Timor-LesteUrban population

2019 Health SDG Profi le: Timor-Leste

74.4

91%

Out-of-pocket expenditure ⁴ In most cases, high percentage of out-of-pocket

expenditure out of the total health expenditure is associated with low financial protection.

Timor-Leste

Urban population²

30.6%

Life expectancy at birth

Life expectancy⁵ measures how long people will live and is an indication of overall mortality of a country's population. Lost healthy life expectancy (HALE) represents equivalent year(s) of full health lost through years lived with morbidity and disability. Although females live longer, lost HALE is longer as well, on average 0.6 years or 6.6% more than males.

Population (000s)¹

1 293

Poverty³

30.3%

GDP per capita³ (Current US$)

3893.6

Current health expenditure as share of GDP⁴

2.4%

0 20 40 60 80

Age (years) Male

Female

HALE Lost HALE

Monitoring the health SDG goal: Indicators of overall progress

(ppp < $1.90 a day)

5.7%

The goal of universal health coverage (UHC) is that all people and communities receive the health care they need, without suffering financial hardship. Monitoring UHC requires measuring health service coverage and financial protection (SDG target 3.8).

Universal health coverage: At the centre of the health goal

HEALTH SERVICES COVERAGE

The summary measure of essential health services coverage, service coverage index of 16 indicators in four main areas: (1) reproductive, maternal, newborn and child health; (2) infectious diseases; (3) noncommunicable diseases; (4) service capacity, access and health security.

FINANCIAL PROTECTION

Financial protection is measured through two indicators:

(1) impoverishment, and (2) catastrophic health expenditure.

Impoverishment: 1.0% or approximately 13 000 people are being pushed into poverty (at $1.90 level) because of out-of-pocket health spending¹⁶ .

Catastrophic expenditure on health: 2.9% of people spent more than 10% of their household's total expenditure on health care¹⁶.

Family planning

coverage⁶ Pregnancyand

delivery care⁶ Child immunization

coverage⁷ (DTP3) Care seeking behaviour suspected pneumonia⁶ 0

50 100

Coverage (%)

46 66 76 71

Reproductive, maternal, newborn and child health

Tuberculosis (effective) treatment

Coverage⁸

HIV antiretroviral

therapy coverage Insecticide-treated bednets/IRS coverage for malaria prevention⁹

Access to basic sanitation¹⁰ (%) 0

50 100

Coverage (%) ₁₀₀

48 44

Infectious diseases

Prevalence of normal fasting glucose level¹¹

Prevalence of normal blood pressure¹¹

Cervical cancer

screening¹² Tobacco non-use¹³ 0

50 100

Coverage (%) ₁₀₀

73

44 1

Noncommunicable diseases

Density of hospital bedsl¹¹, expressed as % of global threshold, 18/10

000

Heath worker density¹⁴, expressed as % of

global threshold, 44.5/10 000

Access to essential

medicines Health security: IHR compliance¹⁵ 0

50 100

Coverage (%)

100

56 44

Service capacity, access and health security

UHC services coverage index of essential health services To provide a summary measure of

coverage, an index of national service coverage is computed by averaging service coverage values across the 16 tracer indicators. The UHC coverage index ranges from 0% to 100%, with 100% implying full coverage across a

range of services.

0 50 100

Coverage (%)

41 50

UHC services coverage index

Out-of-pocket expenditure, as % of the health expenditure (2016)

Public spending on health ⁴ is determined by the capacity of the government to raise revenues and the level of priority it attaches to the health sector.

This profile provides an overview of the current status of progress towards the 13 targets under the

Sustainable Development Goal #3 (SDG3): Ensure healthy lives and promote well-being for all at all ages.

All SDG3 indicators plus other selected health-related indicators are presented using global health estimates or country comparable reported values if available.

When nationally reported indicators from other sources are available, these are included in the references.

66.8 70.4

8.9%

2019 Health SDG Profi le: Timor-Leste

Equity status and trends: Variation by income, geographical location and education*

*There are many dimensions of equity, including but not limited to examples based on income, geographical location, and education presented here but also age, sex, race, and others. SDG 17.18 emphasizes the need for disaggregated data to facilitate better measurement of inequalities.

SDG 3: Health targets

Maternal and child mortality (SDG target 3.1, 3.2)

Births attended by skilled health personnel⁶

¹⁷

²¹

2003 2009 2016

0 50 100

Pe rc en ta ge (% )

18.4

29.9

56.7

Maternal mortality ratio²⁰

2000 2005 2010 2015

0 200 400 600 800

M M R (p er 1 00 0 00 li ve b irt hs )

694.0

215.0

1990 2000 2005 2010 2015 2016 2017 0

50 100 150 200

C M R (p er 1 00 0 liv e bi rth s)

47.6 20.7 174.0

55.0

Child mortality²²

Neonatal mortality rate Under-five mortality rate

Health service delivery

NCD risk factors

2005 2010 2015

0 50 100

Su cc es s ra te

89.0

TB treatment success rate for new cases¹⁹

2005 2010 2015

0 50 100

Pe rc en ta ge (% )

76.0 54.0

Coverage of DTP3 immunization⁷

Cervical cancer screening¹²

Female Male

2000 2005 2010 2015

0 25 50

Pe rc en ta ge (% )

0.82.0 4.92.6

Prevalence of obesity among adults¹⁹ (18+ years of age)

2009 2016

0 50 100

Pe rc en ta ge (% )

62.8

87.0

52.5

72.4

Antenatal care covergae⁶

¹⁷ (4+ visits)

Rural Urban

Variation by education

2010 2012 2014 2016 2018

0 1 2 3 4 5

Pe r p er so n pe r y ea r

2.4 2.4

OPD utilization¹⁸ (per person per year)

2009 2016

0 50 100

Pe rc en ta ge (% )

48.9 62.7

42.2 36.648.4

59.7

Prevalence of stunting among children under-five by mother's education level⁶

¹⁷

None Primary Secondary+

2009 2016

0 50 100

Pe rc en ta ge (% )

69.00

90.10

10.60

26.20

Proportion of births attended by skilled birth

attendant⁶

¹⁷

Quintile 1 (poorest) Quintile 5 (richest)

Variation by geographical location

2009 2016

0 50 100

Pe rc en ta ge (% )

62.7 57.4

Children < 5 yrs with diarrhoea receiving ORT and continued feeding⁶

¹⁷

Bed occupancy rate (BOR)

Variation by income

2000 2005 2010 2015

0 25 50

Pe rc en ta ge (% )

26.9 28.1 26.4

26.4

Prevalence of raised blood pressure among adults¹⁹ (18+ years of age)

Female Male

2014

0 50 100

Pe rc en ta ge (% )

28.9

Prevalence of tobbaco use¹³

Female Male

1%

Current data are insufficient for analysis

2019 Health SDG Profi le: Timor-Leste

Malaria incidence rate⁹

2013 2014 2015 2016 2017 0.0

0.5 1.0

Incidence (per 1000 pop. at risk) _1.1 0.4

0.1 0.5 0.5

TB incidence rate²⁴

2013 2014 2015 2016 2017 0

200 400 600

TB incidence (per 100,000 pop.)

498 498 498 498 498

Communicable diseases (SDG target 3.3)

Indicators SDG

target Year Timor-Leste Regional estimate Probability of dying from any of CVD,cancer,

diabetes,CRD between age 30 and age 70²⁵ 3.4.1 2016 19.9 23.1 Noncommunicable diseases and injuries

Malaria incidence is calculated for confirmed cases

Indicators Year Timor-Leste Regional estimate Hepatitis B surface

antigen prevalance among children under 5 years²⁵ (%)

2015 0.87

Number of people requiring interventions against neglected tropical diseases²⁵

2016 1,279 948

0.26

73,300,000

2003 2009 2016

0 50 100 150 200

Ad ol es ce nt b irt h ra te

78.0

51.0 42.0

Adolescent birth rate⁶

¹⁷

²¹ (per 1000 women aged 15 to 19 years)

International Health Regulations Core Capacity

Index¹⁵ 3.d.1 2018 44 56

National and global health risks

Female Male

2000 2005 2010 2015

0 250 500 750 1000

To ta l N C D m or ta lit y ra te (p er 1 00 0 00 p op .)

627.1 715.7

588.6

735.3

Total NCD mortality¹⁹

2008 2010 2012 2014 2016 0

5 10

D ea th s pe r 1 00 0 00 p op ul at io n

4.3

6.1

Reported road traffic deaths²⁶

(per 100 000 population)

DTP3 immunization coverage among 1-year-

olds⁷ 3.b.1 2017 76

MCV2 immunization coverage by the nationally

recommended age²⁵ 3.b.1 2017 50

PCV3 immunization coverage among 1-year

olds²⁵ 3.b.1 2017 -

88 77 12 Essential medicines and vaccines

Proportion of married or in-union women of reproductive age who have their need for family

planning satisfied with modern methods⁶ 3.7.1 2016 46.9 71.4 Sexual and reproductive health

Age-standardized mortality rate attributed to household and ambient air pollution²⁵

(per 100 000 population) 3.9.1 2016 139.8 165.8

Mortality due to environmental pollution

Prevalence of tobacco use among 15-64 years

old¹³- Female 3.a.1 2014 28.9

Prevalence of tobacco use among 15-64 years

old¹³- Male 3.a.1 2014 70.6

- - Tobacco use

Note: A dash (-) implies relevant data are not available

Mortality rate attributed to exposure to unsafe

WASH services²⁵ (per 100 000 population) 3.9.2 2016 9.9 Mortality rate attributed to unintentional

poisoning²⁵ (per 100 000 population) 3.9.3 2016 0.4

15.4 1.8 Suicide mortality rate²⁵ (per 100 000 population) 3.4.2 2016 4.6

Total alcohol per capita (age 15+ years)

consumption²⁵ 3.5.2 2016 2.1

Road traffic mortality rate²⁵ (per 100 000

population) 3.6.1 2016 12.7

13.2 4.5 20.7

Total net official development assistance to medical research and basic health per capita²⁵

(constant 2014 US$) 3.b.2 2017 9.29

Proportion of health facilities that have a core set of relevant essential medicines available

and affordable on a sustainable basis 3.b.3 - -

0.6

-

Health worker density¹⁴ (per 10 000 population) 3.c.1 2016 25.04 - Health workforce

Adolescent birth rate⁶ (per 1000 women aged

15 to19 years) 3.7.2 2016 42 33.0

New HIV infections²³

Current data are insufficient to determine trends

2019 Health SDG Profi le: Timor-Leste

References

1.World population prospects: the 2019 revision. New York: United Nations, Department of Economic and Social Affairs, Population Division; 2019 (https://population.un.org/wpp/, accessed 29 June 2019).

2. World urbanization prospects: 2018 revision. New York: United Nations, Department of Economic and Social Affairs, Population Division; 2018 (https://population.un.org/wpp/, accessed 29 June 2019).

3.World Bank. (https://data.worldbank.org/, accessed 28 May 2019)

4.Global health expenditure database. Geneva: World Health Organization; June 2019

5.Global health estimates 2016: Life expectancy, 2000–2016. Geneva: World Health Organization; 2018 (https://www.who.int/gho/mortality_burden_disease/life_tables/en/, accessed 29 June 2019).

6. Timor-Leste Demographic and Health Survey 2016. Dili, Timor-Leste and Rockville, Maryland, USA: Government Directorate of Statistics and ICF

7. WHO/UNICEF estimates of national immunization coverage. (http://apps.who.int/immunization_monitoring/globalsummary/countries?countrycriteria%5Bcountry%5D%5B%5D=BGD, accessed 29 June 2019) 8. Global tuberculosis report 2018. Geneva: World Health Organization; 2018 (https://www.who.int/tb/publications/global_report/en/, accessed 15 March 2019).

9. UNAIDS/AIDSINFO [Online database]. (http://aidsinfo.unaids.org/, accessed 29 June 2019) 10. WHO/UNICEF Joint Monitoring Programme estimate 2015.

11. Tracking universal health coverage: 2017 global monitoring report 12. Timor-Leste STEPS Survey (2014)

13. Timor-Leste (2014) Tobacco Factsheet 2018. New Delhi: World Health Organization/SEARO; 2018 14. HRH Profile 2018

15. International Health Regulations (2005) Monitoring Framework, GHO data. Geneva: World Health Organization (https://www.who.int/gho/ihr/en/, accessed 21 March 2019).

16. Hui Wang, Lluis Vinals Torresa & Phyllida Travis. Financial protection analysis of eight countries in the South-East Asia Region: current status and policy responses. Bulletin of the World Health Organization, 2018; 96:610–620.

17. Timor-Leste Demographic and Health Survey 2009-2010. Dili, Timor-Leste and Rockville, Maryland, USA: Government Directorate of Statistics and ICF 18. Calculated. Country reported.

19. WHO. Global Health Observatory (GHO) (https://www.who.int/gho/en/ - accessed 29 June 2019)

20. Trends in maternal mortality: 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva; 2015 (https://apps.who.int/iris/bitstream/handle/10665/194254/9789241565141_eng.pdf;jsessionid=56B6C12830EA6EA8CD0F30A8433E8FC3?sequence=1

21. Timor-Leste DHS 2003. See for births attended by skilled health personnel. Country reported value. 2011=51, 2012=59, 2013=62, 2014=63.9, 2015=63, 2016=56.7; Data Source: HMIS reports (2011-2015) present in Joint Annual Health Sector

22. Levels & trends in child mortality: report 2017: estimates developed by the UN Inter-agency Group for Child Mortality Estimation. New York (NY), Geneva and Washington (DC): UNICEF, World Health Organization, World Bank, United Nation; 2017 (http://www.childinfo.org/, accessed 28 May 2019).

23. See for New HIV infections. Country reported value. 2011=0.9, 2012=1.4, 2013=1.2, 2014=1.4, 2015=1.3; Data Source: HMIS reports (2011-2015) present in Joint Annual Health Sector 24. WHO Global Tuberculosis database [online]. ((https://www.who.int/tb/country/data/download/en/, accessed 29 June 2019). See for TB incidence rate

25. World Health Statistics 2019.

(https://apps.who.int/iris/bitstream/handle/10665/324835/9789241565707-eng.pdf?ua=1, accessed 28 May 2019) 26. Country reported

Other health-related SDGs

Note: A dash (-) implies relevant data are not available

Indicators SDG

target Year Timor-Leste Regional estimate Domestic general government health

expenditure as percentage of general

government expenditure⁴ (%) 1.a 2016 3.2 6.7

General government health expenditure

2000 2005 2010 2015 2016 2017 0

50 100

Percentage (%)

5.0 5.0 5.0 7.0 7.0 11.0 Population with primary reliance on

clean fuels¹⁹ (%)

2009 2016

0 50 100

Percentage (%)

55.2 60.4

Birth registration coverage⁶⋅¹⁷(%)

Proportion of ever-partnered women and girls aged 15 yrs and older subjected to physical, sexual or psychological violence by a current or former intimate partner in previous 12 months²⁵

5.2 2009-2017 35 -

Intimate Partner Violence

Amount of water- and sanitation-related official development assistance that is part of a government-coordinated spending plan²⁵ (constant 2016 US$ millions)

6.3 2017 5.87 1484.41

Proportion of population using safely

managed drinking-water services (%) 6.1 2015 - Proportion of population using safely

managed sanitation services (%) 6.2 2015 -

- - Drinking water services and sanitation

Children under 5 years who are stunted⁶ 2.2.1 2016 45.6 Children under 5 years who are wasted⁶ 2.2.2 2016 22.6 Children under 5 years who are overweight⁶ 2.2.3 2016 10.6

15.2 33 3.4 Child nutrition

Proportion of population with primary

reliance on clean fuels²⁵ (%) 7.1 2017 12 45

Clean household energy

Annual mean concentrations of fine particulate matter (PM2.5) in urban areas²⁵

(µg/m3) 11.6.2 2016 17.9 57.3

Ambient air pollution

Mortality rate due to homicide²⁵

(per 100 000 population) 16.1.1 2016 5.1 4.1

Homicide and conflicts

Birth registration coverage⁶ 16.9.1 2016 60.4 -

Birth registration

Completeness of cause-of-death data (%) 17.19.2 2009-2017 - 10 Cause-of-death data

Prevalence of stunting among children under-five⁶⋅¹⁷ (%)

2009 2016

0 50 100

Percentage(%)

45.6 58.1