Behavioural Insights or Hindsight: A Call for Action to Transform Tomorrow

By The Insight Circle, 23rd November 2025

"A good man delights in receiving advice; all worst men are the most impatient of guidance" – Seneca

On 25 September 2025, the Ministry of Health, in collaboration with the World Health Organization, launched the National Blueprint for Behavioural Insights in Health with much fanfare. This landmark initiative signals a decisive shift away from conventional approaches to health management, embracing instead a preventive and behaviour-driven paradigm—long regarded as the holy grail for lasting and meaningful change.

Everything Is at Stake, Now

But in Malaysia, the stakes are already far too high for us to operate within the slow, retrospective logic of a blueprint anchored in the comfort of hindsight is 20/20. We no longer have the luxury of waiting for hindsight to map out our fault lines—especially when the behavioural determinants of poor health are already well understood. Nor do we need further explanations of present bias, social norms, or behavioural trends; much of this evidence already exists in abundance within the local scientific landscape.

When the National Health and Morbidity Survey (NHMS) 2023 makes crystal clear the alarming proportion of our population now falling within the bandwidth of diabetes, obesity, hypertension, cardiovascular disease, and mental health conditions, the imperative should be obvious: we must act swiftly. What we need now is urgency. Blueprints, by design, introduce layers that create bottlenecks and stall implementation—yet this moment allows for no such delay. We need rapid, applied, real-world behavioural interventions—not more committees or papers.

Therefore, a common observation here is that the gap lies not in knowledge, but in execution. Independent initiatives—such as the Screen–Diagnose–Manage–Monitor framework and chronic disease models like the Integrated Behavioural Model for Diabetes (IBM-DM)—are already being integrated into digital innovations, providing a real-time, ready-made platform for rapid, actionable implementation at a fraction of the cost typically associated with prestigious grants. Forming strategic coalitions and partnering with similar projects can deliver early, tangible wins for Behavioural Insights, bolstering the credibility of its objectives.

Real Behaviour Illusory, Reasonable Assumptions Indispensable

It is almost universally understood that it is nearly impossible to capture the full spectrum of lived behaviours in individuals to reliably forecast their actions. There will, perhaps, always be an intention–behaviour gap. The most we can reasonably aim for is a system built on sound assumptions that can later be adapted and refined to meet the ever-evolving realities of society.

For this reason, the steps outlined in the “Activation Phase” of the blueprint can be bypassed in the name of urgency—what matters most now is fidelity of implementation. In essence, the bottleneck has never been knowledge; it has always been implementation. What we lack is operationalisation, not conceptual understanding. In this regard, the National Blueprint for Behavioural Insights in Health is conceptually rich but operationally distant. Bridging the operational gap also requires insight into the cultural context in which interventions must function.

Empowering People Under the Climate of Conformity

To uncover the mechanisms that drive the uptake of health promotion or behavioural change, one must first understand the national identity of the population in which any intervention will be implemented. Yet little new groundwork is needed—an incremental body of research has already clarified critical paradigms that partially demystify how societies function. Repositories such as The Culture Factor Group, for example, have mapped the national identities of numerous countries worldwide, offering a ready foundation for designing informed and culturally attuned interventions.

Drawing from these insights, it is evident that Malaysia exhibits one of the highest—if not the highest—levels of power distance in the world, alongside relatively low scores in individualism. For behavioural change, this suggests that Malaysians are often entrenched in a collectivistic mindset yet show limited inclination toward self-reflection and intrinsic motivation. The result is an inherent climate of conformity that is resistant to change, reflecting underlying inequalities and a degree of societal passivity. The Behavioural Insights Unit must remain mindful of these community-level obstacles, without the need to reinvent the wheel or revisit situational assessments already available.

Waiting in Vain

Although the NCD epidemic has already taken hold in our community, we are confronted with yet another blueprint—its promises vague at best: phased, systematic, yet agonizingly slow. Meanwhile, chronic diseases are worsening, clinic workflows are breaking down, hospital congestion is escalating, and gaps in disease self-management are undermining outcomes. At the heart of the matter is the urgent need to build culturally responsive interventions that address these critical issues.

In practice, the blueprint adds layers of policy architecture before action, even though direct implementation is already feasible, supported by a robust and sufficient body of research evidence. All stakeholders must recognize that, despite the aspirational commentaries in the Behavioural Insights policy document, Malaysia does not face a knowledge gap—it faces an execution gap that demands immediate and incisive action.