Timor-Leste Health Care Seeking Behaviour Study - Secretaria de ...

More documents

Recommendations

Info

1.3.2 Timor-Leste Survey of Living Standards 2007The Timor Leste Survey of Living Standards (TLSLS) [6] was carried out to build on the modest livingstandards survey that had formed part of the Poverty Assessment in 2001. The TLSLS had twocomponents, a cross-sectional sample of 4500 households, and a ‘panel’ component which followedup half (900) of the households surveyed in 2001. The cross-sectional survey drew on the samplingframe provided by the 2004 Census and collected economic and social data from a nationallyrepresentative sample drawn from five regions across the country. The health module includedseveral questions on health seeking and health services utilisation, thus supplying baselinehousehold-level data on these behaviours and their correlates. Other health data collected in theTLSLS included those issues related to immunisation, bednet use, birth spacing and pregnancy/childbirth.1.3.3 Timor-Leste Health Care Seeking Behaviour Study 2008The HCSBS incorporated both a quantitative (survey) and a qualitative component.The HSCBS survey sample was drawn from the TLSLS sample. This offered opportunities to link HCSBSdata with social data collected previously in the TLSLS. The HCSBS covered different domains ofhealth-seeking, and expanded on some domains included in the TLSLS. In particular, given thenational focus on achieving the MDG targets, maternal and child health issues were prioritised.Unlike the TLSLS, the HCSBS survey sample was not designed to be nationally representative but,rather, to be typical of rural areas that are without ready access to hospitals.The qualitative component of the HCSBS allowed exploration of the processes, beliefs andbehaviours associated with health problems in order to better understand the factors influencinghealth care seeking.Figure 1, below, shows the relationship between the Census, TLSLS and HCSBS.Timor-Leste Health Care Seeking Behaviour Study | 2009Married menquestionnaire2004Timor-Leste Census ofPopulation and Housing2007Timor-Leste Survey ofLiving StandardsHEALTHFigure 1 - Research context2008Timor-Leste Health Care Seeking Behaviour StudySurveyHousehold headquestionnaireMarried womenquestionnaireSince Independence:Qualitative research andsurveys by NGOs and otherstakeholdersService userinterviewsQualitativeService userFGDsProviderinterviews15
Capacity enhancementCollaboration and capacity building were emphasised throughout the HCSBS. The survey was carriedout by the National Statistics Directorate (part of the Ministry of Finance), providing an opportunityto enhance links between it and the MOH. In addition, UNSW advertised for a local Timoreseresearch organisation that would take responsibility, with UNSW support, for the qualitativefieldwork and collaboration on the analysis. Following a competitive tender process, the AlolaFoundation was selected and provided the base for the qualitative team and the Timorese SeniorResearcher. All training and research activities were designed as opportunities for further skillsdevelopment and institutional strengthening. Survey structure and fieldwork was led by theNational Statistics Directorate, and qualitative fieldwork and data collection by the team based at theAlola Foundation. UNSW managed the process through the Project Directors (Prof Anthony Zwi andDr Ilse Blignault), Project Manager (Ms Cynthia Grant), Project Coordinator (Mr Basilio Martins Pinto)and Data Specialists (Dr Diana Glazebrook and earlier, Dr Catherine Bateman Steel).1Section 2 – Literature Review2.1 – International researchA literature review conducted in preparation for the HCSBS aimed to consider similar research thathad been carried out in other settings and to gain an understanding of the theoretical andmethodological issues underpinning research in this field. Articles and papers reporting studies onhealth care seeking in developing countries were reviewed, with a focus on those that dealt withissues highlighted as important in Timor-Leste.The bulk of health care seeking studies around the world have been descriptive, providing anoverview of the patterns of behaviour and the choices people make in relation to their health andthe services with which they interact. Some studies, particularly those which included a qualitativeelement, also offered explanations as why certain choices are made or certain behaviours occur;however many of them were limited to a specific illness or health topic.Generally, patterns of health service utilisation and health care seeking were influenced by socioeconomicstatus, maternal education, and cultural beliefs and perceptions of the causes, and scopefor treating, different conditions. The main barriers to service utilisation were reported as longdistances and poor transportation, health service factors such as staff attitudes and hours ofoperation, and the assessment of the benefits and costs by community members associated with useof available services.TB, malaria and diarrhoea were commonly investigated [27-40], and some patterns of behaviourwere similar across countries and settings. For malaria and TB, for example, home treatment was acommon first step and only after this failed was help sought outside the home [30, 34]. Delay intreatment for diarrhoea was mainly related to lack of recognition of severity [28]. Rural living was aconsistently a barrier to engagement with services, although this was not always simply a function ofdistance [41]. Factors such as lack of information and other health service factors also played a role.1 Further information about the capacity-building aspects of this Study can be found in the HSCBS Project Report.Timor-Leste Health Care Seeking Behaviour Study | 200916
Page 3 and 4: AcknowledgementsWe acknowledge the
Page 5: ForewordHonourable Minister of Heal
Page 12 and 13: Recommendations for the Ministry of
Page 14 and 15: Section 1 - Introduction1.1 Backgro
Page 18 and 19: Satisfaction with services was diff
Page 20 and 21: households. Within each household,
Page 22 and 23: Once the final set of questions was
Page 24 and 25: for all FGDs as well as for all use
Page 26 and 27: Treatment for the illness was sough
Page 28 and 29: mothers carrying infants the journe
Page 30 and 31: (tau todan) should something go wro
Page 32 and 33: Box 2: Midwife demonstrates care of
Page 34 and 35: 4.2.7 MedicationIn relation to trea
Page 36 and 37: esponsibility may be partly mitigat
Page 38 and 39: with bloody diarrhoea (tee raan) to
Page 40: push, preventing premature pushing
Page 43 and 44: In the previous 12 months, 43.3% of
Page 45 and 46: Most informants referred to the nor
Page 47 and 48: The HCSBS survey investigated proce
Page 49 and 50: antenatal care: weighing pregnant w
Page 51 and 52: drug compliance. 27 Some providers
Page 53 and 54: survey activity with little discern
Page 55 and 56: Figure 7 - Improving access, qualit
Page 57 and 58: Education of women is a particularl
Page 59 and 60: 5.4.4 Recommendations for developme
Page 61 and 62: 27. Beiersmann C, Sanou A, Wladarsc
Page 63 and 64: Appendix 2 - Birth spacing narrativ
Page 65 and 66: Appendix 4 - User-provider interact
Page 67 and 68:
Appendix 5 - User blame of provider
Page 70:
TIMOR-LESTE HEALTH CARE SEEKING BEH
show all

Timor-Leste Health Care Seeking Behaviour Study - Secretaria de ...

Create successful ePaper yourself

Delete template?

Save as template?