Malnutrition in Timor-Leste: A Review of the Burden, Drivers, and Potential Response

Provo, Anne Marie; Atwood, Steve; Sullivan, Eileen Brainne; Mbuya, Nkosinathi Vusizihlobo

doi:10.1596/26394

Cited by 12 publications

(13 citation statements)

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“…Lack of adequate water and sanitation were identified as reasons why women do not seek antenatal care. 26 Stock-outs of commodities have been identified as a challenge to implementing nutrition 20 and vaccination programs, 24 making it harder for providers to offer a quality service. Even when skilled health workers are available equipment scarcity poses challenges, for example, when managing PPH patients during transportation via ambulance.…”

Section: Resultsmentioning

confidence: 99%

“…A critical element in delivering quality health care is a skilled workforce, identified in the WHO quality standards as a “competent motivated human resource.” Fourteen articles in the literature search included issues related to human resources for health in Timor-Leste. 16 , 20 , 22 , 23 , 26 - 30 , 33 , 44 , 49 - 51 Two government reports focus on interventions to do with human resources and identify increasing the number of skilled-birth attendants (SBAs) as a priority program area for MNCH services. 22 , 33 Two articles highlight Timor-Leste’s health workforce crisis within the Asia Pacific region and focus on insufficient number of SBAs.…”

Section: Resultsmentioning

confidence: 99%

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Factors Affecting Quality of Care in Maternal and Child Health in Timor-Leste: A Scoping Review

Khorshed

Lindsay

McAuliffe

et al. 2022

Health�Serv�Insights

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Timor-Leste faces many challenges implementing quality maternal, newborn and child health (MNCH) services due to resource constraints and socio-cultural factors that disproportionately affect the health of women and children. A scoping review was conducted to map the quality of MNCH services against WHO quality standards on: 1. Provision of care, 2. Experiences of care, and 3. Cross-cutting standards. The literature search identified 1058 citations, from which 28 full-text articles met the inclusion criteria. The findings highlight health workers’ limited capacity to provide quality services and referrals. The major reasons for this are: a lack of essential supplies, poor infrastructure and transport, limited opportunities for ongoing learning, and gaps in health information systems. Provision of care standards and cross-cutting standards require attention at a broad systems level. Findings related to experiences of care highlight the importance of effective communication, respect, and emotional support, particularly for vulnerable women and children who have difficulty accessing services, and for those who have experienced violence. These experience-related standards could be addressed at an individual health worker and health service level, as well as at a systems level. This review provides direction to focus quality-improvement initiatives within local health facilities, as well as at municipal and national level.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Factors Affecting Quality of Care in Maternal and Child Health in Timor-Leste: A Scoping Review

Khorshed

Lindsay

McAuliffe

et al. 2022

Health�Serv�Insights

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“…Wasting was better amongst children living in the city (14.3%) compared to children living in rural areas (9.8%) and improved to degrees seen in emergencies in Covalima (17.4%) and Oecusse (19.8%). 11 The significance of the three indicators of malnutrition displays the negative dietary reputation and health of children under five Acknowledgments: This research is from DHS data. The authors would also like to acknowledge the support of all those who voluntarily enrolled in this DHS data collection.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and predictor stunting, wasting and underweight in Timor Leste children under five years: An analysis of DHS data in 2016

Maulina

Qomaruddin

Kurniawan

et al. 2022

J. Public Health Afr.

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Stunting, wasting, and being underweight are indicators of malnutrition in a country. The high status reflects the poor nutritional and health status of children under five. We analyzed data from the Demographic and Health Survey conducted in Timor Leste from 2009 to 2016 to identify the prevalence and predictor stunting, wasting, and underweight. The variables analyzed were the mother’s education, mother’s age, mother BMI, mother’s height, number of ANC visits, birth weight, sex of a child, sex of head household, type of residence, wealth index, toilet facility, source of drinking water and province. The sample in this study was 3,723 toddlers. Prevalence of stunting (44.4%), underweight (37.5%) and wasting (25.3%). In the bivariate analysis, the variables statistically significantly associated with stunting, underweight, and wasting was mother’s education, sex of a child, type of residence, wealth index, and province. Improving the nutritional status of children in Timor Leste requires various nutrition and health interventions.

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“…Timor-Leste is a country afflicted by multiple burdens of malnutrition, and sustains one of the world's highest rates of stunting (low height for age), afflicting 47.1% of children under five [1]. Stunted growth is multifactorial, but in Timor-Leste, a contributing cause is likely to be a monotonous diet [2]. There is mounting evidence that fish is an underutilised resource that has the potential to improve dietary quality, but consumption of fish is low at ~6 kg/person/yr [3] compared to neighbouring countries in Asia and the global average of ~20.5 kg/person/yr [4].…”

Section: Introductionmentioning

confidence: 99%

A randomised controlled trial to test the effects of fish aggregating devices (FADs) and SBC activities promoting fish consumption in Timor-Leste: A study protocol

et al. 2022

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Timor-Leste is one of the world’s most malnourished nations where micronutrient-deficient diets are a contributing factor to the prevalence of child stunting, currently estimated to be 45.6% of children under five. Fish are an important source of nutrients and one that may assist the country’s predominantly rural population of agriculturalists to exit poverty and malnutrition. However, a small national fishing fleet producing low catch volumes places fish out of reach of most inland and upland populations where it is needed most. Fish consumption is very low in rural, inland areas compared to coastal, regional, and global averages. This study is a one-year, partially masked, cluster-randomized controlled trial among families living in rural, inland Timor-Leste. We aim to test and compare the effects of two treatments, alone and in combination, on the frequency and volume of household fish consumption in rural, inland areas as a proxy for improved dietary diversity and micronutrient intake. Treatment 1 is the installation of nearshore, moored fish aggregating devices (FADs) to improve catch rates with existing fishing gears. Treatment 2 is a social and behaviour change (SBC) activity to promote fish consumption. Villages in inland communities will be randomized to receive treatment 1, treatment 2, both treatments, or neither treatment. Data will be collected at baseline (prior to the rollout of the treatments) and endline. Our study will determine the impact of an improved supply of fish, along with nutrition-oriented SBC activities, on the fish purchasing and consumption practices of rural, inland households. Findings from this study are urgently needed by Small Island Developing States to guide policy and investment decisions on how best to improve households’ diets using locally available, nutrient-dense foods such as fish. Investments such as these are needed to break the cycle of malnutrition. This trial is registered at clinicaltrials.gov (NCT04729829). Trial registration: Trial registered at clinicaltrials.gov Identifier: NCT04729829.

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Malnutrition in Timor-Leste: A Review of the Burden, Drivers, and Potential Response

Cited by 12 publications

References 0 publications

Factors Affecting Quality of Care in Maternal and Child Health in Timor-Leste: A Scoping Review

Factors Affecting Quality of Care in Maternal and Child Health in Timor-Leste: A Scoping Review

Prevalence and predictor stunting, wasting and underweight in Timor Leste children under five years: An analysis of DHS data in 2016

A randomised controlled trial to test the effects of fish aggregating devices (FADs) and SBC activities promoting fish consumption in Timor-Leste: A study protocol

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