Bhutan’s fertility rate has seen a huge decline over the years, from 5.6% in 1994 to 4.7 in 2000 to 2.3 in 2012. This year the fertility rate dropped to 1.9% which according to the Health Minister Lyonpo Tandin Wangchuk is a huge concern.
The health minister said the situation of population growth is as good as a zero growth due to number of births in a year equaling the number of deaths. He said the situation now, if not taken care of, can be compared to the current population crisis in Japan in future. With the population density of 18 people per square kilometer, Bhutan is still seen as one of the countries with the lowest population densities despite the slight growth in population every year.
Of the 193,951 women in the reproductive age group of 15-49 years, 125,944 (64.9%) have given birth at some point in their lives as per the Bhutan living standard survey 2017 report.
With a total of 820 births from teenage mothers this year, teenage pregnancy is rated to be about 6.4 times more common in rural areas than that in urban areas. The proportion of women who did not receive antenatal care in urban areas was just over 5%, while it was over 11% in rural areas. A slightly higher proportion of women did not receive postnatal care in both urban (10.7%) and rural (15%) areas than antenatal care.
With regard to the first birth, the mean age of women was 21.7 years where of the total women of reproductive age, only 5.7% gave birth in the last 12 months prior to the survey period. Proportionally, the highest births were given by women aged 20 to 29 with 63.2% and the fewest by women aged 15 to 19 at 2.29%. The report also reveals that the teenage pregnancy in the rural area is 3.6 times that in the urban areas for the same period.
Of the 11,474 total live-births, the births to teenage women (15-19 years) made up to not more than 2.1% of all the births in the past 12 months revealing that fertility of a teenage women is 0.8 percent showing the reduction in the past 12 months prior to the survey. Among the dzongkhags, Samdrup Jongkhar is found to have the highest proportion of teenage females who gave birth during the period. The report found that of 31,858 women aged 15-19 years, 244 gave birth in the past 12 months, where just over 3% were married or living together.
The majority of the women (90.9%) who gave birth in the last 12 months received antenatal care. Slightly lower proportion of women received postnatal care as compared to antenatal care, irrespective of both urban and rural areas. While nine out of ten gave birth in a hospital or a health facility, the report revealed that just over 3% gave birth at home without skilled attendants.
The percentage of home deliveries were more in rural areas at about 8%. About 6% of the deliveries in rural areas took place at home without skilled attendants.
Regarding the child survival rate, the number of children born in their lifetime to women aged 15-49 years is estimated at 93% for the entire country. By area of residence, the child survival rate is slightly higher in urban areas (95%) than in rural areas (92.4%). Among the Dzongkhags, it was revealed that PemaGatshel (98%) has the highest child survival rate followed by Monggar and Wangdue Phodrang with over 95 percent, while Trongsa, Haa, and Gasa had the lowest child survival rate of below 89%.