Demographic and Health Survey 2009-10 - Timor-Leste Ministry of ...

CHILD HEALTH 11
This chapter presents the findings on child health from the 2009-10 TLDHS. Its focus is on
vaccination status and treatment practices that are commonly used for children experiencing three
major childhood illnesses: acute respiratory infection (ARI), fever, and diarrhea. Information on
children’s birth weight and size, treatment practices, and contact with health facilities when children
are sick paves the way for strategic planning and implementation of programs to reduce neonatal and
infant mortality. Combined with data on childhood mortality, this information can be used to identify
subgroups of women and children at increased risk because of non-use of maternal and child health
(MCH) services and to assist with planning effective improvements for these services.
Information was obtained for all live births that occurred in the five years preceding the
survey. Wherever possible, data from the 2009-10 TLDHS are compared with data from the earlier
DHS survey in Timor-Leste, conducted in 2003. However, caution should be used in interpreting the
trend data due to differences in the definitions and methodology used in these surveys.
11.1 CHILD’S SIZE AT BIRTH
A child’s birth weight or size at birth is an important indicator of the child’s vulnerability to
the risk of childhood illnesses and the child’s chances of survival. Children whose birth weight is less
than 2.5 kilograms, or children reported to be “very small” or “smaller than average” are considered to
have a higher-than-average risk of early childhood death. Birth weight was recorded in the
questionnaire, if available from written records or mother’s recall, for all births in the five years
preceding the survey. Because birth weight may not be known for many babies, and particularly for
babies delivered at home and who are not weighed at birth, the mother’s estimate of the baby’s size at
birth was also obtained. Even though it is subjective, it can be a useful proxy for the weight of the
child. Table 11.1 presents information on children’s weight and size at birth.
Birth weight was reported for only 26 percent of births in the five years preceding the survey.
It is unlikely that these births are representative of all births because births in urban areas and births to
mothers in higher wealth quintiles are over-represented, and the pattern of birth weights by
background characteristics is likely to be biased. Nevertheless it is important to note that 10 percent of
babies weighed at birth were less than 2.5 kilograms. Low birth-weight babies are twice as likely to be
born to mothers less than age 20 at birth, and they are more likely to be first-order births, births born
to mothers who smoked cigarettes/tobacco, and births to uneducated mothers. One in four children in
Ainaro, one in five children in Aileu, and one in six children in Ermera and Manufahi who were
weighed at birth are of low weight. Differences by urban-rural residence and wealth quintile are
minimal.
Most children were reported by their mothers as average or larger at birth (82 percent), while
10 percent of children were reported as smaller than average, and 5 percent were reported as very
small at birth. The characteristics of mothers with very small children at birth are similar to the
characteristics of children whose weight at birth was less than 2.5 kilograms, consistent with the
notion that a mother’s description of the size of the baby at birth is a good proxy in the absence of a
recorded weight. Children born to very young mothers (