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

The cross-sectional component of the TLSLS only was included in the analysis, panel data wasexcluded. Health care seeking variables were analysed to provide prevalence rates for behaviours,beliefs and actions in the Timor-Leste population. Sample prevalence rates are reported here. As thedesign of the TLSLS aimed to represent the population, sample rates are likely to be indicative ofnational prevalence rates. Results are also available by district [6].Sample prevalence rates for the health seeking behaviours included in the HCSBS survey are alsoreported here. As the sample was designed to be typical of rural areas, the results reported here arelikely to be reflective of the rural population of Timor-Leste. 6 This Study aimed to reflect ruralexperience generally, and did not seek to, and was not statistically powered to, analyse differencesbetween districts.3.4.2 QualitativeHandwritten notes were made at the time of each interview and FGD, and were the same day typedinto full notes with the aid of the digital recording. On average, each in-depth interview team (1interviewer, 1 note-taker) completed 2-3 interviews per day, and each FGD team (1 facilitator, 2note-takers) conducted and developed full notes for one FGD per day. Seventy-three in-depthinterviews, including 13 entry interviews with village heads, were conducted and 38 FGDs. NVivo8[45] computer software was used to facilitate data management and analysis. Full interview recordsin Tetum were read together by the Timorese senior researcher and Australian data specialist, andfollowing discussion, coded for emergent themes. Clarification was sought from the interviewerwhere the informant’s response was unclear.Coding reflected the key issues covered by the instruments (FGD scenarios related to difficult birth,problematic diarrhoea in a child aged 1-5, and birth spacing) as well as themes which were identifiedduring the process of reading and coding interview records. Content that threw light on user andprovider experiences and understanding of the three levels of delay 7 , the range and sequence ofactions taken to seek help, and the elements that constituted a positive experience and outcomewas also sought out. Use of traditional providers and perception of custom as cause of illness, andhow these two factors impact on health care seeking behaviour, in particular use of governmenthealth facilities, was considered integral to the research.Some content was also coded for general interest: locally used words to describe health and relatedconditions which were grouped into a glossary; and insights that may prove of value for teaching andtraining activities.3.5 EthicsEthics approval was obtained through the Human Research Ethics Committee of the University ofNew South Wales, with the support of the Ministry of Health of Timor-Leste. Issues identified aswarranting attention were the development of a response to any ill household members identifiedduring the household survey. A local ombudsman was identified should there be any complaintsregarding the conduct of the research. Verbal informed consent was required for all interviews; asimple verbal description of the research preceded signing. Verbal approval was digitally recorded6 These data should be treated as preliminary.7 First-level delay: decision to seek health care; second-level delay: getting to an appropriate health provider; third-leveldelay: receiving treatment in the health facility [2].22Timor-Leste Health Care Seeking Behaviour Study | 2009