The Low-Risk Birth Centre (LRBC) or Pusat Bersalin Berisiko Rendah (PBBR) is a public healthcare initiative of the Malaysian Ministry of Health that is dedicated to ensuring safe delivery and quality care for low-risk pregnant women by assigning them alternative birth centers with high-class treatment, room, medicine, and food, all the while helping reduce the problem of overcrowding in obstetric facilities of public hospitals.

Background and Problem

Malaysia has 143 hospitals, but only 55 provide specialist obstetrics and gynecology services. Despite the number, expecting mothers still prefer going to specialist hospitals over decentralized community birthing centers, causing the former to become congested with patients and overloaded with the obstetric workload, not to mention compromising patients’ safety due to “not women-friendly” facilities and unfocused medical service.

Solution and Impact

In an attempt to address hospital congestion and to achieve Millennium Development Goals 4 and 5 (reduce child mortality and improve maternal health), health authorities considered assigning pregnant women into high-risk and low-risk categories to identify the appropriate level of care for them: mothers falling under high risk will be cared for in specialist hospitals, while those categorized as low-risk will be assigned to LRBCs that are also capable of providing alternative high-quality care and safe delivery. As a Blue Ocean initiative, LRBCs entail minimum construction cost as it only requires existing buildings that can be renovated in as fast as two months. They may be set up (1) within the same building as labor wards with two separate wings for low risk and high-risk women; (2) within the hospital compound, but not necessarily in the same labor room; and (3) outside the hospital compound but with easy access to the parent hospital. Setting up these centers is the responsibility of the hospital director of the parent hospital. Malaysian hospitals with LRBCs are Hospital Tengku Ampuan Afzan in Kuantan, Pahang, Hospital Tawau in Sabah, Hospital Sultanah Aminah in Johor Bahru, Johor, and Hospital Sultanah Bahiyah II in Alor Setar, Kedah.

Obstetric ward bed occupancy rates of these hospitals are more than 95 % per day. With alternative maternal spaces strategically placed in these hospitals, the bed occupancy rate in the main hospitals is reduced, allowing them to decongest their rooms and facilities. Finally, the main hospitals are capable of focusing on high-risk cases, while LRBCs are able to empower midwives and medical practitioners to practice in a safe environment that supports normal labor. The patients, for their part, have more positive and satisfactory birth experience with LRBCs since these offer high-quality services and facilities at cheaper prices. The normal fee for the delivery only costs RM 10. Other fees like deposit charge, daily ward charge, and delivery suite do not amount greater than RM 15.


The LRBC initiative was launched under Malaysia’s National Blue Ocean Strategy in 2012. It was officiated by YAB Prime Minister of Malaysia Dato’ Sri Mohd Najib Tun Razak in smart partnership with the Federal Territory Islamic Religious Council. There were only three hospitals in Malaysia with functioning LRBCs when the Guidelines for Low-Risk Birth Centres were issued by the Ministry of Health in 2013. Another was established near the Sultanah Bahiyah II Hospital, Alor Setar, Kedah in 2017.