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

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2 | Introduction 1.1.2 Geography Timor-Leste is variously known as Timor-Timur, timur meaning “east” in Malay; Timor- Leste, leste meaning “east” in Portuguese; and Timor Lorosa’e, Lorosa’e meaning “rising sun” in Tetum. The island of Timor is part of the Malay Archipelago and is the largest and easternmost of the Lesser Sunda Islands. To the north of the mountainous island are the Ombai Strait and Wetar Strait, to the south is the Timor Sea, which separates the island from Australia, and to the west lies the Indonesian province of East Nusa Tenggara. The highest point of Timor-Leste is Mount Tatamailau at 2,963 meters. The island of Timor is located at coordinates between 8°50′S and 125°55′E, and the country covers a total area of 14,919 square kilometers (National Statistics Directorate, 2006). The local climate is tropical and generally hot and humid, characterized by distinct rainy and dry seasons. Timor-Leste is divided into 13 administrative districts, 65 sub-districts, and 442 Sucos and 2,225 aldeias. The 13 districts are Ainaro, Alieu, Baucau, Bobonaro, Covalima, Dili, Ermera, Lautem, Liquiçá, Manatuto, Manufahi, Oecussi, and Viqueque. Thirty percent of the population lives in the urban areas, and the rest live in rural areas (NSD, 2010). Dili is the capital. It is the largest city and the main port. The second-largest city is the eastern town of Baucau. Dili has the only functioning international airport, though there is also an airstrip in Baucau that is used for domestic flights. Several languages are spoken in the country. Tetum is the most common language in Timor- Leste and is the first official national language. Portuguese, spoken by fewer people, is the other official language. English and Indonesian are working languages. 1.1.3 Economy Timor-Leste’s economy is one of the poorest in the world (CIA, 2010). During colonization and even before then, Timor-Leste was best known for its sandalwood. In late 1999, about 70 percent of the economic infrastructure of Timor-Leste was destroyed by Indonesian troops and antiindependence militias. Some 300,000 people fled westward. Over the next three years, a massive international program led by the United Nations and manned by civilian advisers, peacekeepers, and police officers led to substantial reconstruction in the country (CIA, 2010). Timor-Leste still suffers from the aftereffects of the conflict. The country faces great challenges in continuing to rebuild infrastructure and strengthen the civil administration. One promising long-term project has been the joint development with Australia of petroleum and natural gas resources in the southeastern waters off Timor. Following independence, Timor-Leste negotiated the Timor Sea Treaty with Australia. This treaty replaced a previous agreement, the Timor Gap treaty, brokered between Indonesia and Australia in 1989. The Timor Sea Treaty established the Joint Petroleum Development Area (JPDA), which is administered jointly by both countries. Under the terms of the treaty, Timor-Leste receives 90 percent of the revenue from petroleum production in the JPDA, and Australia receives the remaining 10 percent. Agriculture and fishery are the backbone of the Timorese economy, and coffee plantations have been of major significance. In 2007, a poor harvest led to deaths from starvation in several parts of the country, and 11 districts required food supplies through international aid. The 2007 Timor-Leste Survey of Living Standards reported that nearly 50 percent of the Timorese lived below the national poverty line, estimated at $0.88 per capita per day. Based on a recent survey-to-survey imputation calculation, the incidence of poverty in the country is predicted to have declined by 9 percentage points between 2007 and 2009 (MOF, 2010). Timor-Leste’s Human Development Index for 2010 is 0.502—positioning the country at 120 out of 169 countries and areas (UNDP, 2010). This is an increase of 17 percent from 0.428 in 2005. During the same period, Timor- Leste’s life expectancy at birth increased by over 2 years.
The government of Timor-Leste has laid out the Fourth Constitutional Government Program for 2007-2012 as the country’s development strategy for the current five years. It defines the longterm development goals in terms of reducing poverty and promoting the equitable growth and life of the Timorese population. The Office of the Prime Minister is preparing the Strategic Development Plan to address the national priorities for the country over the period 2011-2030. 1.2 POPULATION The first census following independence was conducted in 2004, and the second census was completed in August 2010. According to the 2004 Census, the population of Timor-Leste is 923,198 and the annual growth rate is 5.3 percent (NSD, 2006). The population increased by 24 percent over the last 15 years, growing from 747,547 in 1990 to 923,198 in 2004 (NSD, 2006). The population is currently estimated at 1,066,582 with an annual growth rate of 2.4 percent between the 2004 Census and the 2010 Census (NSD, 2010). According to the 2004 Census, life expectancy was estimated at 59 years, and increased to 62 years according to the 2010 Census. 1.3 POPULATION AND REPRODUCTIVE HEALTH POLICIES AND PROGRAMS Shortly after the country gained independence, the Ministry of Health initiated the first National Health Policy Framework (NHPF) for 2002-12, which prioritizes the health needs of the Timorese people and emphasizes the importance of understanding the social determinants of health within the local cultural context. The NHFP seeks to “provide quality of health for the East Timorese by establishing and developing a cost-effective and needs-based health system which will specially address the health issues and problems of women, children, and other vulnerable groups, particularly the poor, in a participatory way” (MOH, 2002a). The NHPF serves as the basis for the formulation of the National Health Promotion Strategy (NHPS) and the National Reproductive Health Strategy (NRHS), which is an outcome of the 1994 International Conference on Population and Development (ICPD) held in Cairo (MOH, 2004a). The primary objectives of the NRHS are: • to substantially increase the level of knowledge in the general population on issues related to sexuality and reproductive health; • to promote family planning in order to stabilize the population growth rate and reduce the incidence of unintended, unwanted, and mistimed pregnancies; • to ensure that all women and men have access to basic reproductive health care services, health promotion, and information on issues related to reproduction; • to reduce the level of maternal mortality and morbidity; • to reduce the level of prenatal and neonatal mortality and morbidity; • to reduce the burden of STIs/HIV; • to meet changing reproductive health needs over the life cycle and to improve the health status of people of reproductive age. Family planning is one of the major components of the Timor-Leste planned development activities under the First Development Plan, 2002-2007. The Timor-Leste Family Planning and Maternal and Child Health project (FP/MCH) functions under the Ministry of Health. The Ministry of Health endorsed the National Family Planning Policy for Timor-Leste in March 2004. The primary objective of this policy is to address population growth and provide guidance on the development and implementation of family planning programs and activities in Timor-Leste (MOH, 2004b). The FP/MCH project began in 2002, and since then it has gradually involved all 13 districts of Timor-Leste. Family planning services have become an integral part of government health services. Currently, temporary modern family planning methods (male condoms, contraceptive pills, and injectables) are provided by peripheral health workers and volunteers on a regular basis through national, regional, zonal, and district hospitals; primary health care centers/health centers; and health Introduction | 3
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 28 and 29: However, the level of chronic energ
Page 31 and 32: MILLENNIUM DEVELOPMENT GOAL INDICAT
Page 33: INTRODUCTION 1 1.1 HISTORY, GEOGRAP
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
Page 79 and 80: Table 3.9.1 Use of tobacco: Women P
Page 81 and 82: FERTILITY 4 One of the major object
Page 83 and 84: 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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