Date of Award


Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr Christina Hemphill Fuller, ScD, MS

Second Advisor

Dr Matt Hayat, PhD


Introduction: In Timor-Leste, anemia affects approximately 21% of reproductive age of women. The established risk factor for anemia is poor nutritional status, but recently solid fuel use in the household has emerged as a possible risk factors. The association between

solid fuel and anemia has been studied in children and pregnant women, but there hasn’t been a study conducted to find the association among all reproductive age women from 15-49 years old.

Aim: The objective of this study is to determine if use of solid fuels (charcoal, wood, and straw/shrubs/grass) compared to cleaner fuels (electricity, LPG. natural gas, biogas, and kerosene) associated with the increasing of the prevalence of anemia among reproductive age women (15-49 years old) in Timor-Leste.

Methods: This study used data from the Timor-Leste Demographic Health Survey (TLDHS) 2009-2010. The data used was based on the individual level within household from 13 districts in Timor-Leste. Bivariable logistic regression analysis was performed to assess associations between each independent variable (type of fuels, age group, BMI group, residence, wealth index, education level and smoking behavior) and the outcome variable (anemia) and mutlivariable logistic regression model was also performed with significant covariates.

Results: The association based on the type of fuels showed that the odds ratio for anemia in women using solid fuels was 1.73 (OR: 95% CI: 1.49 - 2.01) compared to the women using cleaner fuels. After adjustment for other covariates, the odds ratio for anemia in women that use solid fuels was 1.43 (95% CI: 1.29-1.64) compared to women using cleaner fuels.

Discussion: Based on our study population, this study found that reproductive age women 15-49 years old in Timor-Leste who used solid fuel as a source of energy for cooking or heating activities in the household were at higher risk for anemia.