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

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the most recent distribution preceding the survey. Differences in the consumption of vitamin A supplements by sex, residence, breastfeeding status, and mother’s age at birth are small. Differences in vitamin A supplementation by wealth quintiles is marked, with children in the highest wealth quintile much more likely to receive vitamin A supplements than children in the lowest wealth quintile (59 percent versus 44 percent). Children residing in Ainaro are least likely (20 percent) to receive vitamin A supplements compared with children in Manatuto (77 percent). Along with vitamin A deficiency, the prevalence of worm infestation has been high in Timor-Leste (MOH, 2004c). The Ministry of Health therefore integrated the deworming of children age 2-5 into the national biannual vitamin A supplementation program. By 2003, the entire country was covered. Deworming medication is given to children from age 6-59 months. Information on deworming of children was collected in the 2009-10 TLDHS survey. Table 12.8 indicates that 35 percent of children age 6-59 months received deworming tablets in the six months preceding the survey. Children over 24 months are more likely to receive deworming tablets. Children in urban areas are more likely to receive deworming tablets than rural children. District-level variation among children who receive deworming tablets is high, ranging from 7 percent in Ainaro to 64 percent in Manatuto. Mother’s education has a positive influence on children receiving deworming tablets. Age in the 2009-10 TLDHS does not refer to the age of the child during the vitamin A or deworming distribution but rather refers to age on the day of the interview (current status). The inclusion of these “ineligible” children in the denominator may account for some underestimation in the coverage of vitamin A and deworming in these specific age groups at the time of the survey. The 2009-10 TLDHS also assessed reported cases of night blindness among children age 12-59 months. As it would be difficult for mothers to report correctly whether her child had night blindness, two proxy questions were administered: a question on whether the child showed any restriction of movement during the evenings compared with the daytime; and whether the child showed any signs of tripping or bumping into things in the evenings. These types of proxy reports have been used in other population-based surveys in which the parent/guardian was asked if the child has difficulty seeing in the evenings and, to be more specific, was prompted to probe for whether the child bumps into objects or trips over objects in the evenings (Wedner et al., 2004). 164 | Nutrition of Children and Women Table 12.9 Signs of night blindness among children Among children 12-59 months, the percentage who in the past 6 months have exhibited less movement in the evenings and who have tipped over or bumped into things in the evening, by background characteristics, Timor-Leste 2009-10 Background characteristic Percentage who in the past 6 months have: Tripped over Exhibited less or bumped movement in into things in the evenings the evenings Number of children Age in months 12-17 6.9 10.3 946 18-23 8.4 14.9 806 24-35 6.7 14.3 1,959 36-47 6.8 12.0 1,947 48-59 Sex 5.1 10.7 1,745 Male 6.5 12.0 3,736 Female Breastfeeding status 6.6 12.9 3,667 Breastfeeding 7.0 11.4 1,144 Not breastfeeding Residence 6.5 12.5 6,181 Urban 5.3 13.2 1,828 Rural District 7.0 12.1 5,575 Aileu 6.0 11.4 268 Ainaro 23.3 38.4 435 Baucau 5.7 10.0 736 Bobonaro 4.8 13.1 690 Covalima 1.4 1.1 335 Dili 4.7 15.1 1,277 Ermera 0.4 0.3 915 Lautem 4.1 9.8 559 Liquiçá 36.5 41.7 438 Manatuto 2.6 1.9 330 Manufahi 7.3 28.8 302 Oecussi 0.5 4.2 584 Viqueque Mother’s education 1.9 0.4 533 No education 7.4 12.3 2,520 Primary 6.4 12.6 2,059 Secondary 6.1 12.5 2,661 More than secondary Mother’s age at birth 2.5 10.8 163 15-19 4.2 15.4 98 20-29 6.7 12.6 3,054 30-39 6.8 12.7 3,099 40-49 Wealth quintile 5.6 10.9 1,152 Lowest 7.0 12.0 1,553 Second 7.0 13.0 1,441 Middle 6.0 11.8 1,473 Fourth 7.0 11.6 1,445 Highest 5.8 13.7 1,491 Total 6.6 12.4 7,403 Note: Total includes 77 children with information missing on breastfeeding status.
Table 12.9 indicates that about 7 percent of the children showed restricted movements in the evenings and 12 percent were reported to trip or bump into objects. Children age 18-23 months are most likely to show these signs. Children in Ainaro and Liquiçá most often showed these symptoms. It can be noted here that the proportion of children receiving vitamin A supplementation in the 6 months before the survey was lowest in Ainaro (20 percent in Table 12.8). 12.9 NUTRITIONAL STATUS OF WOMEN A woman’s nutritional status has important implications for her health as well as for the health of her children. Malnutrition in women results in reduced productivity, an increased susceptibility to infections, delayed recovery from illness, and heightened risk of adverse pregnancy outcomes. A woman with poor nutritional status, as indicated by a low body mass index (BMI), short stature, anemia, or other micronutrient deficiency, has a greater risk of obstructed labor, having a baby with a low birth weight, producing lower quality breast milk, dying from postpartum hemorrhage, and experiencing illness for herself and her baby. The 2009-10 TLDHS collected information on the height and weight of women in the reproductive age group. In this report, two indicators of nutritional status are presented—height and BMI. The height of a woman is associated with past socioeconomic status and nutrition during childhood and adolescence. A woman’s height is used to predict the risk of difficulty in delivery because small stature is often associated with small pelvic size and the potential for obstructed labor. The risk of giving birth to a low birthweight baby is influenced by the mother’s nutritional status. The cut-off point for the height at which mothers can be considered at risk varies between populations but normally falls between 140 and 150 centimeters. As in other DHS surveys, a cut-off point of 145 cm is used for the 2009-10 TLDHS. The index used to measure thinness or obesity is known as the BMI, defined as weight in kilograms divided by height squared in meters (kg/m 2 ). A cut-off point of 18.5 is used to define thinness or acute undernutrition, and a BMI of 25 or above usually indicates overweight or obesity. According to WHO, a prevalence of more than 20 percent of women with a BMI less than 18.5 indicates a serious public health problem (WHO, 1995). Table 12.10 presents the values of the two indicators of nutritional status and the proportion of women falling into high-risk categories, according to background characteristics. Women for whom there was no information on height and/or weight and for whom a BMI could not be estimated (pregnant women and women with a birth in the preceding two months) are excluded from this analysis. The data analysis on BMI is based on 11,698 women, while the height analysis is based on 12,845 women age 15-49 years. Overall, 15 percent of women are shorter than 145 cm. Women in rural areas are much shorter on average than women in urban areas, with 17 percent falling below the 145 cm cutoff compared with only 9 percent of women in urban areas. Women living in Dili are least likely to be below 145 cm (7 percent), while women in Ermera are most likely (31 percent). Women with a secondary and higher level of education are less likely to be short than women who have no education. Women in the highest wealth quintile are less likely to be below 145 cm than women in the lowest wealth quintile (8 percent and 17 percent, respectively). Table 12.10 shows that there are large differentials across background characteristics in the percentage of women assessed as malnourished or “thin” (BMI less than 18.5) and overweight (BMI 25 or higher). Twenty-seven percent of women were found to be malnourished with BMI
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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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84 | Other Proximate Determinants o
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Table 6.7.1 Recent sexual activity:
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There is little difference in the p
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2 percent among women age 30-34 to
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92 | Fertility Preferences Table 7.
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94 | Fertility Preferences 7.3 NEED
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96 | Fertility Preferences an idea
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98 | Fertility Preferences The perc
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with their death, or they may live
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100 80 60 40 20 102 | Infant and Ch
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104 | Infant and Child Mortality Ta
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8.7 HIGH-RISK FERTILITY BEHAVIOR Th
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ADULT AND MATERNAL MORTALITY 9 The
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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 and 166: In the TLDHS, information on vaccin
Page 167 and 168: Boys (54 percent) are somewhat more
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 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
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Page 213 and 214: HIV/AIDS-RELATED KNOWLEDGE, ATTITUD
Page 215 and 216: percent of women and 61 percent of
Page 217 and 218: person who has AIDS or by sharing c
Page 219 and 220: Comprehensive knowledge about AIDS
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Page 223 and 224: Table 14.6 Payment for sexual inter
Page 225 and 226: 14.5 MALE CIRCUMCISION Male circumc
Page 227 and 228: In the 2009-10 TLDHS, women and men
Page 229 and 230: 100 Percent 80 60 40 20 0 64 Total
Page 231 and 232: 14.8.2 Age at First Sex and Condom
Page 233 and 234: To assess the extent of condom use
Page 235 and 236: WOMEN’S EMPOWERMENT AND DEMOGRAPH
Page 237 and 238: Table 15.2.1 Control over women’s
Page 239 and 240: Table 15.2.2 Control over men's cas
Page 241 and 242: Table 15.4.1 Women’s participatio
Page 243 and 244: Table 15.5.1 Women’s participatio
Page 245 and 246: 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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