Heartiest congratulations to Dr Fairuz binti Abdul Rani on the successful completion of her Doctor of Public Health (DrPH) viva voce defence at the Faculty of Medicine, Universiti Malaya, held on 26 August 2026.
Her doctoral research, entitled “Factors Associated with Household Double Burden of Malnutrition among Communities of Low-Cost Housing Areas in Kuala Lumpur: A Mixed-Methods Study”, addresses an increasingly important public health challenge in Malaysia: the coexistence of maternal overnutrition and child undernutrition within the same household.
Understanding the Double Burden of Malnutrition in Urban Communities
Malaysia is experiencing a complex nutritional transition. While overweight and obesity among adults have become increasingly prominent public health concerns, child undernutrition has not disappeared. When these contrasting forms of malnutrition occur within the same household, they create what is known as the household double burden of malnutrition (DBM).
Despite its public health importance, evidence on household DBM in Malaysia remains limited, particularly among vulnerable families living in urban low-cost housing communities.
Dr Fairuz’s research makes an important contribution towards filling this knowledge gap. Using an explanatory sequential mixed-methods design, she investigated both the magnitude of household DBM and the circumstances influencing healthy eating among families living in low-cost housing areas in Kuala Lumpur.
The quantitative component involved 346 households with children attending public early childhood education centres. The study found a household DBM prevalence of 11.0%, predominantly involving mothers with overnutrition living with underweight children. Maternal short stature and higher child birth order were associated with greater odds of household DBM, whereas increasing maternal age was associated with lower odds.
Importantly, the research went beyond identifying statistical associations. Through in-depth interviews with mothers from households experiencing DBM, Dr Fairuz explored the realities behind the numbers.
Mothers described actively searching for nutrition information, adapting recipes, cooking in bulk and prioritising their children’s diets—sometimes at personal cost. Yet their efforts were constrained by financial pressures, limited nutrition knowledge, family food preferences, convenience meals, rising food prices, unhealthy food environments and difficulties accessing assistance.
By integrating these quantitative and qualitative findings, the thesis demonstrates that household malnutrition cannot be understood simply as a matter of individual food choices. Individual, household, social and structural conditions interact to shape what families are realistically able to eat and provide for their children.
A Significant Doctoral Achievement
Successfully completing a DrPH viva voce represents the culmination of years of rigorous academic training, fieldwork, analysis, critical reflection and perseverance.
Dr Fairuz’s doctoral journey is particularly commendable for successfully undertaking a mixed-methods investigation of a complex and under-researched public health problem. Her work combined epidemiological measurement with qualitative enquiry, enabling the experiences of mothers and families to complement and contextualise the statistical evidence.
The study also generated valuable contemporary evidence from urban low-cost housing communities in Kuala Lumpur, an important population that has received comparatively limited attention in previous Malaysian research on household DBM.
Successfully defending this work before the Committee of Examiners marks an important academic and professional milestone and reflects Dr Fairuz’s development as an independent public health researcher and practitioner.
Contribution to Public Health
The significance of this research extends beyond academia.
Dr Fairuz’s findings reinforce the need to approach maternal and child nutrition as interconnected issues rather than treating adult obesity and childhood undernutrition as completely separate problems. Families may experience both simultaneously, and interventions must therefore recognise the realities of the household as a whole.
Her research supports the development of integrated, family-centred and nutrition-sensitive public health strategies for vulnerable urban communities. These include improving access to affordable healthy foods, strengthening childcare provision, enhancing appropriate nutrition support and ensuring that social assistance mechanisms respond effectively to the pressures experienced by lower-income urban families.
The findings also highlight an important principle for public health practice: knowledge alone does not determine healthy eating. Families may understand the importance of healthier diets but still face economic, environmental and social barriers that restrict their choices.
Addressing the double burden of malnutrition therefore requires collaboration extending beyond the health sector. Ministries and agencies responsible for health, education, social protection, food systems and urban development all have important roles to play.
In this respect, Dr Fairuz’s thesis provides evidence that can contribute to more coordinated maternal and child nutrition policies and programmes in Malaysia, particularly for communities experiencing socioeconomic vulnerability in rapidly changing urban environments.
Acknowledgement
We wish to acknowledge the invaluable guidance and mentorship provided by Dr Fairuz binti Abdul Rani’s supervisors, Assoc. Prof. Dr Nik Daliana Nik Farid and Assoc. Prof. Dr ‘Abqariyah Yahya@Ahmad Noor, whose expertise and support were instrumental in the completion of her thesis.
We extend our sincere gratitude to Professor Dr Poh Bee Koon, Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, the External Examiner, and Assoc. Prof. Dr Farizah Mohd Hairi, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, the Internal Examiner.
We would also like to thank the Committee of Examiners for their thorough evaluation and insightful feedback, including Professor Dr Tan Maw Pin, the Chairperson of the viva voce session, and Professor Dr Victor Hoe Chee Wai Abdullah, Head of the Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya.
Their scholarly assessment, constructive comments and thoughtful engagement contributed greatly to this important academic milestone.
Congratulations and the Journey Ahead
Once again, our warmest congratulations to Dr Fairuz binti Abdul Rani on the successful completion of her Doctor of Public Health viva voce defence.
Her doctoral research reminds us that malnutrition is not always visible in a single form. Within the same household, excess and deficiency can coexist, shaped by circumstances that extend far beyond individual behaviour. Understanding this complexity is essential if public health interventions are to reach the families who need them most.
We look forward to seeing Dr Fairuz translate the knowledge generated through her doctoral research into public health practice, policy, advocacy and future research. May this achievement mark the beginning of an even greater contribution to maternal and child nutrition, urban health and the advancement of equitable public health in Malaysia.
Congratulations, Dr Fairuz, on this outstanding milestone, and best wishes for the next chapter of your public health journey!
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