Abstract:Background: Indigenous populations in Malaysia including the Orang Asli in Peninsular Malaysia and native communities in Sabah and Sarawak have historically experienced systemic marginalisation and poor access to healthcare. Their vulnerability during pandemics is shaped not only by geography or poverty but also by long-standing structural inequities and cultural invisibility within public health systems. Despite their heightened risk, there is limited synthesis of how pandemics have affected these communities and whether national responses have been inclusive. Objectives: This scoping review aims to map the existing body of evidence on pandemic vulnerability among indigenous populations in Malaysia, identify the key factors driving this vulnerability, and explore how national responses have addressed or overlooked their needs. Materials and Methods: The review is being conducted using the PRISMA-ScR framework. Systematic searches are ongoing across PubMed, Scopus, Web of Science, and grey literature platforms including government and NGO repositories. Eligible sources include studies and reports from 2000 to 2025 that document the impact of pandemics (e.g., COVID-19, H1N1, SARS) on indigenous populations in Malaysia. Data extraction is structured to capture vulnerability domains, community and institutional responses, and gaps in health system inclusivity. Preliminary Results: Early screening has identified 20 potentially relevant sources. Preliminary analysis suggests recurring themes of limited healthcare access in remote areas, sociocultural and linguistic barriers, economic fragility, and exclusion from national preparedness planning. Notably, community-led strategies such as voluntary village isolation and the use of indigenous knowledge emerged as forms of grassroots resilience. However, institutional responses remain fragmented, often urban-centric, and culturally unadopted. Gaps persist in mental health outcomes, risk communication, and chronic care continuity. Conclusions: Preliminary findings reinforce the urgent need to embed equity and cultural competence in Malaysia’s pandemic preparedness frameworks. Recognising and integrating indigenous perspectives is essential not only for effective health responses but also for advancing broader planetary health equity.
Keywords: Indigenous Health, Indigenous health, Orang Asli, pandemic vulnerability, Malaysia, health equity, scoping review, planetary health
