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

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134 | Child Health Looking at coverage for specific vaccines, 77 percent of children received the BCG vaccination, 75 percent received the first DPT dose, and 75 percent received the first polio dose. Coverage for all three vaccinations declines with subsequent doses; 66 percent of children received the recommended three doses of DPT, and 56 percent received three doses of polio. These figures reflect dropout rates (which represent the proportion of children who received the first dose of a vaccine but who did not get the third dose) of 12 percent for DPT and 25 percent for polio, respectively. This is a huge improvement from 2003 when the dropout rates for DPT and polio were 45 and 62 percent, respectively. It is interesting to note that dropout rates for polio are higher than for DPT despite the fact that these vaccines should be given together. This may be related to polio vaccination being deliberately withheld when a child has diarrhea or to parental concern for a child receiving it during an episode of diarrhea and refusing it. Sixty-eight percent of children received the measles vaccine (Figure 11.1). Hepatitis B coverage varies slightly from DPT coverage, although they have been given together in a tetravalent vaccine since 2007. This difference is likely due to the inclusion of a small number of children who received the DPT vaccine before the tetravalent vaccine was introduced. Table 11.3 shows the percentages of children age 12-23 months who received specific vaccines at any time before the survey (according to a vaccination card or the mother’s report) and the percentages with a vaccination card. Table 11.3 Vaccinations by background characteristics Percentage of children age 12-23 months who received specific vaccines at any time before the survey (according to a vaccination card or the mother’s report), and percentage with a vaccination card, by background characteristics, Timor-Leste 2009-10 Background characteristic BCG DPT Polio 1 Hepatitis B 1 2 3 0 1 2 3 1 2 3 Measles All basic vaccinations 2 No vaccinations Percentage with a vaccination card seen Sex Male 77.8 76.3 72.4 68.6 66.6 76.3 70.8 58.4 75.5 71.5 68.2 69.0 54.3 21.6 51.8 894 Female Birth order 75.7 73.8 70.1 64.1 64.1 73.3 67.8 53.8 73.7 69.0 63.2 66.5 50.8 23.8 47.4 859 1 80.7 78.8 75.4 71.4 67.5 78.3 75.5 60.9 78.4 74.6 70.8 70.6 57.9 19.3 54.9 323 2-3 77.7 75.3 71.3 67.4 66.1 75.5 70.0 54.1 75.0 70.5 66.1 70.3 51.1 21.4 45.7 505 4-5 77.7 76.6 72.9 67.0 67.6 76.0 70.2 55.6 76.2 71.9 66.8 68.6 51.1 21.4 50.0 418 6+ Residence 72.5 71.3 67.3 61.8 61.3 71.0 64.0 55.6 70.6 66.0 61.3 62.9 51.9 27.1 49.9 507 Urban 85.3 81.1 77.3 70.9 74.3 80.7 73.3 49.2 80.2 75.7 69.5 74.3 47.7 14.5 43.7 424 Rural District 74.0 73.2 69.3 65.0 62.5 73.0 68.1 58.4 72.8 68.5 64.5 65.7 54.1 25.3 51.5 1,328 Aileu 88.0 87.2 87.2 86.4 77.7 88.0 88.0 83.2 87.2 87.2 85.6 83.3 79.2 12.0 73.6 66 Ainaro 59.3 56.7 54.6 52.0 57.9 57.2 54.1 51.7 56.0 53.9 52.0 50.4 46.1 40.7 32.3 113 Baucau 58.2 58.2 53.0 51.8 49.4 59.1 52.7 50.7 58.2 53.0 51.8 52.0 47.1 40.9 48.0 180 Bobonaro 82.4 82.4 82.4 81.5 74.7 82.4 82.4 56.1 82.8 81.9 81.5 79.8 55.2 17.6 49.7 157 Covalima 91.2 88.5 84.5 81.2 57.0 87.2 85.9 71.4 88.5 80.6 77.3 79.7 61.9 8.8 41.2 69 Dili 86.6 81.7 77.6 70.7 76.3 81.0 72.9 44.1 80.3 75.5 68.6 73.3 43.4 13.4 40.5 281 Ermera 64.6 62.0 56.3 51.5 52.0 63.6 52.9 50.3 62.3 55.8 51.0 54.2 44.6 35.4 45.2 200 Lautem 86.8 87.5 86.0 80.9 80.1 86.4 84.6 75.4 86.8 83.5 79.4 80.1 74.6 12.1 73.8 140 Liquiçá 85.6 80.6 70.6 59.4 66.9 80.6 67.1 50.2 79.9 70.0 59.4 66.3 43.7 14.4 52.2 106 Manatuto 71.8 71.8 71.2 69.3 66.8 71.2 69.3 59.9 71.8 71.2 69.3 64.9 53.6 28.2 48.9 87 Manufahi 69.2 69.1 60.2 53.2 58.9 69.7 60.5 46.4 69.8 59.4 53.3 68.4 42.8 28.6 39.1 80 Oecussi 85.9 86.8 83.4 74.1 65.4 86.8 80.7 63.8 86.8 83.4 74.1 74.8 60.0 10.3 64.2 143 Viqueque Mother’s education 74.4 73.1 69.9 64.4 63.3 69.0 67.5 60.2 70.7 69.1 64.5 66.8 57.1 25.6 48.8 130 No education 67.9 66.8 61.4 56.6 56.0 66.8 58.5 50.4 66.7 60.8 56.3 58.6 46.6 31.0 45.1 571 Primary 77.3 76.1 72.2 66.2 63.2 74.4 70.1 57.4 75.7 70.9 65.2 67.1 54.0 22.3 50.1 478 Secondary More than 82.5 80.4 77.9 73.8 73.3 80.6 77.0 61.3 79.7 76.7 72.9 74.8 57.7 17.2 54.3 661 secondary Wealth quintile (100.0) (90.5) (90.5) (86.8) (90.5) (100.0) (86.8) (39.0) (90.5) (90.5) (86.8) (90.5) (39.0) (0.0) (34.2) 43 Lowest 64.5 64.4 60.9 54.8 52.5 64.1 59.6 49.1 63.5 59.8 54.2 53.7 43.2 33.9 43.1 381 Second 70.9 68.6 66.2 62.5 60.6 69.0 64.1 56.8 68.5 65.7 62.3 63.7 53.5 28.9 50.6 359 Middle 78.8 77.9 71.9 68.3 64.1 77.8 71.3 58.5 78.2 71.4 68.0 71.0 55.8 20.7 52.3 349 Fourth 84.8 83.3 79.0 75.8 71.1 81.3 77.1 69.0 82.9 78.6 74.0 78.0 65.5 15.0 57.4 346 Highest 87.0 83.3 80.3 72.5 81.3 84.2 76.3 47.2 82.0 77.9 72.0 74.7 45.2 12.5 45.1 317 Total 76.7 75.1 71.3 66.4 65.3 74.9 69.3 56.2 74.6 70.3 65.7 67.8 52.6 22.7 49.6 1,752 Note: Figures in parentheses are based on 25-49 unweighted cases. 1 Polio 0 is the polio vaccination given at birth. 2 BCG, measles, and three doses each of DPT and polio vaccine (excluding polio vaccine given at birth) Number of children
Boys (54 percent) are somewhat more likely to be fully vaccinated than girls (51 percent). Surprisingly, children in rural areas (54 percent) are more likely to be fully vaccinated than children in urban areas (48 percent). Vaccination coverage varies significantly by district, with Manufahi and Dili having the lowest coverage of fully immunized children at 43 percent each. Aileu and Lautem have the highest coverage of fully immunized children at 79 and 75 percent, respectively. Many of the districts with lower coverage of fully vaccinated children have the highest dropout rates, especially for polio. Dili has a very high dropout rate between polio 1 and polio 3 at 46 percent, compared with less than 5 percent for Aileu. The single biggest reason that full vaccination coverage in rural areas is higher than in urban areas is the very low polio 3 coverage in urban areas (49 percent). In fact all other vaccines have higher coverage in urban than rural areas. Even though oral polio vaccine has minimum side effects and can be given to persons with diarrhea, it can lead to gastrointestinal upset like diarrhea and vomiting, prompting physicians (who operate predominantly in urban areas) to withhold the vaccine from children with diarrhea. Additionally, mothers may not return for follow-up visits upon the physician’s advice to bring their children back once the diarrhea has ceased. The considerably lower coverage in urban areas and particularly in Dili could also be attributed to the 2006 civil unrest in the country, which disrupted all basic health services, severely damaged infrastructure, and displaced thousands of residents from their homes. Vaccination coverage is highest for first-born children (58 percent), with little difference in coverage for children of birth order two and above (about 51 percent). Children whose mothers attend only primary or secondary school are more likely to be fully vaccinated than children whose mothers have no education. The proportion of children fully vaccinated generally increases with wealth quintile, from 43 percent in the lowest wealth quintile to 66 percent in the fourth quintile, and decreases for children in the highest wealth quintile (45 percent). 11.3 TRENDS IN VACCINATION COVERAGE Table 11.4 shows by age cohorts the percentage of children age 12-59 months (at the time of the survey) who received specific vaccines by 12 months of age and the percentage with a vaccination card. Thirty-six percent of children received all their vaccinations by 12 months of age. Children in the oldest cohort (48-59 months) were less likely to have received all their vaccinations (28 percent) than children age 12-23 months (47 percent). This pattern is seen with each vaccine but is most marked when all the vaccines are considered together. Vaccination cards were shown to interviewers for 50 percent of children age 12-23 months, compared with 16 percent of children age 48-59 months. The difference may partly be a result of the cards for older children being lost or misplaced over the longer period of time and may partly be due to a better card uptake in more recent years. Table 11.4 Vaccinations in first year of life Percentage of children age 12-59 months at the time of the survey who received specific vaccines by 12 months of age, and percentage with a vaccination card, by current age of child, Timor-Leste 2009-10 Age in months BCG DPT Polio 1 Hep B 1 2 3 0 1 2 3 1 2 3 Measles All basic vaccinations 2 No vaccinations Percentage with a vaccination card seen Number of children 12-23 76.6 74.2 69.9 64.2 65.2 74.0 68.1 54.4 73.7 69.0 62.9 60.0 47.2 23.1 49.6 1,752 24-35 73.0 70.5 66.6 60.2 58.1 70.3 63.0 45.8 69.6 65.8 58.9 56.5 38.2 26.9 34.7 1,959 36-47 70.7 67.0 64.0 54.7 53.6 67.2 60.2 38.7 66.4 63.4 53.5 51.1 31.4 30.0 26.3 1,947 48-59 64.3 61.7 56.8 49.9 46.7 60.9 52.9 31.8 61.2 56.0 49.2 52.8 27.9 36.3 16.2 1,745 Total 71.6 69.0 64.9 57.6 56.2 68.7 61.5 42.9 68.3 64.1 56.4 55.6 36.3 28.3 31.7 7,403 Note: Information was obtained from the vaccination card or if there was no written record, from the mother. For children whose information was based on the mother’s report, the proportion of vaccinations given during the first year of life was assumed to be the same as for children with a written record of vaccinations. 1 Polio 0 is the polio vaccination given at birth. 2 BCG, measles, and three doses each of DPT and polio vaccine (excluding polio vaccine given at birth) Child Health | 135
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Timor-Leste Demographic and Health
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CONTENTS TABLES AND FIGURES .......
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CHAPTER 7 FERTILITY PREFERENCES 7.1
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14.8 HIV/AIDS-related Knowledge and
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x | Tables and Figures CHAPTER 4 FE
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xii | Tables and Figures Table 11.4
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xiv | Tables and Figures Table 16.4
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FOREWORD The 2009-10 Timor-Leste De
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CONTRIBUTORS TO THE REPORT Elias do
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about three children more than wome
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Postnatal Care. The majority of wom
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However, the level of chronic energ
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MILLENNIUM DEVELOPMENT GOAL INDICAT
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INTRODUCTION 1 1.1 HISTORY, GEOGRAP
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The government of Timor-Leste has l
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1.5 ORGANIZATION OF THE SURVEY The
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1.8 HEMOGLOBIN TESTING In one-third
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In these households, 13,796 women w
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Table 2.1 Household population by a
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The percentage of children not livi
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The Early Childhood Care and Educat
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Table 2.4.2 Educational attainment
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The GAR at the primary school level
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ate (2 percent) than their rural co
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water. Thirty-six percent of househ
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The type of flooring material used
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Table 2.11 Wealth quintiles Percent
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CHARACTERISTICS OF RESPONDENTS 3 Th
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Table 3.2.1 Educational attainment:
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Table 3.3.1 Literacy: Women Percent
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Table 3.4.1 Exposure to mass media:
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Table 3.5.1 Employment status: Wome
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3.4.2 Occupation Respondents who we
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3.4.3 Earnings, Employers, and Cont
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Tables 3.8.1 and 3.8.2 show the per
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Table 3.9.1 Use of tobacco: Women P
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FERTILITY 4 One of the major object
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Table 4.2 Fertility by background c
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calculated in the 2003 DHS follows
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of primary sterility. In Timor-Lest
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Table 4.8 Median age at first birth
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FAMILY PLANNING 5 In 2002, the Coun
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According to the 2003 DHS, knowledg
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Table 5.3.1 Ever use of contracepti
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Table 5.4 Current use of contracept
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Table 5.5 Current use of contracept
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Use increases with parity but with
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Female and male sterilizations are
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Table 5.10 Future use of contracept
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Table 5.13 Exposure to family plann
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Table 5.15 Husband/partner’s know
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6.2 POLYGYNY Polygyny (the practice
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20.9 years. Although the proportion
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Page 118 and 119: Table 6.7.1 Recent sexual activity:
Page 120 and 121: There is little difference in the p
Page 122 and 123: 2 percent among women age 30-34 to
Page 124 and 125: 92 | Fertility Preferences Table 7.
Page 126 and 127: 94 | Fertility Preferences 7.3 NEED
Page 128 and 129: 96 | Fertility Preferences an idea
Page 130 and 131: 98 | Fertility Preferences The perc
Page 132 and 133: with their death, or they may live
Page 134 and 135: 100 80 60 40 20 102 | Infant and Ch
Page 136 and 137: 104 | Infant and Child Mortality Ta
Page 138 and 139: 8.7 HIGH-RISK FERTILITY BEHAVIOR Th
Page 141 and 142: ADULT AND MATERNAL MORTALITY 9 The
Page 143 and 144: 9.2 ADULT MORTALITY Table 9.3 Sibsh
Page 145 and 146: MATERNAL HEALTH 10 Making Pregnancy
Page 147 and 148: among women in the lowest wealth qu
Page 149 and 150: A much lower percentage of Timorese
Page 151 and 152: Table 10.5 Knowledge of danger sign
Page 153 and 154: 10.6.2 Assistance during Delivery O
Page 155 and 156: Table 10.8 Knowledge of danger sign
Page 157 and 158: Table 10.10 Application of material
Page 159 and 160: Table 10.12 Timing of first postnat
Page 161 and 162: Where health services are present,
Page 163 and 164: CHILD HEALTH 11 This chapter presen
Page 165: In the TLDHS, information on vaccin
Page 169 and 170: The data indicate that two percent
Page 171 and 172: 11.6 DIARRHEAL DISEASE Dehydration
Page 173 and 174: Table 11.8 Diarrhea treatment Among
Page 175 and 176: Ten percent of children with diarrh
Page 177: There are marked differences in the
Page 180 and 181: international reference population
Page 182 and 183: 80 Percent 70 60 50 40 30 20 10 150
Page 184 and 185: 60 50 40 30 20 10 152 | Nutrition o
Page 186 and 187: Table 12.2 shows the percentages of
Page 188 and 189: 100 Percent 90 80 70 60 50 40 30 20
Page 190 and 191: Table 12.5 Foods and liquids consum
Page 192 and 193: Table 12.6 Infant and young child f
Page 194 and 195: Table 12.7 shows the percentage of
Page 196 and 197: the most recent distribution preced
Page 198 and 199: Table 12.10 Nutritional status of w
Page 200 and 201: Table 12.12 shows data on micronutr
Page 202 and 203: 12.12 PREVALENCE OF ANEMIA IN WOMEN
Page 205 and 206: MALARIA 13 Malaria remains a leadin
Page 207 and 208: 13.1.2 Use of Mosquito Nets by Chil
Page 209 and 210: Tables 13.3 and 13.4 show the perce
Page 211 and 212: The highest prevalence of fever is
Page 213 and 214: HIV/AIDS-RELATED KNOWLEDGE, ATTITUD
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person who has AIDS or by sharing c
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Comprehensive knowledge about AIDS
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HIV or AIDS on all four indicators
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Table 14.6 Payment for sexual inter
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14.5 MALE CIRCUMCISION Male circumc
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In the 2009-10 TLDHS, women and men
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100 Percent 80 60 40 20 0 64 Total
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14.8.2 Age at First Sex and Condom
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To assess the extent of condom use
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WOMEN’S EMPOWERMENT AND DEMOGRAPH
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Table 15.2.1 Control over women’s
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Table 15.2.2 Control over men's cas
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Table 15.4.1 Women’s participatio
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Table 15.5.1 Women’s participatio
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15.5 ATTITUDES TOWARD WIFE BEATING
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Table 15.6.2 Attitude toward wife b
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Table 15.7.1 Attitude toward refusi
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Women’s empowerment is closely as
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Table 15.8 Indicators of women’s
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pathways: its negative association
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DOMESTIC VIOLENCE 16 In the words o
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partner] hit, slapped, kicked, or d
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Table 16.1 Experience of physical v
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Among women who have never been mar
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who experienced sexual violence fir
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Domestic violence is not limited to
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Table 16.8 Forms of spousal violenc
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Table 16.9—Continued Emotional vi
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Table 16.10 Spousal violence by hus
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16.14 Physical Violence by Women ag
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16.15 HELP-SEEKING BEHAVIOR OF WOME
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16.17 SOCIAL NORMS AND VALUES The f
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REFERENCES Acharya, M. 2010. Effort
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Ministry of Health (MOH) [Timor-Les
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World Health Organization (WHO), Wo
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256 | Appendix A during the populat
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A.5 SURVEY RESULTS 258 | Appendix A
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ESTIMATES OF SAMPLING ERRORS Append
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Table B.1 List of selected variable
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Table B.3 Sampling errors for Urban
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Table B.5 Sampling errors for Aileu
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Table B.7 Sampling errors for Bauca
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Table B.9 Sampling errors for Coval
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Table B.11 Sampling errors for Erme
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Table B.13 Sampling errors for Liqu
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Table B.15 Sampling errors for Manu
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Table B.17 Sampling errors for Viqu
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282 | Appendix C Table C.2.1 Age di
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284 | Appendix C Table C.5 Reportin
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286 | Appendix C Table C.7 Nutritio
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PERSONS INVOLVED IN THE 2009-10 TIM
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Martinho da Costa Cesaltina Falcao
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QUESTIONNAIRES Appendix E Appendix
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296 | Appendix E Introduction and C
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IF AGE 15 IF AGE 0-17 YEARS IF AGE
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300 | Appendix E HOUSEHOLD CHARACTE
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302 | Appendix E NO. QUESTIONS AND
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306 | Appendix E WEIGHT, HEIGHT AND
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308 | Appendix E WEIGHT, HEIGHT, AN
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310 | Appendix E
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312 | Appendix E INTRODUCTION AND C
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314 | Appendix E SECTION 2. REPRODU
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212 316 | Appendix E 213 214 215 21
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326 | Appendix E LAST BIRTH NEXT-TO
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350 | Appendix E LAST SEXUAL PARTNE
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352 | Appendix E SECTION 7. FERTILI
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356 | Appendix E SECTION 8. HUSBAND
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362 | Appendix E SECTION 10. OTHER
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364 | Appendix E SECTION 11. MATERN
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366 | Appendix E SECTION 12. DOMEST
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372 | Appendix E INSTRUCTIONS: 2 04
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374 | Appendix E INTRODUCTION AND C
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376 | Appendix E SECTION 2. REPRODU
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378 | Appendix E SECTION 3. CONTRAC
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380 | Appendix E 311 Where is that?
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386 | Appendix E SECTION 5. FERTILI
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388 | Appendix E SECTION 6. EMPLOYM
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390 | Appendix E SECTION 7. HIV/AID
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