Health systems are complex. Understanding the challenges and opportunities to strengthen them takes time and commitment. Since 2019, the World Bank, with help from the Advance Universal Health Coverage Trust Fund (Advance UHC), has been providing the government of Timor-Leste with tailored, comprehensive analytics and advisory support to develop a deeper understanding of the ways it can improve the quality and availability of health services for its people.
Analyses shed light on factors compounding the health outcomes of vulnerable Timorese communities to below the average line of international standards, where 42 percent of the population of 1.3 million live in poverty. For example, the Timor-Leste Human Capital Review (2023) found that the country, Asia’s youngest nation, is facing various human capital challenges. Timorese children born today will be less than half as productive as adults unless they receive a complete education and access to comprehensive health care. The review identified the need for short- and medium-term investments in health, education and social protection to ensure Timor-Leste’s future socio-economic development.
The Human Capital Review launch in October 2023 led to the inception of an Inter-Ministerial Task Force for Social Affairs, chaired by Vice Prime Minister Mariano Sabino Lopes. This high-level task force is a vital accountability mechanism monitoring public health expenditure, progress towards core human development targets, and inter-ministerial and development partner collaboration.
The Timor-Leste Economic Report – Investing in the Next Generation (2022) looked at investments to reduce malnutrition in young children, address the health and productivity of the population, and tackle the country’s learning crisis. It presents the World Bank’s economic outlook for the country and provides an in-depth examination of selected policy issues relevant to Timor-Leste.
Another exciting stream of work has been looking at how digital technologies could be integrated into the health system. Given Timor Leste’s mountainous terrain and frequent natural disasters, there is significant potential for technological solutions that could help address some of the country’s most significant health service delivery challenges. This has included a scoping report for telemedicine and feasibility assessment for the use of drones to deliver medical supplies during emergencies.
The Timor-Leste Public Expenditure Review: Changing Course: Towards Better and More Sustainable Spending (2021), also supported by Advance UHC resources, assessed the quality of public spending, by evaluating its efficiency and effectiveness, while delving into sustainability considerations. It strengthened the evidence base for decision-making on public expenditure and revenue management.
Finally, analytics supported by the fund unveiled bottlenecks in the health care system and were critical enablers that informed the design of the Health Emergency Preparedness and Response Trust Fund (HEPR-TF) Project. It continues to provide critical analytical underpinnings for the project.
As 2025 approaches, funding activities continue to support the improvement of performance-based budgeting and financing mechanisms aimed at enhancing the efficiency of primary healthcare facilities. Training supported by development partners is steadily improving public financial management capacity at the subnational level. Analytics on the disparities in quality of health services are focusing on how to improve equitable access to high-quality health services. This work will inform a better understanding of where there are gaps in service delivery, especially for remote area and vulnerable communities.