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UNFPA in Timor-Leste



UNFPA, the United Nations Population Fund, expands the possibilities for women and young people to lead healthy and productive lives. It is the lead UN agency for delivering a world where every pregnancy is wanted, every childbirth is safe and every young person's potential is fulfilled. Since UNFPA started working in 1969, there has been real progress - the number - and rate - of women dying from complications of pregnancy or childbirth has been halved. Families are smaller and healthier. Young people are more connected and empowered than ever before.

Since 2003 UNFPA Timor-Leste has supported governmental and nongovernmental organizations activities to address population issues and has strongly promoted reproductive rights and gender equality as key elements to achieve human rights and human dignity. Over the past decade UNFPA assistance contributed towards establishing basic social services and generating baseline socio-demographic data for the newly-independent Timor-Leste. In the area of sexual and reproductive health, UNFPA supported the provision of comprehensive reproductive health services and training, with a focus on safe motherhood, particularly emergency obstetrical and newborn care (EmONC), and family planning (FP). Major achievements included the development of the National Reproductive Health Strategy 2004-2015, the 2004 National Family Planning Policy 2004 and the National Behavior Change Communication Strategy for Reproductive Health 2008-2012.


In the area of gender, UNFPA advocated and provided support for raising awareness of domestic violence. Achievements include the formulation, adoption and implementation of the 2010 Law Against Domestic Violence , the strengthened capacity of the Secretariat of State for the Promotion of Equality to address gender issues, and prevent gender-based violence and the development of the National Action Plan on Gender-Based Violence. In the area of population and development, UNFPA provided support to the 2004 and 2010 national population and housing censuses.

The Millennium Development Goals (MDG) 2014 Report shows that living standards and human development have improved significantly in Timor-Leste since independence. Selected MDG targets for gender equality, child mortality, maternal health, malaria and tuberculosis have been achieved. Out of 29 indicators and sub-indicators, 9 have achieved their targets and 14 show significant improvement. However, despite Timor-Leste's considerable development progress, deeply rooted economic and social issues remain with considerable disparities in key maternal health indicators between districts, education and wealth quintiles.

While the total fertility rate continues to decline, it stands at 5.7 - the highest in the region. The total fertility rate is considerably higher in rural (6.0) than in urban (4.2) areas. Estimates of the maternal mortality ratio range from 270 to 570 deaths per 100,000 live births. Among young women aged 15 to 19, the maternal mortality ratio is 1,037 per 100,000 live births. Skilled health personnel assist only 30 per cent of current deliveries, and facility delivery is low, at 20 per cent.

Contraceptive prevalence among married women aged 15 to 49 doubled between 2003 and 2009-2010, rising to 22 per cent, and has since stagnated in the low twenties. All told, over half the married women of reproductive age (15-49) have expressed a desire to space or limit the number of children they have. Yet less half of this demand for family planning is being met. Nearly one in three women aged 15 to 49 having an unmet need for family planning, with women aged 20 to 24 having the highest unmet need.

In 2010, 38 per cent of women aged 15 to 49 reported that they had experienced physical violence, and 75 per cent of married women reported that violence had come from a partner. Despite strong policy reform and a dynamic role by civil society organizations, gaps between informal and formal justice mechanisms, capacity of service providers and implementation challenges, particularly in the health sector, indicate that violence against women and girls remains a significant problem throughout the country.

Although Timor-Leste is considered to have a low HIV prevalence rate (0.2 per cent), there is a concentrated epidemic among key affected populations - sex workers (1.5 per cent) and their clients, men who have sex with men (1.3 per cent) and transgender (2.6 per cent). Timor-Leste faces specific vulnerabilities which may accelerate the transmission of HIV and sexually transmitted infections. These include high levels of population movement and social displacement (rural to urban and cross-border migration), high unemployment, low awareness of HIV and sexually transmitted infections and low condom use. Many young people are not equipped with the knowledge and life skills to manage sexually transmitted infections and HIV risk in an increasingly challenging environment. Comprehensive knowledge on HIV among youth is much lower in the poorest (11 per cent) than in the richest (35 per cent) wealth quintiles.


2015 marks the launch of the United Nations Population Fund (UNFPA) 3rd Country Programme (2015-2019). The Timorese government recently released its Millennium Development Goals (MDGs) Report for 2014. Overall the MDG indicators show that living standards and human development have improved significantly in Timor-Leste since independence. Selected MDG targets for gender equality, child mortality, maternal health, malaria and tuberculosis have been achieved. Out of 29 indicators and sub-indicators, 9 have achieved their targets and 14 show significant improvement. Yet in spite of these achievements, much remains to be done.

UNFPA and other development partners need to maintain and even scale up the present levels of commitment and interventions in order for the country to properly sustain and leverage the progress and gains made in human development and institution building over the past 10 years. Insufficient capacity is likely to remain as a major challenge in the short/medium term.

Expanding access to family planning has been a key aim of health and development programming for almost 50 years. Family planning is connected to all eight Millennium Development Goals. (Family planning-generates wealth and reduces hunger (MDG 1); prolongs education (MDG 2); empowers women and girls (MDG 3); saves infants (MDG 4); improves maternal health (MDG 5); prevents pediatric HIV (MDG 6); reduces pressure on the environment (MDG 7); and promotes global partnerships (MDG 8).

Increased access to family planning and reproductive health services supports women's social and economic well-being by enabling them to choose the number and spacing of their children. Women who are able to delay childbearing are more likely to meet their educational goals, obtain productive employment, increase household income, and thus help reduce extreme poverty. Better birth spacing reduces the incidence of low birth weight and poor maternal nutrition. Family planning results in more wealth and less hunger.

For teenage girls, early pregnancy often brings an end to education-girls often have to drop out of school due to unintended pregnancy or to help care for younger siblings. A 2010 study found that 99% of adolescent mothers in Timor-Leste dropped out of school. By increasing access to family planning, teenage girls would be more likely to stay in school, and in turn, send their own daughters to school.

Using family planning empowers women. When women are empowered and are decision-makers n their families, they spend more resources on their children's nutrition, healthcare and education. Involving men in family planning can lead to changes in gender norms. Empowering women in many ways, including their ability to achieve their desired family size, is the most important driver of modern development efforts.

Birth spacing through family planning reduces child mortality. Children born three to five years apart are 2.5 times more likely to survive than children born two years apart. About 750 infant deaths are averted in Timor each year by preventing unintended pregnancies. If we could meet all demands for contraception, another 1,000 infant deaths would be prevented each year.

Family planning is to maternal health what immunization is to child health. Family planning allows spacing of pregnancies and can delay pregnancies in young women at increased risk of health problems and death from early childbearing. Family planning can prevent pregnancies among older women who also face increased risks from childbirth. About 95 maternal deaths are averted in Timor each year by preventing unintended pregnancies. If we could meet all demands for contraception, another 125 maternal deaths would be prevented each year.

Family planning and reproductive health services are essential to preventing the spread of HIV/AIDS. Women with HIV who have unintended pregnancies run the risk of transmitting the virus to their children. Improving access to condoms can reduce the number of infections acquired through sexual intercourse. Increasing contraception use among HIV-positive women through voluntary family planning services can avert almost 30 percent more cases of mother-to-child-transmission than anti-retrovirals alone.

A family with fewer children needs less food, land and water and puts less pressure on a country's forests and tillable land. The slower population growth that would result from meeting women's needs for family planning and reproductive health contribute to strategies that promote environmental sustainability. Moreover, family planning is five times less expensive than conventional green technologies for reducing atmospheric carbon dioxide that leads to climate change.

Fifty years of global investment in family planning programs have contributed to strong collaboration among international agencies, governmental ministries, multinational organizations and local community groups.

In 2015, the world shifts its focus toward a new development agenda. As the next-generation goals expand the focus from social and human development to also include economic and environmental objectives, we should not underestimate the positive ripple effects of family planning across all three areas. Timor-Leste has set an ambitious goal of doubling contraceptive use by 2019. Family planning could bring more benefits to more Timorese at less cost than any other single technology now available.