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

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However, the level of chronic energy deficiency among nonpregnant women is still high, with more than one-quarter of women having a BMI less than 18.5. The mean BMI has increased only slightly over the years from 19.5 in the 2003 DHS to 20.2 in the 2009-10 TLDHS. A mother’s nutritional status during pregnancy is important both for the child’s intrauterine development and for protection against maternal morbidity and mortality. Night blindness is an indicator of severe vitamin A deficiency, and pregnant women are especially prone to experience it. More than nine in ten mothers (94 percent) consumed vitamin A-rich foods, and more than one-half (53 percent) consumed iron-rich foods in the 24 hours preceding the survey. Fifty-five percent of women received vitamin A postpartum, an improvement from the 23 percent of women who received vitamin A postpartum reported in the 2003 TLDHS. Iron supplementation during pregnancy has been a key health initiative in Timor-Leste since 2003. The proportion of women who took iron supplements during pregnancy has risen from 43 percent in 2003 to 61 percent in 2009-10. However, 37 percent of women did not take any iron supplements during their most recent pregnancy. Further, only 16 percent of women took the recommended dose of iron supplements for 90 days or more during their pregnancy. In addition, 13 percent of women received deworming medication during pregnancy, 31 percent received supplementary food while pregnant with their last birth, and 29 percent received supplementary food while breastfeeding their last-born child. Thirteen percent of mothers reported having difficulty seeing at night but, when this figure is adjusted to include only those mothers who had no difficulty seeing in the daytime, only 2 percent of mothers suffered from night blindness during their most recent pregnancy in the last five years. This is a decrease from the 13 percent of mothers reported with night blindness in the DHS 2003 survey. Iron deficiency anemia is one of the most common nutritional problems in Timor-Leste. Overall 21 percent of Timorese women age 15- 49 are anemic, with 18 percent mildly anemic, 4 percent moderately anemic, and less than 1 percent severely anemic. However, pregnant women are more likely to be anemic (28 percent) than women who are breastfeeding (25 percent) xxviii | Summary of Findings and women who are neither pregnant nor breastfeeding (19 percent). HIV AND AIDS Knowledge of HIV and AIDS. Forty-four percent of women and 61 percent of men have heard of HIV and AIDS. Women are most aware that the chances of getting the HIV virus can be reduced by limiting sex to one uninfected partner who has no other partners (36 percent). In addition, 26 percent mention that abstaining from sexual intercourse will prevent the transmission of HIV. Among men, the most commonly known prevention method is also limiting sex to one uninfected partner who has no other partners (49 percent). Knowledge of condoms and the role that they can play in preventing the transmission of HIV is much less common among women than among men (30 percent versus 45 percent). Fewer women and men (27 percent and 42 percent, respectively) are also aware that both using condoms and limiting sex to one uninfected partner can reduce the risk of getting the HIV virus. Many Timorese adults lack accurate knowledge about the ways in which the HIV virus can and cannot be transmitted, with women being much less knowledgeable than men. Only 33 percent of women and 46 percent of men know that a healthy-looking person can have the HIV virus. One in four women and two in five men know that HIV cannot be transmitted by mosquito bites, or that a person cannot become infected by sharing food with a person who has HIV or sharing clothes with a person who has HIV. About twice as many men as women (28 percent and 15 percent, respectively) say that a healthy looking person can have the virus and reject the two most common local misconceptions (that HIV can be transmitted by mosquito bites and by sharing food). Attitudes towards People Living with HIV and AIDS. Knowledge and beliefs affect how people treat those they know to be living with HIV or AIDS. In the 2009-10 TLDHS, a number of questions were posed to respondents to measure their attitudes towards people living with HIV or AIDS (PLWA). Twice as many women as men (55 percent and 26 percent, respectively) state that they would be willing to care for a family member with the AIDS virus in their home. Eighty-four percent of women and 87 percent of men say that they would not want to keep secret that a family member was infected with the AIDS virus, while 44 percent of women
and 28 percent of men say that a female teacher with AIDS should be allowed to continue teaching. A relatively lower proportion of women and men (34 percent and 22 percent, respectively) say they would buy fresh vegetables from a shopkeeper with AIDS. The percentage expressing accepting attitudes on all four measures is low: 11 percent among women and 3 percent among men. HIV-Related Behavioral Indicators. Just over 1 percent of men age 15-49 reported having had two or more sexual partners during the 12 months prior to the survey, with men reporting a mean number of just under two partners in their lifetime. Among men with two or more partners in the 12 months preceding the survey, 19 percent used a condom at last sex. Five percent of men reported that they had engaged in paid sex in the year before the survey, and among those who paid for sex, only 26 percent reported using a condom the last time they paid for sex. DOMESTIC VIOLENCE The 2009-10 TLDHS included a series of questions that focus on specific aspects of domestic and interpersonal violence, including acts of physical, sexual, and emotional violence. Due to ethical considerations, only one woman was administered the domestic violence module in each selected household, and the violence module was not administered if privacy could not be obtained. Approximately one-third of women (38 percent) have experienced physical violence since age 15. One percent of women experienced physical violence often, while 28 percent experienced physical violence sometimes in the past 12 months. Urban women are more likely than rural women to have experienced physical violence since the age of 15 (49 percent compared with 35 percent). This is corroborated by the fact that more than half of the women in Dili district, which is primarily urban, reported experiencing physical violence since the age of 15 years. Women in Manufahi (76 percent) are most likely to report having ever experienced physical violence. Experience of physical violence in the past 12 months is highest among women in Manufahi (65 percent) and lowest in Ainaro (8 percent). Among ever-married women who have ever experienced physical violence, 74 percent reported that a current husband or partner committed the physical violence against them, while 6 percent reported that they experienced physical violence by a former husband/partner. Other perpetrators commonly reported by evermarried women were mother/stepmother (34 percent) and father/stepfather (26 percent), sisters and brothers (11 percent), and other relatives (6 percent). About 3 percent of women have experienced sexual violence, with the proportion of women who have experienced sexual violence ranging from less than 1 percent in Viqueque to 7 percent in Baucau, Lautem, and Aileu. For 16 percent of women who ever experienced sexual violence, the first experience of such violence occurred at age 15-19; 6 percent first experienced sexual violence at age 10-14; and less than 1 percent first experienced sexual violence before age 10. One in ten women who experienced sexual violence first experienced it at age 20-49. The main perpetrators of sexual violence against ever-married women are current husbands/ partners (71 percent) or former husbands/partners (9 percent). The findings from the survey also indicate that overall, 4 percent of women in Timor-Leste experienced physical violence during pregnancy. Violence by husbands against wives is not the only form of spousal violence; women may sometimes be the perpetrators of violence. Six percent of married women report that they have initiated physical violence against their current or most recent husbands, while 5 percent say that they have committed such violence in the 12 months preceding the survey. About one in five women (24 percent) who experience violence seek help. Women who experience both physical and sexual violence (50 percent) are most likely to seek help. Seven percent of women who experienced violence in Manufahi sought help, compared with one in two women in Covalima (51 percent). Summary of Findings | xxix
Page 1 and 2: Timor-Leste Demographic and Health
Page 3 and 4: CONTENTS TABLES AND FIGURES .......
Page 5 and 6: CHAPTER 7 FERTILITY PREFERENCES 7.1
Page 7: 14.8 HIV/AIDS-related Knowledge and
Page 10 and 11: x | Tables and Figures CHAPTER 4 FE
Page 12 and 13: xii | Tables and Figures Table 11.4
Page 14 and 15: xiv | Tables and Figures Table 16.4
Page 17: FOREWORD The 2009-10 Timor-Leste De
Page 21: CONTRIBUTORS TO THE REPORT Elias do
Page 24 and 25: about three children more than wome
Page 26 and 27: Postnatal Care. The majority of wom
Page 31 and 32: MILLENNIUM DEVELOPMENT GOAL INDICAT
Page 33 and 34: INTRODUCTION 1 1.1 HISTORY, GEOGRAP
Page 35 and 36: The government of Timor-Leste has l
Page 37 and 38: 1.5 ORGANIZATION OF THE SURVEY The
Page 39 and 40: 1.8 HEMOGLOBIN TESTING In one-third
Page 41: In these households, 13,796 women w
Page 44 and 45: Table 2.1 Household population by a
Page 46 and 47: The percentage of children not livi
Page 48 and 49: The Early Childhood Care and Educat
Page 50 and 51: Table 2.4.2 Educational attainment
Page 52 and 53: The GAR at the primary school level
Page 54 and 55: ate (2 percent) than their rural co
Page 56 and 57: water. Thirty-six percent of househ
Page 58 and 59: The type of flooring material used
Page 60 and 61: Table 2.11 Wealth quintiles Percent
Page 63 and 64: CHARACTERISTICS OF RESPONDENTS 3 Th
Page 65 and 66: Table 3.2.1 Educational attainment:
Page 67 and 68: Table 3.3.1 Literacy: Women Percent
Page 69 and 70: Table 3.4.1 Exposure to mass media:
Page 71 and 72: Table 3.5.1 Employment status: Wome
Page 73 and 74: 3.4.2 Occupation Respondents who we
Page 75 and 76: 3.4.3 Earnings, Employers, and Cont
Page 77 and 78: 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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13.1.2 Use of Mosquito Nets by Chil
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Tables 13.3 and 13.4 show the perce
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The highest prevalence of fever is
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HIV/AIDS-RELATED KNOWLEDGE, ATTITUD
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percent of women and 61 percent of
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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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