CLTS: Lessons learnt from a pilot project in Timor Leste

Timor Leste, emerging from conflict ridden independence is one of the poorest countries in Asia, with major challenges in rebuilding infrastructure, particularly water and sanitation in rural areas. Community Led Total Sanitation is a relatively new approach to eliminate open defecation through community mobilisation and behaviour change, rather than subsidy and latrine construction. This paper discusses CLTS in the Timorese context, and highlights some key challenges in assessing the potential of CLTS to address sanitation issues. Some problems identified include a lack of coherence between the integration of water supply and sanitation, and the promotion of CLTS in isolation of any project activities that utilise any form of incentive or subsidy. The knock- on effect of the long term sustainability of latrine usage and maintenance CLTS is questioned unless further research clarifies the demand responsiveness of CLTS in conjunction with subsidy driven water supply.

The politics of Timor-Leste : democratic consolidation after intervention

The Politics of Timor-Leste explores the critical issues facing the Asia-Pacific's youngest nation as it seeks to consolidate a democracy following years of international intervention. The authors study the challenges that have burdened the state since it broke from Indonesia amid the violence of 1999 and formally achieved full independence in 2002. They assess the notable accomplishments of Timor-Leste’s leaders and citizens, and consider the country’s future prospects as international organizations prepare to depart. A close study of Timor-Leste sheds light on ambitious state-building projects that have been initiated, with varying success, across the globe.

Contributors to this volume map the nation’s recent political evolution through studies of its constitutional debates, political parties, and foreign policy responses to powerful neighbors. They address the social and economic conditions that complicate Timor-Leste’s political development, such as gender discrimination, poverty, corruption, and security-sector volatility. The contemporary history of Timor-Leste reflects the experiences of many postcolonial and developing countries that have sought to establish a viable state following conflict and a declaration of independence. This small nation has been the subject of five consecutive UN missions with varying mandates. The Politics of Timor-Leste ought to serve as a key source for comparative postcolonial studies and a guide to future trends in international state-building and assistance.

The inter-section of political history and health policy in Asia - the historical foundations for health policy analysis

One of the challenges for health reform in Asia is the diverse set of socio-economic and political structures, and the related variability in the direction and pace of health systems and policy reform. This paper aims to make comparative observations and analysis of health policy reform in the context of historical change, and considers the implications of these findings for the practice of health policy analysis. We adopt an ecological model for analysis of policy development, whereby health systems are considered as dynamic social constructs shaped by changing political and social conditions. Utilizing historical, social scientific and health literature, timelines of health and history for five countries (Cambodia, Myanmar, Mongolia, North Korea and Timor Leste) are mapped over a 30-50 year period. The case studies compare and contrast key turning points in political and health policy history, and examines the manner in which these turning points sets the scene for the acting out of longer term health policy formation, particularly with regard to the managerial domains of health policy making. Findings illustrate that the direction of health policy reform is shaped by the character of political reform, with countries in the region being at variable stages of transition from monolithic and centralized administrations, towards more complex management arrangements characterized by a diversity of health providers, constituency interest and financing sources. The pace of reform is driven by a country's institutional capability to withstand and manage transition shocks of post conflict rehabilitation and emergence of liberal economic reforms in an altered governance context. These findings demonstrate that health policy analysis needs to be informed by a deeper understanding and questioning of the historical trajectory and political stance that sets the stage for the acting out of health policy formation, in order that health systems function optimally along their own historical pathways.