Health Service Delivery and Utilization in Timor-Leste : A Qualitative Study
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Washington, DC
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This report was written as part of a
broader Health Sector Review in Timor-Leste currently being
undertaken by the World Bank. Timor-Leste struggles with a
burden of disease since independence. Poor health is related
to environmental sanitation, poverty, food security, a
shortage of doctors, and the difficulty of reaching some
rural communities. Some problems are specific to
Timor-Leste: violence during the Indonesian occupation, the
destruction of the health care sector, and a situation of
medical pluralism in which long-established practices of
traditional healers co-exist with recent biomedical
services. One obstacle the health sector faces is client low
utilization of health services. The 2003 Demographic and
Health Survey (DHS) reports that about a fifth of poor
households have never used the health care facility closest
to their house. While it is clear that many households are
unwilling or unable to access health care, the reasons for
these barriers are poorly understood. One aim of this report
is to help fill this gap in knowledge by providing
contextual information on health seeking behavior. A second
aim is to shed light on human resource challenges in the
health sector.
Palabras clave
ABUSES, ACCESS TO CLINICS, ACCESS TO HEALTH CARE, AID, AILMENTS, AMBULANCE, ANAEMIA, ANTENATAL CARE, ANTIMALARIAL DRUGS, ANTIMALARIALS, ANXIETY, APPENDICITIS, BIOMEDICINE, BIRTH ATTENDANT, BIRTH ATTENDANTS, BIRTHS, BLEEDING, BRAIN, BREASTFEEDING, BURDEN OF DISEASE, CHILD HEALTH, CHILDBIRTH, CHILDBIRTHS, CLEANLINESS, CLINICS, COMMUNICABLE DISEASES, COMMUNITY HEALTH, COMMUNITY HEALTH CARE, COMMUNITY RELATIONS, CONTRACEPTION, DESCRIPTION, DIABETES, DIAGNOSIS, DISTRICTS, DOCTOR, DOCTORS, DYING, EMPLOYMENT, EPIDEMIC, EXPENDITURES, FAMILIES, FAMILY PLANNING, FATHER, FEVER, FOOD SECURITY, GENDER, GENDER ISSUES, HEALTH BELIEFS, HEALTH CARE, HEALTH CARE COSTS, HEALTH CARE EXPENDITURES, HEALTH CARE FACILITIES, HEALTH CARE PROVIDERS, HEALTH CARE SECTOR, HEALTH CARE UTILIZATION, HEALTH CARE WORKERS, HEALTH CLINICS, HEALTH EQUITY, HEALTH FACILITIES, HEALTH MINISTRIES, HEALTH ORGANIZATION, HEALTH ORGANIZATIONS, HEALTH OUTCOMES, HEALTH POLICY, HEALTH POSTS, HEALTH PROMOTION, HEALTH RESEARCH, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE DELIVERY, HEALTH SERVICE UTILIZATION, HEALTH SERVICES, HEALTH SYSTEM, HEALTH WORKERS, HERBAL REMEDIES, HIGH FEVER, HOME CARE, HOMES, HOSPITAL CARE, HOSPITALS, HOUSEHOLDS, HUMAN RESOURCES, ILLNESSES, IMMUNIZATION, INCOME, INFANTS, INFECTION, INJURY, INTEGRATION, INTERMEDIARIES, INTERVENTION, INTERVENTIONS, IRON, IRON DEFICIENCY ANEMIA, LABOUR MARKETS, LAWS, MALARIA, MALNUTRITION, MATERNAL AND CHILD HEALTH, MATERNAL HEALTH, MEDICAL ANTHROPOLOGY, MEDICAL ASSISTANCE, MEDICAL TECHNOLOGY, MEDICAL TREATMENT, MEDICINES, MENTAL HEALTH, MENTAL ILLNESS, MIDWIFE, MIDWIVES, MIGRATION, MISCARRIAGE, MOBILE CLINICS, MOTHER, MOTHERHOOD, MOTHERS, NURSE, NURSES, NURSING, NUTRITION, OCCUPATION, ORAL REHYDRATION, OVERCROWDING, PATIENT, PATIENTS, PHARMACEUTICALS, PHARMACIST, PHARMACISTS, PHARMACY, PHYSICIAN, PREGNANCY, PREGNANT WOMEN, PRENATAL CARE, PRIMARY CARE, PRIMARY HEALTH CARE, PRIVATE PHARMACIES, PSYCHOSIS, PUBLIC HEALTH, PUBLIC HEALTH SERVICES, REPRODUCTIVE HEALTH, RESPIRATORY INFECTIONS, RESPIRATORY TRACT INFECTIONS, ROOMS, RURAL AREA, RURAL AREAS, RURAL COMMUNITIES, SAFETY, SEXUALITY, SMEAR TEST, SOCIAL SCIENCE, SPECIALISTS, SURGERY, SYMPTOMS, TB, TRADITIONAL BIRTH ATTENDANTS, TRADITIONAL MEDICINE, TRAININGS, TREATMENT, TYPHUS, URBAN AREAS, VACCINATION, VACCINES, VECTORS, VICTIMS, VIOLENCE, VOMITING, WOMAN, WORKERS, WOUNDS