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The protection and management of the natural and built environment and monitoring its relation to and impact on health is an important component of any country’s health system. The first line of defence in disease prevention is controlling the physical, chemical and biological agents in the environment that have the potential to affect populations. Environmental health services were an integral component of the evolution of the Malaysian health system and covered aspects such as the provision of clean water and safe disposal of solid waste and wastewater in rural and urban settings, vector and rodent control, air pollution control, and climate change. Systems thinking analysis demonstrates how the development of environmental health services requires the health system to interface with non-health sectors and re-think the responsibilities and functions of the health systems. Issues include development of the requisite human resources, organisational and financial re-structuring, and governance measures.
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