Assessing teachers' perceptions of health education in East Timor
Centre for International Health
Science and Mathematics Education Centre
Curtin University of Technology
East Timor today with a population of 950,000 is the world's newest democracy. This qualitative case study was conducted with a selected sample of primary and secondary school teachers in Baucau District of East Timor. The study aimed to assess teachers' perceptions about implementing school based health science education. The research used an interpretive qualitative case study approach with multiple methods, including focus group discussions, semi-structured interviews, school visits and classroom observations. Questions were designed to explore the teachers' knowledge and attitudes towards health science education. Major constraints identified by the study included severe time limitations within the school schedule, the shortage of educational resources, the complex issue of language, widespread socio-economic deprivation, and lack of ongoing teacher professional development. The study findings identified that school teachers in East Timor could be actively involved in promoting health and hygiene through a school based health science education initiative. School based health education was generally perceived to have several benefits in terms of increasing understanding of health among students, children conveying health messages to household members, promoting sustainability of the program as teachers were respected members in the community, and increasing community awareness of health issues.
Background to the world's newest nation
Historical overview of the road to independence
The Portuguese reached the coast of Timor on the enclave of Oecussi in 1515. It was only in the 1700s that a governor was installed in Dili, the capital of East Timor. Portuguese colonisation ensured that the native population, particularly the coffee growers, never managed to accumulate much capital. East Timor remained largely underdeveloped with an economy based on barter. During the Second World War, Japan invaded East Timor in February 1942 and remained in East Timor until September 1945. By the end of the Second World War East Timor was in ruins and approximately 60,000 East Timorese had lost their lives (UNDP, Human Development Report, 2002).
The 1960s was a new era of colonisation where Portugal tried to help the country recover through a series of three successive five year plans, nevertheless this was not sufficient to overcome decades of underdevelopment and neglect. Portugal governed East Timor with a combination of direct and indirect rule, leaving traditional East Timorese society almost untouched (UNDP, Human Development Report, 2002).
In 1974, the transition to democracy in Portugal had a sudden impact on all its colonies. In East Timor in 1974, two political parties, the Timorese Democratic Union (UDT) and the Frente Revolucionaria do Timor Leste Independente (Fretilin), formed a coalition, to prepare for eventual independence. In August 1975, the UDT, supported by the Indonesian government, launched a coup attempt to seize power from the Portuguese and halt the progress of the Fretilin. The coup failed and most of the UDT members fled into Indonesian West Timor (UNDP, Human Development Report, 2002). The leadership of Fretilin took the decision to establish Falintil (The Armed Forces for National Liberation of East Timor). Falintil was Fretilin's military front to organise the East Timorese in their struggle for independence. In November 1975, the Fretilin declared East Timor as the Republic Democratica de Timor Leste (RDTL), recognised only by a few mainly former Portuguese colonies (ETAN report, 2000).
Indonesia invaded East Timor in December 1975, and ruled the tiny island for 24 years, during this regime more than 200,000, a quarter of the population, lost their lives. The Indonesian occupation favoured strong direct rule, but the East Timorese people never accepted this and were determined to preserve their culture and national identity in which religion and the Catholic Church played a crucial rule (UNDP, Human Development Report, 2002). The November 1991 massacre at Santa Cruz, the 1992 capture and imprisonment of resistance leader Xanana Gusmao, the 1996 Peace Prize to Bishop Belo and Jose Ramos Horta, on behalf of the people of East Timor, put the spotlight on the human rights situation in East Timor. Following the economic crisis in 1997 and 1998 in Indonesia and the overthrow of the Suharto regime, an agreement was reached between the Portuguese and the Indonesian governments to hold a referendum under the auspices of the United Nations (UNDP, Human Development Report, 2002).
The referendum and the electoral process
In August 1999, East Timor under the auspices of the United Nations held a referendum on independence. With an overwhelming voter turnout, the East Timorese chose independence. The announcement of the results sparked an explosion of systematic violence and killings that lasted until the UN peacekeeping forces arrived in late September (AUSAID, 2001). In 21 days nearly the entire population was uprooted and displaced. Some fled to the mountain areas of East Timor, some 250,000 were taken to camps in West Timor. Some 90% of public buildings and infrastructure in East Timor were systematically destroyed. The conclusion of the electoral process, on 17 April 2002 paved the way for East Timor's independence on 20 May 2002 (AUSAID, 2001).
Education reconstruction in East Timor
Education in the world's newest nation is facing enormous challenges and struggling under harsh conditions in all aspects of education reconstruction, namely infrastructure, human and material resources, curriculum and the dilemma of language learning (AUSAID, 2001). A school mapping exercise began in April 2001 to examine each school's physical condition, the facilities available; the area served by each facility, the projected student population and the student retention rates. More than 700 primary, 100 junior secondary, 40 pre-schools and 10 technical colleges are currently functioning in the country. Of these, 535 schools and more than 2780 classrooms have been rehabilitated to basic operational level under the Transitional Administration's Emergency School Readiness Project. Investment in technical and vocational training for older students is another fundamental priority of the educational administration (UNICEF, 2001).
Teacher professional development
In 2000, UNICEF's main activities included efforts to ensure an adequate level of pay for teachers, supplying UNICEF's School-in-a-Box and recreational/sporting kits, and distribution of building materials for the rehabilitation of approximately 90 schools. Primary Teacher Training began in January 2000 in Dili and follow up training continued throughout the year, moving to cluster schools at district and sub-district level (UNICEF, 2000a).
The UN sponsored workshop to train teachers trained fifty-two East Timorese teachers in a two week seminar. The course was intended to provide future Timorese primary school teachers with training in civic education, human rights, English, natural sciences, mathematics, and the history of East Timor. Forty of the fifty-two teachers were deployed to outlying districts to teach, while 12 attended an advanced "training for trainers" course in Dili. The UN Children's Fund (UNICEF) sponsored the training program for teachers (UNICEF, 2000a).
In May 2000, the United Nations Transitional Administration in East Timor (UNTAET) and National Council for Timorese Resistance (CNRT) organised a proficiency test for teachers in Indonesian. 5000 teachers were found capable of teaching in primary schools. The situation in the secondary schools was even more difficult with no secondary teachers, and university students were encouraged to take up jobs in secondary schools. Most of these teachers have had no training in teaching or classroom management (UNDP, Human Development Report, 2002). Australia sent 15 Australian teachers to the University of East Timor to teach English and computer training to over 1,000 students in the area of technical and vocational education. Six East Timorese vocational education teachers were trained at Hawthorn and Bendigo TAFE colleges in Australia, enabling them to return home to train East Timorese in the technical trades (AUSAID, 2001).
Health indicators in East Timor
Although currently 80% of the population has access to health services of some description (WHO, 2003), there is an acute lack of trained health workers, and doctors. Continuing problems include:
Currently, the World Health Organization (WHO) are assisting the East Timorese Government and the Ministry of Health in East Timor by providing technical assistance and programs to develop, among other areas: local skills for emergency and disaster planning; surveillance of communicable diseases; health staff training; and a core program of immunisation (WHO, 2000; 2003).
- A strong potential for epidemics of malaria, dengue haemorrhagic fever, Japanese encephalitis, cholera, typhoid, tuberculosis and diarrhoea (WHO, 2003).
- Maternal, infant and under five mortality rates are at unacceptably high levels (WHO, 2003).
- Around half of all women and young children have anaemia and around half of all children under five are underweight (WHO, 2003).
- Water supplies and sanitation reportedly remain very poor, with inadequate or non-existent systems for the formal collection of garbage and hazardous medical waste (Adhikary, 2002).
- 41% of the population lives below the national poverty line of 55 US cents per day (UNDP-HDR, 2004).
- Often people presenting to health services and hospitals only at a very late stage of disease or health problems.
- Few primary health centres and few functioning health centres especially in the districts.
- Destruction of health records during the mayhem of 1999.
- Poor general infrastructure that impacts on health care, eg roads, transport, communication, education.
- Staff working under difficult situations.
Focusing resources on effective school health (The FRESH approach)
Good health and nutrition are both essential inputs and important outcomes of basic education (UNESCO, 2001; UNICEF, 2000; World Bank, 2001). First, children must be healthy and well-nourished in order to fully participate in education. In addition, a healthy, safe and secure school environment can help protect children from health hazards, abuse and exclusion (UNESCO, 2002; UNICEF 2000b; World Bank, 2001). International agencies such as WHO, UNICEF, UNESCO and the World Bank believe that there is a core group of cost effective strategies for making schools healthy for children and implementing school based health science education. These agencies have launched a partnership to promote health science education called FRESH (Focusing Resources on Effective School Health). Through this approach health science education is implemented in schools that address the provision of safe water and sanitation, a skills based health education, and school based nutrition and health services (UNESCO, 2002; UNICEF, 2000b; World Bank, 2000). The FRESH approach was launched at the World Education Forum (2000) in Dakar, Senegal. Working together to promote this approach, the agencies call for the following four components to be made available in all schools:
- Health related policies: School based policies should ensure a safe and secure physical environment and a positive psychosocial environment.
- Safe water and sanitation facilities: as first steps in creating a healthy school environment.
- Skills based health education: This approach to health, hygiene and nutrition education focuses on the development of knowledge, attitudes, values and life skills concerning health.
- School based health and nutrition services: Schools can effectively deliver some health and nutritional services as long as the services are simple, safe and address problems that are prevalent and recognised as important in the community (UNESCO, 2002; UNICEF 2000b; & World Bank, 2001).
School health science education
The arguments for using schools for the dissemination of health education and treatment are logical: there are invariably more schools than health centres in developing countries, and as schools effectively gather children together in one place, they provide an ideal environment for targeted health education (Elvevag, 2004). There are numerous reports of the effective use of school based health programs to diagnose and/or treat conditions such as malaria and schistosomiasis (Hall, Adjei & Kihamia, 1996; UNESCO, 2002). Furthermore, children are accustomed to receiving instruction in classroom situations and they are thus more receptive to specific health education messages and relay it to other household members. Indeed, school health programs are so efficacious in influencing community perceptions and behaviours that they have been specifically identified by the World Bank (1993) as one of the six most cost effective public health strategies in use. It has also been noted that teacher involvement had the added benefit of promoting the sustainability of the program and garnering community support, as teachers were often influential and respected members in the community (Elvevag, 2004).
The child to child concept
Information conveyed by school children to other household members is generally perceived to be modern, reliable, and believable. This concept was also effectively used by schools in Uganda (Ministry of Education, Uganda, 1992; Carnegie, 2000). Child-to-Child (CTC) ideas and activities represent an approach to health education and may be integrated with broader health education programs. In Uganda there has been a long and intensive effort on children's health education and health promotion through primary schools. The CTC approach has been an integral part of the school system in Uganda since the mid-1980s. Based at the Institute of Teacher Education, Child-to-Child Uganda has, over the years, developed an association of schools, which promote CTC approaches in the classroom and in co-curricula activities. The Government of Uganda, supported by UNICEF, also initiated the School Health Education Project (SHEP) in 1985, which involved the extensive training of teachers and production of teaching/learning materials, incorporating CTC concepts (Carnegie, 2000).
Framework for the study
A case study approach
When embarking upon educational research, several methodological orientations are possible. The challenge in this case was to select a methodology that would provide the best information and possible answers to the research questions. This study used a case study approach because a case study is the most appropriate format for school based research and is a meaningful endeavour for teachers (Hitchcock & Hughes, 1995). Similar to the representations used by Niyozov (2001), the research was bounded in space (the tiny island nation of Timor Leste), time (the post-conflict period 2003-2005), population (teachers and students), focus (context, health science education, attitudes and perceptions) and scale (primary and lower secondary schools). In addition, the research focused on the socio-cultural context of the post-conflict period, thus becoming "more than an intensive, holistic description and analysis of a social phenomenon. Concerns with the socio-political and cultural contexts are what set this study apart" (Merriam, 1998, p. 23). The study made use of different methods of data collection, which have been chosen to take into consideration the complexity of the situation, are culturally sensitive and can be communicated to the reader (Earnest, 2003).
In the context of Timor Leste (East Timor), the study was an inquiry into a complex transitional society. The case study used a multi-method approach using qualitative data with interpretative analysis to allow triangulation of methods and cross validation of the data (Denzin & Lincoln, 2000). The research was based on a non-experimental, cross-sectional study design, utilising primarily qualitative research methods. Since the aim of the study was to evaluate the teachers' current perspectives and attitudes towards implementing a school based health science education program, a cross-sectional design was considered appropriate for meeting the study's data collection requirements. This study thus used a qualitative design using a within method triangulation approach (Meijer, P.; et al, 2002).
Research data was obtained through focus group discussions and interviews with teachers from schools selected for the study, combined with observation of classroom interactions. Focus group discussions were chosen as an appropriate tool for data collection, as group dynamics can stimulate discussions, and generate topics that can be pursued in greater depth in the semi-structured interviews. It was also felt that insights obtained through interviewing were critical to gaining an understanding of the teachers' perspectives and concerns.
Interviews with key informants from the District Education office and NGOs involved with health science education to head teachers provided insights into challenges faced in implementation. Observation of classroom interactions was conducted in the selected schools; this triangulation of information increased the validity and reliability of the data obtained, and the use of multiple investigative techniques permitted the researcher to gain a greater awareness of challenges faced by the teachers and provided a valuable perspective with which the data obtained from interviews and discussions could be compared. The first author carried out the research over four visits to East Timor during a two year period.
Working in a cross-cultural environment
Several researchers have outlined the challenges of working in a cross cultural environment and the care required to maintain cultural integrity (Grbich, 1999; Birbili, 2000). A trained Timorese interpreter/ translator worked with the first author during the study in order to elicit responses and provide a culturally sensitive approach to the research process (Pryor and Reeder, 1993, p.190). The first author has lived and worked in several post-conflict societies (Uganda, Rwanda, Kosovo) and has an understanding of the complexities in these societies. Usunier (1999) suggests starting with a broad conceptual area and then asking the interpreter to elicit key words related to the area to be used in the interviews. Birbili (2000) argues that both the researcher and the participant may not share the same world view but may understand each other through dialogue. All interviews were translated by the interpreter. The translated interviews were then back translated by a bilingual Timorese educator to check for meaning and understanding (Kapborg & Bertero 2002; Birbili, 2000).
The data analysis was guided by the Framework Approach to Data Analysis (Pope et al, 2000, Lacey & Luff, 2001). The key stages involved:
- Familiarisation - immersion in the raw data in order to list key ideas and recurrent themes.
- Identifying a thematic framework - identifying the key issues, concepts and themes by which the data can be examined and referenced.
- Indexing - applying the thematic framework or index systematically to all the data in textual form by annotating the transcripts with numerical codes from the index.
- Charting - the charts contain distilled summaries of views and experiences.
- Mapping and interpretation - using the charts to define concepts and find associations between themes with a view to providing explanations for the findings.
Quality criteria used in the study
The discipline and rigour of qualitative analysis depends upon presenting solid descriptive data, which is often called thick descriptions (Denzin & Lincoln, 2000), in such a way that others reading the results can understand and draw their own interpretations (Patton, 1990, p.375). The use of multiple data collection methods can also be seen as triangulation. Patton (2002) describes different forms of triangulation, two of which have been used for this study. First, triangulation of methods involves different techniques for data collection that can combine both quantitative and qualitative methods. Second, using the accounts of different participants in the interview process refers to multiple perspectives triangulation. Interviews carried out with multiple participants help obtain a multi-dimensional picture by an amalgam of perspectives rather than only a single view. In order to guarantee construct validity, this study used multiple sources of evidence and key informants reviewed draft reports at regular intervals (Ritchie, 2001). Patton (2002) recommends both openness and integrity in the conduct of the fieldwork and in the reporting of the results.
The District Education Officer in Baucau, East Timor was informed of the study and granted permission for the study. Permission for the study was also sought from the school head teachers. A one page research summary of the research was presented to teachers, head teachers and key informants, identifying the objectives and methodology. The summary asserted that all opinions and information provided by informants would be kept strictly confidential and that any information used in the recommendations or final report would be presented in such a way that the source could not be identified. Following this, voluntary informed consent was sought to participate in the research. Informants were also informed from the outset that they had the right to withdraw at any time during the interview or focus group discussion.
Discussion and implications
UNESCO (2002) and WHO (1996) have mandated that basic health science education on the 'killer diseases' (malaria, measles, tuberculosis) be incorporated in the general science syllabus for all primary and junior secondary schools, but in most developing countries this is usually not incorporated. The responsibility for health science education typically falls on the classroom teacher, although some disease specific topics like HIV/AIDS might also be incorporated into general or environmental science classes, or in religious and moral education classes, as appropriate. However, training for health science educators occurred on a very irregular basis in East Timor with no refresher courses. Teachers in every school commented that their knowledge of health science education was incomplete and that they would consequently require comprehensive information if they were to teach children effectively.
The issue of language
Currently the huge problem all educators (primary and secondary teachers, head teachers and lecturers) in East Timor face is that of language. After the conflict the new government decided to adopt Portuguese as the official language of East Timor. Most of the young teachers in the schools under study did not speak Portuguese; they spoke Bahasa and the local dialect Tetum. The issue of language is a big problem in the country, where most of the young people do not speak Portuguese but Bahasa, only the older elite and the Diaspora who returned from Portugal, Mozambique and Angola speak the language. The teachers in primary and junior secondary school under study are given limited free lessons per week to learn the language but are not enthusiastic about the process. All the teachers researcher interviewed expressed this dilemma concerning language.
There is currently confusion about languages. We have textbooks in Indonesian but the level of Indonesian known by the students is not good so sometimes we have to explain in Tetum. All of us young teachers in the school do not speak Portuguese (teachers at a junior secondary school).
I hope the Portuguese teachers who have come from Portugal and are sponsored by the government of Portugal will stay for a long time at least 10-12 years. They must stay longer than this honeymoon stage, only then will our children achieve a level of proficiency (an experienced educator).
Health science education in primary and junior secondary schools
Most of the science and health education taught in schools was based on theory and there was very little practical science at both the primary and junior secondary level. Most junior secondary schools did not have any laboratories.
Many students are fascinated by some of the concepts taught in science, but we do not have any books and it would help if they have practical activities, charts and books and are shown how to use these books (a primary school science teacher).
Most teachers in primary schools and science teachers in secondary schools in East Timor have never done any laboratory work and do not do demonstrations. Many of them have never been given any training in practical activities. They recognised openly their lack of skills and pedagogical knowledge in this area. Teachers asked for support material for teaching science and health education. They also expressed concern that the provision of laboratory equipment would not change their style of teaching because of existing factors: large classes, lessons times, lack of physical space in schools and a lack of in service training.
At present we do not have any books or curriculum to teach science. We only teach from experience. We teachers have consultation together and talk to each other and then plan. We are mothers so we have the experience of health, water, hygiene, disease and our environment (headmistress of a government primary school)
Ability and motivation to participate in health education programs
Teachers also pointed out that even though the program was directed towards the children, it could have a beneficial impact throughout the community, and were enthusiastic about the role they could play in improving community awareness. Teachers were acutely aware of the various interrelated socio-economic and cultural factors which contributed to delays in seeking treatment and empathised with the challenges faced by community members in gaining access to timely medical care. It is certainly crucial to recognise poverty's central role in constraining the health care choices of community members by limiting their access to transportation and treatment.
Teachers' attitudes have also been identified as a key determinant in the success of school health programs by Magnussen et al. (2001), who reported that the teachers' levels of involvement and interest greatly influenced the students' and parents' enthusiasm for and compliance with a school based health science education program in Tanzania. Although teachers in this study were generally very positive about their role as educators, there was considerable variation in their attitudes towards the community in general. While the majority appeared to consider their role as valued and important, some of the teachers lamented the low levels of respect which they experienced from parents, and also the low salaries that they received from the Ministry of Education.
Health education methods
The need is to develop health education materials locally in cooperation with health workers and teachers, to ensure that they are appropriate and effective, and have maximum familiarity and appeal to the target audience. Indeed, as Mathews et al. (1995) have highlighted, health education programs need to be developed and implemented with the full consultation and cooperation of the target community, if they are to be acceptable and sustainable. Although the majority of teachers relied heavily on didactic methods, such as repetition and rote memorisation during observed classes, they nonetheless expressed great interest in using visual aids and participatory approaches for teaching health science education. An effective training program for the teachers needs to take into consideration the severe staff shortages and high rates of teacher attrition. Any school based health education program implemented should have an evaluation component, as this would serve to both identify problems and possible solutions associated with the program,
Recommendations from the Study
- Based upon the findings of this study, a school based health science education program is likely to have the greatest impact if education materials are developed in the local language (Tetum) and the content matter is adjusted to the differing needs of primary students. Health messages should be concise and should include an explanation of how the disease can be contracted and what preventative measures can be taken;
- In order to maximise the impact of a school based health science education program, it would be necessary to concurrently target local communities with a simple health science education messages.
- Where feasible, all teachers in a school should be invited to participate in workshops and training. This will help ensure the sustainability of programs in the schools and will contribute to increased levels of correct knowledge concerning health science education in both the school and community.
- Training workshops should be provided at regular intervals, accompanied by periodic evaluations and opportunities for feedback.
- There must be a will by the Ministry of Education in East Timor to make health science education a priority and it must be introduced in all schools both primary and secondary in all districts and subdistricts of the country.
Like the WHO 1996 and 2003 reports on improving school health programs, this research also identified the challenges facing a post-conflict transitional society as an acute lack of infrastructure and resources, lack of trained teachers to teach health science education, an impoverished population that struggles to survive, a shortage of funds to train teachers and buy resources. Meeting and talking to the teachers and students has given the researcher another lesson in resilience, endurance and hope and that teachers in the transitional nation of Timor Leste want to succeed against all odds.
Adhikary, S. (2002). Environmental Health in East Timor. Assignment report: 23 November 2000 - 2 March 2001. New Delhi: World Health Organization Regional Office of South-East Asia.
AUSAID (2001). Country report on East Timor. The Australian Agency for International Development, Canberra, Australia.
Birbili, M. (2000). Translating from one language to another. Social Research Update, No. 31.
Carnegie, R. (2000). Skills for Healthy Living: Child-to-Child and Life Skills Education in Uganda. Child-to-child Trust, UK.
Denzin, N. & Lincoln, Y. (2000). Handbook of qualitative research (second ed.). California: Sage.
Dunn, J. (2003). East Timor: A rough passage to independence. New South Wales: Longueville Books.
Earnest, J. (2003). Science education reform in a post-colonial developing country in the aftermath of a crisis: The case of Rwanda. Unpublished PhD Thesis. Science and Mathematics Education Centre, Curtin University of Technology, Western Australia
Elvevag, I. (2004). Teachers' perceptions and attitudes towards school-based health education to increase awareness and case detection of Buruli ulcer in an endemic region of Ghana. Unpublished Master's Thesis, Centre for International Health, Curtin University of Technology, Western Australia
ETAN (2000). Excerpt of the speech by Commander Taur Matan Ruak of the FALINTIL.
Grbich, C. (1999). Approaches to health. Health in Australia: Sociological Concepts and Issues, 4-9.
Hall, A., Adjei, S. & Kihamia, C. (1996). School health programmes. Africa Health, 18, 22-23.
Hitchcock, G. & Hughes, D. (1995) (1989). Research and the teacher: A qualitative introduction to school-based research. London: Routledge and Kegan Paul.
Lacey, A. & Luff, D. (2001). Trent focus for research and development in primary health care: An introduction to qualitative analysis. Trent Focus.
Mathews, C., Everett, K., Binedell, J. & Steinberg, M. (1995). Learning to listen: Formative research in the development of AIDS education for secondary school students. Social Science & Medicine, 41(12), 1715-1724.
Merriam, S. (1998). Qualitative research and case study applications in education. San Francisco, CA: Jossey-Bass.
Meijer, P., Verloop, N., & Beijaard, D. (2002). Multi-method triangulation in a qualitative study on teachers' practical knowledge: An attempt to increase internal validity. Quality and Quantity, 36, 145-167.
Ministry of Education (1992). Government White Paper on Education. Kampala, Uganda.
Niyozov, S. (2001). Understanding teaching in post-Soviet, rural, mountainous Tajikistan: Case studies of teachers' life and work. Unpublished PhD Thesis. Ontario Institute for Studies in Education, University of Toronto, Canada.
Kapborg, I. & Bertero, C. (2002). Using an interpreter in qualitative interviews: Does it threaten validity? Nursing Inquiry, 9(1), 52-56.
Patton M. Q. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oakes, CA: Sage.
Patton, M. Q. (1990). Qualitative evaluation and research methods. Newbury Park, CA: Sage.
Pope, C., Ziebland, S. & Mays, N. (2000). Qualitative research in health care: Analysing qualitative data. British Medical Journal, 320, 114-116.
Pryor, J.B. & Reeder, G.D. (1993). The social psychology of HIV infection. Hillsdale, NJ: Lawrence Erlbaum Associates. Inc.
Ritchie, J. (2000). Not everything can be reduced to numbers. In C. A. Bergland (Ed.), Health Research. Melbourne: Oxford University Press.
UNESCO (2000). Dakar framework for action: The World Education Forum. Dakar, Senegal, April 2000 [Available online at ] http://www.unesco.org/
UNESCO (2002). Teaching and Learning for a sustainable future. A multimedia teacher education programme. [Available online]
UNICEF (2000a). Emergency Programmes - East Timor Donor Update. Dili, East Timor.
UNICEF (2000b). Focusing resources on effective school health. UNICEF, Geneva.
UNICEF (2001). Country report for East Timor. The United Nations Children's Emergency Fund, Dili, East Timor.
UNDP (2002). East Timor Human Development report 2002, The way ahead. The United Nations Development Programme in East Timor, Dili, East Timor.
UNDP (2004). East Timor Human Development report 2004, The way ahead. The United Nations Development Programme in East Timor, Dili, East Timor.
Usunier, J.-C. (1999). The use of language in investigating conceptual equivalence in cross-cultural research.
World Bank (2001). World Development Report 1993. Investing in Health, "School Health at a Glance", Oxford University Press, New York.
World Bank (1993). Improved learning through better health, nutrition and education for the school-aged child.
WHO (2003). Democratic Republic of Timor Leste: Country profile for emergencies and disasters. Geneva: World Health Organization.
WHO (2000). East Timor health sector situation report: January - December 2000. East Timor: World Health Organization.
WHO (1996). Improving school health programs barriers and strategies. Geneva: World Health Organization.
|Authors: Jaya Earnest has more than eighteen years experience working in universities and schools in India, Kenya, Uganda, Rwanda, East Timor and Australia. Jaya was educated in India and England and completed her PhD at Curtin University of Technology, Western Australia where she is currently a Lecturer. She is involved in research projects in Australia, India, Sri Lanka and East Timor and currently supervises doctoral students with a focus on post-conflict societies and the developing world.
Dr Jaya Earnest, Centre for International Health, Curtin University of Technology, GPO Box U1987, Perth WA 6845, Australia. Email: firstname.lastname@example.org
Rekha Koul has taught high school students for a short time, followed by teaching at undergraduate level and finally over twelve years of research/extension activities aimed at women as main beneficiaries at the Agricultural University Kashmir, India. She obtained her Doctorate in Science Education from Curtin University of Technology, Western Australia. At present Rekha is working on learning environment projects in Australia. Her most recent research has involved studies of classroom learning environments and teachers' interpersonal behaviour.
Dr Rekha Koul, Science and Mathematics Education Centre, Curtin University of Technology, GPO Box U1987, Perth WA 6845, Australia.
Please cite as: Earnest, J. and Koul, R. (2006). Assessing teachers' perceptions of health education in East Timor. In Experience of Learning. Proceedings of the 15th Annual Teaching Learning Forum, 1-2 February 2006. Perth: The University of Western Australia.
Copyright 2006 aya Earnest and Rekha Koul. The authors assign to the TL Forum and not for profit educational institutions a non-exclusive licence to reproduce this article for personal use or for institutional teaching and learning purposes, in any format (including website mirrors), provided that the article is used and cited in accordance with the usual academic conventions.
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