INTRODUCTION

The period from conception to a child’s second birthday, about 1,000 days, is when the base for lifelong health and wellbeing is built. It is recognised as one of the most crucial periods for physical growth and brain development in children^1,2. For healthcare professionals, this period offers the most significant opportunity to influence long-term health, cognitive development, and socioeconomic outcomes. However, for many children in marginalised communities, this window is obstructed by systemic inequities. The majority of children in marginalised communities continue to face higher rates of stunting and preventable mortality/morbidity despite national progress for the ‘mainstream’ communities. The benefits of modern child health are not distributed equally.

This paper examines: (i) who the marginalised child populations in Malaysia are; (ii) the magnitude of the gap between those populations and mainstream communities for first-1,000-days outcomes; (iii) the systemic obstacles that sustain that gap; and (iv) what can be done to overcome them. To address these questions, we draw on data from national surveys, the Department of Statistics Malaysia, international health organisations, and peer-reviewed publications and grey literature published between 2008 and 2026.

Note that this is a narrative rather than systematic review and some comparisons rely on older data and grey literature because newer disaggregated data are not in the public domain. Climate-related determinants are excluded by scope. The paper draws on a single jurisdiction and is not intended as a cross-country comparison.

Who are the Marginalised Communities in Malaysia?

Population estimates for 2025 show 9.03 million children aged below 18, or 26.4% of the total population (Table 1)³.

Table 1. Population Data on Children in Malaysia, 2025³

Children and their families that are marginalised in Malaysia form a significant proportion of the population (Table 2). The groups described below are each marginalised in different ways, but this paper is concerned with a single, specific window of harm: the 1,000 days from conception to the second birthday. For each group, we attempt to identify the mechanisms by which marginalisation obstructs the first 1,000 days - antenatal access, safe delivery, birth registration at birth, neonatal follow-up, immunisation, breastfeeding, nutrition of the pregnant mother and infant, and early detection and intervention for developmental delay. Outside this window, the harms are real and well documented; inside this window, they are developmentally irreversible. That is the argument of this paper.

Children Living in Poverty

The 2024 poverty statistics of the Department of Statistics Malaysia (DOSM)⁴ put the mean Poverty Line Income (PLI) at RM2,705, with 5.1% of households in absolute poverty and 0.09% in hardcore poverty. The estimated number of households living in absolute poverty would be ~416,000 (based on data from DOSM^4,5). It is estimated that approximately 1.0-1.2 million children live in absolute poverty (note that low-income groups would have a typically higher than the national average household size and more children). Absolute poverty was higher in rural households (9.9%) than in urban households (3.7%), and by state it was highest in Sabah (17.7%) and Kelantan (11.5%).

Relative poverty was 16.7%, measured as household income below half the national median (RM3,509 in 2024). The number of children living in relative poverty would be 3.2-3.5 million (estimated 1.44 million households).

Indigenous Children

The government probably holds counts of indigenous (Orang Asli) children in Peninsular Malaysia, but these are not shown in national data publications. Often, they are included under a ‘Bumiputera’ or ‘Other-Bumiputera’ category (with East Malaysians). The Orang Asli of Peninsular Malaysia comprise 18 sub-groups across three major groupings (Negrito, Senoi, and Proto-Malay). In a special report on the demographic of Orang Asli⁶ it was reported that the population of Orang Asli in 2025 was 227,900. The same report showed that one-third (33.3%) of Orang Asli were aged 0–14 years in 2020. From these figures, a reasonable estimate of the population of Orang Asli children in 2025 would be in the range of 85,000-100,000. In East Malaysia, the indigenous peoples include the Kadazan-Dusun, Murut and Bajau in Sabah, and the Iban, Bidayuh, Melanau and Penan in Sarawak. This paper gives particular attention to the Penan. Data on the Penan population in Sarawak is also weak. It was estimated at 11,000 in 2008⁷ but other informal estimates say current numbers are up to 16,000 (various, unverified estimates). No national figure exists for Penan children, although they probably make up 30–40% of the community.

Migrant, Refugee and Stateless Children

Data on migrant, refugee and stateless children in Malaysia is poor. UNHCR Malaysia had 211,360 registered refugees and asylum-seekers at the end of October 2025⁸. About 90% (189,760) were from Myanmar, with most of the remainder from Pakistan, Yemen, Somalia, Afghanistan, Syria, Sri Lanka, Palestine and Iraq; 64,801 were under 18. In 2019 the UNHCR estimated 450,000 stateless persons in Sabah⁹. However, in March 2022 the Sabah Chief Minister put the number of non-citizen residents at 810,443, or 23.7% of the state’s population, most of them Bajau Laut⁹. Welfare Department figures for 2019 recorded 1,933 stateless children (1,098 boys, 835 girls) living in welfare homes across the country¹⁰. Population data for 2025 shows that 703,100 children (aged 0-19 years) are non-citizens (excluding data on persons in Malaysia of other citizenship) and comprise 7% of the childhood population¹¹. Most of these children would probably be stateless children.

The first 1000-days mechanism of harm for this group is access: to antenatal care, safe delivery, birth registration at birth, neonatal follow-up, and infant immunisation. Each of these is obstructed by immigration-enforcement concerns and by the higher cost of public-facility care for non-citizens.

Children in Prison/Detention

Women make up 7-9% of the total Malaysian prison population^12,13. Under Regulation 13 of the Prisons Regulations 2000, a mother in prison may keep her child with her until the age of three, often so that she can continue breastfeeding. There is a lack of proper nursery or dedicated facilities in most prisons that house women. No figures have been published on the number of young children living with their mothers in prison. A separate issue involves children, including infants, being held in immigration detention centres without suitable facilities, sometimes separated from parents or kept with them in inappropriate conditions. The Home Minister announced that as of 31 August 2025, 2,196 children were detained (11% of the 20,143 undocumented migrants) at 18 immigration depots and two temporary facilities¹⁴. The majority of these children (66%) are unaccompanied and separated from their families¹⁵.

The first 1000-days mechanism of harm here is not imprisonment itself but its developmental correlates: maternal stress and trauma during pregnancy, childbirth under detention protocols, disrupted or absent breastfeeding, infection exposure in crowded facilities, and interruption of routine infant care and surveillance.

Looked After Children (Institutions or Residential Care)

Malaysia has no complete count of looked-after children. The ‘Children Statistics Malaysia 2025’³ cites two different figures. Firstly, the number of inmates in government children's institutions for 2024 was 2,078. Secondly, the number of ‘inmates’ of childcare centres for 2024 was 38,955 (possibly including those run by private and civil society organisations). Some homes are unregistered, making the exact number difficult to track. OrphanCare Foundation Malaysia estimated that there were ~64,000 children living under institutional care in Malaysia in 2021¹⁶.

For the first-1000-days window, institutional placement of infants and very young children has specific developmental consequences: relational deprivation, inconsistent caregiving, constrained language exposure, variable nutrition quality, and increased infection risk. These are not aggregated into the national discussion because the national discussion treats alternative care as a child-protection issue rather than a developmental one.

Children with Disabilities

Malaysia’s data on childhood disability are inadequate. Data of the Welfare Department (JKM) up to February 2026 show 219,564 children aged 18 years or younger registered persons with disabilities¹⁷; there is gross under-representation of girls registered. The absence of anti-discriminatory protection exposes children with disabilities to discrimination, especially in the right to mainstream education, access to insurance coverage and future employment. Hence, many families hesitate to register with JKM. UNICEF¹⁸ estimates that about one child in ten worldwide, close to 240 million children in all, has a disability. Using the 2025 population of children³, the registered children with disabilities amounts to 2.43% of all children, far below the expected 10% from international data. However, the 2022 National Health and Morbidity Survey (NHMS) on maternal and child health found developmental delay in 7.4% of children aged 6–59 months¹⁹. Note that the NHMS disability rates do not include childhood disability due to psychosocial (mental health) issues. Hence, it would be reasonable to accept the UNICEF rate and assume that approximately 10% of all children in Malaysia have a disability.

Table 2. Population of Marginalised & Potentially Marginalised Children in Malaysia

What are the Problems Faced by Children in Marginalised Communities?

Here the focus will be on the first 1,000 days and not to inequalities faced in later years in life like school education, employment, etc. The key impacts on children and pregnant mothers for marginalised communities are summarised below. The key problems are poverty-related barriers and inadequate access to healthcare.

Poor Maternal Nutrition/Health & Teenage Pregnancies

Poor maternal nutrition slows the baby’s growth in the womb and leads to low birth weight, especially the symmetrical small-for-gestational-age (SGA) baby. These babies are at higher risk of death before the age of five and of developmental delay²⁰. National data from 2019 found anaemia in 29.9% of Malaysian women of reproductive age. Anaemia points to poor nutrition and raises the risk that the baby is born small and later becomes stunted²¹.

The first 1,000 days begin biologically before pregnancy is confirmed. The primordial follicle takes months to mature before ovulation, and the mother’s metabolic state shapes the intrauterine environment from conception forward. That state includes her nutrition, her micronutrient status (folic acid, vitamin D, iodine, iron) and her psychosocial wellbeing. For first-1,000-days policy, this means preconception nutrition and maternal mental health are not preparatory; they are part of the window. An impoverished woman who becomes pregnant without antenatal preparation enters the first 1,000 days at a disadvantage that no amount of neonatal care can fully recover. Hence, we need to work with families before the mother becomes pregnant, at least 6 months (180 days) before conception.

Findings from National Obstetric Registry²² and NHMS 2024²³ suggest that 40-50% of women in pregnancy are overweight or obese, often linked to poverty. Obesity is associated with gestational diabetes mellitus (GDM prevalence 27.1%) and with more complications in pregnancy and delivery¹⁹.

Ministry of Health (MoH) facilities recorded 41,842 pregnancies among girls aged 19 years or younger over 2020–2024²⁴. Of these 16,951 involved unmarried girls. Note that the data is only from MoH health facilities and the problem is probably much larger if we had national data. Teenage pregnancies have a strong correlation with poverty, lack of education, nutritional deficiencies, high rates of adverse birth outcomes and perinatal mortality, with significant psychosocial impact²⁵.

Perinatal Psychosocial Health

Perinatal psychosocial health - encompassing depression, anxiety, and psychosis during pregnancy and the first year after birth - is one of the most consequential yet often neglected determinant of child outcomes in the first 1,000 days. Maternal psychosocial illness directly impairs infant attachment, breastfeeding initiation and duration, cognitive stimulation, and early brain development in the child, with effects that can persist across the child's lifetime. For marginalised mothers in Malaysia, this burden is both amplified and invisible.

A 2018 review of postnatal depression across cultures reported rates in Malaysia ranging from 6.8% to 27.3%²⁶. The relationship between poverty and perinatal depression in Malaysia is well established and a local study showed that postpartum mothers from low incomes households were two to three times as likely as middle- and high-income mothers to report postpartum depressive symptoms²⁷.

Perinatal mental health services have improved, but a large treatment gap remains²⁸. For refugee, stateless, and undocumented mothers, the barriers are even greater, making perinatal psychosocial illness in these communities almost entirely unaddressed. Undetected and untreated perinatal depression in marginalised mothers directly impairs the neurological, nutritional, and emotional development of the child in the first 1,000 days.

Stunting in Children & Breastfeeding

Nationally, 21% of children under five were stunted in 2022¹⁹. Locally, childhood stunting is higher in households with low income (B40)²⁹, remote rural communities (Pahang 28%, Sabah 25%)¹⁹ and indigenous children under two years of age (41%)³⁰. Families often rely on calorie-dense but nutrient-poor options with resultant micronutrient deficiencies in iron, zinc, and Vitamin A. Stunting has lifelong consequences. A stunted child is unlikely to reach full adult height. Stunting is also linked to smaller brain growth, possibly poorer cognitive development and lower productivity in adult life, and so to a lifetime poverty trap³¹. Evidence also links stunting to later adult obesity, more childhood infections, premature death and a higher likelihood that the following generation will also be stunted³². Stunting in children is also well associated with an increased under-five mortality³³.

The World Health Organization (WHO) regards exclusive breastfeeding for the first six months as one of the most effective ways to lower child mortality and promote healthy development³⁴. There is limited national data on exclusive breastfeeding but 50.6% of mothers continue breastfeeding children aged 12–23 months¹⁹. Generally, lower-income groups and rural populations tend to have higher exclusive breastfeeding rates than higher-income and urban groups¹⁹. But the milk composition and quality in malnourished mothers needs more evaluation. 

Under-5 Mortality

Malaysia has met the SDG 3.2 targets for neonatal and under-five mortality at national level, but a national average can hide large gaps. Mortality data are not routinely broken down by region, income or ethnicity, so the communities that have not reached the target remain unseen³⁵. Under-five deaths in 2016 show how large these gaps are. Compared with the major ethnic groups, the age-specific mortality rate ratio was 11.0 for Orang Asli children in Peninsular Malaysia, 1.7 for the indigenous groups of Sabah and Sarawak, and 25.0 for children of Indonesian and Myanmar residents^35,36,37.

Access to Healthcare

There is considerable research to show that poverty is a major barrier to accessing health care and health information^38,39. Half the specialist human resources in the country are in the private sector but the private health services are out of the reach of the majority of poor families. Following advocacy with the Minister of Health in 2008–2009, responsibility for Orang Asli health care was moved from JAKOA, the Orang Asli development agency, to the Ministry of Health. However, access to health remains inconsistent for Orang Asli children⁴⁰ and depends on interest from local health authorities. There is also mistrust of the health services by some Orang Asli communities. Health access for remote rural communities in Sabah remains a challenge⁴⁰. Migrant, refugee and stateless parents are deterred from seeking care for their children by fear of arrest and deportation, cost, frequent relocation for work, language barriers and, at times, disrespectful treatment by health staff. Government-run public healthcare facilities are accessible but at a much higher cost compared to Malaysian citizens; often out of the reach of most migrant, refugee and stateless families⁴⁰. Much of the current healthcare provision is ad hoc by civil society organisations (CSOs).

Early Childhood Development and Care

With 1 in 10 children having a developmental delay or disability¹⁸ it is critical that all children have access to routine developmental surveillance and screening to identify problems early, have prompt access to diagnostic services, and receive timely early intervention and good-quality early childhood care. All these are lacking or non-existent in marginalised children with most missing the prime window for therapy⁴⁰. The majority of early intervention services are run by CSOs (with a waiting list and with very limited governmental support) or accessible at costly private centres/therapists⁴¹. The ‘disability-associated cost’ often pushes families deeper into poverty.

For children with disabilities specifically, routine developmental surveillance in the first 1,000 days is not a general good; it is a rights-based imperative. The United Nations Committee on the Rights of the Child urged Malaysia to “organize the collection of data on children with disabilities and develop an efficient system for diagnosing disability” and to “take immediate measures to ensure that children with disabilities have access to healthcare, including early detection and intervention programmes”⁴².

Birth Registration as a First 1000-Days Equity Determinant

Birth registration at birth is the single most consequential administrative event in the first 1,000 days. Without a birth certificate, a child has no stable pathway into subsidised healthcare, routine immunisation records, national childhood surveillance systems, school enrolment, or social assistance⁴². For the first-1000-days initiative, the operational implication is that universal birth registration at birth is a precondition, not a deliverable.

How Big is the Gap Between Marginalised and ‘Mainstream’ Communities?

Much of our data nationally is aggregated. Although household income data is collected this is rarely shown by social class in relation to health or nutrition. Hence, it is difficult to see the gross disparity between pregnant mother and children in marginalised community’s vs those in non-marginalised communities for the first 1,000 days. Table 3 is a limited attempt to show some disparities using available data. The disparities are huge and the gap possibly ever widening.

Table 3. Estimates of Disparity Between Marginalised and ‘Mainstream’ Communities*

What Hinders the Marginalised Communities from Achieving Equity in the First 1,000 Days?

Malaysia’s National Children’s Policy and Action Plan⁴⁵ is framed around inclusion, equity and non-discrimination, and states that it covers every child in the country, consistent with the Convention on the Rights of the Child (CRC) and the Child Act 2001. Its non-discrimination clause, however, makes that coverage subject to the laws and regulations already in force⁴⁵. This qualifier materially weakens the force of the policy’s promise of universality, because it leaves intact the very legal and administrative barriers and existing discriminatory policies that exclude certain groups from health, education, registration, and protection; most notably for stateless, refugee and migrant children, those held in detention, and those with disabilities.

Malaysia has no comprehensive anti-discrimination law that satisfies CRC standards. The existing safeguards, namely Article 8 of the Federal Constitution, the Child Act 2001, the Persons with Disabilities Act 2008 and the Mental Health Act 2001, do not address the structural barriers these communities face. Five CRC reservations remain in place, covering non-discrimination (Art. 2), name and nationality (Art. 7), freedom of thought, conscience and religion (Art. 14), free and compulsory primary education (Art. 28(1)(a)), and torture and deprivation of liberty (Art. 37). As such we have national-governmental-systemic-barriers and policies that create profound inequalities for vulnerable and marginalised children in Malaysia.

The Committee’s January 2026 Concluding Observations make the same point⁴². Malaysia has not yet achieved “full compliance with the Convention and the Optional Protocols” and continues to exhibit “structural discrimination against indigenous children, including Orang Asli children, children with disabilities, children living in poverty, lesbian, gay, bisexual, transgender and intersex children and asylum-seeking, refugee, migrant, undocumented and stateless children” (paragraph 26)⁴². Malaysia has made progress, including meeting the national SDG 3.2 targets for child mortality³⁵. The Committee’s concern is with the children that this progress has not yet reached.

But we must ask why certain populations of Malaysian pregnant mothers and young children - including indigenous communities, interior Sabah and the urban poor - continue to face much higher rates of poverty and preventable mortality/morbidity despite national progress? The main reason is the social determinants of health. Households that are poor, excluded or affected by disability have the weakest access to health services, early childhood education and basic infrastructure; it is their infants who die or fall ill most often, and their mothers who carry the greatest burden of illness in pregnancy. There are inadequate financial and human resources allocated or targeted to alleviate poverty and provide healthcare in marginalised communities. The present model of our healthcare is curative, tending to focus on disease and not health; it is centred on doctors and illness, costly, fragmented and hospital-based⁴⁶. The commercialisation of healthcare services has worsened our maternal and child health services, creating a private-public divide, inaccessible to poorer communities.

The persistence of inequality and disparity in the first 1,000 days in Malaysia is primarily a failure of policy choice and implementation. A middle-income country that possesses the data, the institutions, and the fiscal instruments to reduce child poverty and health inequity carries the responsibility for the gap between what its systems can deliver and what they currently deliver. The condition is neither natural nor inevitable. In the first 1,000 days, the consequence of that failure is a cohort of Malaysian children - Orang Asli, interior Sabah, non-citizen, urban poor, in detention, or looked-after - whose developmental trajectories are being set below their genetic potential by the decisions of a state that is otherwise capable of protecting them.

What can we Do to Overcome these Systemic Inequities?

Bridging the equity gap, so that every child, regardless of birth circumstances, receives a fair start, is the urgent priority. The mechanism by which poverty, legal status, and geographic isolation create the biological embedding of adversity, leading to lifelong disparities, requires further examination. Addressing the social determinants of health that create disparate outcomes is the next step.

Civil society organisations cannot meet the task of ending inequality in all children in Malaysia – they can elevate small groups of mothers and children but even there often face national policy hindrances. A change and reform in government policy and action is required. The key action that healthcare professionals and civil society can do is to be child advocates and activists to petition for change in government policy. The following are key recommendations of change required and key institutional and policy reform that we should advocate for, adapted and updated from our earlier published recommendations⁴⁷:

Collect Granular Disaggregated Data

The lack of disaggregated data hides the impact of social determinants of health and the size of the problem in marginalised communities. Advocacy is required for mandated, full disclosure and linked access to data – health indices with socio-economic status by geographical region and ethnicity.

Report SDG targets by Marginalised Groups

SDG achievements should be reported by individual marginalised community rather than by national aggregate. Under-five mortality rates are required by social class and by marginalised group.

End Poverty for All Children Through Child-Rights-Based Budgeting

Child poverty that persists in a country with Malaysia’s resources is a national failing. The United Nations Committee on the Rights of the Child urged that Malaysia adopt a “child-rights-based approach in the elaboration of the State budget, by implementing a tracking system for the allocation and the use of resources for children throughout the budget” and that budget lines for children in disadvantaged or vulnerable situations be “protected even in situations of economic crisis” (paragraph 14)⁴². This, rather than generic safety-net language, is the budgetary reform Malaysia needs. It requires: (a) mapping all families at risk; (b) defining protected, disaggregated budget lines for indigenous, stateless, refugee, looked-after, and disabled children; (c) tracking expenditure against those lines publicly; and (d) ensuring that social assistance reaches children regardless of their parents’ employment status or immigration status (Committee paragraph 60(b))⁴². Government should plan and deliver this with the civil society organisations that already work with these families.

Ensure Universal Healthcare & Education Access

Enact a law that gives every child and pregnant woman in Malaysia the right to health care, whatever their legal status, in line with Article 24 of the CRC and the Child Act 2001 (revised 2006) and ensure that every birth is registered. No child should be refused basic immunisation or necessary care. Remove the high fees charged to migrant, refugee and stateless children, and ensure that families are not arrested or detained when they attend a hospital, clinic or community learning centre. Introduce and enforce a policy that gives every child access to education, including early childhood education, regardless of status.

Reform National Policy and Withdrawal of CRC Reservations⁴²

1.       Withdraw every remaining CRC reservation.

2.       Bring all domestic law and policy into line with the CRC, including a comprehensive revision of the Child Act.

3.       Accede to the 1951 Refugee Convention and its 1967 Protocol.

4.       Accede to the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families (1990).

Conclusion

While the policy reforms set out above are medium- and long-term, paediatricians and primary care health professionals can be advocates and take the following action.

1.       We can use our professional authority. Paediatricians in Malaysia are trusted voices on child rights; that trust is a professional asset that can be deployed in advocacy.

2.       Consider extending our work and commitments into the community⁴⁶.

3.       Partner with civil society organisations that work with marginalised communities.

4.       Document situations in which a child is denied care, delayed care, or receives inadequate care because of legal status, cost, or geography. Unpublished documentation becomes the evidence for the advocacy set out in the recommendations.

5.       Focus our research on marginalised children and use that data to advocate for change.

Healthcare professionals are challenged to reconsider our role, not only as clinicians but as systemic advocates of social justice and health equity. Rights-based solutions must be implemented: poverty reduction programmes, with universal access to nutrition, health and early intervention. Dismantling barriers within healthcare delivery, improving support for vulnerable families, and using data-driven advocacy to influence national policy must be done collectively. The healthcare workforce must be deployed more effectively to underserved areas. All laws, policies and institutions must be examined for discriminatory effect, and active steps taken to rectify it.

This is a call to action to move from a position of passive observation to actively safeguarding every child’s rights, beginning with those most at risk. “Leaving No Child Behind” must not be a catch phrase but a policy reality with measurable, enforceable commitments.

Acknowledgment

We would like to thank colleagues in child rights advocacy and paediatrics for reading the manuscript and offering many valuable suggestions.

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30.   Chew CC, Ibrahim HA, Balan VK, Abd-Aziz NA, Puah HM, Amar-Singh HSS. Growth management and prevalence of underweight of indigenous children (Orang Asli) in Peninsular Malaysia: a clinical audit. BMC Pediatr. 2022 Aug 10;22(1):481. doi: 10.1186/s12887-022-03532-7.

31.   Dewey KG, Begum K. Long‐term consequences of stunting in early life. Maternal & Child Nutrition. 2011 Oct;7(Suppl 3):5-18. doi: 10.1111/j.1740-8709.2011.00349.x.

32.   Adair LS, Fall CH, Osmond C, Stein AD, Martorell R, Ramirez-Zea M, et al. Associations of linear growth and weight gain in early life with adult health and human capital in low-income and middle-income countries: a prospective cohort study. Lancet. 2013 Aug 10;382(9891):525-34. doi: 10.1016/S0140-6736(13)60103-8.

33.   Danaei G, Andrews KG, Sudfeld CR, Fink G, McCoy DC, Peet E, et al. Risk factors for childhood stunting in 137 developing countries: a comparative risk assessment analysis at global, regional, and country levels. PLoS Med. 2016 Nov 1;13(11):e1002164. doi: 10.1371/journal.pmed.1002164.

34.   World Health Organization (WHO). Infant and young child feeding. Geneva: World Health Organization; 2023 Sep 5 [cited 2026 Apr 15]. Available from: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding

35.   Amar-Singh HSS. Successes and challenges in implementing SDG 3 in Malaysia. SDG Policies and Practices in Malaysia, edited by Teo Lee Ken and Debbie Loh, Persatuan Promosi Matlamat Pembangunan Lestari (Society for the Promotion of Sustainable Development Goals), 2023, pp. 148–177. Available from: https://resources.appgm-sdg.com/resources/sdg-policies-and-practices-in-malaysia/

36.   Hung LC, Aina Mariana AM. A study on under five deaths in Malaysia in the year 2016. Technical Report. Putrajaya: Family Health and Development Division, Ministry of Health Malaysia; 2020 Sep. Report No.: MOH/K/ASA/113.20(TR)-e [cited 2026 May 23]. Available from: https://hq.moh.gov.my/bpkk/images/3.Penerbitan/2.Orang_Awam/8.Kesihatan_Kanak_Kanak/2.PDF/6_technical_report_of_under_five_deaths_in_malaysia_year_2016.pdf

37.   Amar-Singh HSS. Malnutrition and poverty among the Orang Asli (indigenous) children of Malaysia: submission for UN Special Rapporteur on Extreme Poverty. Geneva: United Nations Office of the High Commissioner for Human Rights (OHCHR); 2019 [cited 2026 May 23]. Available from: https://www.ohchr.org/Documents/Issues/Poverty/VisitsContributions/Malaysia/IndigenousChildren.pdf

38.   The World Bank. Poverty and health [Internet]. Washington (DC): The World Bank; 2014 [cited 2026 May 23]. Available from: https://www.worldbank.org/en/topic/health/brief/poverty-health

39.   Wan Amirah WU. Deepening Malaysia’s understanding of poverty. Kuala Lumpur: Khazanah Research Institute; 2024 [cited 2026 Mar 27]. Available from: https://www.krinstitute.org/publications/deepening-malaysia-understanding-of-poverty

40.   Amar-Singh HSS. Children’s Access to Healthcare: Speaking for the unspoken needs of children and what we can do to make it better. Medico Legal Society of Malaysia; 2022 [cited 2026 Mar 31]. Available from: https://mpaeds.my/wp-content/uploads/2022/02/Childrens-Access-to-Healthcare-V8-Share-Amar.pdf

41.   Amar-Singh HSS, Ng LT. Future of early intervention services in Malaysia. Malaysia: National Early Childhood Intervention Council; 2021 [cited 2026 May 23]. Available from: https://necicmalaysia.org/wp-content/uploads/2024/09/Future-of-Early-Intervention-Services-in-Malaysia-13-share.pdf

42.   United Nations Committee on the Rights of the Child. Concluding observations on the combined second to fourth periodic reports of Malaysia [Internet]. Geneva: United Nations; 2026 Feb 26 [cited 2026 May 23]. Report No.: CRC/C/MYS/CO/2-4. Available from: https://tbinternet.ohchr.org/_layouts/15/treatybodyexternal/Download.aspx?symbolno=CRC%2FC%2FMYS%2FCO%2F2-4&Lang=en

43.   United Nations Department of Economic and Social Affairs (UN DESA). Breaking the cycle: addressing inequalities in child survival to promote inclusive social development. New York: United Nations; 2025 Oct 31 [cited 2026 May 23]. Policy Brief No.: 183. Available from: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/undesa_pd_2025_pb183.pdf

44.   United Nations Inter-Agency Group for Child Mortality Estimation (UN IGME). Levels and trends in child mortality: report 2025. New York: UNICEF; 2026 Mar 17 [cited 2026 May 23]. Available from: https://data.unicef.org/resources/levels-and-trends-in-child-mortality-2025/

45.   Ministry of Women, Family and Community Development (KPWKM). National children’s policy and action plan. Putrajaya: Ministry of Women, Family and Community Development; 2025 [cited 2026 May 23]. Available from: https://kpwkm.gov.my/uploads/content-downloads/file_20251113084249.pdf

46.   Amar-Singh HSS. Addressing community health challenges. Malaysian Journal of Paediatrics and Child Health. 2025 Jul;31(S1):105–111. doi: 10.51407/mjpch.v31iS1.365.

47.   Amar-Singh HSS, San YW. Regaining Malaysia’s humanity and child rights. CodeBlue [Internet]. 2023 Jan 25 [cited 2026 May 23]. Available from: https://codeblue.galencentre.org/2023/01/regaining-malaysias-humanity-and-child-rights-dr-amar-singh-hss-yuenwah-san/