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

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226 | Domestic Violence 16.1 MEASUREMENT OF VIOLENCE Collecting valid, reliable, and ethical data on intimate partner violence poses particular challenges because (1) what constitutes violence or abuse varies across cultures and individuals; (2) a culture of silence usually surrounds domestic violence and can affect reporting; and (3) the topic is a sensitive one. Ensuring the safety of respondents and interviewers when asking about domestic violence in a familial setting and protecting women who disclose violence raises specific ethical concerns. The responses to these challenges by the 2009-10 TLDHS are described below. 16.1.1 The Use of Valid Measures of Violence The 2009-10 TLDHS measures violence committed by spouses and other household members. Accordingly, information was obtained from ever-married women on violence by spouses and by others, and from never-married women on violence by anyone, including boyfriends/ girlfriends. International research on violence shows that intimate partner violence is one of the most common forms of violence against women. Thus, spousal/partner violence was measured in more detail than violence by other perpetrators by using a modified Conflict Tactics Scale (CTS) (Strauss, 1990). Specifically, spousal violence was measured using the following set of questions for women: (Does/did) your (last) husband/partner ever do any of the following things to you? 1. Push you, shake you, or throw something at you? 2. Slap you? 3. Twist your arm or pull your hair? 4. Punch you with his fist or with something that could hurt you? 5. Kick you, drag you, or beat you up? 6. Try to choke you or burn you on purpose? 7. Threaten or attack you with a knife, gun, or any other weapon? 8. Physically force you to have sexual intercourse with him even when you did not want to? 9. Force you to perform any sexual acts you did not want to? When the answer to the question was “yes,” women (with the exception of widows) were asked about the frequency of the act in the 12 months preceding the survey. A “yes” answer to one or more of items 1-7 above constitutes evidence of physical violence, while a “yes” answer to items 8 or 9 constitutes evidence of sexual violence. Emotional violence among ever-married women was measured in a similar way, using the following set of questions: (Does/did) your (last) husband ever: 1. Say or do something to humiliate you in front of others? 2. Threaten to hurt or harm you or someone close to you? 3. Insult you or make you feel bad about yourself? This approach of asking about specific acts to measure different forms of violence has the advantage of not being affected by different understandings of what constitutes a summary term such as violence. By including a wide range of acts, this approach has the additional advantage of giving the respondent multiple opportunities to disclose any experience of violence. In addition to these questions asked only of ever-married women, all women were asked about physical violence from persons other than their current or most recent spouse/partner with the question: From the time you were 15 years old, has anyone [other than your (current/last) husband/
partner] hit, slapped, kicked, or done anything else to hurt you physically? Respondents who answered this question in the affirmative were asked who had done this to them and the frequency of such violence during the 12 months preceding the survey. All women were also asked: At any time in your life, as a child or as an adult, has anyone ever forced you in any way to have sexual intercourse or perform any other sexual acts? Respondents who said “yes” were then asked questions about the age at which this first happened and the person who committed the act. Although this approach to questioning is generally considered to be optimal, the possibility of underreporting of violence, particularly sexual violence, cannot be entirely ruled out in any survey. 16.1.2 Ethical Considerations Three specific protections were built into the questionnaire, in accordance with the World Health Organization’s ethical and safety recommendations for research on domestic violence (WHO, 2001b): • Only one eligible person in each household was administered the questions on violence. Individual interviews using TLDHS Women’s Questionnaires were carried out in every household selected for the DHS survey (that is, 11,463 households in the sample). The domestic violence module was administered to women in one-third of households selected for the TLDHS individual interview. The DHS protocol specifies that the domestic violence module can only be administered to one randomly selected person per household. Therefore, in households with more than one eligible woman, the respondent for the module was randomly selected through a specially designed simple selection procedure (based on the ‘Kish Grid’), which was built into the Household Questionnaire. Interviewing only one person in each household using the domestic violence module provides assurance to the selected respondent that other respondents in the household will not talk about the types of questions the selected respondent was asked. • Informed consent for the survey was obtained from the respondent at the beginning of the individual interview. In addition, at the beginning of the domestic violence section respondents were read an additional statement informing them that the subsequent questions could be sensitive and reassuring them of the confidentiality of their responses. • The domestic violence module was implemented only if privacy could be obtained. If privacy could not be obtained, the interviewer was instructed to skip the module, thank the respondent, and end the interview. If a translator was needed to conduct the interview, respondents were not asked questions from the domestic violence module to maintain privacy. 16.1.3 Special Training for Implementing the Domestic Violence Module Complete privacy is also essential for ensuring the security of the respondent and the interviewer. Asking about or reporting violence, especially in households where the perpetrator may be present at the time of interview, carries the risk of further violence. Accordingly, interviewers were provided specific training for implementing the domestic violence module in order to enable the field staff to collect violence data in a secure, confidential, and ethical manner. Although most women interviewed do not necessarily ask for help, some abused women may ask the interviewer for assistance. To prepare for this possibility, interviewers were provided with a nationwide list of available network services at the district level for women facing violence. These included contact information on central and regional offices of Psychosocial Recovery and Domestic Violence | 227
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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
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MATERNAL HEALTH 10 Making Pregnancy
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among women in the lowest wealth qu
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A much lower percentage of Timorese
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Table 10.5 Knowledge of danger sign
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10.6.2 Assistance during Delivery O
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Table 10.8 Knowledge of danger sign
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Table 10.10 Application of material
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Table 10.12 Timing of first postnat
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Where health services are present,
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CHILD HEALTH 11 This chapter presen
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In the TLDHS, information on vaccin
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Boys (54 percent) are somewhat more
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The data indicate that two percent
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11.6 DIARRHEAL DISEASE Dehydration
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Table 11.8 Diarrhea treatment Among
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Ten percent of children with diarrh
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There are marked differences in the
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international reference population
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80 Percent 70 60 50 40 30 20 10 150
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60 50 40 30 20 10 152 | Nutrition o
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Table 12.2 shows the percentages of
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100 Percent 90 80 70 60 50 40 30 20
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Table 12.5 Foods and liquids consum
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Table 12.6 Infant and young child f
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Table 12.7 shows the percentage of
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the most recent distribution preced
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Table 12.10 Nutritional status of w
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Table 12.12 shows data on micronutr
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12.12 PREVALENCE OF ANEMIA IN WOMEN
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MALARIA 13 Malaria remains a leadin
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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
Page 221 and 222: HIV or AIDS on all four indicators
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
Page 247 and 248: Table 15.6.2 Attitude toward wife b
Page 249 and 250: Table 15.7.1 Attitude toward refusi
Page 251 and 252: Women’s empowerment is closely as
Page 253 and 254: Table 15.8 Indicators of women’s
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Page 257: DOMESTIC VIOLENCE 16 In the words o
Page 261 and 262: Table 16.1 Experience of physical v
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Page 267 and 268: Domestic violence is not limited to
Page 269 and 270: Table 16.8 Forms of spousal violenc
Page 271 and 272: Table 16.9—Continued Emotional vi
Page 273 and 274: Table 16.10 Spousal violence by hus
Page 275 and 276: 16.14 Physical Violence by Women ag
Page 277 and 278: 16.15 HELP-SEEKING BEHAVIOR OF WOME
Page 279 and 280: 16.17 SOCIAL NORMS AND VALUES The f
Page 281 and 282: REFERENCES Acharya, M. 2010. Effort
Page 283 and 284: Ministry of Health (MOH) [Timor-Les
Page 285: World Health Organization (WHO), Wo
Page 288 and 289: 256 | Appendix A during the populat
Page 290 and 291: A.5 SURVEY RESULTS 258 | Appendix A
Page 293 and 294: ESTIMATES OF SAMPLING ERRORS Append
Page 295 and 296: Table B.1 List of selected variable
Page 297 and 298: Table B.3 Sampling errors for Urban
Page 299 and 300: Table B.5 Sampling errors for Aileu
Page 301 and 302: Table B.7 Sampling errors for Bauca
Page 303 and 304: Table B.9 Sampling errors for Coval
Page 305 and 306: Table B.11 Sampling errors for Erme
Page 307 and 308: 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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