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

1.8 HEMOGLOBIN TESTING
In one-third of the households selected for the 2009-10 TLDHS, women age 15-49 and
children age 6-59 months were tested for anemia. Anemia testing was only carried out if consent was
provided by the respondent and, in the case of a minor, by the parent or guardian. The protocol for
hemoglobin testing was approved by the Ministry of Health in Timor-Leste.
Hemoglobin testing is the primary method for diagnosis of anemia. In the 2009-10 TLDHS,
testing was done using the HemoCue system. A consent statement was read to the eligible woman and
to the parent or responsible adult of young children and women age 15-17. This statement explained
the purpose of the test, informed prospective subjects and/or their caretakers that the results would be
made available as soon as the test was completed, and requested permission for the test to be carried
out.
Before the blood was taken, the finger was wiped with an alcohol prep swab and allowed to
air-dry. Then the palm side of the end of one finger was punctured with a sterile, nonreusable, selfretractable
lancet. A drop of blood was collected with a HemoCue microcuvette and placed in a
HemoCue photometer where the results were displayed. For children age 6-11 months who were
particularly undernourished and thin, a heel puncture was made to draw a drop of blood. The results
were recorded in the Household Questionnaire, as well as on a brochure, given to each woman,
parent, or responsible adult, which explained what the results meant.
1.9 PRETEST, TRAINING, AND FIELDWORK
1.9.1 Pretest
For the pretest, 10 interviewers were recruited to interview in the two local languages. The
training for the pretest and fieldwork took place from April 27 to May 23, 2009. Both rural and urban
households were selected for the pretest in three districts (Bobonaro, Viqueque, and Dili). Based on
the findings of the pretest, the Household, the Woman’s, and the Man’s Questionnaires were further
refined in both of the local languages.
1.9.2 Training
The National Statistics Directorate (NSD), in close coordination with the MOH, recruited and
trained 101 persons for the fieldwork to serve as supervisors, field editors, male and female
interviewers, quality control staff, and reserves. They participated in the main training held in Dili
from July 13 – August 8, 2009. Staff from MOH, NSD, and ICF Macro led the four-week training
course, which was conducted mainly in Tetum and included lectures, presentations, practical
demonstrations, and practice interviewing in small groups as well as several days of field practice.
The participants also received anthropometric training and training in hemoglobin testing.
After the training on how to complete the Household, Woman’s, and Man’s Questionnaires
was completed, all trainees were given written and oral tests to gauge their understanding of the
TLDHS questionnaires and interviewing techniques. On the basis of their scores on the exam and
overall performance in the classroom and during field practice, 88 trainees were selected to participate
in the main fieldwork. From the group, 10 of the best trainees were selected as quality control staff, 13
of the best male trainees were selected as supervisors, and 13 of the best female interviewers were
identified as field editors. The remaining 52 trainees were selected to be interviewers. All selected
field staff were trained in anthropometric measurement taking.
After completing the interviewers’ training, the field editors and supervisors were trained for
an additional three days on how to supervise the fieldwork and edit questionnaires in the field, in
order to ensure data quality. The participants also received training on hemoglobin testing.
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