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

More documents

Recommendations

Info

Treatment for the illness was sought by 76.6% of those who reported a health complaint in the past30 days. The primary reason for not seeking treatment was also ascertained and two reasonsemerged as most important: “not serious enough” (45.6%) and “health facility too far” (36.7%).Other reasons, such as “health workers not present” (3.1%) or “no transport” (2.6%), were lessfrequently cited.The health facility that was most often visited first was a public hospital, followed by a health clinicand a public health post. 9 Cuban doctors were recorded a separate category and 12.8% said thatthey had visited a Cuban doctor first. In the TLSLS only 0.3% reported visiting a traditionalpractitioner first (Table 2).Table 2 - Usage of health providers for health problemsin the past 30 days (TLSLS sample)Type of health care soughtfirstNo. of peoplen (%)Public hospital 1,124 (24.8)Health clinic 655 (14.4)Public health post 637 (14.0)Cuban doctor 582 (12.8)Other nurse 536 (11.8)Community health centre 397 (8.8)Mobile clinic 153 (3.4)Church clinic 116 (2.6)Other doctor 111 (2.5)Midwife 110 (2.4)Cuban nurse 81 (1.8)Other 23 (0.5)Traditional practitioner 14 (0.3)Total 4,539 (100.0)Timor-Leste Health Care Seeking Behaviour Study | 200925The primary reasons reported for visiting a health facility were for a consultation (76.7%) or fortreatment of illness (12.1%). The secondary reasons given were much the same: medications (75.2%)and consultation (12.8%). Visiting for other reasons, such as prenatal checks and immunisation, wasrarely reported (
Figure 3 - Health providers 'used' by households in previous 12 months for any illnesses (HCSBSsample)1009080Households visiting provider (%)7060504030201014.920.4 19.412.637.24336.8• Traditional Providers• Government Providers• Private Providers• Other Providers17.2 18.514.34.514.30Health provider4.2.2 Physical factorsLong distances to health facilities discourage attendance, in particular for non-urgent conditionsand preventive care, and also for severe conditions because the journey itself is perceived tocontribute to deterioration in the patient’s condition. During the wet season, even short distancescan become impassable. Communities deploy various strategies to overcome the physical barriers.In some cases the long journey stimulates collective action, for example in relation to groups ofwomen walking together to facilities to support and protect one another.In the HCSBS survey, travel time to a health facility for the most recent visit by a household memberwas under 1 hour in 44.9% of cases. Nearly a third of patients (29.2%), however, had to travel forover two hours, while 5.1% had to travel for over five hours. Most people (77.9%) walked to thefacility; others went by motorbike (9.2%), microlet (3.8%), car (1.3%) or bicycle (1.7%).In the qualitative work, distance was highlighted as having a major influence on health service usage.At one research site, informants said that when there had been a health post in their aldeia theyattended ‘continuously’ (beibeik) for minor and serious complaints, but since the facility had beenrelocated elsewhere in the suco their ability to access services had greatly diminished.Long distances (e.g. 24km round trip for villagers from Citrana aldeia walking to Baocnana subdistrict,Oecusse) to health facilities discouraged attendance for non-urgent conditions andpreventive activities such as antenatal care and immunisation. Informants claimed that the longjourney, up- and down-hill, to the health post could cause deterioration in a person’s condition. For26Timor-Leste Health Care Seeking Behaviour Study | 2009
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 16 and 17: 1.3.2 Timor-Leste Survey of Living
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 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

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

Create successful ePaper yourself

Delete template?

Save as template?