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ANC Antenatal CareBCC Behaviour Change CommunicationBCI Behaviour Change InterventionBEOC Basic Emergency Obstetric CareBSP Basic Services PackageCCT Café Timor network (Clinica Café Timor)CD Communicable Diseases

CDP&C Communicable Diseases Prevention and Control

CEOC Comprehensive Emergency Obstetric CareCHC Community Health CentreCIMCI Community Based Integrated Management of Childhood IllnessesCVD Cardio-vascular DiseaseDHC District Health CouncilDHMT District Health Management TeamsDHS Demographic and Health SurveyDOTS Directly Observable Treatment Short Course EC European CommissionFHPP Family Health Promoter ProgrammeFP Family PlanningFY Fiscal Year (Jan-Dec)GFATM Global Fund for Aids, Tuberculosis and MalariaGDP Gross Domestic ProductGSB General State Budget (OGE)HAST HIV/AIDS/TuberculosisHDI Human Development IndexHRH Human Resource for HealthHDR Human Development Report

HIV/AIDS Human Immunodeficiency Virus /Acquired Immune Deficiency Syndrome

HMIS Health Management Information SystemHNGV Guido Valadares National HospitalHP Health PostHRD Human Resource DevelopmentHSP Hospital Services PackageHSSP Health Sector Strategic Plan (2008-2012)

ICS Institute of Health Sciences (Instituto de Ciências de Saúde)

ICT Information and Communication Technology

IDS Integrated Disease SurveillanceIEC Information, Education, CommunicationIMCI Integrated Management of Childhood IllnessesIMR Infant Mortality RateIYCF Infant and Young Child FeedingJAPS Joint Annual Planning SummitLLITN Long Lasting Insecticide Treated Net

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LSMS Living Standard Measurement Survey MC Mobile ClinicsMCH Maternal and Child Health MDGs Millennium Development GoalsM&E Monitoring and EvaluationMICS Multiple Indicator Cluster SurveyMMR Maternal Mortality RatioMoE Ministry of EducationMoH Ministry of HealthMoF Ministry of FinanceMAEOT Ministry of State AdministrationMTEF Medium Term Expenditure FrameworkMTR Mid-Term ReviewNCD Non Communicable DiseaseNDP National Development PlanNGO Non Government OrganisationNHA National Health AccountsO&G Obstetrics and GynaecologyOH&S Occupational Health and SafetyPER Public Expenditure ReviewPHC Primary Health CareQA Quality AssuranceRH Reproductive Health

SAMES Autonomous Medical Supply System (Serviço Autónomo de Medicamentos e Equipamentos de Saude)

SBA Skilled Birth AttendantSIP Sector Investment ProgrammeSPWG Strategic Planning Working GroupSWAp Sector Wide ApproachTA Technical AssistanceTB TuberculosisTBA Traditional Birth AttendantTORs Terms of ReferenceTFET Trust Fund for East TimorUN United NationsUNFPA United Nations Population FundUNICEF United Nations Children’s Fund VCT Voluntary Counselling and Testing (HIV/AIDS)WHO World Health Organisation

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NATIONAL HEALTH SECTOR STRATEGIC PLAN 2011-2030 xii!

A,&&".'R/,.'"$#B+."+.9#-,I#*,+-#&".';+.$(",-"+.)'."*+",$%.+C'",*("$#-#9'$'-*"0#%#0,*=D"!-"*1,(".'9#.)>"%.,+.,*=" ;+0/("A,&&"?'"+-"'-(/.,-9" *1'"@,-,(*.="%&#=(" ,*("(*'A#.)(1,%".+&'"#00+.),-9&="*1.+/91"0&'#."%+&,0,'("#-)".'9/&#*,+-(>"?="'(*#?&,(1,-9",-*'.('0*+.,#&"0+-(/&*#*,C'"?+),'("#?&'"*+"+C'.('#"(=(*'$"")'C'&+%$'-)>"#-)"?="'(*#?&,(1,-9"#)$,-,(*.#*,C'"#-)"$#-#9'$'-*"*++&(".'R/,.')"*+"*.#-(&#*'"1'#&*1"%+&,0,'(",-*+"%.#0*,0'D

Critical Factors for Health Sector Development:The following analysis is imperative for a successful development of Timor-Leste’s health sector.Assumptions:k"":+&,*,0#&"(*#?,&,*="#-)"0+$$,*$'-*"*+"-#*,+-#&")'C'&+%$'-*k""8$#&&"0+/-*.="k""8$#&&"-/$?'."+;"%+%/&#*,+-k""EC#,&#?,&,*="+;"S,-#-0,#&"d'(+/.0'(

Risks:k""M1#-9'(",-"b+C'.-$'-*"0+$$,*$'-*"*+"*#H'"*1'"%&#--')"(*.#*'9,'(";+.A#.)"k""5,$,*')";/-)("#&&+0#*')"*+"*1'"1'#&*1"('0*+."*1.+/91"b'-'.#&"8*#*'"c/)9'*k""8&+A"%.+9.'((",-"7/$#-"d'(+/.0'("<'C'&+%$'-*k""F'#H".'9/&#*+.="$'#(/.'("#-)"&#A"'-;+.0'$'-*",-"*1'"-#*,+-#&"1'#&*1"(=(*'$

As a twenty year operational document on the sector, the NHSP is a living dynamic document that will be revised regularly and amended based on the outcome of its implementation and on constructive comments and feedback from stakeholders. It provides the basis for formulating short-term operational plans that guide the implementation of sector activities on the basis of consensus developed with related sector constituent partners.

In presenting this National Health Sector Strategic Plan, the Ministry of Health hopes to capture the interest and commitment of stakeholder to the plans therein, while invoking the support of all concerned to succeed in achieving a better and healthier tomorrow.

Marion Kelly

Marion Kelly

Marion Kelly

Marion Kelly

Marion Kelly

Marion Kelly

1

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Marion Kelly

Marion Kelly

Marion Kelly

Marion Kelly

3

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52010 Health Statistic Report.

Marion Kelly

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Disease <1 1 - 4 5 - 14 15 - 45 46 and older

Total Hospital DeathsNo. of

deaths% of Total

Hospital Deaths

Bronchopneumonia/Pneumonia 37 26 12 25 36 136 11.5

All forms of TB 3 5 18 75 75 176 14.9

Malaria 6 8 18 22 4 58 4.9

Cardiovascular Disease 1 1 1 14 21 38 3.2

Injury 0 1 5 19 9 34 2.9

Liver Disease 1 0 0 12 19 32 2.7

Cerebrovascular Disease 0 0 0 11 20 31 2.6

Renal Disorder 2 0 10 7 11 30 2.5

Diarrhoeal Diseases 10 10 1 7 1 29 2.4

Asthma Bronchiale/COPD 1 0 1 7 17 26 2.2

Meningitis/Encephalitis 2 4 4 7 0 17 1.4

Malnutrition 4 9 0 1 0 14 1.2

Anemia 1 2 0 10 0 13 1.1

9

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2016-2020(Consolidation)

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STEWARDSHIP (GOVERNANCE)

SUPPORT SYSTEM FINANCINGPUBLIC

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NON-FOR-PROFIT)

SERVICE DELIVERY (PROVISION)

HEALTH POLICY & REGULATION

HEALTH SYSTEM RESPONSIVENESS &

ACCOUNTABILITY

INTER-SECTORAL COLLABORATION

HEALTH HUMAN RESOURCE

DRUGS AND ESSENTIAL MEDICAL SUPPLIES

LABORATORY& BLOOD BANK SERVICES

INFRASTRUCTURE AND NON-MEDICAL SUPPLY

PUBLIC(GSB)

PRIVATE (HOUSEHOLDS)

DONORS

NATIONAL HOSPTIAL

REGIONALL HOSPITAL

DISTRICT HOSPITAL

SPECIALISED HOSPTIAL

LABORATORY SERVICES

PHARMACY

COMMUNITY HEALTH CENTRE OR CLINIC

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INTEGRATED COMMUNITY HEALTH SERVICE (SISCA)

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Marion Kelly

Marion Kelly

Marion Kelly

Marion Kelly

Marion Kelly


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Marion Kelly

Marion Kelly


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Marion Kelly

Marion Kelly

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Expected Results/ Key Indicators:

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Strategy IndicatorTarget2015

Target 2020

Target2025

Target2030

1.

Strengthen community empowerment in participating and to take lead in the identification of health issues and practices that hinders access to health services.

% SISCa post management led by community leaders

50% 100% 100% 100%

2.Advocating for inter-sectoral collaboration and commitment in community level services.

Coordination mechanisms among different sectors developed and functioning in support of SISCa

100% 100% 100% 100%

3.Standardize comprehensive health service package at SISCa levels.

% of identified rural area with access to full packages of SISCa

50% 100% 100% 100%

37

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67

SECTION V: HUMAN RESOURCES FOR HEALTH

V.1 DEVELOPMENT OF HEALTH HUMAN RESOURCES12

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13Road Map for development of health professionals is attached in Annex C.

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V.2 MANAGEMENT OF HEALTH HUMAN RESOURCES

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Marion Kelly

Marion Kelly

69

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Marion Kelly

Marion Kelly

Marion Kelly

NATIO

NAL H

EALTH SECTO

R STRATEGIC PLAN

2011-203094

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;,%;%*)I'N%('%,C"!$Z"#$%!"&'*#,M+#M,)

Health Professional Ethics Commission National Health Council Minister &

Vice-Minister of HealthNational HIV-AIDS

Commission National Commission for

Drugs & Food Control

O!ce of Health Inspector General

O!ce of Health Research & Development Control

Autonomous Health Institutions

National Health Institute

HNGV & Referral Hospitals

National Health Laboratory

National Ambulance Services

SAMES

National Directorate of Health Policy, Planning & External Cooperation

Dir. of Health Policy & Cooperation

Dir. of Planning, Monitoring & Evaluation

O!ce of Health Communication & Protocol

Legal O!ce

National Directorate of Hospital, Referral and

Community Health Services

Dir. of Control of Communicable Diseases

Services

Dir. of Control of Non-Communicable Disease

Services

Dir. of Maternal & Child Health

Dir. of Hospital & Referral Services

O!ce for Epidimiological Surveillance & Emergency

Preparedness

National Directorate of Health HumaN Resources

Dir. of Human Resources Planning

Dir. of Humanan Resources Development

Dir. of Human Resources Management

Dir. of Budget & Financial Management Services

Dir. of Administration Services

Dir. of Logistic & Asset Management Services

Dir. of Procurement Services

National Directorate for Health Administration &

Management

Director General of Health

95

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% of locally identified food analyzed in the food com-position table

20% 50% 70% 90%

Develop food recipes and modeling to address dif-ferent needs

% of locally produced food with recipes for different needs

No. of surveys on food con-sumption con

50%

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Implement WRA NFS education and counseling including health seeking behavior and food taboos ( before, during and after pregnancy)

Introduce and implement under-two growth moni-toring with counseling and MUAC screening for children 24-59 months

% of health workers trained in adolescent nu-trition

9o%% Improve and Maintain

Maintain Maintain

% of pregnant and lacta-tion women receiving counseling

50% 75% 90% Maintain

% of adolescent receive counseling on nutrition


% of health workers who understand how to use the WHO growth chart

95% 95% 95% 95%

% of health workers who provide counseling

75% 90% Maintain Maintain

% of mothers receiv-ing counseling through growth monitoring activi-ties


% of children screened and referred to health facilities


Establish a national train-ing centre for nutrition and food security in coor-dination with agriculture and education sector

Establish national nutrition training center (NNTC)

1 NNTC estab-lished

MaintainMaintain Maintain

% of health staff trained on nutrition and food security 90% Maintain Maintain Maintain

% of health staffs enrolled into formal or informal program (to build leader-ship and technical capacity in NFS)


% Hospital equipped with clinical nutritionist (dieti-cian)

HN: 2 MD special-ist diet.HD: 3 Dietacian and 1 MD dietacian

Maintain Maintain Maintain

% DHS equipped with S1-nutrition

30% 70% 100% Maintain

% CHC equipped with community nutritionist (D3)

30% 50% 70% 100%

Develop university level curriculum (bachelor and master degree) and faculty position in NFS

% faculty use nutrition cur-riculum

100% Maintain Maintain Maintain

Develop and incorporate NFS education in school curricula

% school use NFS educa-tion 25% 50% 70% 80%


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STRATEGIES ACTIVITIES OUTPUT INDICATORS

IMPLEMENTATION TIMEFRAME

Target2015

Target2020

Target2025

Target2030

Enhancing access to TB diagnostic and treatment services that are accountable to clients and based on human rights ap-proach

Government commitment supported by long-term planning adequate human resources and sustainable financing

develop medium and long-term budgeted plans of action in line with national health and development plansdevelop an evidence base on the impact of TB interventions

Case detection through quality assured bac-teriology and strengthening of the laboratory network

maintain a quality assured laboratory network for sputum smear microscopy develop capacity for culture and drug suscep-tibility testing at NHL ensure availability of supplementary diagnos-tics modalities at appropriate levels.ensure adherence to the recommended diag-nostic algorithms by all health care providers

Access to standardized treatment, under proper case management conditions, including direct-ly observed treatment and patient support to increase adherence, chance of cure, and reduce the risk of acquiring drug resistance

Uninterrupted supplies of quality assured anti-TB drugs and other consumables at all facilities Accurate recording and reporting on all no-tified cases and their outcomes for efficient monitoring of programme performance and evaluation of impact of TB control interven-tions

% of New smear positive registered out of esti-mated New smear posi-tive cases.

75 80 85 90

% of new smear posi-tive cases successfully treated out of new smear positive registered.

>85 >85 >85 >85

Number (%) of designat-ed microscopy centers that are part of external quality assurance pro-tocol

YW"PYVVl) YW"PYVVlQ YW"PYVVlQ YW"PYVVlQ

Number (%) of districts reporting no stock-out of anti-TB drugs

13 (100%) 13 (100%) 13 (100%) 13 (100%)

Number of districts sub-mitting reports on time

13 (100%) 13 (100%) 13 (100%) 13 (100%)




Target2015

Target2020

Target2025

Target2030

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national health sector strategic plan 2011-2030

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