General health in Timor-Leste: self-assessed health in a large household survey.
OBJECTIVE
Timor-Leste is one of the world's newest nations and became a democracy in 2002. Ranked 150 out of 177 in the 2007 UNDP Human Development Index, the country has the worst health indicators in the Asia-Pacific region. The objective of this study was to collect and analyse data on subjectively assessed general health, health service use, migration and mobility patterns.


METHODS
The data collection involved recording self-reported status of general health using a structured questionnaire. The survey was administered to 1,213 Timorese households in six districts using a multi-stage random cluster sampling procedure. Basic descriptive statistical analyses were performed on all variables with SPSS version 13.


RESULTS
More than a quarter (27%) of respondents reported a health problem at the time of the survey. Only approximately half of respondents assessed their health to be good (53%) or average (38%). Barriers reported in the uptake of healthcare services were no felt needed; difficulty in accessing services and unavailability of service.


CONCLUSIONS
Results reveal that Timor-Leste needs a more decentralised provision of healthcare through primary healthcare centres or integrated health services. Trained traditional healers, who are familiar with the difficult terrain and understand cultural contexts and barriers, can be used to improve uptake of public health services. An adult literacy and community health education program is needed to further improve the extremely poor health indicators in the country.


CONCLUSIONS
Key lessons that emerged were the importance of understanding cultural mechanisms in areas of protracted conflict and the need for integrated health services in communities.
Earnest
Jaya
J
Centre for International Health, Curtin University of Technology, Western Australia. J.Earnest@curtin.edu.au
Finger
Robert P
RP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D006297:Health Services Accessibility; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007214:Indonesia; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011157:Population Dynamics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D055815:Young Adult