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

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