Combating maternal mortality in the community

mother in Timor-Leste


“has a one in 35 chance of dying in childbirth or from pregnancy-related complications compared to Australian women who face a one in 13,300 risk.” (UNICEF, State Of The World's Children Report 2009).

This statistic demonstrates huge risks that pregnant women face in Timor-Leste. With a fertility rate of 7.8 live births per woman and with up to 90% of women giving birth at home, this statistic affects every extended family in Timor-Leste. Alola is working with the Ministry of Health and other agencies to encourage women to attend health facilities for antenatal care and to give birth in hospitals. Our maternity pack program is one initiative to encourage women to give birth at one of the major hospitals in Timor-Leste.

However, women in rural areas most often rely on traditional birth attendants or family members, and often do not access midwifery assistance available at local health centers and health posts. Alola’s Mother Support Group (MSG) members are crucial in providing important information and services to women in rural areas.

Maternity pack


Pakote Maternidade (Maternity Pack)

In 2006 Fundasaun Alola began distributing maternity packs for Dili and Baucau hospitals with the objective of supporting safe hospital birth. Alola recruited staff at the Taibessi sewing center to produce the packs. Maternity packs are distributed monthly as requested by hospitals. They were also distributed to the SHIO program in Liquica. Since 2006 the total distribution for two years is 11,288 packs. Fundasaun Alola also trained MSG members to provide counseling for the women who received maternity packs in both Dili and Baucau hospitals to ensure that they were given appropriate information.

A Maternity Pack, provides a woman who gives birth in either Dili or referral hospital with 2 cotton sarongs, 6 pairs of underpants, washable sanitary napkins, 1 baby outfit, a towel, 6 cotton nappies and baby soap, plus literature promoting good health for women and their communities in Timor-Leste. The maternity packs help encourage the women to give birth in hospital where they and their babies have the best chance of surviving childbirth and they can receive the care and advice they need for a healthier start in life. 


Shio MCH


Suku Hadomi Inan ho Oan (SHIO)

Alola in consultation with the Ministry of Health (MoH) has piloted a community-based safe motherhood program in Liquica District in 2007/2008. This is known as SHIO, which literally translates as ‘the village loves its mothers and children. SHIO is modelled on the Indonesian program known as Desa Siaga (Siap, Antar Jaga). The concept is a basic village whose people have the readiness, resources and the ability to resolve health problems independently in order to create healthy villages.The initial objectives of SHIO are to raise community awareness about birth preparedness; recognize danger signs during pregnancy, child birth and postpartum; and to assist and support women with obstetric complications with transport to a health facility. SHIO members also support activities run by the Ministry of Health in their suco (sub-district) on monthly basis.

SHIO program uses a Participatory Problem Analysis Approach to engage communities to identify, analyze and resolve problem of the obstetric complications faced by women and the associated difficulties faced by both their family and the community,in assisting women with the complication.

SHIO created a number of community networks in each village to respond to the contributing factors, such as:

  • A notification network; to register pregnant and lactating women, families who are using birth spacing methods , couples of reproductive age and children 1-5 years old.
  • A transport network that assesses and coordinates transport options; fundraising networks help to raise and provide funds to use for transporting women with difficult births and normal births to a health facility or to give birth at home assisted by skilled provider.
  • A health promotion network; to promote maternal nutrition, basic newborn care, basic safe motherhood, infant and young child feeding, family planning, male and female reproductive health and to provide other information related maternal and child health .

This project was successful in increasing the number of antenatal care visits, births assisted by skilled provider (both at home and hospital) and family planning in piloted villages.