Factors Associated with Exclusive Breastfeeding in Timor-Leste: Findings from Demographic and Health Survey 2009-2010

Exclusive breastfeeding is known to have nutritional and health benefits. This study investigated factors associated with exclusive breastfeeding among infants aged five months or less in Timor-Leste.The latest data from the national Demographic and Health Survey 2009-2010 were analyzed by binary logistic regression. Of the 975 infants included in the study, overall 49% (95% confidence interval 45.5% to 52.7%) were exclusively breastfed. The exclusive breastfeeding prevalence declined with increasing infant age, mothers with a paid occupation, who perceived their newborn as non-average size, and residence in the capital city Dili, was associated with a lower likelihood of exclusive breastfeeding. On the other hand, women who could decide health-related matters tended to breastfeed exclusively, which was not the case for others whose decisions were made by someone else. The results suggested the need of breastfeeding promotion programs to improve the exclusive breastfeeding rate. Antenatal counseling, peer support network, and home visits by health workers could be feasible options to promote exclusive breastfeeding given that the majority of births occur at home

Multidimensional assessment of institutionalized elderly: the reality of a brazilian institution

Background: The population aging in Brazil is characterized by the accumulation of progressive disabilities in their functional activities and daily life. To consider the elderlies in his/her multiple dimensions turns out to be a critical issue to improvetheir assistance to an institu-tionalized level, improving their health and quality of life. To perform a mini-overall evaluation of institutionalized elderly person to trace their profile in relation to the socio-demographic, functional capacity, nutritional status and cognition. Methods: Descriptive study, with a cross-sectional design and quan-titative approach performed in a long - stay institution for the elderly in Natal, RN. The research was approved by the Research Ethics Com-mittee of the Federal University of Rio Grande do Norte, under opinion number 164/2011.Results: 63.3% of the elderly were female, with ages varying from 61 to 103 years. 60.0% were single; 56.7% were literate. 66.7% had no children and 55% lived with their families before the institutio-nalization. As for the institutionalization time, 63.3% resided in the institution for four years. As what concerns the aspects of health, 73.3% of the elderly presented hearing difficulties, 90% make use of medicines predominantly to diabetes and hypertension. There is clear evidence that the institutionalization has been harmful to the elderly as with regards basic activities of daily living, nutritional status and cognitive aspects. Conclusion: The progressive disability in functional activities of daily life interferes directly in the quality of life, increasing dependency and minimizing the autonomy of these individuals. It is necessary to effec-tive implementation of public policies directed to the institutionalized elderly from the perspective of effective actions for improved attention and assistance

Factors Associated with Non-Utilisation of Health Service for Childbirth in Timor-Leste: Evidence from the 2009-2010 Demographic and Health Survey

Background: Timor-Leste is a young developing country in Asia. Most of its infrastructure was destroyed after a long armed conflict for independence. Despite recent expansion of health facilities and investment in healthcare, maternal mortality remains high with most mothers still giving birth at home. This study investigated factors affecting the non-utilisation of health service for childbirth in the aftermath of the independence conflict. Methods: The Timor-Leste Demographic and Health Survey 2009-2010 was the latest two-stage national survey, which used validated questionnaires to obtain information from 26 clusters derived from 13 districts of the country. Factors influencing non-utilisation of health facility for childbirth were investigated using univariate and multivariable logistic regression analyses, accounting for the cluster sampling and sample weight of the survey. Results: Of the total 5986 participants included in the study, 4472 (74.8%) did not deliver their last child at a health facility. Lack of education for the mother (adjusted odds ratio (OR): 2.04; 95% confidence interval (CI) 1.56 to 2.66) and her partner (OR: 1.45; 95% CI 1.14 to 1.84), low household wealth status (OR: 5.20; 95% CI 3.93 to 6.90), and rural residence (OR: 2.83; 95% CI 2.22 to 3.66), were associated with increased likelihood of non-utilisation of health facility for childbirth. Working mothers (OR: 1.55; 95% CI 1.32 to 1.81), who had high parity (OR: 1.78; 95% CI 1.36 to 2.32) and did not attend antenatal care service (OR: 4.68; 95% CI 2.65 to 8.28) were also vulnerable for not delivering at a health facility. Conversely, the prevalence of non-utilisation of health facility for childbirth reduced with increasing number of service components received during antenatal care visits (OR: 0.72; 95% CI 0.64 to 0.80).Conclusions: Only a quarter of Timorese women delivered at a health facility. In order to reduce maternal mortality, future interventions should target disadvantaged mothers from poor families, those residing in rural areas, have higher parity but no education, and who seldom attend antenatal care service, by improving their utilisation of health facility for childbirth