The Bhutanese Leading the way.
About 180 health administrators and professionals from across the country are attending the 4th Biennial Health Conference (BHC) that began on September 14 in Thimphu with the theme “Enhancing collaboration, coordination and consolidation in the health sector.”
The conference is considered as the highest policy making forum that upholds participatory approach in making informed-decisions, said the health minister, Lyonpo Tandin Wangchuk. “It provides platform that stimulates healthy debate over the issues and policies to enhance service delivery and also an avenue to rejoice and celebrate accomplishments made by the dedicated health workforce spread across the 20 districts to fulfill the noble vision of our monarchs.”
Highlighting some of the major achievements of the health sector the minister said that life expectancy estimated at 32.4 in 1960 has increased to 69.5 in 2014. Maternal death has declined from 255 deaths per 100,000 live births in 2009 to 86 per 100,000 live births in 2012.
The minister also said that Bhutan became one of the first two countries to eliminate measles in the WHO South-East Asia Region (SEAR) before the regional target of 2020. Bhutan was also conferred the 2017 World No-Tobacco Day Award for the nation’s initiative in implementing measures to ban production and sale of tobacco in the country. The award, he said, is a fitting tribute to the foresight and wisdom of our visionary monarchs.
He said that Bhutan signed the “Call for Action to end TB in the South East Asia Region by 2030”, in March 2017 at Delhi along with other member states. Likewise, by 2018, Bhutan will have no local transmission of Malaria in the country and is targeting to receive WHO Malaria free-certification by 2020.
The minister also said that the three-month maternity leave has been extended to six months from 1st March, 2016 bearing in mind that good nutrition and care during the first thousand days of a child’s development sets a healthy foundation for all the years that follow. Similarly, the government has provided Ambulances to all strategic health facilities to compensate for the less number and physical presence of health workers.
“Today there are 118 functional ambulances as compared to 82 in 2013. The Helicopter services is also provided during critical emergencies and emergencies in places not connected with roads. This is a big achievement in realizing our maximum health care coverage.” Lyonpo said “The government has finalized the Nutrition and Food Strategy along with an Action Plan to address the nutritional issues in the country.”
To address the rising trend in suicidal deaths, a National Suicide Prevention Action Plan is being implemented, Lyonpo said. “One of the major causes of depression and morbidity is alcohol. The government has developed the National Policy and Strategic Framework to reduce harmful use of alcohol,” he said.
The government has also decided to double the current BHTF capital to Nu 3.0 billion by 2018. This year the government will provide Nu 500m to support the BHTF. The government has also earmarked 1% health contribution to BHTF starting from 2014-15 fiscal years. BHTF would be functioning with total autonomy by end of November, 2017. Until now all essential drugs and most vaccines are provided by proceeds of Bhutan Health Trust Fund (BHTF), which took over the financing of essential drugs in 2014.
The minister said that new hospitals are being built at Dewathang in Samdrupjongkhar, Haa, Tsirang, Samtse and Gelephu. A 150-bed “Gyaltsuen Jetsun Pema Mother and Child Hospital” is being constructed in Thimphu for the benefit of women and children.
But the health sector is confronted with several pressing problems and challenges according to the minister.
Communicable diseases remain a substantial burden to the people and the health system and non-communicable diseases are increasing rapidly. Further, there is an emergence of a few interrelated issues like crime, substance abuse and suicide/other mental health problems in the younger population.
Likewise, Outbreaks like Peripheral Neuropathy (PN) which occurred amongst soldiers, monks and students between 1998 and 2012 pose substantial challenges to the health system. The majority of these outbreaks, including the last seven, were reported among boarding schoolchildren.
“Sustaining the framework of free healthcare delivery is a critical challenge,” Lyonpo said. He added that in the face of rising costs, increased expectations and demand for quality health services and dwindling partner resources for health, provision of free health services represents a major challenge.
Among the different categories of health workers, the urgency is most for bridging the gap of specialists and female community health workers. “Shortage of human resources continues to be another challenge in providing equitable access to quality health care,” he said.
He said the ministry introduced the annual award system to healthcare facilities to recognize hard work in-terms of implementing 5S-Continous Quality Improvement (CQI) in their respective hospitals.
5S stands for Sort, Set, Shine, Standardize and Sustain. Besides this, Quality Assurance activities to rank the laboratories based on Laboratory performance was also initiated. The evaluation was conducted in accordance to the level of health facilities.
