Although Bhutan has achieved 90% coverage on basic health services, the recent report by UNICEF on partnering to ensure equity and happiness for children of Bhutan revealed there is still a need to monitor and improve the quality of services provided by health facilities for young children.
A UNICEF supported study for under-five mortality in health facilities and contributing factors identified the major causes of death among newborns such as, pre-term birth with 37%, sepsis at 22%, and other intrapartum related problems with 22%.
The study further states that, “70% of newborn deaths occurred in the first week of life. In the age group of children 1 to 59 months, the major cause of death was found due to pneumonia with 59%, followed by non-communicable diseases 21% and 12% due to meningitis.”
The study also reveals the major contributing social factor, in both the age groups, was the delay of parents and caregivers in seeking health care.
The deaths that occurred within three to seven days of hospitalization are recorded at 24% and 1% more was seen after seven days.
The study also provides the necessary evidence for policy level decision-making to improve the health system capacity and quality of health services to further reduce under-five mortality.
Much progress continues in the training and deployment of skilled birth attendants and increasing deliveries in health facilities.
However, about 31% of births are still not attended by skilled birth attendants and 37% of deliveries still occur outside health facilities.
“44% of all under-five deaths are contributed by neonatal deaths,” states the report adding that, “There is now a recognized need for a more strategic approach to changing negative beliefs, misconceptions and practices, and to promote good health-seeking behavior. To this effect, an integrated communication strategy and materials for maternal and child health has been developed for finalized and rolling out in 2013”.
The report is a culmination of collective efforts in partnership with the Royal Government of Bhutan across several ministries, civil society organizations, the Dratshang, the UN system and other development partners in pursuit towards the achievement of the Millennium Development Goals for children and women in Bhutan.
2012 saw a tremendous potential for continued growth, to advance the rights of children, adolescents/ youth and women to survival, growth, development, participation and protection with strong focus on addressing inequities and implementation barriers. The report further mentions that much remains to be done in influencing deeply embedded social norms that are detrimental to well-being of children and women, such as child marriage, poor nutritional practices, maternal and child health or use of improved sanitation facilities.