The scope of pain as 5th vital sign is expanded in all health facilities of the Ministry of Health Malaysia, as directed by the Director General of Health ref: KKM.600-28 / 2/10 Vol. 2 (43), 30 August 2017 on Pengukuhan Dan Peluasan Skop Pain As 5th Vital Sign Dan Program Pain Free Bagi Fasiliti Kementerian Kesihatan Malaysia. Implementation and expansion of pain free programs is divided into 2 phases. Phase one focuses on the implementation of Pain as 5th Vital Sign which is expected to be implemented in all health clinics started on 2018 until 2024. This is an initiative to further strengthen the quality of existing services in health clinics by taking pain as an important vital sign with other vital signs. Pain score as the 5th vital sign, should be evaluated in all patients using pain ruler and managed accordingly. The second phase started on 2024 focusing on implementation of pain management requires the involvement of all disciplines as well as the need for additional medications and services. Pain management at the health clinic focuses more on chronic pain because most patients who seek treatment at the health clinic experience chronic pain rather than acute pain.