Women and Child health in Timor-Leste
Reported, January 6, 2012
Upon gaining Independence from Indonesia in May 2002 Timor-Leste officially became the worlds newest nation. The countrys health system was completely devastated during the violent events of August 1999. Since that time the new government, assisted by a United Nations mission, has faced the enormous challenge of rehabilitating its health sector, virtually from scratch.Health policy is still under development and there is
not yet any reliable national health information system.Strengthening of reproductive health services, in
particular focusing on increasing the proportions of births attended by a skilled health professional;
enhancing the capacities of skilled health providers,in particular the nurse-midwives and increasing
access to emergencies obstetric and neonatal services and child health, has been embedded in health sector
national efforts from the very beginning and even leading up to Independence.
The total population of Timor-Leste in 2002 was 850,000. Available data show that more than 40%
of the population live below the poverty line, which is US$0.55 per day. As with many countries in the region, the population below age 15 is high believed to be in the region of 36%-49%, but as reliable vital registration is not yet fully operating in all parts of the country, all population data is only estimates.
Status of maternal health Reliable data on the general situation regarding maternal health is not yet fully documented. Early mortality studies in 2000 show the maternal mortality ratio (MMR) to be in the region of 660 per 100,000 live births, (although regional estimates put this at a high figure 800 per 100,000 live births). The socioeconomic situation does not yet favour womens health, despite the fact that government has made maternal mortality reduction one of its specific goals.
One of the many consequences of the crisis before independence for maternal health, was that very few
citizens, particularly women, had confidence in the health services. Thus, utilization of health care fo
pregnancy and childbirth prior to Independence was never very high. The breakdown of the infrastructure
and the referral networks that occurred prior to Independence has led to many women giving birth
with no formal assistance from the health sector.
Currently, in the region only an estimated 8-9% of women give birth with the assistance of a skilled birth
attendant.
Family planning and the burden of unsafe abortion A number of reports show that prior to Independence, womens knowledge of contraceptive methods was very low.
Family planning efforts are developed in close collaboration with religious leaders.The current consensus around family planning and birth spacing is to see family planning as an effort of all parents to improve the health and education of their children.
Family planning services are being introduced in the country to assist with birth spacing.
Current estimates suggest TFR 7.6 in 2002 and contraceptive prevalence rate (CPR) was 7.0 in 2001.
Exclusive breastfeeding: Although almost all children in Timor-Leste are breastfed at some stage, recent surveys show low rates of exclusive breastfeeding at 4 months and lower rates still at 6 months.
Nutritional status: Malnutrition is a major child health problem in Timor-Leste. Both severe wasting and malnutrition with oedema are commonly seen. Since 2002 there have been 2 national health surveys and 3 other district nutrition surveys. They consistently show alarmingly high ra tes of wasting,stunting and underweight in children underfive years. Mean rates of moderate or severe wasting range from 12-18.7%, moderate or severe stunting from 41-58% and moderate or severe underweight from 42.6-65.4%.
Complications of malnutrition, such as Vitamin A deficiency and anaemia are also common. The recent DHS showed 29.1% of children under-five are anaemic (Hb < 11 g/dl), 5.6% have moderate to severe anaemia (Hb < 9 dg/l), and 0.8% have severe
anaemia (Hb < 7 dg/l).
Improving maternal, newborn and child health through Health policy
Timor Lestes Health Policy Framework, highlights maternal and child health as a national priority.Individual micro-policies are still being developed.Although there are no specific maternal, newborn,and child health policies yet finalised, there are recently drafted national strategies for IMCI, EPI,nutrition, reproductive health and health promotion.
Credits:
CARE International. Assessment of nutritional status and vaccine coverage in Timor-Leste. Dili: Timor Leste, CARE International,2004
More Information:http://www.searo.who.int/LinkFiles/
Improving_maternal_newborn_and_child_health_timor-leste.pdf