In a significant step towards improving maternal and child health, the Ministry of Health (MoH) has embarked on a comprehensive Mother and Child Health (MCH) program, leading in a new period of care and support for expecting mothers and the child. Launched on 14 October 2023, this initiative aligns with national priorities and the ‘2020 Policy,’ with a primary goal to strengthen the well being of mothers and children throughout Bhutan.
While Bhutan has made remarkable progress in the maternal and child health, several challenges continue, including high maternal and newborn mortality rates, inadequate utilization of maternal health services, and a deficiency in early-stage care for pregnant women. According to UNICEF data, Bhutan has an under-five mortality rate of 26.7 deaths per 1,000 live births and a neonatal mortality rate of 15 deaths per 1,000 live births 12. The data available on maternal mortality rate in Bhutan is from 2020, which was 60 maternal deaths per 100,000 live births.
These challenges are further complicated by the declining Total Fertility Rates (TFR). Bhutan’s commitment to addressing these issues is unwavering. Recent statistics reveal that the country’s fertility rate has dropped to 1.866 births per woman in 2023, marking a 1.43 percent decline from the previous year. The declining trend in fertility rates has raised concerns, prompting the government’s goal of raising TFR from 1.9 percent to 2.1 percent by 2034 as outlined in the 13th Five-Year Plan.
The comprehensive MCH program aims to tackle the above mentioned challenges head-on by focusing on two key aspects: improving access to maternal and child health services and promoting health-seeking behaviors. The program encompasses a wide array of services, including fertility and preconception services, medical screening, multiple micronutrient supplements (MMS), mental health screening during Antenatal Care (ANC) and Postnatal Care (PNC), screening for intimate partner violence, oral health screening, maternal exercises, lactation management, screening and management of developmental delays, and conditional cash incentives for eligible women.
MoH has identified several key issues affecting the health and well-being of mothers and children in the country. These include variations in healthcare access across different regions, limited use of healthcare services in remote areas, particularly among women with lower educational backgrounds and lower socioeconomic status.
According to MoH, this program is not just a short-term solution, but a long-term investment in Bhutan’s future. By emphasizing comprehensive maternal and child healthcare, the nation is investing in human capital development, reducing healthcare costs, fostering social stability, and promoting economic growth.
It is a testament to Bhutan’s unwavering dedication to the well-being and potential of its population, in line with national development objectives and priorities.
However, as with any initiative, there are voices within the community with their concerns and suggestions. A 35-year-old pregnant woman working in the corporate sector in Thimphu shared her views regarding the conditional nature of the allowances under the program, which currently apply only to Royal Civil Service Commission employees. She said, “The allowances should be extended to all women to prevent any disparities and ensure that every mother receives the support she needs.”
Additionally, there is a notable need for increased awareness of the services offered by the program. A 29-year-old woman visiting the Gyaltsuen Jetsun Pema Wangchuck Mother and Child Hospital pointed out that critical services like preconception care, medical screening, micronutrient supplements, and mental health screening require more public knowledge. She added, “Many couples hesitate to seek these services due to lack of awareness or uncertainty about where to go for consultation.”
The concerns and suggestions put forth by these women underscore the importance of not only launching such programs, but also ensuring that they reach all segments of the population and that there is widespread awareness of the available services. To truly make a difference in maternal and child health, it is crucial that the benefits and knowledge are accessible to every hopeful mother.