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João S Martins

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Dr Joao Martins is a medical doctor with 30 years’ experiences. He holds MpH and PhD from Otago University, New Zealand and the University of New South Wales (UNSW), Australia respectively. Dr Joao has vast of experiences working with national and international organizations including UNFPA, World Bank, MSF, Care International, UNSW, WHO and was once appointed as vice minister for Health of Timor-Leste. Dr Joao has authored more than 12 publications and co-authored more than 40 publications, many of them published in highly reputed international peer reviewed journals. He also served as a Dean of Faculty of Medicine of the Universidade Nacional de Timor-Lorosae, prior to his current position as the Director of the Division of Postgraduate for Clinical areas of the the Universidade Nacional de Timor-Lorosae. During this Covid-19 pandemic, Dr Joao has been appointed as a member of the Integrated Centre of Crisis Management (Centro Integrado Gestao de Crise) that advised directly to the Prime Minister office and the Ministry of Health in fight against Covid-19.
Dr Joao is taking part in the CoMo Consortium along with the team from Timor-Leste to support the government of Timor-Leste through the mathematical modelling application with the effort to mitigate the spread of Covid-19 and its impact to the Timorese population in the country.
Supervisors: Professor Anthony Zwi and Professor Paul Kelly

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Papers by João S Martins

Multiple cardiovascular risk factor care in 55 low- and middle-income countries: A cross-sectional analysis of nationally-representative, individual-level data from 280,783 adults

PLOS global public health, Mar 27, 2024

Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; the... more

De Alma-Ata a Astana: a trajetória dos cuidados de saúde primários nos países da CPLP

The Perception of Population and Health Professionals regarding the National Immunization Program of Timor-Leste

The 2017 National Immunization Program (NIP) provide vaccination against tuberculosis, diphtheria... more The 2017 National Immunization Program (NIP) provide vaccination against tuberculosis, diphtheria, tetanus, polio, pertussis, hepatitis B, invasive Haemophilusinfluenzae serotype b disease, measles, rubella and human papillomavirus infections. The Timorese health system is faced with the search for a model of the National Health Strategic Plan (NHSP 2011-2030) work plan for its health system, which is adequate to the current and future needs of its population.In addition to preventing these deadly diseases, vaccination of newborns and expectant mothers, integrated into programs such as Timor-Leste Expanded Vaccination Program (EVP).The overall objective of study characterizes the perception of the population and health professionals about the NIP under of this investigation. Methods:This is a cross-sectional and mixed-methodological study of qualitative and quantitative descriptive type of methods, including observations, closed interviews and focus group discussion (FGD). A study p...

Unmet need for hypercholesterolemia care in 35 low- and middle-income countries: A cross-sectional study of nationally representative surveys

PLOS Medicine, 2021

Background As the prevalence of hypercholesterolemia is increasing in low- and middle-income coun... more Background As the prevalence of hypercholesterolemia is increasing in low- and middle-income countries (LMICs), detailed evidence is urgently needed to guide the response of health systems to this epidemic. This study sought to quantify unmet need for hypercholesterolemia care among adults in 35 LMICs. Methods and findings We pooled individual-level data from 129,040 respondents aged 15 years and older from 35 nationally representative surveys conducted between 2009 and 2018. Hypercholesterolemia care was quantified using cascade of care analyses in the pooled sample and by region, country income group, and country. Hypercholesterolemia was defined as (i) total cholesterol (TC) ≥240 mg/dL or self-reported lipid-lowering medication use and, alternatively, as (ii) low-density lipoprotein cholesterol (LDL-C) ≥160 mg/dL or self-reported lipid-lowering medication use. Stages of the care cascade for hypercholesterolemia were defined as follows: screened (prior to the survey), aware of dia...

Lifetime Prevalence of Cervical Cancer Screening in 55 Low- and Middle-Income Countries

JAMA, 2020

Association between country preparedness indicators and quality clinical care for cardiovascular disease risk factors in 44 lower- and middle-income countries: A multicountry analysis of survey data

PLOS Medicine, 2020

Background Cardiovascular diseases are leading causes of death, globally, and health systems that... more Background Cardiovascular diseases are leading causes of death, globally, and health systems that deliver quality clinical care are needed to manage an increasing number of people with risk factors for these diseases. Indicators of preparedness of countries to manage cardiovascular disease risk factors (CVDRFs) are regularly collected by ministries of health and global health agencies. We aimed to assess whether these indicators are associated with patient receipt of quality clinical care. Methods and findings We did a secondary analysis of cross-sectional, nationally representative, individual-patient data from 187,552 people with hypertension (mean age 48.1 years, 53.5% female) living in 43 low- and middle-income countries (LMICs) and 40,795 people with diabetes (mean age 52.2 years, 57.7% female) living in 28 LMICs on progress through cascades of care (condition diagnosed, treated, or controlled) for diabetes or hypertension, to indicate outcomes of provision of quality clinical ...

Cardiovascular disease risk profile and management practices in 45 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level survey data

PLOS Medicine, 2021

Background Global cardiovascular disease (CVD) burden is high and rising, especially in low-incom... more Background Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic characteristics, and (2) the prevalence of self-reported blood pressure (BP) medication use among those with and without an indication for such medication as per World Health Organization (WHO) guidelines. Methods and findings We conducted a cross-sectional analysis of nationally representative household surveys from 45 LMICs carried out between 2005 and 2017, with 32 surveys being WHO Stepwise Approach to Surveillance (STEPS) surveys. Country-specific median 10-year CVD risk was calculated using the 2019 WHO CVD Risk Chart Working Group non-laboratory-based equations. BP medication indications were based on the WHO Package of Essential Noncommunicable Disease Interventions guideline...

Analysis of attained height and diabetes among 554,122 adults across 25 low- and middle-income countries

Objective: The prevalence of type 2 diabetes is rising rapidly in low-income and middle-income co... more Objective: The prevalence of type 2 diabetes is rising rapidly in low-income and middle-income countries (LMICs), but the factors driving this rapid increase are not well understood. Adult height, in particular shorter height, has been suggested to contribute to the pathophysiology and epidemiology of diabetes, and may inform how adverse environmental conditions in early life affect diabetes risk. We therefore systematically analyzed the association of adult height and diabetes across LMICs, where such conditions are prominent. Research Design and Methods: We pooled individual-level data from nationally representative surveys in LMICs that included anthropometric measurements and diabetes biomarkers. We calculated odds ratios (ORs) for the relationship between attained adult height and diabetes using multilevel mixed-effects logistic regression models. We estimated ORs for the pooled sample, major world regions, and individual countries, in addition to stratifying all analyses by se...

Diabetes Prevalence and Its Relationship With Education, Wealth, and BMI in 29 Low- and Middle-Income Countries

Diabetes Care, 2020

OBJECTIVEDiabetes is a rapidly growing health problem in low- and middle-income countries (LMICs)... more OBJECTIVEDiabetes is a rapidly growing health problem in low- and middle-income countries (LMICs), but empirical data on its prevalence and relationship to socioeconomic status are scarce. We estimated diabetes prevalence and the subset with undiagnosed diabetes in 29 LMICs and evaluated the relationship of education, household wealth, and BMI with diabetes risk.RESEARCH DESIGN AND METHODSWe pooled individual-level data from 29 nationally representative surveys conducted between 2008 and 2016, totaling 588,574 participants aged ≥25 years. Diabetes prevalence and the subset with undiagnosed diabetes was calculated overall and by country, World Bank income group (WBIG), and geographic region. Multivariable Poisson regression models were used to estimate relative risk (RR).RESULTSOverall, prevalence of diabetes in 29 LMICs was 7.5% (95% CI 7.1–8.0) and of undiagnosed diabetes 4.9% (4.6–5.3). Diabetes prevalence increased with increasing WBIG: countries with low-income economies (LICs) ...

Intersectoral collaboration for people-centred mental health care in Timor-Leste: a mixed-methods study using qualitative and social network analysis

International Journal of Mental Health Systems, 2019

Background Intersectoral collaboration is fundamental to the provision of people-centred mental h... more Background Intersectoral collaboration is fundamental to the provision of people-centred mental health care, yet there is a dearth of research about how this strategy operates within mental health systems in low- and middle-income countries. This is problematic given the known attitudinal, structural and resource barriers to intersectoral collaboration in high-income country mental health systems. This study was conducted to investigate intersectoral collaboration for people-centred mental health care in Timor-Leste, a South-East Asian country in the process of strengthening its mental health system. Methods This study employed a mixed-methods convergent design. Qualitative data elicited from in-depth interviews with 85 key stakeholders and document review were complemented with quantitative social network analysis to assess understandings of, the strength and structure of intersectoral collaboration in the Timorese mental health system. Results There was consensus among stakeholder...

Are people-centred mental health services acceptable and feasible in Timor-Leste? A qualitative study

Health Policy and Planning, 2019

People-centred mental healthcare is an influential concept for health system strengthening and su... more People-centred mental healthcare is an influential concept for health system strengthening and sustainable development that has been developed and promoted primarily in Western contexts. It characterizes service users, families and communities as active participants in health system development. However, we have limited understanding of how well people-centred mental healthcare aligns with the multiplicity of peoples, cultures, languages and contexts in low- and middle-income countries (LMICs). Timor-Leste, a lower-middle income country in South-East Asia, is in the process of strengthening its National Mental Health Strategy 2018–22 to align with people-centred mental healthcare. To support the implementation of this Strategy, this study investigated the acceptability and feasibility of people-centred mental health services in Timor-Leste. In-depth semi-structured individual (n = 57) and group interviews (n = 15 groups) were conducted with 85 adults (≥18 years). Participants were s...

Service user and family participation in mental health policy making in Timor-Leste: a qualitative study with multiple stakeholders

Introduction Participation in mental health system strengthening by people with mental health pro... more Introduction Participation in mental health system strengthening by people with mental health problems and their families is a cornerstone of people-centred mental health care, yet there is a dearth of research about participation from low- and middle-income countries (LMICs), particularly from the Asia Pacific region. Hence, this study aimed to assess the current situation, challenges, enabling factors and future actions for service user and family participation in mental health policy making in Timor-Leste. Methods In-depth interviews were conducted with 85 adults (≥18 years) who were: (1) mental health service users (n = 20) and their families (n = 10); (2) government decision makers (n = 10); (3) mental health and social service providers (n = 23); (4) civil society (n = 9); and (5) other groups (n = 13). Interview data was analysed using framework analysis. Results There was limited service user, family and community participation in mental health policy making in Timor-Leste. ...

The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1·1 million adults

The Lancet, 2019

Social inclusion and exclusion of people with mental illness in Timor-Leste: a qualitative investigation with multiple stakeholders

BMC Public Health, 2019

Health system performance for people with diabetes in 28 low- and middle-income countries: A cross-sectional study of nationally representative surveys

PLOS Medicine, 2019

Consumption of Fruits and Vegetables Among Individuals 15 Years and Older in 28 Low- and Middle-Income Countries

The Journal of Nutrition, 2019

Background The WHO recommends 400 g/d of fruits and vegetables (the equivalent of ∼5 servings/d) ... more Background The WHO recommends 400 g/d of fruits and vegetables (the equivalent of ∼5 servings/d) for the prevention of noncommunicable diseases (NCDs). However, there is limited evidence regarding individual-level correlates of meeting these recommendations in low- and middle-income countries (LMICs). In order to target policies and interventions aimed at improving intake, global monitoring of fruit and vegetable consumption by socio-demographic subpopulations is required. Objectives The aims of this study were to 1) assess the proportion of individuals meeting the WHO recommendation and 2) evaluate socio-demographic predictors (age, sex, and educational attainment) of meeting the WHO recommendation. Methods Data were collected from 193,606 individuals aged ≥15 y in 28 LMICs between 2005 and 2016. The prevalence of meeting the WHO recommendation took into account the complex survey designs, and countries were weighted according to their World Bank population estimates in 2015. Poiss...

Understanding HRH recruitment in post-conflict settings: an analysis of central-level policies and processes in Timor-Leste (1999–2018)

Human Resources for Health, 2018

Determinants of health care utilisation: the case of Timor-Leste

International health, Jan 11, 2018

Health financing and delivery reforms designed to achieve universal health coverage (UHC) need to... more Health financing and delivery reforms designed to achieve universal health coverage (UHC) need to be informed by an understanding of factors that both promote access to health care and undermine it. This study examines the level of health care utilisation in Timor-Leste and the factors that drive it. Data from a nationally representative cross-sectional survey of health care utilisation in 1712 households were used to develop multilevel models exploring how need and predisposing and enabling factors explain health care utilisation at both primary and secondary care facilities. Need was found to be the key driver in seeking both primary care and hospital services. Rural households were less likely to go to hospital (odds ratio 0.7) than urban households. The poorest quintile was also less likely to use more expensive hospital services than other socio-economic groups. Understanding the determinants of seeking health care in Timor-Leste is of considerable policy significance, because ...

“I go I die, I stay I die, better to stay and die in my house”: understanding the barriers to accessing health care in Timor-Leste

BMC Health Services Research, 2016

State-building and human resources for health in fragile and conflict-affected states: exploring the linkages

Human resources for health, Jan 15, 2015

Human resources for health are self-evidently critical to running a health service and system. Th... more Human resources for health are self-evidently critical to running a health service and system. There is, however, a wider set of social issues which is more rarely considered. One area which is hinted at in literature, particularly on fragile and conflict-affected states, but rarely examined in detail, is the contribution which health staff may or do play in relation to the wider state-building processes. This article aims to explore that relationship, developing a conceptual framework to understand what linkages might exist and looking for empirical evidence in the literature to support, refute or adapt those linkages. An open call for contributions to the article was launched through an online community. The group then developed a conceptual framework and explored a variety of literatures (political, economic, historical, public administration, conflict and health-related) to find theoretical and empirical evidence related to the linkages outlined in the framework. Three country c...

Multiple cardiovascular risk factor care in 55 low- and middle-income countries: A cross-sectional analysis of nationally-representative, individual-level data from 280,783 adults

PLOS global public health, Mar 27, 2024

Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; the... more

De Alma-Ata a Astana: a trajetória dos cuidados de saúde primários nos países da CPLP

The Perception of Population and Health Professionals regarding the National Immunization Program of Timor-Leste

The 2017 National Immunization Program (NIP) provide vaccination against tuberculosis, diphtheria... more The 2017 National Immunization Program (NIP) provide vaccination against tuberculosis, diphtheria, tetanus, polio, pertussis, hepatitis B, invasive Haemophilusinfluenzae serotype b disease, measles, rubella and human papillomavirus infections. The Timorese health system is faced with the search for a model of the National Health Strategic Plan (NHSP 2011-2030) work plan for its health system, which is adequate to the current and future needs of its population.In addition to preventing these deadly diseases, vaccination of newborns and expectant mothers, integrated into programs such as Timor-Leste Expanded Vaccination Program (EVP).The overall objective of study characterizes the perception of the population and health professionals about the NIP under of this investigation. Methods:This is a cross-sectional and mixed-methodological study of qualitative and quantitative descriptive type of methods, including observations, closed interviews and focus group discussion (FGD). A study p...

Unmet need for hypercholesterolemia care in 35 low- and middle-income countries: A cross-sectional study of nationally representative surveys

PLOS Medicine, 2021

Background As the prevalence of hypercholesterolemia is increasing in low- and middle-income coun... more Background As the prevalence of hypercholesterolemia is increasing in low- and middle-income countries (LMICs), detailed evidence is urgently needed to guide the response of health systems to this epidemic. This study sought to quantify unmet need for hypercholesterolemia care among adults in 35 LMICs. Methods and findings We pooled individual-level data from 129,040 respondents aged 15 years and older from 35 nationally representative surveys conducted between 2009 and 2018. Hypercholesterolemia care was quantified using cascade of care analyses in the pooled sample and by region, country income group, and country. Hypercholesterolemia was defined as (i) total cholesterol (TC) ≥240 mg/dL or self-reported lipid-lowering medication use and, alternatively, as (ii) low-density lipoprotein cholesterol (LDL-C) ≥160 mg/dL or self-reported lipid-lowering medication use. Stages of the care cascade for hypercholesterolemia were defined as follows: screened (prior to the survey), aware of dia...

Lifetime Prevalence of Cervical Cancer Screening in 55 Low- and Middle-Income Countries

JAMA, 2020

Association between country preparedness indicators and quality clinical care for cardiovascular disease risk factors in 44 lower- and middle-income countries: A multicountry analysis of survey data

PLOS Medicine, 2020

Background Cardiovascular diseases are leading causes of death, globally, and health systems that... more Background Cardiovascular diseases are leading causes of death, globally, and health systems that deliver quality clinical care are needed to manage an increasing number of people with risk factors for these diseases. Indicators of preparedness of countries to manage cardiovascular disease risk factors (CVDRFs) are regularly collected by ministries of health and global health agencies. We aimed to assess whether these indicators are associated with patient receipt of quality clinical care. Methods and findings We did a secondary analysis of cross-sectional, nationally representative, individual-patient data from 187,552 people with hypertension (mean age 48.1 years, 53.5% female) living in 43 low- and middle-income countries (LMICs) and 40,795 people with diabetes (mean age 52.2 years, 57.7% female) living in 28 LMICs on progress through cascades of care (condition diagnosed, treated, or controlled) for diabetes or hypertension, to indicate outcomes of provision of quality clinical ...

Cardiovascular disease risk profile and management practices in 45 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level survey data

PLOS Medicine, 2021

Background Global cardiovascular disease (CVD) burden is high and rising, especially in low-incom... more Background Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic characteristics, and (2) the prevalence of self-reported blood pressure (BP) medication use among those with and without an indication for such medication as per World Health Organization (WHO) guidelines. Methods and findings We conducted a cross-sectional analysis of nationally representative household surveys from 45 LMICs carried out between 2005 and 2017, with 32 surveys being WHO Stepwise Approach to Surveillance (STEPS) surveys. Country-specific median 10-year CVD risk was calculated using the 2019 WHO CVD Risk Chart Working Group non-laboratory-based equations. BP medication indications were based on the WHO Package of Essential Noncommunicable Disease Interventions guideline...

Analysis of attained height and diabetes among 554,122 adults across 25 low- and middle-income countries

Objective: The prevalence of type 2 diabetes is rising rapidly in low-income and middle-income co... more Objective: The prevalence of type 2 diabetes is rising rapidly in low-income and middle-income countries (LMICs), but the factors driving this rapid increase are not well understood. Adult height, in particular shorter height, has been suggested to contribute to the pathophysiology and epidemiology of diabetes, and may inform how adverse environmental conditions in early life affect diabetes risk. We therefore systematically analyzed the association of adult height and diabetes across LMICs, where such conditions are prominent. Research Design and Methods: We pooled individual-level data from nationally representative surveys in LMICs that included anthropometric measurements and diabetes biomarkers. We calculated odds ratios (ORs) for the relationship between attained adult height and diabetes using multilevel mixed-effects logistic regression models. We estimated ORs for the pooled sample, major world regions, and individual countries, in addition to stratifying all analyses by se...

Diabetes Prevalence and Its Relationship With Education, Wealth, and BMI in 29 Low- and Middle-Income Countries

Diabetes Care, 2020

OBJECTIVEDiabetes is a rapidly growing health problem in low- and middle-income countries (LMICs)... more OBJECTIVEDiabetes is a rapidly growing health problem in low- and middle-income countries (LMICs), but empirical data on its prevalence and relationship to socioeconomic status are scarce. We estimated diabetes prevalence and the subset with undiagnosed diabetes in 29 LMICs and evaluated the relationship of education, household wealth, and BMI with diabetes risk.RESEARCH DESIGN AND METHODSWe pooled individual-level data from 29 nationally representative surveys conducted between 2008 and 2016, totaling 588,574 participants aged ≥25 years. Diabetes prevalence and the subset with undiagnosed diabetes was calculated overall and by country, World Bank income group (WBIG), and geographic region. Multivariable Poisson regression models were used to estimate relative risk (RR).RESULTSOverall, prevalence of diabetes in 29 LMICs was 7.5% (95% CI 7.1–8.0) and of undiagnosed diabetes 4.9% (4.6–5.3). Diabetes prevalence increased with increasing WBIG: countries with low-income economies (LICs) ...

Intersectoral collaboration for people-centred mental health care in Timor-Leste: a mixed-methods study using qualitative and social network analysis

International Journal of Mental Health Systems, 2019

Background Intersectoral collaboration is fundamental to the provision of people-centred mental h... more Background Intersectoral collaboration is fundamental to the provision of people-centred mental health care, yet there is a dearth of research about how this strategy operates within mental health systems in low- and middle-income countries. This is problematic given the known attitudinal, structural and resource barriers to intersectoral collaboration in high-income country mental health systems. This study was conducted to investigate intersectoral collaboration for people-centred mental health care in Timor-Leste, a South-East Asian country in the process of strengthening its mental health system. Methods This study employed a mixed-methods convergent design. Qualitative data elicited from in-depth interviews with 85 key stakeholders and document review were complemented with quantitative social network analysis to assess understandings of, the strength and structure of intersectoral collaboration in the Timorese mental health system. Results There was consensus among stakeholder...

Are people-centred mental health services acceptable and feasible in Timor-Leste? A qualitative study

Health Policy and Planning, 2019

People-centred mental healthcare is an influential concept for health system strengthening and su... more People-centred mental healthcare is an influential concept for health system strengthening and sustainable development that has been developed and promoted primarily in Western contexts. It characterizes service users, families and communities as active participants in health system development. However, we have limited understanding of how well people-centred mental healthcare aligns with the multiplicity of peoples, cultures, languages and contexts in low- and middle-income countries (LMICs). Timor-Leste, a lower-middle income country in South-East Asia, is in the process of strengthening its National Mental Health Strategy 2018–22 to align with people-centred mental healthcare. To support the implementation of this Strategy, this study investigated the acceptability and feasibility of people-centred mental health services in Timor-Leste. In-depth semi-structured individual (n = 57) and group interviews (n = 15 groups) were conducted with 85 adults (≥18 years). Participants were s...

Service user and family participation in mental health policy making in Timor-Leste: a qualitative study with multiple stakeholders

Introduction Participation in mental health system strengthening by people with mental health pro... more Introduction Participation in mental health system strengthening by people with mental health problems and their families is a cornerstone of people-centred mental health care, yet there is a dearth of research about participation from low- and middle-income countries (LMICs), particularly from the Asia Pacific region. Hence, this study aimed to assess the current situation, challenges, enabling factors and future actions for service user and family participation in mental health policy making in Timor-Leste. Methods In-depth interviews were conducted with 85 adults (≥18 years) who were: (1) mental health service users (n = 20) and their families (n = 10); (2) government decision makers (n = 10); (3) mental health and social service providers (n = 23); (4) civil society (n = 9); and (5) other groups (n = 13). Interview data was analysed using framework analysis. Results There was limited service user, family and community participation in mental health policy making in Timor-Leste. ...

The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1·1 million adults

The Lancet, 2019

Social inclusion and exclusion of people with mental illness in Timor-Leste: a qualitative investigation with multiple stakeholders

BMC Public Health, 2019

Health system performance for people with diabetes in 28 low- and middle-income countries: A cross-sectional study of nationally representative surveys

PLOS Medicine, 2019

Consumption of Fruits and Vegetables Among Individuals 15 Years and Older in 28 Low- and Middle-Income Countries

The Journal of Nutrition, 2019

Background The WHO recommends 400 g/d of fruits and vegetables (the equivalent of ∼5 servings/d) ... more Background The WHO recommends 400 g/d of fruits and vegetables (the equivalent of ∼5 servings/d) for the prevention of noncommunicable diseases (NCDs). However, there is limited evidence regarding individual-level correlates of meeting these recommendations in low- and middle-income countries (LMICs). In order to target policies and interventions aimed at improving intake, global monitoring of fruit and vegetable consumption by socio-demographic subpopulations is required. Objectives The aims of this study were to 1) assess the proportion of individuals meeting the WHO recommendation and 2) evaluate socio-demographic predictors (age, sex, and educational attainment) of meeting the WHO recommendation. Methods Data were collected from 193,606 individuals aged ≥15 y in 28 LMICs between 2005 and 2016. The prevalence of meeting the WHO recommendation took into account the complex survey designs, and countries were weighted according to their World Bank population estimates in 2015. Poiss...

Understanding HRH recruitment in post-conflict settings: an analysis of central-level policies and processes in Timor-Leste (1999–2018)

Human Resources for Health, 2018

Determinants of health care utilisation: the case of Timor-Leste

International health, Jan 11, 2018

Health financing and delivery reforms designed to achieve universal health coverage (UHC) need to... more Health financing and delivery reforms designed to achieve universal health coverage (UHC) need to be informed by an understanding of factors that both promote access to health care and undermine it. This study examines the level of health care utilisation in Timor-Leste and the factors that drive it. Data from a nationally representative cross-sectional survey of health care utilisation in 1712 households were used to develop multilevel models exploring how need and predisposing and enabling factors explain health care utilisation at both primary and secondary care facilities. Need was found to be the key driver in seeking both primary care and hospital services. Rural households were less likely to go to hospital (odds ratio 0.7) than urban households. The poorest quintile was also less likely to use more expensive hospital services than other socio-economic groups. Understanding the determinants of seeking health care in Timor-Leste is of considerable policy significance, because ...

“I go I die, I stay I die, better to stay and die in my house”: understanding the barriers to accessing health care in Timor-Leste

BMC Health Services Research, 2016

State-building and human resources for health in fragile and conflict-affected states: exploring the linkages

Human resources for health, Jan 15, 2015

Human resources for health are self-evidently critical to running a health service and system. Th... more Human resources for health are self-evidently critical to running a health service and system. There is, however, a wider set of social issues which is more rarely considered. One area which is hinted at in literature, particularly on fragile and conflict-affected states, but rarely examined in detail, is the contribution which health staff may or do play in relation to the wider state-building processes. This article aims to explore that relationship, developing a conceptual framework to understand what linkages might exist and looking for empirical evidence in the literature to support, refute or adapt those linkages. An open call for contributions to the article was launched through an online community. The group then developed a conceptual framework and explored a variety of literatures (political, economic, historical, public administration, conflict and health-related) to find theoretical and empirical evidence related to the linkages outlined in the framework. Three country c...