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1、WHO Timor?LesteCountry Cooperation Strategy2021?2025ISBN:9789290210047Country Cooperation Strategy Timor-Leste|20212025 World Health Organization 2022Some rights reserved.This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence(CC BY-NC-SA 3.0 IGO;https:
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12、 Strategy2021?2025ContentsExecutive summary1.Introduction2.Health and development situation48424697483.WHOTimor-Leste collaboration:progress during past five years4.Setting the strategic agenda5.Implementing the CCS strategic agenda6.Monitoring and evaluationReferencesAnnexes2.1 Political
13、,economic,demographic and social context2.2 Overall health status of the population2.3 Health system and progress towards universal health coverage2.4 Health sector response to SDG priorities2.5 Reducing vulnerability to climate change:preventing,preparing for,and responding to health emergencies2.6
14、 Beyond the health sector4.1 Prioritization process4.2.Strategic priorities and focus areas?5.2 Harnessing the strengths of all health partners5.3 Collaborating with the UN system and the Global Action Plan for Healthy Lives and Well-being for All6.1 Monitoring of CCS implementation6.2 CCS evaluatio
15、nAnnex 1:Mapping of CCS priorities?Annex 3:Key interventions in HNAP to control and reduce air pollution.606263767878596768687276Timor-Leste-WHOCountry Cooperation Strategy 2021?2025iAcronyms and abbreviationsAMR Antimicrobial ResistanceCHC Community Health CentreDHS Demographic and Health Survey?GP
16、W General Programme of Work?HEOC Health Emergency Operation CentreHNAP Health National Adaptation PlanHP Health Post?JEE Joint External ExaminationMMR Maternal Mortality RatioNAPHS National Action Plan for Health SecurityNCD Noncommunicable DiseaseNHSSP National Health Sector Strategic PlanNTDs Negl
17、ected Tropical DiseasesPHC Primary Health CareRMNCAH Reproductive,Maternal,Newborn,Child and Adolescent Health?STEPS STEPwise Approach to Noncommunicable Disease Risk Factor SurveillanceTAPS Tobacco Advertising,Promotion and SponsorshipTFR Total Fertility RateUHC Universal Health CoverageUNSDCF Unit
18、ed Nations Sustainable Development Cooperation FrameworkWSP Water Safety PlanTimor-Leste-WHOCountry Cooperation Strategy 2021?2025iiWHO Regional Director forSouth-East AsiaIt is my pleasure to introduce this fourth Country Cooperation Strategy(CCS)20212025 for the Democratic Republic of Timor-Leste.
19、This document will form the basis for WHO?s collaborative work with the government of Timor-Leste and other United Nations agencies and development partners to achieve theUN Sustainable Development Goals(SDGs)andWHO?s thirteenth General Programme of Work.In doing so,this CCS aims to anticipate and a
20、ddress Timor-Leste?s future health needs as defined in the country?s National Health Sector Strategic Plan 20112030.Timor-Leste has in recent years made commendable progress on strengthening health systems and improving health status and outcomes,achieving several health-related Millennium Developme
21、nt Goals.Timor-Leste has significantly increased immunization coverage and eliminated several infectious diseases,such as polio,measles,and maternal and neonatal tetanus.High-level political commitment has been critical to the country?s achievements,andwill be especially important in tackling noncom
22、municable diseases,addressing communicablediseases such as TB,and mitigating risks associated with disasters,environmental threats,and health emergencies.This new CCS is designed to provide Timor-Leste needs-based technical support over the next five years,with a focus on health system strengthening
23、 to achieve the SDGs.It was developed in close consultation with the Ministry of Health,as well as with nongovernmental organizations,civil society,United Nations agencies and other development partners.I thank all stakeholders for their contributions.As a trusted partner of the Democratic Republic
24、of Timor-Leste,WHO Country and Regional?ces will continue to provide its full support to the Ministry of Health in its e?orts to improve health and well-being and achieve Health for All.MessageiiiTimor-Leste-WHOCountry Cooperation Strategy 2021?2025iiiH.E.Minister of Health,Democratic Republic of Ti
25、mor-Leste?Health and other stakeholders and development partners,which included Bilateral Agencies,?donors.WHO has been providing technical assistance to the Government of Democratic Republic of?Timor-Leste has made remarkable progress in strengthening its health system and improving the health stat
26、us of the population.Overall life expectancy has increased.Timor-Leste has successfully achieved the MDG4 target by reducing infant and under 5 mortality and substantial progress being made in improving maternal and child health outcomes including increased immunization coverage,eradication and elim
27、ination of infectious diseases like polio,measles,maternal and neonatal tetanus.Support provided by WHO has been very helpful to attain these precious gains.We are thankful to WHO.Despite a number of achievements,the country has been facing challenges like increasing noncommunicable diseases,high bu
28、rden of communicable diseases especially TB,increased risks associated with disasters,environmental threats and health emergencies during diseases?June,accompanied by the worst flooding crisis in many decades,has severely disrupted Essen-tial Health Services in Timor-Leste.The government,with suppor
29、t from WHO,has successfully?Strong political commitment exists to implement the SDG Agenda and great emphasis has been?2030.The Ministry of Health appreciates the identification of the four strategic priorities?Country Cooperation Strategy 2021?2025.These are very much in alignment with the National
30、MessageTimor-Leste-WHOCountry Cooperation Strategy 2021?2025iv?Health Sector Strategic Plan(20112030)of Timor-Leste.This comprehensive strategic?further strengthened.Timor-Leste-WHOCountry Cooperation Strategy 2021?2025vWHO RepresentativeThe World Health Organization has been working closely with th
31、e Government of the?for Timor-Leste is the fourth strategic continued collaboration that describes the medium-term strategic vision and guides its work in Timor-Leste.This CCS has been developed based on lessons learned and experiences includingbest practicesand partnership experiences from the prev
32、ious CCS.An extensive consultative,iterative and interactive process has been followed that included in-depth interviews,group discussions,?agencies and development partners,non-governmental organizations,academic institutions,professional bodies and civil society organizations.The underlying princi
33、ples of the CCS development process included ownership,alignment with the national priorities,harmonization?advantages and expertise.?people from Health Emergencies including disease outbreaks and disasters through strengthened?Supporting health systems by strong and sustainable leadership and gover
34、nance at every level towards the vision of“Healthy East Timorese People in a Healthy Timor-Leste”.These strategic priorities are inextricably linked and aligned with the National Health Sector?The CCS will serve as an instrument to navigate and foster multisectoral engagement and integrated approach
35、es to achieve the health-related SDGs.ForewordTimor-Leste-WHOCountry Cooperation Strategy 2021?2025vi?Timor-Leste-WHOCountry Cooperation Strategy 20212025viiTimor-Leste-WHOCountry Cooperation Strategy 2021-2025viiiExecutive summary?its health system and improving the health status of its population.
36、This has resulted in an increased life expectancy,and the achievement of Millennium Development Goals such as a reduction in infant and under-five mortality,an improvement in maternal and child health outcomes,and an increase in immunization coverage.Further,the country has successfully eliminated i
37、nfectious diseases such as polio,measles,and maternal and neonatal tetanus.There is full political commitment?streamlined the procurement and supply of medicines,consumables,personal protective?and tertiary health care,to better respond to future pandemics and other disaster situations.Despite this
38、substantial progress,Timor-Leste faces new challenges,such as the increasing?risks associated with disasters,environmental threats,and emergence and re-emergence of?by disrupting the maintenance of essential health services and negatively impactingsocioeconomic outcomes.?distribution and supply of l
39、ogistics and medicines.The Government of Timor-Leste has been?to the provision of UHC for all Timorese,free at the point of delivery.?health goals,the goals of the WHO regional flagship programmes,and the global goals and?billion targets of the Thirteenth General Programme of Work?as relevant to and
40、 agreed upon by the government of Timor-Leste.The CCS complements?of the fact that improving the health and well-being of the Timorese population is the joint responsibility of the government,WHO and development partners,the CCS will be monitored and evaluated jointly with the government and the dev
41、elopment partners.Timor-Leste-WHOCountry Cooperation Strategy 2021?20251Strategic Priority 1:Strategic Priority 2:Strategic Priority 4:Strategic Priority 3:Country Cooperation Strategy 2021?2025?Timor-Leste-WHOCountry Cooperation Strategy 2021?20252Fig.1.Country Cooperation Strategy 2021?2025Chapter
42、 IIntroductionCountry Cooperation Strategy 2021?2025?of the Democratic Republic of Timor-Leste for the development and strengthening of the?became a Member State of the South-East Asia Region.The Country Cooperation Strategy?with the government and partners.The strategic priorities of the CCS are de
43、signed to provide need-based technical support to the government for the next five years to strengthen the health system with an eye to achieving the SDGs.This CCS has been developed on the basis of the lessons learnt and experiences gained during the previous CCSs,as well as extensive consultations
44、 and policy dialogues with the government?following objectives were kept in mind during the formulation of the CCS:?to achieve the desired results.Policy dialogue and strategic support will be the mode of delivery to support the major transformations envisaged in the health system,while technical?ca
45、pacity.Service delivery will be used as a modality in times of emergency or to provide critical services as provider of last resort.To set in motion a process to transform the health system and promote country ownership?To encourage the development of partnerships involving multiple health and devel
46、opment?Timor-Leste-WHOCountry Cooperation Strategy 2021?20255?for the implementation,monitoring and evaluation of the CCS,technical assistance will be?of global goods to the Timor-Leste context,implement the Regional Flagship Programmes1,support intercountry collaboration and share learning.A mid-te
47、rm review of the CCS will be conducted in the year 2023 and a final evaluation by the end of 2025.Source?Driving public health impact in every country?PolicydialogueMature health systemFragile health systemTo developsystems ofthe futureTo build highperformingsystemsTo buildnationalinstitutionsTo fil
48、l criticalgaps inemergenciesStrategicsupportTechnicalassistanceServicedeliveryStepping up leadershipDiplomacy and?multisectoral?Focusing globalpublic goodson impactNormativeguidance and?data,researchand innovationTimor-Leste-WHOCountry Cooperation Strategy 2021?20256Happy children in Manufahi munici
49、palityChapter IIHealth and Development SituationCountry Cooperation Strategy 2021?2025Timor-Leste-WHOCountry Cooperation Strategy 2021?202592.1 Political,economic,demographic and social context2.1.1 Political2.1.2 Economic2.1.3 DemographicTimor-Leste,a small country located in the island of Timor,be
50、came an independent state in?unitary,semi-presidential,representative democratic republic.The Prime Minister is the head of government,while the President exercises the functions of head of state.East Timor has a multiparty system.Legislative power is vested both in the government and the National P
51、arliament.Usually,the Prime Minister is the leader of the political party that forms a majority or majority coalition in the unicameral national parliament.There are 13 ministries,including the Ministry?developmental sectors,including the achievement of the health Millennium Development Goals.Howeve
52、r,in recent years,Timor-Leste has faced a series of political crises,leading to the?Timor-Leste aspires to become an upper middle-income country by 2030 and has developed its?dependent on the petroleum sector,oil and gas revenues being the main sources of governmentrevenue.The percentage of the popu
53、lation living below the national poverty line fell from 50.4in 2007 to 41.8 in 20142.Overall,the economic situation has worsened,with a decline in the?3?forecasted that the petroleum sector is likely to grow smaller in the coming years,causing asharp contraction of the GDP and a rise in inflation.Th
54、e key challenges facing Timor-Leste arethe diversification of economic activity from the public to the private sector,and from petroleumto other sectors.Most of the countrys population lives in rural areas and is heavily reliant onsubsistencagriculture,with very limited access to markets.According t
55、o the 2015 Census,Timor-Leste had a population of 1,179,654.The population was relatively young,the median age being 19.6 years,and the annual population growth rate was?,a large cohort of young population will enter the reproductive age group in the coming decades.This young population will place a
56、 burden on?the future.Timor-Leste-WHOCountry Cooperation Strategy 2021?2025102.1.4 SocialTimor-Leste ranked 131st?6.The attendance rate for primary school?Report 2017,published by the World Economic Forum,ranked Timor-Leste at 128 among 144?However,the prevalence of violence against women is alarmin
57、g.As per the findings of the?physically abused by their male partners,reports experiencing severe violence.As per DHS?Experiences Study7.Fig.3.Population pyr?r-Le?te,2015Age group?year?70+65-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-145-90-4Males51%of the populationFemales49%of the popu
58、lationPercentage of total populationSource:Timor-Leste Population and Housing Census,2015Timor-Leste-WHOCountry Cooperation Strategy 2021?2025112.2 Overall health status of the population?Source:World Health Statistics,WHO,2018The Global Burden of Disease Study 2017 explored the causes of
59、 death in Timor-Leste and the?trends,the country will face a double disease burden by 2040:NCDs will be the major cause of?neonatal illnesses will still be among the top 10 causes?.Further,the study revealed that compared to 2007,poor diet,high blood pressure,high blood glucose,tobacco use,and high
60、cholesterol were increasingly becoming disease risk factors in the country10.While there was an?period,they remained in the list of top 10 disease risk factors.Malnutrition,which has been?would continue.?life expectancy,a good summary measure of the overall health of the population,improved by?.1005
61、95269592000Life expectancy at birth?Health life expectancy200720152016500Timor-Leste-WHOCountry Cooperation Strategy 2021?2025122.3 Health system and progress towards universal health coverageThe Constitution of Timor-Leste protects the right to health,medical care and a healthy environment.aUnder A
62、rticle 57,the State has the responsibility of providing free universal health care through a decentralized public health-care system.Since 2002,successive governments have been?provider and care is free of charge.?presents a vision for a“Healthy East Timorese People in a Healthy Timor-Leste”11.The G
63、overnment has just initiated work to adapt the NHSSP to better respond to the current?comprehensive set of reforms,was launched in July 2021.These relate to a new health financing strategy,human resources for the health strategy,and an essential package of primary care services.a The Constitution of
64、 Timor-Leste,entered into force on 20 May 2002A doctor conducting medical check up during house-to-house visit as part of Saude Na Familia programme Timor-Leste-WHOCountry Cooperation Strategy 2021?202513?Health care is financed predominantly from public sources.According to the National Health?12.W
65、hile external funding from development partners has played a very important role since the country regained independence,its importance has?total health spending12.While domestic general government health expenditure was seen to be increasing over the five years,it declined as a proportion of genera
66、l government expenditure,?13.?interventions to accelerate progress towards UHC14.These include introducing public financial?performance-based allocation of resources to municipalities.?Year?2000%806040200Development Partners(DP)Voluntary Health Insurance(VHI)Households out-of-p
67、ocket expenditures(OOP)Domestic General Govt.Health Expenditure(GGHE-D),reccurent)Timor-Leste-WHOCountry Cooperation Strategy 2021?202514?protection.The coverage of essential health services is defined as the average coverage of essential services based on tracer interventions that include reproduct
68、ive,maternal,newborn?and most disadvantaged population.Fig.6,based on the composite UHC index using 16 indicators,shows that the estimated essential health services coverage has more than doubled since 200015.Health services in Timor-Leste are organized at four levels of care:outreach services,healt
69、h posts,community health centres at the municipal and submunicipal levels,and referral hospitals at the regional and national levels.Private sector involvement in the health system is low,with only 52?and?12.?40506020002005201020152020A nurse providing counselling to a mother of newborn b
70、aby Timor-Leste-WHOCountry Cooperation Strategy 2021?202515Primary health careb SISCa aims at delivering population-based interventions in the community.The interventions include promotion of health,mass drug administration for neglected tropical diseases and immunizations,health registration,and fo
71、llow-up of children,pregnant women and people with chronic conditions.c?domiciliary visits.Recording the overall households and individuals health status and clinical information are a part of these visits,as are clinical consultations,follow-up,long-term care,and referrals by a multidisciplinary te
72、am of health professionals.d?in schools,including general hygiene and health education,oral and eye check-ups,monitoring of weight and growth,provision of vitamin A and coordination of immunization.?level are the HPs,which cover a population of between 1500 and 2000 in rural areas and around 5000 in
73、 urban settings.Community ambulatory health services are provided by the CHCs to a population of between 7500 and 12,000 in rural areas and around 15,000 in urban settings.The three main?b?c and the school-based health programme.d?Secondary and tertiary care?and Oecusse.They have been providing a co
74、mmon set of services,including internal medicine,paediatrics,surgery,obstetrics and gynaecology,emergency care and ambulatory outpatient care.The referral hospitals have around 500 beds.Half of these are distributed among the five district?National Referral Hospital Guido?National DiagnosticsService
75、?Timor-Leste-WHOCountry Cooperation Strategy 2021?202516Quality?16.As part of the comprehensive set of health system?households,it is more than a two-hour walk to the nearest primary health facility17.A 2016 study18on the barriers to access to health services found that a lack of transport facilitie
76、s for patients was a?the hospital.Sometimes they had to resort to having patients carried by porters or on horseback.?accessible and acceptable substitute for hospital care.Poverty,the lack of education,opportunity?levels of utilization of health-care services,especially among vulnerable groups.A 20
77、14 World Bank report revealed that despite the fact that care is free,wealthier patients access hospital care at nearly twice the rate at which poorer patients do19.This is backed by the?ePeople with?physical access,and because health workers lack the basic knowledge and skills to assist them.Servic
78、es for persons with mental disabilities are extremely limited20.?outpatient and emergency services covering all major medical and surgical specialties.Specialist services are largely unavailable in Timor-Leste,mainly due to the lack of trained specialists and?for the transfer of patients for special
79、ist tertiary care.e?Timor-Leste-WHOCountry Cooperation Strategy 2021-20258Timor-Leste-WHOCountry Cooperation Strategy 2021?202518?Timor-Leste has been doing well in terms of the overall workforce numbers,with the density of?21.Source?institutions produce more than 800 new health professionals a year
80、.The health workforce includes health professionals such as doctors,nurses,midwives and allied health professionals,including laboratory technicians,pharmacy technicians,physiotherapists and nutritionists.?summary of the workforce in the public health sector22.Though the country has been successful
81、in increasing the number of health workers,serious concerns have arisen about the health workforce in terms of skill mix,productivity,and even future?One third of the human resources for health are working in the municipality of Dili,though the area?workforce.?Global StrategyOn HRH 2016?World Health
82、Report 200601011.0152017Medical Specialist35889648624General DoctorAllied Health Professional*MidwifeNurseNurse?s Aid?otal491112.112.712.721.222.025.02030405060Health workers(doctors,nurses,and midwives)DoctorsNurses and MidwivesCadr?roupAv?o.Timor-Leste-WHOCountry C
83、ooperation Strategy 2021?202519?strategic documents provide guidelines and orientation on the continuous enhancement of health?commitment and investments have not been secured.?Target 3.8 of the SDGs underscores the importance of access to essential medicines and vaccines for all as part of attainin
84、g UHC.The government has established the Servio Autnomo?Refresher training on Timor-Leste Health Information System for HMIS,EPI and MCH Focal Points Timor-Leste-WHOCountry Cooperation Strategy 2021?202520?was developed in 2010 and updated in 2017.?infrastructure,death of trained personnel,lack of m
85、onitoring,and fragmentation of the?Directorate of Pharmacy and Medicines is responsible for some regulatory functions.With the increasing number of pharmaceutical importers and drug outlets,as well as the ongoing?13.WHO has estimated the?23.H.E Minister of Health,H.E Vice Minister of Health and WHO
86、Representative along with SAMES Executive Directorand team visited SAMES warehouseTimor-Leste-WHOCountry Cooperation Strategy 2021?202521?2.4 Health sector response to SDG priorities?infrastructure,death of trained personnel,lack of monitoring,and fragmentation of the?Directorate of Pharmacy and Med
87、icines is responsible for some regulatory functions.With the increasing number of pharmaceutical importers and drug outlets,as well as the ongoing?13.WHO has estimated the?23.The access to modern family planning methods,decreasing desire for very large families,and?fThis is one of the fastest declin
88、es in the world,but it is still 2.7 births higher than the global average and almost three times higher than the Asia-Pacific average of 2.1.Moreover,there are regional variations in the TFR across the country.The unmet need for contraceptiong was?.While the birth rates are traditionally the highest
89、 among rural adolescent girls,they seem to be increasing among urban girls.f Fertility rates differ,depending on the source consulted.For example,the TFR based on the 2015 Census is 4.5,while that based on?g The unmet need is the percentage of women of the age of 15-49 years who want to stop or dela
90、y childbearing,but are not using any method of contraception.A midwife in Community Health Center providing counselling to a mother of newborn babyTimor-Leste-WHOCountry Cooperation Strategy 2021?202522?24.?2030.Good progress has been made in the number of institutional deliveries and deliveries ass
91、isted by skilled birth attendants,according to successive DHSs.However,the 2016 DHS revealed that?3019Neonatal mortality?Under-5 mortality807060504030201002003 DHS2016 DHS2009-10 DHSTimor-Leste-WHOCountry Cooperation Strategy 2021?202523?campaigns.As a result,the vaccination coverage for
92、children under one year of age has reached?been free of locally transmitted measles for three years,Timor-Leste was verified as having eliminated endemic measles and controlled rubella and congenital rubella syndrome.?established.A twinning agreement between Timor-Leste and Sri Lanka on the strength
93、ening of?in the country.However,to sustain the progress,technical support from WHO and the United?On the basis of the Maternal Death Surveillance and Response Annual Report for 2017,the?h reflecting a lack of?three DHSs,the mortality rates of both infants and under five-year-olds have steadily decre
94、ased,by about half,since 2003.Neonatal mortality,on the other hand,declined by one?The country has been able to significantly reduce the under-five and neonatal mortality rates compared to the 1990 baseline.Preterm birth complications are the foremost cause of?Undernutrition is an important underlyi
95、ng cause of child mortality.Timorese children have the?of Breastmilk Substitutes.h?Timor-Leste-WHOCountry Cooperation Strategy 2021?202524?stagnated at approximately 500 new cases per 100 000 population per year26.The barriers to the reduction of the TB burden include lackings in case-finding,diagno
96、sis and treatment,as well as?-?Table 2:TB burden,2018TB burdenTotal TB incidence?Number(thousand)Rate(per 100 000 population)Source:?Midwives demonstrating the importance of vaccine to the mothers at Community Health CenterTimor-Leste-WHOCountry Cooperation Strategy TB event:signing pledg
97、e?Actions for Ending TB by 2025 at the same event.?the second highest incidence rate in the WHO South East Asia Region and one of the highest in the world To combat the scourge of TB in Timor?Leste,the National Strategic Plan for Ending TB was developed with support from WHO The National Plan for Ac
98、celerated Actions,launched by the Prime Minister,is in line with the National Strategic Plan and aims to close gaps in prevention and care.?developed with technical support from WHO This application is a part of a broader vision and innovation in transitioning?Fund Grant.Timor-Leste-WHOCountry Coope
99、ration Strategy ?plan to continue the outreach activity to screen individuals and households.We are continuing with?Sr Constantino Lopes?TB,Timor-Leste?ted to extending the most scientific and actionable technical assistance and partner with all stakeholders in supporting the Ministry of
100、Health and people of Timor-Leste in realizing their vision?Dr Arvind Mathur?Timor-Leste?disabling and sometimes fatal disease,is not only an objective defined in the National Health Plan or in the?constitutional duty undertaken towards our citizens,who wish to see the right to a?H.E.Taur Matan Ruak?
101、Timor-Leste-WHOCountry Cooperation Strategy 2021?202527?reported was 840 in 2018.Between 2011 and 2017,the average number of new cases per year?27.?sex workers and men who have sex with men and transgender men considered to be thepopulations most at risk28?29.A new strategy for?among the general pop
102、ulation and key populations.?30.With the aim of reducing the incidence of?in order to achieve its goals.H.E Vice Minister of Health,WHO Representative together with Ministry of Health team,and civil society representativesreleasing advocacy poster during Hepatitis advocacyTimor-Leste-WHOCountry Coop
103、eration Strategy 2021?202528?Among the goals set by the country is the elimination of lymphatic filariasis by 2024 and of yaws by 2023,in addition to the control of soil-transmitted helminths.The MoH successfully conducted round 1 of the mass drug administration against lymphatic filariasis and soil
104、-transmitted?Early intervention and raising awareness among the community are the other priorities.Although the government has been successful in eliminating leprosy through the use of multidrugtherapy throughout the country,it remains endemic in a few municipalities,including Dili.Laboratory techni
105、cian taking the student blood sample to check for microflariaeWHOs staf conducting physical exam to LF patient in the feldDoor-to-door patient visit for morbidity managementand disability prevention to lymphatic flariasis Contented children together with WHO and Ministry of Health teams during Trans
106、mission Assessment Survey(TAS)Timor-Leste-WHOCountry Cooperation Strategy 2021?202529?31,though the precise rate is not?occured outside the hospital.A WHO STEPs survey on NCD surveillance,undertaken in 2014,found a high prevalence of risk factors32?three or more risk factors,including smoking,an unh
107、ealthy diet,overweight and high blood?the types of risk factors,particularly smoking,alcohol consumption and dietary habits,including the?Table 3:Key risk factors for NCDs among adults(1869 years)in Timor-Leste,2014Source?Key risk factors?70.6Men(%)Combined(%)Women(%)56,128.9With raised blood pressu
108、re or on medication for hypertension45.339.328.0With raised fasting blood glucose or on medication for diabetes1.51.6Ate 80TBD?NHSSP,GPW 13,UNSDCF,Regional Flagships,SDGsNHSSP,GPW 13,UNSDCF,Regional Flagships,SDGsNHSSP,GPW 13,UNSDCF,Regional Flagships,SDGsNHSSP,GPW 13,UNSDCF,Regional Flagships,SDGs?
109、Indicator?This CCS will be contributing to priority health national indicators.Table 5 shows how the indicators are aligned to the GPW 13 result framework,SDGs,UNSDCF and NHSSP.?Tuberculosis incidence per 1 000 persons per year?Communicable diseasesMaternal health498TB programme,MoH?249100?,GPW 13,U
110、NSDCF,Regional Flagships,SDGs?,GPW 13,UNSDCF,Regional Flagships,SDGsTimor-Leste-WHOCountry Cooperation Strategy 2021?202555Proportion of births attended by skilled health personnelUnder-5 mortality rateMaternal healthChild health?NHSSP,GPW 13,UNSDCF,Regional Flagships,SDGsNHSSP,GPW 13,UNSDCF,Regiona
111、l Flagships,SDGsNeonatal mortality rateMortality due to cardiovascular diseases,cancer,diabetes or chronic respiratory disease?deviation from the median of the WHO Child Growth?Child healthNoncommunicable diseases?80?TBDTBDReduction by half?,GPW 13,UNSDCF,Regional Flagships,SDGsUNSDCF?,GPW 13,UNSDCF
112、,SDGs?,GPW 13,UNSDCF,SDGs?Emergency preparedness and responseEmergency preparedness and response?vwww.ghsindex.org80TBDGPW 13?,GPW 13,UNSDCF,Regional Flagships,SDGsTimor-Leste-WHOCountry Cooperation Strategy 2021?202557Tobacco and Alcohol Control Council as per Article 24 decree Law?Governance?-Toba
113、cco and Alcohol Control Council establishedNHSSP,GPW 13WHO STEPS survey of NCDs?GovernanceNCDSTEPS survey conductedCode for Breastmilk Substitutes implemented?GPW 13,UNSDCF SDGs,Regional Flagships-WHO STEPS survey 2014Updation of National Multisectoral AMR Action PlanDevelopment and implementation o
114、f national digital health strategy?of Timor-LesteGovernance?Environmental healthHuman resources?and National e-Health?AMR Action Plan updated and implementedNational digitalhealth strategy?developed and implementedStrategic Plan for National?University of Timor-Leste developed and implemented?GPW13,
115、Regional Flagships?,GPW 13,UNSDCF,SDGs?GPW 13-a?b?to political,socioeconomic,and environmental risks that can confound outbreak preparedness and response in the light of adherence to international norms.?Implementing the CCS StrategicAgendaCountry Cooperation Strategy 2021?2025Timor-Leste-WHOCountry
116、 Cooperation Strategy 2021?202560?1.2.3.4.?Timor-Leste.The“way of working”adopted will depend on the need,national capacity and partnership environment in relation to each strategic priority and focus area.Emphasis will be laid on the development of leadership,advocacy,policy dialogue and the streng
117、thening of national institutions to enhance the impact.?include the following.Strategic policy dialogue?support the government with evidence and policy options and examples of best practice from across the globe that are relevant to the national context,for example,emphasis would be laid on a multis
118、ectoral approach for the prevention of NCDs,nutrition and AMR containment.St?cooperation with the MoH and other ministries,the UN system,the development partners?development partners,and help mobilize resources for health and develop sound national strategies on health sytems.?the?of health programm
119、es and services,for example,the strengthening of PHC and implementation of essential services package.Service delivery?and critical shor ages of supplies.?Provide healthleadership anddeveloppartnershipsGenerate,translate anddisseminateknowledgethrough researchSet normsandstandardsProvidetechnical su
120、pportArticulateethical andevidencebased policyoptionsMonitor healthsituation andassess healthtrendsTimor-Leste-WHOCountry Cooperation Strategy 2021?202561To achieve a sustainable impact,a longer-term technical assistance plan,with a follow-up?missions would be planned to build national capacity to a
121、ccelerate the unfinished tasks in?enhancement of technical capacity.?sector,more joint programming would be undertaken,involving the development partners,professional groups,NGOs and civil society organizations.A comprehensive plan would be developed in line with the WHO Framework of Engagement with
122、 Non-State Actors to involve professional bodies,civil society organizations and NGOs.Research and the dissemination of knowledge would be one of the priority focuses during the CCS period.To build research capacity and increase knowledge sharing,stronger networks would be developed with academic in
123、stitutions and WHO collaborating centres.Based on the lessons from the last CCS period,more emphasis would be laid on resource mobilization.Coordination with current donors would be strengthened and new funding opportunities would be explored.A comprehensive resource mobilization plan specific to th
124、e four strategic?public health.?priority areas such as human resources for health,PHC,RMNCH,food and nutrition,NCDs,?in All Policies”approaches.?d?and technical expertise that are needed to deliver support from each of the three levels of the?provide support for adapting the global tools to the regi
125、onal context,implementing theTimor-Leste-WHOCountry Cooperation Strategy 2021?202562?5.2 Harnessing the strengths of all health partnersThe development partners which are providing support to the health sector include multilateral?and the Global Fund.?cooperation for sharing experience,exchange of t
126、echnology and expertise within the Region and also to assist in mobilizing resources.Bilateral partnersDevelopment PartnersHealth Coordination GroupAustraliaEuropean Union?CubaPortugalThailandROKNew ZealandJapanChinaMultilateral partnersUN Women?UNFPAWFPUNDPWHOWorld BankADBGlobal FundsNGOs/CSOs/Othe
127、rsGlobal Health Institutions?Timor Leste Red CrossGlobal Health AllianceSaint John of God?Maluk TimorAlola FoundationNational Alliance for Tobacco ControlWater AidCRS RACS?CatalpaMarie StopesThe DPHCG is currently chaired by DFAT and co-chairedby WHO.It works closely with the MoH with thefollowing o
128、bjectives:To strengthen the health sector in line with?S?To align,collaborate and coordinate DPworkplans as per government policiesTo avoid duplication of resources and e?orts,?cyTo facilitate information sharing betweenpartners and the governmentTo ensure policy coherence across all healthprogramme
129、s supportedTo establish stronger links with relatedministries?departmentsMother embracing the baby childTimor-Leste-WHOCountry Cooperation Strategy 2021?202563k?It focuses on the country level and its aim is to leverage the strengths and capacities of each of the six member organizations?improve the
130、 survival,health and well-being of every woman,newborn,child and adolescent?agencies to improve collaboration so as to accelerate progress towards the health-related SDGs,with a focus on strengthening PHC.5.3 Collaborating with the UN System and the Global Action Plan for Healthy As a member of the
131、United Nations Country Team,WHO has been working very closely with all the UN agencies and has strong partnerships through which it can support the MoH.At the country level,the UNSDCF is the primary overarching instrument for coordinating andimplementing UN System activities in support of the Nation
132、al Priorities and the 2030 SDG Agenda.As the CCS elaborates the strategic health priorities for WHO,in line with the UNSDCF?and partnership among the UN agencies.To achieve a greater impact,emphasis will be laid on?k NCDs,AMR,food safety,health financing,essential medicine,water and sanitation,waste
133、 management and environmental health.To accelerate progress with respect to the health-related SDGs,the Global Action Plan for Healthy Lives and Well-being for All was launched at the UN General Assembly in September?the heads of the signatory agencies,as shown in Fig.17.Lives and Well-being for All
134、?Better engagement with countries?ENGAGEACCELERATEALIGNACCOUNTProgress in countries through joint action under specific programmatic?Progress in delivery of global public goodsSupporting countries by harmonizing their operational and financial strategiesReviewing progressLearning together to enhance
135、 shared accountabilitySupporting countries by harmonizing their policies and approachesTimor-Leste-WHOCountry Cooperation Strategy 2021?202565?Minister of Health,Timor-Leste?the centrality of the data is maintained without the need to create a spearate and new?challenges to circumvent.The vaccinatio
136、n target group was the entire adult population,and the task of maintaining dual dose vaccination records for every individual was daunting.Manual data entry raised challenges related to real time collection of vvaccination data,collation and centralization of data from 13 municipal divisions with 72
137、 CHCs,and merging data from hundreds of vaccination posts.T?operational?National Parliament President Aniceto Guterres Lopes,in the presence of HE Prime Minister Taur Matan Ruak on 7 April 2021,on the occasion of World Health Day.?following immunization,and can be used as a?of vaccine deployment.The
138、 tracker has made it possible to compile daily and cumulative vaccine coverage reports for review and monitoring by the Minister of Health,Director General of Health Services and other key?Dr.Arvind MathurWHO Country Representative,Timor-Leste?system in use globally,it is crucial that Timor-Leste sh
139、ould keep this up and find?How Timor-Leste employed digital innovation during the pandemicH.E Prime Minister,Taur Matan Ruak and H.E President of the National Parliament ofcially launchingthe Timor-Leste Health Information System COVID-19 Immunization Tracker?Monitoring and EvaluationCountry Coopera
140、tion Strategy 2021?2025Timor-Leste-WHOCountry Cooperation Strategy 20212025686.1.Monitoring of CCS implementationPurpose:ThepurposeofmonitoringtheimplementationoftheCCSwouldbeto:1)ensurethat thepriorityactivitiesunderthe CCSarebeingcarriedout?andinatimelymanner;and 2)receive early warning signals to
141、 identify problems/challenges related to the implementationof the strategic priorities.Process:TheperformanceoftheCCSwillbemonitoredregularlybytheJointMonitoringGroup,composed of st?members from the WHO Country?ce,Regional?ce and headquarters,UN country team,and members from the MoH and other partne
142、rs.The mechanisms ofcoordination to be used by WHO together with the MoH will consist of six reviews of monthly performance,and the annual review of the Biennial Work Plan will be strengthened.Factors thatmayhamperthesmoothimplementationoftheCCSpriorities,suchasthepoliticalscenario,natural disasters
143、,including disease outbreaks,and socioeconomic conditions,will be closely monitoredthroughout.TheprogressoftheCCSwillbesharedannuallyattheHealthDevelopmentPartnersGroup?smeetingsandtheannualreportwillbecirculatedamongallstakeholders.The main achievements,best practices and lessons learnt will be doc
144、umented at the end of each biennium.These periodical reviews will be used as major inputs for the mid-term and final evaluation of the CCS.6.2.CCS evaluationThe main purpose of the evaluation will be to measure whether the targets identified in the countryresultsframeworkhavebeenachieved,andtodeterm
145、inewhetherthe CCShascontributedto the achievement of the national targets and health-related indicators of the UNSDCF and SDGs.The evaluation process will be commissioned by the WHO Representative.A working groupfortheevaluationoftheCCSwillbeformed.Itwillbecomposedofst?fromtheCountry?ce,and st?rs fr
146、om the Re?ce and headquarters.Mid-term evaluation:The main purpose of the mid-term evaluation would be to assess the progress made in the focus areas of the CCS and to determine whether the expected achievements are on track.In addition,the evaluation will aim to identify impediments that may requir
147、e changes to the strategic priorities,and recommend actions to enhance progress during the second half of the CCS cycle.The review will adopt an interactive and participatory approach,involvingstakeholders.ThesewillincludetheMoH,developmentpartners,academic institutions,professionalgroupsandNGOs.Ont
148、hebasisoftheassessmentandrecommendations,a joint action plan will be developed with the MoH.Timor-Leste-WHOCountry Cooperation Strategy 2021?202569?Final evaluation?recommendations on priorities and ways of working to strengthen collaboration under the next generation CCS.To ensure that the evaluati
149、on is made in an independent and objective manner,an Evaluation?evaluation policy and practice guidance41,42,43,the group will review the implementation of the CCS and the progress made towards the outcomes defined.The main aspects covered by the?the strategic priorities.The final findings and recom
150、mendations of the evaluation will be shared with all relevant stakeholders,including the MoH,members of the UN country team and other development partners.Monitoring will be carried out on a regular basis by the Joint Monitoring Group,composed of?and members of the MoH and other partners.The?in moni
151、toring and evaluation are shown in Fig.18.2021CCS launch?Monitorimplementation2023Mid-termevaluation2023-2025Monitorimplementation2025FinalevaluationOutcome and impact indicators chosen for each strategic priority,with baselines andtargets establishedBased on WHO GPW13 results frameworkCountry level
152、 datacapacity strengthenedEnsurealignment of?workplan withCCS prioritiesand annuallymonitorimplementationof the focusareasReport sharedwith MoH andcoursecorrectionsmade as neededEnsurealignment of?workplan withCCS prioritiesand annuallymonitorimplementationof the focusareas?Framework and SEA Regiona
153、l Results Measurement Framework,WHO outputs and UNSDCF country indicatorsJoint evaluation withGovt.and DPs,usingobjective methodologyto determine relevance,?validate report published withlessons learnt for next generation CCSTimor-Leste-WHOCountry Cooperation Strategy 2021?202570Vaccination roll-out
154、:a success story from Timor-LesteThe first dose of the COVID-19 vaccine was administered on 7 April 2021,coinciding with?the countrywide campaign by taking the first shots.Though the vaccine arrived in the country in April 2021,the work to obtain the final physical delivery began nearly a year ago.O
155、n 28 May 2020,the Minister of Health sent a“letter of intention”to join the COVAX Facility,supported by WHO,to the WHO Director-General.This was followed up with a letter to Gavi,the Vaccine Alliance in September 2021.On 19 November 2021,the COVAX Facility confirmed?Market Commitment(AMC).WHO provid
156、ed technical assistance to the MoH in the development?On 12 January 2021,a Prime Ministerial dispatch instituted an Interministerial Commission(IMC),chaired by the Vice Prime Minister and including seven cabinet ministers,to coordinate and steer the COVID-19 vaccination campaign.A National Technical
157、 Committee(NTC)chaired by the Director General Health Services was formed.The director generals under other relevant ministries,and heads of the armed forces and police were included in the committee.The national EPI Working Group of the MoH continued to work as the key technical advisory body.In co
158、ordination with WHO technical experts,the national EPI Working Group developed a costed National Vaccine Development Plan(NVDP)in consultation with the NTC and IMC.The?2021,the NVDP was duly submitted to the COVAX Facility.With the NVDP in place,WHO recruited international consultants to assist in t
159、he development of technical guidelines and training materials for the campaign and for training health workers.The WHO EPI team conducted national-level training of trainers and assisted in conducting municipal-level trainings on a range of subjects,including volunteer orientation,listing of target
160、population and microplanning.It conducted hands-on demonstration of vaccine administration,injection safety,vaccination rollout,waste disposal and adverse events following immunization.The first COVID-19 vaccine advocacy session on the media for Oxford AZ was conducted on 19 February 2021.And the fi
161、rst batch of COVID-19 vaccines arrived on 5 April 2021.The first phase of vaccination targeted the priority group health workers,frontline workers and?ministers and members of Parliament to participate in the campaign to increase vaccination coverage in all municipalities.On 16 October 2021,the coun
162、try received the first shipment of the Pfizer COVID-19 vaccine for the age group of 1218 age group.The Pfizer vaccine rollout began on 28 October 2021.Excited school children after getting their frst dose of Pfzer vaccineHealth workers along with WHO EPI team in feld for COVID-19 vaccination driveWH
163、O Representative observing the community vaccination drive in RAEOATraining of Trainers for health workers ahead of Pfzer vaccine campaignA nurse providing vaccine shot to school children during the vaccine campaign in schoolsCommunity members after receiving their frst dose of COVID-19 vaccineTimor
164、-Leste-WHOCountry Cooperation Strategy 2021?202572References?-?-mor-leste-popu-?-?-?-?-?Timor-Leste National Health Accounts 2013-2017,Summary Report.Ministry of Health Timor-Leste and WHO.?-?Timor-Leste and Macao SAR China.Geneva:World Health?-?1.2.3.4.5.6.7.8.9.10.11.12.13.14.15.16.17.18.19.20.Tim
165、or-Leste-WHOCountry Cooperation Strategy 2021?202573?-?Human Resources,Ministry of Health,Timor-Leste.WHO.Estimating service consumption for updating the primary health care essential service package in?Population Division,Timor-Leste?WHO.Ending Preventable Child Deaths from Pneumonia and diarrhoea
166、by 2025:The integrated Global Action?-?-?-?-?-?National survey for noncommunicable disease risk factors and injuries using WHO STEPS approach in?-?-?-?-?-?21.22.23.24.25.26.27.28.29.30.31.32.33.34.35.36.37.38.39.Timor-Leste-WHOCountry Cooperation Strategy 2021?202574Further Reading?-?Demographic and
167、 Health Survey 2016,General Directorate of Statistics,Ministry of Finance,Timor-Leste,?-?-?National Directorate for Human Resources.?Timor-Leste,July 2019.?-?Timor-Leste TB Profile,Global TB Report 2018,WHO Estimates of TB and MDR-TB burden produced in consulta-?-?-?-?1.2.3.4.5.6.7.8.9.10.11.12.13.1
168、4.?-?-?40.41.42.43.Timor-Leste-WHOCountry Cooperation Strategy 2021?202575National survey for noncommunicable disease risk factors and injuries using WHO STEP approach in?-?-?-?15.16.17.?-?-?World Health Organization,World health statistics 2019:monitoring health for the SDGs,sustainable develop-?-?
169、-?-?-?Zero Hunger Challenge,National Action Plan for a Hunger and Malnutrition Free Timor-Leste,National Council?-?-?-?Framework for action in building health systems resilience to climate change in South-East Asia Region,?-?18.19.20.21.22.23.24.25.26.27.28.29.30.Timor-Leste-WHOCountry Cooperation S
170、trategy 2021?202576A?EAS OF S?E?IC ALI?ME?P?IO?I?Y 1and?ocu?area?Operational planning?HSSP?20112030?priorit?CCS?20152019?SDCF?20202025?prioriti?WHO?PW13 goal?egional Flag?hip?S?rom the 2030 agenda?Are?o?upport identi?ied to achieve prioriti?Delivery of health?ervice?,including?a?ic package o?:matern
171、al health;child health;nutrition;control o?communica?le di?ea?e?,?uch a?malaria,?B,HI?AIDS,lepro?y,lymphatic?ilari?;?C?;mental health and epilep?y;oral health and eye health?Section?,p.3?Development?management of human re?ourc?for health?Section?,p.6?Development of health infrastructure,including me
172、dical equipment and supplies,transport and am?ulance?ervic?Section?,p.70?Development of support services,including d?and con?uma?le?,la?oratory,?lood?ank?ervice?,health in?ormation?y?tem?Section?,p.77?Financing the national health system?Section?,p.86?SP1:Strengthening health?y?te?to en?ure?HCSP2:Re
173、ducing burdenof communica?le di?ea?SP3:Reducing burdenof?CD?,mentalhealth,violence,injuries,disabilities and ageing SP4:?mproving reproductive,maternal,new?orn,child,and adole?cent health and nutritionOUTCOME 4:By 2025,the people of Timor-Leste increasingly demand and have accessto gender-responsive
174、 e?uitable,high?uality,resilient and inclusive primary health care and?trengthened?ocial protection,including in times of emergencies.Sub-outcome 4.1:By 2025,health care institutions provide improved delivery of?uality,gender-responsive,e?uitable and resilient primary health care,including sexual an
175、d reproductive health,for?HC,and in times of emergencies OUTCOME 1:By 2025,nutrition,food security and agricultural productivity have improved for all,irrespective of individual ability,gender,age,socioeconomic status and geographical location Sub-outcome 1.1:By 2025,access to?uality nutrition servi
176、ces,in particular for adolescents,women of reproductive age and children under five years of age?including life-saving interventions,micronutrient supplementation,social protection programmes,infant and young child feeding,in particular breastfeeding?,hygiene,water and sanitation services have impro
177、ved significantly and sustainably for all Contribute to 1 billion more people with?HC Outcome 1.1:?mproved acce?to qualitye?ential health?erv?Outcome 1.2:Reduced number of peoplesu?ering?inancial hard?hip?Outcome 1.3:?mproved availability of e?entialmedicine?,vaccine?,diagno?ti?and devices for prima
178、ry health care Continue progressing towards?HC with focus on human re?o?for health and e?ential medicin?.Accelerate reduction of maternal,neonatal and under-?ive mortality.Finish the task of eliminating?and other diseases on the verge of elimination.Prevent and control?CD?through multisectoral polic
179、ies and plans,with focus on“best buys”.Accelerate e?orts to End?B by2030.S?3.?:Achieve UHC,including financial risk protection,access to?uality essential health-care services and access to safe,e?ective,?uality and a?ordable essential medicines and vaccines for all.S?3.c:Substantially increase healt
180、h financing and the recruitment,development,training and retention of the health workforce in developing countries,especially in least developed countries and small island developing States.S?3.3:End the epidemics of A?DS,tuberculosis,malaria and neglected tropical diseases and combat hepatitis,wate
181、r-borne diseases and other communicable diseases.S?3.?:Support the research and development of vaccines and medicines for communicable and noncommunicable diseases.S?3.4:Reduce by one third premature mortality from noncommunicable diseases through prevention and treatmentand promote mental health an
182、d well-being.S?3.5:Strengthen the prevention and treatment of substance abuse,including narcotic drug abuse and harmful use of alcohol.S?3.1:Reduce the global maternal mortality ratio.S?3.2:End preventable deaths of newborns and children under 5 years of age.S?3.?:Ensure universal access to sexual a
183、nd reproductive health-care services,including for family planning,information and education,and the integration of reproductive health into national strategies and programmes.S?2.2:End all forms of malnutrition,including achieving by 2025,the internationally agreed targets on stunting and wasting i
184、n children under 5 years of age,and address the nutritional needs of adolescent girls,pregnant and lactating women and older persons.By 2025,the people o?imor-Le?te have acce?to equita?le,high-quality,re?ilient,inclu?ive,and people-centred?HC?Strengthened health s?stem through:?improved?rkforce?impr
185、oved access to medicines?health information?sustainable financing?implementation of service packages?2 Improved care through the life course and for communicable and noncommunicable diseases Support in the?ollowing area?:?Electronic medical record for PHC?implementation of SnF?Strengthening of the N
186、ational Regulatory Authority for medicines,devices,vaccines and blood products?Priority implementation of interventions on human resources for health,health financing and?uality improvement?Strengthening of health information systems and implementation of telemedicine strategies?Strengthening of the
187、 emergency care system and critical care services?secondary leve?mplementation and monitoring of multisectoral action plan on NCDs?ntegration of the Package of Essential NCD interventions with PHC?mplementation of guidelines on eye and oral health care?Revision of mental health strategy on the basis
188、 of the Mental Health Gap analysis?ncrease of immunization coverage and introduction of new vaccine?s?Establishment of malaria-free certification?mplementation of national plan for elimination of TB?Updation of National Strategic Plan on H?A?DS and ST?s?Revision of strategies on RMNCAH-family planni
189、ng and support for implementation of high-impact evidence-based strategies?Maternal and Child Health department?s response to Maternal and Perinatal Death Surveillance and Response System,together with UN?CEF and UNFPA?Establishment of colposcopy centre in maternity outpatient department of national
190、 hospital,and online NBBDS?new born birth defects database system?in national hospital and 5 regional hospitals?Curriculum revision by National University of Timor-Leste for School of Nursing and Midwifery and procurement process for establishment of skill laboratories for the university faculty?mpl
191、ementation of National Health Sector Nutrition Strategy?Supported strengthening of health sector capacity to address Gender Based?olenceA?EAS OF S?E?IC ALI?ME?P?IO?I?Y 2and?ocu?area?Operational planning?HSSP?201130?priorit?CCS?201519?SDCF?202025?priorit?WHO?PW13 goal?egional Flag?hip?S?rom the 2030
192、Agenda?Are?o?upport identi?ied to achieve prioriti?Services for emerging di?ea?Section?F,p.61?SP5:Emergency preparation,surveillance and response,including implementing the I?OUTCOME 4:By 2025,the people of Timor-Leste increasingly demand and have accessto gender-responsive,e?uitable,high-?uality,re
193、silient and inclusive primary health care,and strengthened social protection,including in time?o?emergen?COME 6:By 2025,national and subnational institutions and communities?particularly at-risk populations,including women and children?are better able to manage natural resources and achieve enhanced
194、 re?ilience to climate change impact?,natural and human-induced hazard?,and environmental degradation,inclusively and sustainablyContribute to 1 billion more people?etter protected?rom emergen?Outcome 2.1:Country health emergency preparedne?trengthenedOutcome 2.2:Emergence of high-threat in?ectiou?h
195、azard?preventedOutcome 2.3:Health emergen?rapidly detected and re?ponded Scale up capacity development in emergency ri?managementS?3.d:Strengthen the capacity of all countries,in particular developing countries,for early warning,risk reduction and management of national and global health risks.S?3.d
196、.1:Strengthen?nternational Health Regulations?HR?capacity and health emergency preparedness.S?3.9:Substantially reduce the number of deaths and illnesses from hazardous chemicals and air,water and soil pollution and contamination.S?13.3:?mprove education,awareness generation and human and institutio
197、nal capacity on climate change mitigation adaptation,impact reduction and early warning.By 2025,the people o?imor-Le?te are?etter protected?rom health emergen?,including di?ea?e out?rea?and natural di?a?t?,through?trengthened national prevention,preparedne?and re?pon?e capa?ilit?.?1 Strengthened Nat
198、ional capaci?in emergenc?health preparedness?2 Strengthened prevention of high-threat infectious hazards?Strengthened National capaci?to build climate resilient health s?stem?Support for NAPHS implementation,in line with the lessons learnt from CO?-19 response?Enhancement of national capacity for he
199、alth emergency preparedness and responses,including strengthening of the National?ntegrated Diseases Surveillance and Response System,laboratories and case management?Enhancement of?HR core capacity?including coordination,points of entry and?uarantine?Support for establishment of national HEOC and e
200、mergency medical teams A?EAS OF S?E?IC ALI?ME?P?IO?I?Y 3and?ocu?area?Operational planning?HSSP?20112030?priorit?CCS?20152019?SDCF?20202025?Priorit?WHO?PW13 goal?egional Flag?hip?S?rom the 2030 Agenda?Are?o?upport identi?ied to achieve prioriti?Annex 1:Mapping of CCS priorities to national,regional a
201、nd global strategic agenda,with key deliverables identifiedTimor-Leste-WHOCountry Cooperation Strategy 2021?202577Services for emerging di?ea?Section?F,p.61?Health promotion?Section?H,p.65?SP3:Reduce the?urden o?CD?,mental health,violence,injuries,disabilities and ageing SP5:Emergency preparedness,s
202、urveillance and response,including implementing the?HR?focus on?ocial determinant?Sub-outcome 4.3:Behaviour change?or determinant?o?health By 2025,communities,particularly women and girls,persons with disabilities,and civil society actors are engaged and empowered to influence decisions and behaviou
203、r that a?ect health and well-being to ensure that the needs of the poor,less educated,rural communities,women and children,persons with disabilities,migrant and mobile populations and other marginalized and vulnerable population groups are metContribute to 1 billion more people en?oying?etter health
204、 and well-?eing Outcome 3.1:Determinant?o?health addre?ed,leaving no one behind Outcome 3.2:Reduced risk factors through multi?ectoral approach?Outcome 3.3:Healthy settings and health in all policies promotedPrevent and control noncommunica?le di?ea?through multi?ectoralpol?and plans,with focus on“b
205、est buys”.S?3.4:Reduce by one third premature mortality from noncommunicable diseases through prevention and treatment and promote mental health and well-being.S?3.6:Halve the number of global deaths and injuries from road tra?ic accidents.S?6.2:Achieve access to ade?uate and e?uitable sanitation an
206、d hygiene for all and end open defecation,paying special attention to the needs of women and girls and those in vulnerable situations.By 2025,the people o?imor-Le?teen?oy?etter health and well-?eing?y addre?ing determinant?o?health through?trong multi?ectoral action.?1 Strengthen legal and regulator
207、?mechanism for health protection and promotion?2 Facilitate environmental health and improve access to clean air,?r and sanitation?Strengthen health promotion interventions for improved health?behaviors?Support for development and implementation of National Health Promotion Strategy?Strengthening sc
208、hool health promotion interventions?Support for implementation of evidence-based interventions to reduce malnutrition and promote healthy diets?Support for implementation of programme on strengthening water?uality surveillance and improving water safety?Support for integration of climate-related ris
209、k interventions with national policy,planning and regulatory frameworks?Support for implementation of HNAP?for climate change?and National Environmental Health Strategy?Support for tobacco cessation interventions?including policy on taxes and comprehensive TAPS ban?Support for implementation of Nati
210、onal Food Safety Strategy?Support for framing and implementing alcohol prevention policy?Support for ratification and implementation of Code for Breastmilk Substitutes?Support for promotion of rights of disabled people to health through legal framework?Support for and promotion of policies and inter
211、ventions on road safety and drowning prevention and promotion of the same?Health Promoting School policy guideline and implementation?Healthy Lifestyle physical activity promotion and implementation supported A?EAS OF S?E?IC ALI?ME?P?IO?I?Y 4and?ocu?area?Operational planning?HSSP?20112030?priorit?CC
212、S?20152019?SDCF?20202025?prioriti?WHO?PW13 goal?egional Flag?hip?S?rom the 2030 Agenda?Are?o?upport identi?ied to achieve prioriti?Health planning and?inancial management systems?Section?.6,p.83?Financing the?tional Health Sy?tem?Section?,p.86?Delivery o?health?ervic?,?Section?,p.33?Health partner?h
213、ip and colla?oration?Section?,p.84?Health re?earch and in?ormation?Section?,p.8182?Implementation,monitoring and evaluation?Section?,p.91?Cross-cuttingSub-outcome 4.2:Evidence-?a?ed deci?ion-making and digital?y?tem?By 2025,evidence,such as sex-disaggregated data,is systematically used for policies,
214、strategies,programmes and investment decisions to address public health needs,determinants of health and multisectorality,including through strengthened digital health systems Sub-outcome 4.4:Health?inancing and?udgeting By 2025,sustainable and gender-responsive financing and budgeting for health is
215、 ensured to address unmet need for health services,reduce financial hardship arising from out-of-pocket payments and increase resilience to shocks,especially for vulnerable population groups Strategic Priority 5:Accountable,inclusive and participatory governance and?uality public services Sub-outcom
216、e 5.2:E?ective and innovative public administration facilitated by SDG-focused,evidence-based and gender-responsive planning and budgeting systems and professional and meritocratic civil service professionals at all levelsContribute to the“triplebillion”goal and Strategic Priority 4 on health leader
217、ship and evidence generation for decision-making Foundational?or alltechnical outcom?and Outcome 4.1:Strengthened country capacity in data and innovationCross-cuttingS?3.a:Strengthen the implementation of the WHO Framework Convention on Tobacco Control in all countries,as appropriate S?3.5:Strengthe
218、n the prevention and treatmentof substance abuse,including narcotic drug abuse and harmful use of alcohol By 2025,the health?y?tem?upported?y increa?ingly?trong and?u?taina?le leader?hip and governance at every level toward?the vi?ion o?Healthy Ea?t?imore?e People in a Healthy?imor-Le?te?4.1?ective
219、governance?tructure?and mechani?m?trengthened to improve?unctionality and regulation o?health?y?tem?2 Communi?engagement and em?erment for the realization of the right to health?Monitoring and addressing equi?to ensure that no one is le?behind?4 WHO acts as an e?ective leader,convener and advocate f
220、or health through partnerships and collaboration?ith all sectors of government,UNCT and development partners?Support for strengthening of the National Regulatory Authority?Support for establishment of professional councils?doctors,nurses,midwives?Support for establishment and operation of National C
221、odex Commission?Support for establishment of Tobacco and Alcohol Control Council?as per Article 24 decree La?Support for implementation of revised NHSSP?2021?2030?Support for updating and implementing the National Multisectoral AMR Action Plan?Strengthening of national capacity on health research an
222、d knowledge management?Strengthening MoH leadership capacity,including through National University of Timor-Leste?Strengthening national capacity to track progress in the context of global?GPW 13 and SDGs?and regional?Regional Flagships?goals?Strengthening partnership with local stakeholders,includi
223、ng NGOs,professional bodies,academia and civil society organizations,for people?s participation in health?People?s Health Assembly?Enhancing engagement with parliamentarians?Strengthening coordination among UN agencies and other development partners for health Timor-Leste-WHOCountry Cooperation Stra
224、tegy 2021?202578FAC?:Timor-Leste?s?uick response to the CO?-19 crisis has been a result of e?ective government leadership,supported by technical guidance from WHO and needs-based support from the UHC Partnership.WHY I?M?E?S:Timor-Leste has a fragile health system,with limited capacity for managing c
225、ritical cases,few functional isolation facilities and di?iculties in procuring timely medical supplies.?ES?L?S:Timor-Leste has now increased its capacity to respond to CO?-19 and is better prepared than before to deal with the emergence and control of new cases.WHO guided the nationwide response by
226、providing technical assistance to establish?uarantine and isolation centres?set up testing facilities?train health workers and emergency responders in case management,infection prevention and surveillance?and build capacity for data collection.?t also provided the country with its first set of test
227、kits and personal protective e?uipment?PPE?for health workers.Moving ahead,WHO supported several vaccine procurement deals through CO?A?and bilateral agreements with countries.?t also supported vaccine advocacy campaigns,the capacity-building of health-care workers,as well as the streamlined launchi
228、ng of vaccination and e?uitable distribution of vaccines across the districts.I?P?AC?ICE:WHO raised the alarm about the urgent need for CO?-19 preparedness,and the UHC Partnership,along with other multilateral and bilateral partners,provided critical technical,logistical and financial support for th
229、e CO?-19 response.WHO was on the ground straight away when the first suspected case of CO?-19 was reported.The initial patient interview and support for testing was provided by WHO sta?backed by the UHC Partnership.WHO?s previous work with Timor-Leste was helpful in launching an e?ective response.?n
230、 2019,WHO helped Timor-Leste develop its Pandemic?nfluenza Preparedness Plan and integrate it with the National Action Plan for Health Security.This placed Timor-Leste in a strong position to prepare for all health security situations in the medium-to long-term,map multisectoral health security reso
231、urces and take action around CO?-19 for sustainable preparedness.Moving?orward:Stronger surveillance and expanded testing are currently providing?ears on the ground?to pick up early signals of cases.All referral hospitals and municipalities now act as sentinels and collect samples on a regular basis
232、.A la?technician working at the?ational Health La?oratory on the PC?work?tation donated?WHO?imore?e health worker?undergoing training on how to u?e PPE?acilitated?WHO and other health development partne?Source:Stories from the field:special series on the CO?-19 response?Timor-Leste,23 July 2020,Univ
233、ersal Health Coverage Partnership https:?tory-timor-leste?According to the?inding?o?Demographic Health Survey carried out in 2016,e?po?ure to?oke in?ide the home,either?rom the u?e o?olid?uel?or cooking or?rom?moking?acco,ha?potentially har?ul health e?ect?.Eighty-?even percent o?hou?ehold?u?e?olid?
234、uel?,con?i?ting mo?tly o?irewood,?or cooking.?he u?e o?olid?uel?or cooking i?more common in rural are?95%?than in ur?an area?5?%?.In?imor-Le?te,62%o?hou?ehold?cook outdoor?under a cover,14%cook outdoor?,and 12%each cook in a?eparate?uilding and in?ide the hou?e.The following interventions have been
235、emphasized in the Health National Adaptation Plan?2020?2024?to reduce and control air pollution:1.conducting research and studies on climate change,air pollution and respiratory illness?2.developing national policy and strategy for controlling air pollution,including national standards for both indo
236、or and outdoor air?uality?3.promoting use of improved cooking stove in the rural community?4.awareness generation on solid waste?domestic and industrial?management to reduce ambient pollution?and5.procuring and installing air?uality monitoring stations in major urban areas and monitoring public tran
237、sport.?Annex 3:Key interventions in HNAP to control and reduce air pollution1,183,643(2015)00709508Population6Total numberof hospitals344Total no.of health posts84.373%Adult literacyrates(M&F)Immunizationcoverage(infants)142MaternalMortalityRatio91.5(Urban)&68.6(Rural)81.1(Urba
238、n)&38(Rural)Populationhaving improvedaccess to waterPopulationusing improvedsanitation facilities13No.of districts/municipalities71Total CHCs103Sex ratio30InfantMortalityRate19NeonateMortalityRate3.7Govermenthealth expenditureas a%of GDPLife expectancyat birth 69.5(M&F:71.6&67.5)ToiletWHO Timor-LesteCountry Cooperation Strategy2021?2025