In remote regions of Timor-Leste, pregnancy and childbirth experiences are directly shaped by geography, access, culture and infrastructure. Steep mountainous terrain, limited transport options, and low health literacy mean that essential maternal, newborn and nutritional care can be difficult to access in many remote communities. As a result, mothers and newborns can experience entirely preventable diseases and complications. Strengthening frontline health support, particularly through midwives and nutritionists, is central to changing this reality.
Often the first, and sometimes the only, point of professional care for pregnant women and newborns in rural communities, midwives play a vital role in providing safe, skilled care throughout pregnancy, birth and the early postnatal period. Alongside this, nutritionists support the prevention and management of malnutrition, helping to address a critical underlying risk factor for poor maternal and newborn outcomes. At Maluk Timor, supporting both midwives and nutritionists is a key part of our commitment to strengthening healthcare across the nation. Through training, system strengthening, and improved access to essential resources, we help ensure more women and newborns receive timely, high-quality care when it is needed most.
The challenges facing maternal care in remote communities
In many regions throughout Timor-Leste, access to maternal and child health services has historically been limited. Many women are unable to attend antenatal appointments, and home births without skilled attendants can also be common. The remote nature of these communities means that healthcare facilities are often too far away, creating a barrier to consistency and necessary care throughout pregnancy and childbirth.
These conditions present significant challenges for delivering safe, effective care. For midwives and nutritionists like, identifying high-risk pregnancies, recognising early signs of malnutrition, ensuring timely referrals, and supporting women through birth and the postnatal period requires strong community trust, reliable access, and close coordination. This work depends on collaboration not only within communities, but also with the Ministry of Health, local authorities and other non-government organisations.
Maluk Timor’s maternal and child health program takes a multi-pronged approach to addressing these challenges. By working alongside midwives, nutritionists, community health workers and local partners, we’re actively building healthcare systems to strengthen the care that’s available at every stage of pregnancy and early life.
Using outreach and access to bring care closer
One of the most effective ways we can support midwives and nutritionists to deliver quality care in remote settings is by reducing the distance between healthcare services and the communities they serve. Maluk Timor supports mobile outreach clinics that bring antenatal, newborn and nutritional services directly to women who may otherwise go without essential care.
Through these outreach clinics, midwives are equipped to:
- Conduct regular antenatal checks
- Identify high-risk pregnancies earlier
- Provide health education, nutritional counselling and pregnancy support
- Promoting and educating pregnant women to give birth at health care facilities rather than opting for a home delivery
We’re also working to train community health care workers, called PSFs (Promotor Saude Familiar). These PSFs are elected from their communities to become local health promoters, creating links between their communities and national healthcare facilities. We work with PSFs to equip them with relevant skills and knowledge about maternal health, infectious and chronic diseases, and health promotion. These PSFs provide complementary support to our midwives as an integral part of their community, sharing crucial information as they educate their community members.
Integrating maternal care with nutrition support
Maternal and newborn health simply can’t be separated from nutritional health. Malnutrition remains sadly common in Timor-Leste, creating significant risks for both mothers and babies without adequate treatment.
Maluk Timor integrates malnutrition screening, counselling, and follow-up into its maternal health work to provide holistic support. Pregnant women, mothers, and children can all receive nutritional assessments during clinic visits. If malnutrition is identified, we’re able to provide tailored counselling and ongoing support to reduce its impact and provide a higher quality of life.
Across 2024-2025 alone, 350 women and children were identified as having malnutrition. Maluk Timor provided ongoing assessment and counselling, working to improve healthcare outcomes for each of these patients.
Partnering for sustainable impact
As with so much of our work across Timor-Leste, our impact is stronger when we work in partnership. Our maternal and newborn and nutrition-focused health programs are implemented in close collaboration with the Timor-Leste Ministry of Health, alongside key partners including the New Zealand Embassy and Australian Catholic University.
These partnerships help ensure maternal and newborn care initiatives, including nutrition support, align with national health priorities. By strengthening existing systems and building local capacity, we support sustainable, long-term improvements in care for women, newborns and families in remote communities.
Conclusion
When midwives are supported with access, outreach, community collaboration, and integrated care systems, the impact extends far beyond individual births. Women are supported with the quality of care necessary for a safe pregnancy, newborns have critical care as their life begins, and Timorese families gain peace of mind from knowing they have access to urgent and ongoing skilled care.
By investing in midwives and the systems that support their work, Maluk Timor is helping to strengthen maternal and newborn care across Timor-Leste’s regional and remote communities – and, as a result, the health and wellbeing of communities for generations to come.
We couldn’t do this critical work without the support of our global family. Join the Maluk Timor family of supporters and be a part of providing this transformative care to mothers and newborns across Timor-Leste, directly investing in the country’s future through this early intervention.