Timor-Leste 2016 Demographic and Health Survey Key Findings The 2016 Timor-Leste Demographic and Health Survey (2016 TLDHS) was implemented by the General Directorate of Statistics, Ministry of Planning and Finance and Ministry of Health. The funding for the 2016 TLDHS was provided by the Government of Government of Timor-Leste, the United States Agency for International Development (USAID), the United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO), the European Union, and the World Bank. ICF provided technical assistance through The DHS Program, a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in countries worldwide. Additional information about the 2016 TLDHS may be obtained from the General Directorate of Statistics, Ministry of Finance Building #5, Palacio do Governo, Dili, Timor-Leste; Telephone +670 333 9646; E-mail: info@ mof.gov.tl; Internet: www.mof.gov.tl. Additional information about The DHS Program may be obtained from ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA (telephone: 301-407-6500; fax: 301-407-6501; e-mail: [email protected]; Internet: www.DHSprogram.com). Suggested citation: General Directorate of Statistics (GDS) and ICF. 2018. 2016 Timor-Leste Demographic and Health Survey Key Findings. Rockville, Maryland, USA: GDS and ICF. Cover photographs: ©2014 Peter Shanks. Used under Creative Commons (CC BY 2.0) license. © 2008 Arturo Sanabria, Courtesy of Photoshare ABOUT THE 2016 TLDHS The 2016 Timor-Leste Demographic and Health Survey (TLDHS) is designed to provide data for monitoring the population and health situation in Timor-Leste. The 2016 TLDHS is the second Demographic and Health Survey conducted in Timor-Leste and the objective of the survey was to provide reliable estimates of fertility levels, marriage, sexual activity, fertility preferences, family planning methods, breastfeeding practices, nutrition, childhood and maternal mortality, maternal and child health, and HIV/AIDS and other sexually transmitted infections (STIs) that can be used by program managers and policymakers to evaluate and improve existing programs. Who participated in the survey? A nationally representative sample of 12,607 women age 15-49 in all selected households and 4,622 men age 15-59 in one-third of the selected households were interviewed. This represents a response rate of 99% of women and 97% of men. The sample design for the 2016 TLDHS provides estimates at the national level, for urban and rural areas, and for each of the 13 municipalities. 2016 Timor-Leste Demographic and Health Survey Page 1 CHARacTERISTICS OF HOUSEHOLDS AND RESPONDENTS Household Composition Households in Timor-Leste have an average of 5.3 members. Overall, 18% of households are headed by women. Forty-one percent of the household population is under age 15. Water, Sanitation, and Electricity Nearly 8 in 10 (79%) households have access to an improved water source. Urban households are more likely to have access to an improved water source (92%) than rural households (74%). Half (50%) of households use improved sanitation. Three in four (75%) urban households use improved sanitation, compared to 42% of rural households. Fifty percent of households use unimproved sanitation—9% use a © 2005 Steven Nowakowski, Courtesy of Photoshare shared facility, 14% use an unimproved facility, and 27% have no facility. Overall, 73% of households have Ownership of Goods electricity. Nearly all (98%) urban households have electricity, compared to 66% of rural households. More than 8 in 10 (84%) households in Timor-Leste own a mobile phone. Fewer households own a television (40%) or radio (25%). Urban households Water, Sanitation, and Electricity by Residence are more likely than rural households to own these Percent of households with: goods. In contrast, rural households are more likely Total Urban Rural than urban households to own agricultural land or 98 92 farm animals. 79 74 75 73 66 Education 50 More than 1 in 5 (22%) women and 19% of men age 42 15-49 have no education. Fifteen percent of women and 18% of men have some primary education, while 52% of women and 51% of men have some secondary Improved Improved Electricity education. Eleven percent of women and 12% of men source of sanitation have more than secondary education. Three-quarters drinking water (75%) of women and 82% of men are literate. Education Percent distribution of women and men age 15-49 by highest level of education attended 11 12 More than secondary 52 51 Secondary Primary 15 18 22 19 No education Women Men Page 2 2016 Timor-Leste Demographic and Health Survey FERTILITY AND ITS DETERMINANTS Total Fertility Rate Trends in Fertility Currently, women in Timor-Leste have an average of Births per woman for the 3 years before the survey 4.2 children. Fertility has declined dramatically over the last 13 years, from 7.8 children per woman in 2003 to 4.2 children per woman in 2016. 7.8 Fertility is higher in rural areas (4.6 children per 5.7 woman) than in urban areas (3.5 children per woman). 4.2 Fertility also varies by municipality, from a low of 3.6 children per woman in Dili to a high of 5.7 children per woman in Ainaro. 2003 2009-10 2016 TLHS TLDHS TLDHS Fertility decreases as a woman’s level of education increases. Women with no education have an average of 4.8 children, compared to 3.3 children among women with more than secondary education. Fertility also decreases as household wealth* increases. Women in the poorest households have on average 1.8 children more than women in the richest households (5.2 versus 3.4). Total Fertility Rate by Municipality Births per woman for the 3 years before the survey Dili Timor-Leste 3.6 4.2 Lautem Baucau 4.9 Liquiçá 4.6 4.4 Aileu Manatuto 4.0 4.6 Ermera Viqueque 4.3 4.6 Bobonaro Manufahi 4.6 Ainaro 4.3 SAR of 5.7 Oecussi Covalima 4.0 4.2 * Household wealth is assessed via household assets such as type of flooring, source of water, availability of electricity, and possession of durable consumer goods. Each household is assigned a score based on the household assets. The households are then divided into five groups of equal size, or quintiles, based on their relative score 2016 Timor-Leste Demographic and Health Survey Page 3 Age at First Sexual Intercourse, Marriage, Teenage Fertility and Birth In Timor-Leste, 7% of adolescent women age 15-19 Timorese women begin sexual activity 2.4 years have begun childbearing—5% are mothers and 2% earlier than Timorese men. The median age at first are pregnant with their first child. Teenage fertility sexual intercourse for women age 25-49 is 20.5 years, is twice as high in rural areas (8%) as in urban areas compared to 22.9 years among men age 25-49. Women (4%). By municipality, teenage fertility ranges from in urban areas begin sexual activity 1.6 years later than 3% in Dili to 10%in Bobonaro and SAR of Oecussi. women in rural areas. In contrast, men in rural areas Polygyny begin sexual activity 0.9 years later than men in urban Four percent of women and 1% of men age 15-49 are areas. More than one-quarter (26%) of women begin in polygynous unions. Polygyny is most common sexual activity before age 18, compared to 15% of men. among women in Bobonaro (11%) and among men in Men marry substantially later than women. One in SAR of Oecussi (4%). five (20%) women age 25-49 are married by age 18, compared to 3% of men age 25-49. The median age at first marriage among woman age 25-49 is 21.7 years, while the median age at first marriage among men age 30-59 is 26.8 years. Half of Timorese women age 25-49 have their first birth by age 23.0 years. Women in urban areas have their first birth 1.2 years later than woman in rural areas (median age of 23.9 versus median age of 22.7). Median Age at First Sex, Marriage, and Birth Among women and men age 25-49 Women Men 26.8* 22.9 23.0 20.5 21.7 na Median Median Median age at age at first age at first sex marriage first birth *Men age 30-59 © 2012 Jessica Fehringer/MEASURE Evaluation, Courtesy of Photoshare Page 4 2016 Timor-Leste Demographic and Health Survey FAMILY PlaNNING Current Use of Family Planning Family Planning Overall, 26% of married women age 15-49 use any Percent of married women age 15-49 using family planning method of family planning—24% use a modern method and 2% use a traditional method. The most Any method 26 popular modern methods among married women are 24 injectables (12%), implants (6%), the pill (2%) and the Any modern method IUD (2%). Injectables 12 Use of modern family planning methods varies Implants 6 dramatically by municipality; 8% of married women 2 in Lautem use a modern method, compared to 35% in Pill SAR of Oecussi. There is no clear relationship between IUD 2 modern family planning use and a woman’s level of education or household wealth. Any traditional method 2 Trends in Family Planning Use The use of any method of family planning increased slightly from 22% in 2009-10 to 26% in 2016. Similarly, use of modern methods of family planning increased slightly from 21% to 24% over the same time period. In contrast, the use of traditional methods of family planning has remained relatively unchanged. Current Use of Modern Methods by Municipality Percent of married women age 15-49 using a modern method of family planning Dili Timor-Leste 24% 24% Baucau Lautem Liquiçá 21% 8% 25% Aileu Manatuto 33% 21% Ermera Viqueque 18% 17% Bobonaro Manufahi 30% Ainaro 34% SAR of 17% Oecussi Covalima 35% 32% 2016 Timor-Leste Demographic and Health Survey Page 5 Demand for Family Planning Exposure to Family Planning Messages Thirty-six percent of married women age 15-49 want Television is the most common source of family to delay childbearing (delay their first birth or space planning messages; 17% of women and 28% of men out births) for at least two years, while 16% do not age 15-49 saw a family planning message on television want any more children.