individual paediatricians and NGOs, and still faces a shortage of trained paediatricians.659,660
How many children receive specialist paediatric palliative care each year, and are pediatric opioid formulations stocked?
Help answer it:Search PubMedHospice care in Malaysia
How the hospice model works here, who can use it, who pays and who it reaches. Covered 4 of 4.
What does hospice care look like in Malaysia?
Hospice model. What does hospice mean here, who runs it, and in what settings? Every country on this question
In Malaysia, hospice mainly means NGO-run community home care, started in 1991 under voluntary organizations, alongside public hospital palliative units and public clinic domiciliary care. In 2021, 25 of 29 registered community palliative care teams were registered under the Malaysian Hospice Council, and Hospis Malaysia is a charity serving about 2000 patients a year. Local writing uses hospice and community palliative care almost interchangeably.301,47
Who can get hospice care in Malaysia?
Hospice eligibility. Who can enter hospice, on what criteria, and how late do patients arrive? Every country on this question
Most community palliative care patients come by referral from hospitals. At one NGO community center, 86.7% of 4346 referred decedents had cancer, and median referral-to-death was 32 days for cancer and 19 days for noncancer patients (2017 to 2019, single center).47,302
Do Malaysian NGO hospices apply formal prognosis or diagnosis criteria at intake?
Help answer it:Search PubMedWho pays for hospice care in Malaysia?
Hospice funding. Who pays for hospice care: a public benefit, insurance, charity or families? Every country on this question
NGO community palliative care is offered free of charge and most community palliative care is donor-dependent. Hospis Malaysia is described as largely dependent on private donors, which the authors see as a limit to national expansion.47
Does the Ministry of Health give any grants or contracts to NGO hospices?
Help answer it:Search PubMedHow many people reach hospice in Malaysia?
Hospice reach. How many dying people use hospice, and who is left out? Every country on this question
NGO hospice services are mainly restricted to urban areas. In 2021 community teams operated in most of Malaysia except Perlis and Labuan, and in Sarawak NGOs provided community palliative care in only 2 of 40 districts. Median travel distance to the nearest palliative care service was 82 km in East Malaysia.47,301
What share of Malaysians who die with palliative needs are seen by an NGO hospice?
Help answer it:Search PubMedWhat fills the gap in Malaysia
How people get care outside formal services: families, faith communities, volunteers, health workers, healers, other medicines and charity. Described, not scored.
- Family caregiving
In a case report from an NGO hospice in Kuala Lumpur, adult children cared for their dying mother at home as a filial duty. With training and phone support, they gave anticipatory subcutaneous morphine injections, while also experiencing anticipatory grief and worry about overdose.301
Single-site evidenceSelf-reported- Faith communities
Nineteen patients with stage 4 cancer at the National Cancer Institute Malaysia described spirituality as a source of strength when facing a poor prognosis. They asked for culturally sensitive end-of-life discussions and better spiritual care.479
Single-site evidence- Volunteers and compassionate communities
Community palliative home care in Malaysia began in 1991 through hospices run by voluntary organizations, and several NGO hospices now operate. The authors note these services are mainly limited to urban areas because of limited resources, staff and networks.301
National evidenceSelf-reported- Community health workers and home-based care
A statewide domiciliary palliative care program run from eight health clinics in Sarawak saw 113 patients with terminal illness in its first year, most with advanced cancer. Most patients (72%) received care in urbanized locations, and the authors call for more rural and indigenous outreach.478
Subnational evidenceSelf-reported
Sources cited here
- 70Zin CS.
Ten years of strong opioid analgesics consumption in Malaysia and other Southeast Asian countries. Journal of Pharmacy and Bioallied Sciences 2020;12(Suppl 2):S846-S851. DOI 10.4103/jpbs.JPBS_252_19. Strong opioid consumption from 2005 to 2014 in defined daily doses per 1,000 inhabitants per day, from Pain and Policy Studies Group data drawing on INCB reports; fentanyl, then pethidine, then morphine in Indonesia.
- 151Lim RBL, Yeat CL, Vighneshvaran R, Kasinathan N, Ahmad Subki SZ, Singh AHS, et al.
Mapping levels of palliative care service development in Malaysian public hospitals using the WHO public health model of palliative care. Journal of Pain and Symptom Management 2023;66(3):221-229. DOI 10.1016/j.jpainsymman.2023.05.017. Abstract read. National survey of Ministry of Health hospitals: share with formal palliative services and share with oral morphine available.
- 150Lim R.
Improving cancer pain management in Malaysia. Oncology 2008;74(Suppl 1):24-34. DOI 10.1159/000143215. Abstract read. Government survey data: a minority of cancer pain patients receiving regular opioid analgesia, and physicians reporting knowledge gaps and fear of respiratory depression.
- 47Segarmurthy MV, Lim RB, Yeat CL, Ong YX, Othman S, Taher SW, et al.
Mapping palliative care availability and accessibility: a first step to eradicating access deserts in low- and middle-income settings. Journal of Palliative Care 2023;39(4):255-263. DOI 10.1177/08258597231214485. Counts 29 registered community-based palliative care teams nationally, 25 of them under the Malaysian Hospice Council, and reports the share of public primary care clinics offering domiciliary palliative care.
- 46Sivalingam N, Lim RBL, Rampal L.
Palliative care in Malaysia: the need to do much more. Medical Journal of Malaysia 2021;76(3):279-283. Reports the field dating from 1991 and the service counts set out in the National Palliative Care Policy and Strategic Plan 2019 to 2030: seven Ministry of Health hospitals with resident palliative medicine specialists, four of them with inpatient units, four public teaching hospitals and five private hospitals with specialist services.
- 45National Specialist Register of Malaysia and the Malaysian Hospice Palliative Care Council.
Specialist registration criteria list palliative medicine as a distinct subspecialty entry, and registrant records carry it alongside internal medicine. The council states that doctors intending to train in palliative medicine undertake basic specialist training in internal medicine first. No gazette notice giving a recognition year was located in either source.
- 657Yahaya Y, Mohideen FBS, Baharom N, et al.
Between efficacy and ambivalence: Family perceptions of Methadone Maintenance Therapy in Malaysia. Int J Drug Policy 2026;149:105149. Qualitative interviews with 20 family members of methadone clients at two primary care addiction clinics; not palliative care specific. Abstract read.
- 658Song W, Shari NI, Abdullah MFILB, et al.
Acceptance and commitment therapy improves the quality of life of breast cancer patients by reducing helplessness: a randomized controlled trial. BMC Palliat Care 2026;25(1). Randomized trial of 80 breast cancer patients at one Malaysian tertiary cancer center; single-site. Abstract read.
- 659Khalid F, Chong LA
National Pediatric Palliative Care Needs from Hospital Deaths. Indian J Palliat Care 2019;25(1):135-141. Retrospective review of the national admissions database for child deaths in Ministry of Health hospitals, 2012 to 2014; hospital deaths only. Abstract read.
- 660Khoo EJ
Paediatric palliative care around the world: Malaysia. Curr Probl Pediatr Adolesc Health Care 2023;54(1):101452. Single-author narrative overview and case study of paediatric palliative care development in Malaysia; expert opinion. Abstract read.
- 301Leong YY, Hamzah E, McCarthy S, et al.
Providing End-of-Life Care in the Community: What Are the Challenges in Malaysia? J Hosp Palliat Care 2022;25(3):133-137. Case report with background on the history of NGO hospice home care in Malaysia; all authors work at Hospis Malaysia, so the service description is a self-report by the provider. Full text read.
- 302Yip YY, Hwong WY, McCarthy SA, et al.
Duration of Referral-to-Death and its Associated Factors Among Cancer and Noncancer Patients: Retrospective Cohort Study of a Community Palliative Care Setting in Malaysia. J Palliat Care 2022;38(2):111-125. Retrospective cohort of 4346 decedents referred to one community palliative care center (2017 to 2019); two authors are Hospis Malaysia clinical staff, and the abstract does not name the center. Abstract read.
- 479Chung I, Khoo SY, Low LL
An Insight Into the Experiences of Malaysian Patients With Advanced Cancer and Their Preferences in End-of-Life Care: A Qualitative Study. Am J Hosp Palliat Care 2024;42(1):5-13. Interviews with 19 patients with stage 4 cancer at the National Cancer Institute Malaysia. Abstract read.
- 478Leong YY, Choo YL, Wong SLK, et al.
Service utilization of a novel statewide domiciliary palliative care program in Malaysia. Med J Malaysia 2026;81(4):483-488. Retrospective cohort of 113 patients seen in the first year of a domiciliary palliative care program run from eight health clinics in Sarawak; authors describe their own program. Abstract read.