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MoH prepares new measures to address neonatal mortality
Infant mortality remains a pressing health concern in Bhutan, particularly neonatal deaths, which account for nearly 70% of all infant fatalities. Neonatal deaths are those that occur in the first month of the baby’s life after birth.
The Ministry of Health (MoH) said, “Almost 70% of infant deaths in Bhutan are contributed by the neonatal deaths.”
The leading causes of neonatal mortality in Bhutan include prematurity-related complications, neonatal sepsis, and congenital anomalies. In the post-neonatal period, conditions like pneumonia, congenital heart diseases, and hemato-oncology diseases (blood cancer, blood disorders) continue to claim the lives of many infants.
According to the National Health Survey 2023, Bhutan has significantly reduced its infant mortality rate (IMR), dropping from 34.1 per 1,000 live births in 2012 to 15.2 per 1,000 live births in 2023.
Vaccination coverage has also reached nearly 100% for most infant immunizations, helping prevent deadly diseases such as childhood tuberculosis, polio, and pneumococcal diseases. “In 2024, there were virtually no infant deaths attributed to these conditions,” the Ministry said.
Despite the progress, challenges remain. Between January 2024 and now, Bhutan has reported about 85 infant deaths, 58 of which occurred in the neonatal period and 27 in the post-neonatal period. It’s important to note that these figures are based on health facility reports, as community deaths are not included in the data.
To address this, the Ministry has developed the Bhutan Every Newborn Action Plan (2025–2029), which aims to reduce preventable newborn and infant deaths by 2029.
A critical area of focus for the Ministry is addressing human resource constraints, particularly the shortage of trained healthcare professionals in neonatal and pediatric care.
Although the Ministry offers various training programs, such as Certificate and Master’s Courses for nurses and sub-specialty training for doctors, financial incentives for career advancement remain insufficient, many professionals are hesitant to upgrade their qualifications. “Although we have training programs for Nurses to undergo Certificate and Masters Courses, for General Doctors to undergo Specialist training, and for Specialist doctors to undergo Sub-specialty training, not many come forward due to the lack of financial incentives,” said the Ministry.
In addition to human resource challenges, geographical barriers continue to hinder timely healthcare access. Bhutan’s rugged terrain makes it difficult to provide essential services in remote areas.
While ambulances are available, they lack crucial medical equipment, such as portable ventilators and infusion pumps, necessary for transporting critically ill newborns.
The Ministry has acknowledged the limited funding available for continuous professional development and the adoption of advanced healthcare technologies, and efforts are underway to address these gaps.
In response to these challenges, the Ministry has launched several initiatives. Through the Accelerating Maternal and Child Health Program (AMCHP) and the 1000 Golden Days initiative, the Ministry aims to increase service utilization from conception through a child’s second birthday.
In partnership with NMS and KGUMSB, the Ministry is also offering in-service training on Neonatal Basic and Advanced Life Support (NBLS/NALS) to healthcare workers involved in deliveries and neonatal care, particularly to combat birth asphyxia—one of the leading causes of neonatal deaths.
An important breakthrough in infant care has been the identification and prevention of Infantile Beriberi, a condition caused by vitamin B1 deficiency that once contributed significantly to infant mortality. Previously misidentified as meningo-encephalitis, this disease primarily affected exclusively breastfed infants under six months.
The Ministry, in collaboration with UNICEF and Vitamin Angels, launched the Maternal Micronutrient Supplement (MMS) in May 2023. Unlike the previous Iron-Folic Acid supplementation, MMS not only prevents anemia but also reduces the incidence of Infantile Beriberi, low birth weight, and stillbirths. “It helps prevent anemia while also reducing the incidence of Infantile Beriberi, low birth weight, preterm births, and stillbirths,” the Ministry stated.
Exclusive breastfeeding rates have also shown significant improvement. According to the National Health Survey 2023, the percentage of infants exclusively breastfed under six months rose from 51.4% in 2015 to 69.4% in 2023.
To further support breastfeeding, the Ministry, in collaboration with KGUMSB, has developed a training program for healthcare workers, enhancing their skills in breastfeeding and lactation management.
To further advance maternal and newborn care, the Ministry is undertaking infrastructure projects such as the Gyaltsuen Jetsun Pema Wangchuck Mother and Child Hospital and the Multi-Disciplinary Super-Specialty Hospital, which are set to provide state-of-the-art services for maternal and newborn care.
The establishment of a Lactation Management Center and Human Milk Bank at JDWNRH, as well as Lactation Management Units in regional hospitals, are also underway to improve breastfeeding support.
Short-term clinical attachments for nurses at JDWNRH’s Neonatal Intensive Care Unit (NICU) and Pediatric Intensive Care Unit (PICU) have been introduced to improve neonatal care skills.
The Ministry is also looking ahead with plans to establish specialized fields like neonatology and pediatric cardiology, with several doctors already returning from sub-specialty training abroad.
The Ministry said, “The goal is to reduce preventable neonatal and infant deaths, improve overall child health outcomes, and ensure that Bhutan’s healthcare system is well-equipped to address these challenges.”
