Developing criteria for a profession to be considered as profession of allied health in Malaysia: a qualitative study from the Malaysian perspective

**Background:** The Malaysian Allied Health Profession Act (Act 774) distinguishes between 'allied health profession' (AHP) and 'profession of allied health' (PAH), but does not specify criteria for defining PAH. This ambiguity poses challenges for regulation and implementation. The study aimed to develop criteria for identifying PAH through stakeholder perspectives, supporting healthcare policy direction in Malaysia.

**Methods:** Two qualitative methods were used: document review and focus group discussions (FGDs). Document review analyzed Malaysian and international documents (e.g., Act 774, MQF 2.0, occupational safety guidelines) to identify key themes. Six FGDs were conducted with 25 participants from four stakeholder groups: higher education providers (HEPs), employers, professional associations, and regulatory bodies. Two FGDs were heterogeneous (mixed stakeholders). FGDs were held virtually (August – September 2021) due to COVID-19, each lasting 1.5 – 2.5 hours. Data were analyzed using deductive and inductive thematic content analysis in ATLAS.ti version 9.

**Key Results:** Sixteen codes emerged from the FGDs. The six most frequent codes were: risk of harm (frequency 62), set of competency and skills (46), formal qualification (40), defined scope of practice (37), relevant training (36), and healthcare team (18). Risk of harm was considered the most important criterion, with participants emphasizing direct patient care (e.g., physiotherapy, occupational therapy) and indirect harm (e.g., lab-based work). Practitioners also face risks like workplace injuries, chemical exposure, and physical assaults. The second criterion, set of competency and skills, highlighted the need for clinical reasoning, assessment skills, and credentialing. Formal qualification required recognized tertiary education, aligned with professional scope. Defined scope of practice and healthcare team involvement underlined the importance of clear roles and multidisciplinary collaboration. Relevant training referred to structured, certified programs (e.g., 800 clinical hours for dietitians). Ten less frequent criteria (e.g., related to people’s health, autonomy, CPD) were also noted but mentioned fewer than nine times cumulatively.

**Clinical Implications:** The study provides empirically derived criteria for defining PAH in Malaysia, supporting the implementation of Act 774. These criteria are interrelated and should be considered collectively. The findings emphasize the need for: (1) risk management in academic curricula, (2) standardized competency and qualification frameworks, (3) clear scope of practice to avoid overlaps, (4) multidisciplinary teamwork, and (5) recognized training pathways. Policymakers can use these criteria to regulate existing and emerging allied health professions, protect public safety, and enhance professional accountability. The study also highlights the importance of adapting to digital health and evolving healthcare needs.