The Bhutanese Leading the way.
A report by the Ministry of Health (MoH) has outlined significant actions to address the critical challenges facing the healthcare system, including overcrowding at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) and the urgent need for enhanced diagnostic capacity.
The comprehensive report, responding to resolutions adopted by the National Assembly, provides an in-depth measure to improve the quality and accessibility of healthcare services in the country.
Overcrowding has long been a major issue at JDWNRH, with the Emergency Department (ED) particularly strained.
According to the report, in 2023 more than 40,000 patients visited ED, equating to four patients per bed every day. The overcrowding is exacerbated by a shortage of beds in other hospital wards, causing long waits in ED for patients requiring specialized or long-term care.
A key factor contributing to this strain is the growing number of patients with chronic illnesses and those requiring palliative care, who often occupy beds in the already-overloaded wards. To alleviate this pressure, JDWNRH has refurbished its old Obstetrics/Gynecology and Pediatric wards, adding 36 additional beds for medical patients. This expansion has significantly reduced the burden on ED, allowing quicker transfers and reducing wait times.
MoH has also focused on staffing, deploying 18 additional nurses to the Medical Ward to improve patient care.
Furthermore, a long-term solution to address the needs of chronic and palliative care patients is being implemented under the patronage of Her Majesty the Royal Grandmother, with the establishment of a hospice facility in Simtokha. This facility will provide the necessary care for patients needing extended attention, relieving pressure on JDWNRH’s wards.
The report states, “Efforts are underway to streamline the patient referral systems. One such initiative includes strengthening the clinical management of cases across the country in consultation with the heads of clinical departments, which has helped reduce self-referral cases.”
Another contributing factor according to the report about overcrowding is the high number of patients who bypass primary health centers and self-refer to JDWNRH.
To reduce this strain, MoH is strengthening clinical management at regional health centers and organizing specialized health camps in dzongkhags. Moreover, MoH is also working on strategies to refer chronic patients back to local health centers to ensure better distribution of patient care across the country.
While addressing overcrowding is a key priority, MoH has also recognized the critical need to enhance diagnostic services to meet the growing healthcare demands. “I also wanted to refurbish MRI and CT Scan, it has been about 15 years and none of the government could buy new machines,” stated the Health Minister.
The limited availability of diagnostic equipment, such as CT and MRI machines, has been a block in providing timely and accurate diagnoses. The equipment shortage has contributed to long wait times and delays in patient diagnoses, which can negatively impact patient outcomes.
To address this gap, MoH has submitted proposals to the World Health Organization (WHO) and the Embassy of Japan for the procurement of additional diagnostic machines. The cost of these machines is significant but MoH is working tirelessly to secure funding from external donors.
A proposal has been submitted to the WHO Country Office for the procurement of one CT scanner and one MRI machine, with approval expected from the WHO South-East Asia Regional Office. Additionally, MoH has made a grant aid request to the Embassy of Japan to procure three CT scanners and three MRI machines for JDWNRH and two other referral hospitals.
These machines are crucial to meeting the growing diagnostic needs of the country’s healthcare system.
“The provision of these additional machines will be crucial to ensure uninterrupted and timely diagnostic services at JDWNRH and two referral hospitals. With these advanced imaging systems, the hospitals will be better equipped to manage patient diagnoses, reduce waiting times, and improve overall healthcare delivery in Bhutan,” reads a statement from the report.
While MoH seeks new diagnostic equipment, there are financial and logistical challenges to procuring brand-new machines. To address these hurdles, MoH is also exploring the possibility of acquiring refurbished CT and MRI machines.
However, customs regulations, which restrict the importation of second-hand goods, may pose a challenge.
MoH plans to submit a proposal to the Cabinet for guidance on the acquisition of refurbished equipment, which could provide a more cost-effective solution.
