(formerly IRIN News) Journalism from the heart of crises

"Spectacular" reduction in child mortality rates

Timor-Leste has made significant strides in healthcare. The country's fertility rate dropped to 5.7 births per woman aged 15-49, two children less than in 2003
Matt Crook/IRIN

Timor-Leste, one of the world’s newest and poorest nations, has achieved significant declines in infant mortality, under-five mortality and fertility rates, according to the country’s latest Demographic and Health Survey (DHS).

Preliminary data from the survey - the full results of which will be released later this year - indicate Timor-Leste’s fertility rate now stands at 5.7 births per woman aged 15-49, two children less than in 2003. Also, since the last survey in 2003, the infant mortality rate dropped from 60 to 44 deaths per 1,000 births, while the under-five rate fell from 83 to 64 deaths per 1,000 births.

“In terms of the infant and under-five mortality rates, the reduction is quite spectacular,” said Rui de Araujo, Timor-Leste’s health minister from 2001 to 2007.

Experts attribute the drop in fertility rates to better educated women, more women in the workforce and increased availability of reproductive-health services.

“It was good to see that use of skilled birth attendants and other maternal services went up,” said Marisa Harrison from Health Alliance International (HAI), an NGO working with the government to expand maternal and newborn care.

The survey also shows a greater demand for family planning.

“The most surprising change that we read in the DHS was that now 72 percent of married women want to space their children or stop having children. That’s increased from 35 percent in 2003,” said Melinda Mousaco, country director of Marie Stopes International, an organization focused on sexual health issues.

Challenges ahead

Former minister De Araujo said the DHS results show the country was right to focus its policies on primary health care, health promotion, community involvement and education.

“Between 2001 and 2007, one of the policy decisions that influenced a lot was that the health budget would have to allocate 60 percent to primary healthcare and only 40 percent to hospital care,” he said.

Continued focus on primary care should keep Timor-Leste on track to achieve key Millennium Development Goals, such as reducing child mortality and improving maternal health, he said.

Nonetheless, experts agreed it is important not to become complacent. Malnutrition rates remain a big problem, with almost half of all children undernourished, 15 percent severely so.

Meanwhile, only 30 percent of deliveries are assisted by a health professional, with only 22 percent of all deliveries done at health facilities. Reducing maternal and neonatal mortality rates is reliant on a high prevalence of births being attended by health professionals.

Although Timor-Leste’s health sector is dogged by a lack of trained health professionals, experts are heartened by the survey findings.

“Timor-Leste is still suffering from staffing shortages, particularly midwives, so it is encouraging to see that they’ve still been able to improve the indicator results in maternal and child health and in family planning,” said Kristen Graham, maternal and child health adviser for Clinic Cafe Timor (CCT), the primary healthcare division of Cooperativa Cafe Timor.

Timor-Leste emerged just over a decade ago from a savage Indonesian military occupation between 1975 and 1999, during which about 200,000 people perished. The country achieved formal independence in 2002.


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