The Bhutanese Leading the way.
In the remote mountains of Laya, residents are confident in the healthcare available at their Basic Health Unit (BHU) for their newborns. Routine check-ups, weight, height, vaccinations, and basic monitoring have become the cornerstone of newborn care in the region.
For most parents, this is more than enough. But while families feel reassured, a closer look reveals a gap between perception and reality when compared to urban hospitals.
Pema Lhaden, 25, who delivered her baby in Punakha hospital but returned home after a week, said she diligently takes her child for regular check-ups. However, she said, “I have to breastfeed my baby, I rarely get to eat nutritious food. I heard it directly affects the baby too, but until now, my baby has been growing healthy,” she said.
Pema also shared the challenges her family faced in bringing their newborn home from the last road connection. “We not only had a tough time traveling to Gasa on bumpy roads for the ultrasound, but also had to carry my newborn through the dust on the return journey,” she said. She emphasized that the government could make better use of the rooms already allocated for ultrasound and delivery services, so that babies could be born closer to home and families would not have to endure such harsh travel conditions in challenging weather.
Many other mothers shared similar views. They noted the challenges of traveling long distances with newborns in harsh weather, yet stressed that the hospital’s routine services were sufficient.
This reporter also met with Leki Tshering, 28, and his wife Pema, 22, parents of a one-year-old son. Like many others, they too traveled to Punakha for the delivery and returned home about a week later.
When asked about the health facilities available in the region, Pema shared that the hospital in Punakha provides everything their baby needs. She added that whenever their child falls ill, they are able to get all the necessary medicines from the hospital.
“Whenever our child falls sick, we can get all the medicines we need,” said Pema.
Namgay Om, 27, who came to witness the Royal Highland Festival with her 23-day-old baby, said she also takes her child for all the routine health check-up and has not faced any challenges so far.
However, not all residents view the situation the same way. Reflecting on his early days of parenthood, Leki Tshering, who has observed hospitals in urban dzongkhags, noted the differences. “The local BHU in Laya has improved, but it lacks many of the facilities I’ve seen elsewhere. In urban areas, hospitals have advanced machines and better delivery facilities. Here, we manage with routine check-ups, but it’s not the same.”
The need to travel outside Laya for delivery further highlights the region’s limitations. While the two Health Assistants at the BHU are trained to assist with deliveries, the absence of doctors, according to the mothers, means that they do not trust the BHU for childbirth and are often referred to Dzongkhags like Punakha or Thimphu based on their preference.
Pema Choden, the Health Assistant (HA) for Laya BHU, mentioned that the hospital provides regular newborn check-ups, covering immunization, weighing, and height measurements. She notes that most mothers bring their babies on time, though occasional delays occur due to household or herding responsibilities.
When asked about how newborn babies are treated when they fall sick and the most common illnesses observed in the region, the HA said that there are not many cases reported. The common ones, she noted, would be mild pneumonia. She added that pneumonia cases are very rare, about one in twenty, and credited this to the quality care provided by mothers.
Since most residents are not aware of the kinds of healthcare facilities available for newborns in less geographically challenged areas, they believe their babies receive all necessary care through routine check-ups.
However, when asked about the availability of advanced facilities for newborns, the Health Assistant explained, “There are only routine health check-ups for newborn babies, which include immunization, weighing, and measuring their height. However, there is no machine to treat jaundice and no blue light machine.”
She also recalled a case in which a baby developed jaundice and had to be referred to Gasa Hospital due to the lack of necessary equipment in the BHU.
However, Care for Child Development (C4CD) classes are being provided to mothers until their babies reach the age of two, covering the age range from 0–2 years. “I inform the parents or mothers through a group that has been created and remind them to attend the classes,” she said.
There is a total of nine sessions under the program, which focus on teaching parents how to stimulate and support their babies’ mental development. The first session begins from birth to six months, guiding mothers on how to engage and respond to their infants in ways that encourage healthy growth and learning.
Apart from routine newborn check-ups and the Care for Child Development (C4CD) classes, the BHU does not have any additional specialized healthcare facilities for newborns.
While residents feel their newborns are well cared for, their perception is shaped by what they see locally. Routine check-ups are tangible and visible, while the lack of advanced equipment or specialized care goes largely unnoticed.
UNICEF notes that Bhutan is on track to reduce newborn mortality and is focused on equitable access to quality newborn health services across the health system. “Through training on Early Essential Newborn Care and Kangaroo Mother Care, and by strengthening supply systems, even remote communities like Laya can access essential care for their newborns,” said UNICEF.
In Laya, routine check-ups have transformed newborn healthcare, giving parents confidence that their babies are healthy. Yet, a closer look reveals that the comfort of routine care may mask gaps in infrastructure that could matter in emergencies. Moreover, this gap highlights a fundamental difference between perceived adequacy and the potential risks that could arise in emergencies.
As residents continue to rely on local facilities, the contrast with urban hospitals presents the lack of awareness, access, and preparation that must go hand in hand, even in the most remote corners of Bhutan.
This story was covered as part of the media reporting grant from UNICEF
