Investigator(s)
| WHO Technical Officer |
Mokryeon Cho WHO Timor-Leste County office Mokryeon Cho 
|
| Principal Investigator |
Rita Soares Official of school health unit, Department of education and health promotion, Ministry of Health Timor-Leste Rita Soares
|
Title(s) and abstract
| Scientific title | Individual-level analysis of health conditions among primary and pre-secondary school children in Dili, Timor-Leste: a secondary analysis of school-based screening records |
| Public title | Health conditions among school children in Dili, Timor-Leste: an analysis of school health screening records |
| Background | The 2025 Primary Health Care Package (PHCP) nationwide school health screening assessed 262,434 students across all 14 municipalities of Timor-Leste, establishing the country’s first baseline prevalence data for key child health conditions. However, data reported to the national health information system were aggregated at the school level, precluding individual-level age- and sex-adjusted analyses, multivariable modelling, and estimation of design parameters such as intraclass correlation coefficients (ICC) and design effects (DEFF). Individual-level records are retained on paper B2 class-register forms at schools. This study will retrieve and digitise records from a probability sample of schools in Dili to enable individual-level analysis. Dili was selected based on operational feasibility, data completeness, and suitability for multilevel modelling. The presence of five Community Health Centres enables assessment of between-team variation, while the large and heterogeneous student population supports stable subgroup estimates. Findings are expected to inform programme planning and resource allocation. |
| Objectives | Primary: • Estimate age- and sex-specific prevalence of key health conditions using individual-level data with survey-adjusted weights • Identify individual-level associated factors of health conditions through multivariable logistic regression, adjusting for age, sex, grade, and school type Secondary: • Estimate ICC and DEFF at school and CHC-area levels to inform future survey design • Validate the school-type proxy for age stratification used in the nationwide analysis • Examine co-occurrence patterns of health conditions at the individual level |
| Study Methods | A stratified two-stage cluster sampling design is employed. Schools are stratified by post-administrative area (5) × school type (3) and selected via systematic probability proportional to size (PPS) sampling using PHCP enrolment as the measure of size. All individual records within selected schools are included (complete enumeration within clusters). The sample comprises 37 schools across five areas of Dili, covering approximately 21,900 student records. Metinaro (9 schools) is included as a complete census reference. Analysis will include survey-weighted descriptive statistics and multivariable logistic regression. |
| Expected outcomes and use of results | This study will produce age- and sex-adjusted prevalence estimates of key child health conditions in Dili, identify individual-level determinants, and quantify CHC screening variation. Findings will be submitted for publication journal paper. A policy brief will also be prepared for the Ministry of Health and Ministry of Education, providing actionable recommendations for screening protocol standardisation and resource allocation for school health programmes in Timor-Leste. |
| Keywords | school health; health screening; primary health care |
Research Details
| Student research | No |
| Start Date | 11-May-2026 |
| End Date | 30-Jun-2026 |
| Key Implementing Institution | World Health Organization Timor Leste |
| Multi-country research | No |
| Nationwide research | No |
| Timor-Leste | |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | Child Health |
| Involves human subjects | No |
| Data Collection | Secondary data |
| Proposal reviewed by other Committee | No |