Objectives: The main objective was to determine those characteristics of the family and household that affects child
health (as measured by child size for age) in the rural Ossu area of Timor-Leste.
Methods: Interviews of parents in 102 households assessed reproductive histories, the amount and type of resources
available and family composition (number, sex, and age of members). Height, weight, and mid-upper arm circumference
were measured for all children in the household. To standardize for age and sex, raw measures were transformed into
WHO Z scores and compared across households.
Results: Children were low in both height and weight relative to international standards and older children compared
with international standards more poorly than under-fives. There was no evidence of sex difference in relative
growth. The number of children in a household was negatively associated with height but not weight and positively
with BMI. Children living in the villages more distant from Ossu town center had significantly lower Z scores for height
than children in town. No crop or livestock indices were related to growth. Fostered children did not show growth different
from biological children, but biological children in households with fostered children were slightly larger for age.
Conclusions: Short stature inflates BMI and harvest season measures may have captured short-term increases in
children’s energy balance. Social networks may increase child well-being by moving children toward resource richer
households. Social and cultural factors influence resource allocations among children and their health in rural TimorLeste