NURSES' WORK ENVIRONMENT IN TIMOR-LESTE: A SWOT ANALYSIS

Abstract

Background: Nursing is fundamental to healthcare systems, contributing to care delivery, health promotion, and continuity of care. In resource-constrained settings such as Timor-Leste, structural and organizational limitations may adversely affect nurses' working conditions and the quality of care. Objective: To analyze the weaknesses of the nursing work environment in Timor-Leste by identifying the organizational, structural, and contextual factors influencing professional practice and health service delivery. Methods: An exploratory descriptive qualitative study was conducted using the SWOT framework. Data were collected between January 10 and September 20, 2024, through semi-structured interviews with 12 purposively selected participants, including nurses and health service managers. The interview data were analyzed using thematic content analysis with the support of ATLAS.ti software. Data collection continued until thematic saturation was achieved. Results: Five interrelated weaknesses characterized the nursing work environment: workforce shortages, limited material resources and infrastructure, insufficient investment in health promotion, limited community engagement, and weaknesses in care organization. These constraints interacted to reduce service capacity, compromise continuity of care, and limit the implementation of preventive and health promotion strategies. Conclusion: The nursing work environment in Timor-Leste is shaped by interconnected structural and organizational weaknesses, with workforce shortages emerging as the central constraint. These findings provide evidence that may inform workforce planning and strategies to strengthen nursing practice and primary healthcare in resource-constrained settings.