Examining gender barriers to family planning and maternal and child health service access and utilization in post-conflict Timor-Leste

Priority needs in maternal, neonatal and child health (MNCH) in Timor-Leste remain unmet. Maternal and child health is among the worst in Southeast Asia and utilization of essential MNCH services remains low. The fertility rate is among the highest in Southeast Asia and unmet need for family planning (FP) is high. A deeply entrenched patriarchal culture persists in Timor-Leste and the country's history of prolonged conflict and instability has resulted in a severely weakened health infrastructure that is virtually incapable of responding to the health needs of women and children. In response, a comprehensive gender assessment of Timor-Leste identified gender barriers to achieving improved outcomes in FP/MNCH to inform those working in FP/MNCH at the country level. Pulling from this assessment, this study will further analyze these barriers through a post-conflict lens to determine the unique impact of post-conflict instability on service access and utilization among Timorese women. A global desk review of gender barriers to FP/MNCH services in post-conflict settings, followed by a detailed analysis of the post-conflict environment in Timor-Leste and its impact on maternal and child health outcomes will accompany the main findings of the original gender assessment and offer additional recommendations. Women are disproportionately affected by conflict. A collapse in social support mechanisms leave women vulnerable to violence and exploitation and weakened health systems lead to poor maternal and child health outcomes. It is critical to consider the impact of Timor-Leste's prolonged history of conflict and instability when assessing barriers to FP/MNCH services.