Needs assessment on quality in Timor-Leste: step 2 of the Twinning Partnership for Improvement between Timor-Leste and Macao SAR China

Without quality care, universal health coverage (UHC) cannot be achieved. The Ministry of Health of Timor-Leste, in pursuit of UHC, is working with partners, including WHO, to place a renewed emphasis on improving the quality of care provided across the health system.

As part of this effort, Timor-Leste and Macao SAR China have entered into a partnership arrangement using the WHO Twinning Partnerships for Improvement (TPI) approach. This approach aims to build sustainable, trusting partnerships; identify opportunities for technical collaboration to spark improvements in care; and facilitate spread of best practice across the system, ensuring that the national direction on quality is informed by implementation experience. Within the systematic TPI approach, a needs assessment has been carried out jointly between the Ministry of Health of Timor-Leste, the Macao SAR China Health Bureau and WHO. The codeveloped needs assessment approach involved a desk review of key documents, stakeholder interviews and facility visits. This report outlines the needs assessment findings and recommendations resulting from these.

There are several important assets across the Timorese health system for improving quality. For example, there is a dedicated Cabinet of Quality Assurance within the Ministry of Health with a mandate for improving care, which has started implementing various initiatives. There have been initial efforts to build capacity in quality improvement methods, with pilot sites currently implementing improvement interventions. Saúde na Família, the flagship community health initiative, represents a potentially important platform for engaging communities. There have also been successful efforts at the national hospital to build capacity and understanding about quality of care, supported by a development partner. Indeed, several development partners are working to support improvements in quality, notably WHO and UNICEF. Importantly, there is clear enthusiasm to improve patient care among health professionals and health system leaders.