Healthcare Scenario of Bhutan

Healthcare Scenario of Bhutan

Are you planning to build or restructure or venture in any healthcare venture in Bhutan? Looking for information about the major healthcare players in Government, Private diagnostic centers that are available in Bhutan? Are you looking to find out which part of the of the city’s is best to venture in or what all facilities are available and what all should be planned for new setup? In this article Hospaccx Healthcare Consultancy has mapped all on major players in terms of medical facilities and healthcare scenario in Bhutan.

Below is the superficial and macro level survey if you need a refined market and financial feasibility or any other study related to healthcare is required you can contact Hospaccx Healthcare business consulting Pvt. ltd on info@hhbc.in or hospaccx.india@gmail.com Or you can visit our website on www.hhbc.in

Overview

Bhutan officially the Kingdom of Bhutan is a landlocked country in South Asia at the end of the Himalayas. Bhutan is bordered by India to the west, south and east and China to the north. Bhutan is second least populous nation. Thimphu is its capital and largest city, while Phuntsholing is its financial center. The national language is Bhutanese.

Population Mix

In 2017, the population of Bhutan was 804,161;

Due to external migration, the population increased by 2,124. The population growth rate was 1.46%.

Average Literacy Rate in 2012 was 67.7%, of which 75.85% were males and 59.55% were females.

Average Literacy Rate of Urban and Rural was 79.35% and 56.05% respectively.

Mortality Rates of Bhutan

The sex ratio of the total population was 1.130 (1,130 males per 1000 females) which is higher than global sex ratio.(2017)

In 2017, the Death Rate was found to be 6.5 per 1,000 population.

In 2016, Life Expectancy in Bhutan was 70.2 years –  Male = 69.93 years and Female 70.46 years.

Economy

Bhutan’s currency is the ngultrum. The rupee is also accepted as legal tender in the country. Though Bhutan’s economy is one of the world’s smallest, it has grown rapidly in recent years, by eight percent in 2005 and 14 percent in 2006.

In 2007, Bhutan had the second-fastest-growing economy in the world, with an annual economic growth rate of 22.4 percent. This was mainly due to the commissioning of the gigantic Tala Hydroelectric Power Station.

GDP per capita has increased from USD 560 in 1990 to USD 2655 in 2015

Bhutan’s economy is based on agriculture, forestry, tourism and the sale of hydroelectric power to India. The industrial sector accounts of 22% of the economy.

The total government health expenditure (TGHE) has increased to 88% in 2010, with a fall to 73% in 2014.

Vulnerabilities

Bhutan’s location, mountainous landscape and precipitation, particularly in the monsoon season, make the country vulnerable to numerous natural disasters. Flash floods and landslides, particularly during the monsoon season, are common.

Despite an abundance of water in the rainy season, the country faces seasonal and local water shortages in the dry season. These seasonal droughts increase the risk of fires, affecting both human settlements and the forest.

Snow-, hail- and windstorms are common in the winter months.

Bhutan is prone to natural disasters and hazards such as earthquake, landslides, floods and outbursts of supraglacial lakes.

Connectivity

Air

Paro Airport is the only international airport in Bhutan. Yongphulla Airport in Trashigang is a small domestic airport.

Growth Plans of Bhutan

Bhutan Youth Employment and Rural Entrepreneurship Project

The Bhutan Youth Employment and Rural Entrepreneurship Project was introduced in May 2017. The project’s goal is to increase employment opportunities in Bhutan, specifically for youth; many of the opportunities created are in agriculture. With more job opportunities, the Bhutanese economy will continue to improve as a result of this project.

Strengthening Public Financial Management Project

The Strengthening Public Financial Management Project was introduced in September 2017 and will conclude in January 2021. The project’s goal is to help the Bhutanese manage their budget and public funds more efficiently. This will help the development and strengthening of public services and governance.

Urban Development Project

The Urban Development Project aims at improving the quality of life in Bhutan through enhancement of basic urban services in selected secondary towns in the country.

The project has two major components:

1) the institutional development component will strengthen the capacity of the Urban Development and Housing Division (UDHD)

2) the urban development component will consist of water supply investments and chlorination equipment, confined to the rehabilitation, and increased capabilities of existing systems, as well as the construction of some new schemes. The solid waste management program will include a public information campaign, and, comprehensive programs of training for waste management personnel will be provided. In addition, sanitation of septic tanks, and urban infrastructure, such as drains, urban roads, and civic facilities will be provided.

Healthcare Scenario of Bhutan

Healthcare in Bhutan falls under the Ministry of Health (MoH).

Most hospitals in Bhutan are public hospitals, with the government responsible for investment in buildings, equipment and supplies. At present, only JDWNRH has major equipment, i.e. one magnetic resonance imaging (MRI) and one computed tomography (CT) scan system. In the private sector, only diagnostic services and retail pharmacy shops exist.

Currently patient information system is paper-based, leading to wastage, inefficiency in medical record-keeping. Patients’ clinical history and prescriptions are not known since a majority of them do not keep prescriptions safely. Every time a patient sees a physician, patient is treated as a new case.

Dual practice (as of 2016) i.e. private practice for government health professionals are not permitted.

Geographical Distribution

In terms of geographical distribution of hospitals by region – 2015

Source: Health Management and Information System, Policy and Planning Division, Ministry of Health, Royal Government of Bhutan, 2016

Western (48%) region has more percentage of hospitals as compared to eastern (29%) and central (23%) region.

Growth of Hospital Beds

The total number of hospital beds; representing an increase from 1.6 hospital beds per 1000 population in 2008 to 2.0 per 1000 population in 2015.

Number of Hospital Beds

Distribution of Health Professionals among the region and 20 districts

There are 269 number of doctors and 1039 number of nurses in the country.

Description of Health Facilities in Bhutan

BHU – Basic Health Unit.

Source -The Kingdom of Bhutan Health System Review, Health Systems in Transition,Vol. 7 No.2, 2017 

Distribution of Public health facilities/beds by region/dzongkhag, 2015 

 

Sources: Health Management and Information System, Policy and Planning Division, Ministry of Health, Royal Government of Bhutan, 2016 and Health Care and Diagnostic Division, Department of Medical Supply.

Health information technology

The penetration rate of mobile cellular service has increased from 0% in 2003 to 87% by the end of 2015, which is close to the average penetration rate of about 90.5% in LMICs (World Bank, 2016).

Mobile phone coverage has contributed to improved access to health services, such as tracking of pregnant mothers for antenatal care (ANC) and postnatal care (PNC) services by primary health workers in Bhutan. It has facilitated telemedicine consultation among primary health-care workers and specialists.

The internet penetration has increased from less than 1% in 2008 to about 62% by the end of 2015

In 2008, the tele-consultation setup between Bhutan and Chandigarh and between Bhutan and Lucknow in India was commissioned and established as part of the SAARC telemedicine project. 

Patient referral abroad

Medical procedures that cannot be carried out within the country are referred to India. A referral committee at JDWNRH decides the suitability of cases for referral as per guidelines. Cases eligible for referral are cardiac and neurosurgeries, kidney transplants (provided a volunteer donor is available), and cancer treatment including radiotherapy. The government bears all the associated costs including travel.

For the past six years (2010–2015), cancers, heart diseases and kidney and urology diseases have topped the number of referrals, 85% of total referred cases in 2014–2015.

Major changes in recent years

The establishment of the HHC(Health Help Centre), providing ambulances to    BHU(Basic Health unit)-IIs, introduction of the helicopter service, institution of EMTs (Emergency Medical Technicians) in the ambulances, improved emergency department with emergency physicians and setting up of the EMSD (Emergency Medical Services Division) has helped to improve emergency care and patient survival. However, with the introduction of the air ambulance service, the cost of emergency evacuations has drastically increased (USD 2625 for one hour of flying time). Between its introduction in November 2015 and October 2016, a total of 102 patients have been airlifted.

Diseases

Bhutan is tackling the triple burden of disease – communicable infectious disease, non-communicable lifestyle-related diseases and diseases related to injuries, nutrition and maternal mortality. There are a host of other emerging and re-emerging infections that are causing increasing morbidity and mortality.

Bhutan saw the last case of poliomyelitis in 1986 and was officially declared polio-free in 2014.

Medical Colleges in Bhutan

The recognized institutes imparting education and training in medical and/or health field in Bhutan :-

Khesar Gyalpo University of Medical Sciences of Bhutan

Institutions below come under Khesar Gyalpo University of Medicine Sciences:

1.Faculty of Nursing and Public Health

2.Faculty of Traditional Medicine

3.Reldri Academy of Health science

4.Faculty of Postgraduate Medicine.

Hospitals in Bhutan

Jigme Dorji Wangchuck National Referral Hospital (JDWNRH)

It had a humble beginning in 1956 when the 3rd Druk Gyalpo commanded the construction of the first allopathic hospital in Lanjophaka, Thimphu. The hospital was shifted to its present location in 1974 and named Thimphu General Hospital. 368 bedded hospital. Thimphu General Hospital was re-named Jigme Dorji Wangchuck National Referral Hospital in the honour of the 3rd King, Jigme Dorji Wangchuck, the father of modern Bhutan in the year 2000. JDWNRH is the largest hospital in the country providing primary, secondary and tertiary services.  JDWNRH serves as western regional referral hospital for the 6 western Dzongkhags and National Referral Hospital for the country.

Mongar Regional Referral Hospital

150 bedded(4 OTs, 9 ICUs and 2 Dialysis) hospital offers the– Medical, Pediatrics, General Surgery, Orthopedic, Gynecology, Radiology, Psychiatry, Dentistry, Anesthesiology, Pathology and ENT specialities.

Paro General Hospital – 40 Beds

Tsirang General Hospital – 60 Beds

Samtse General Hospital – 60 Beds

 

Diagnostic Centres in Bhutan

New Life Diagnostic Centre

Menjong Diagnostic Centre Pvt. Ltd.

 

Conclusion

Bhutan being the small country with small population size. The country is vulnerable with level of preparedness and special facilities that are being provided to the population. Limited number of hospitals, health professionals and medical equipments shows the undesirable medical condition of the country. And also it takes about 3hrs for most of the population by any means of travel to visit the nearest health facility.

The country needs hospital with advanced technologies and modern equipments to cater the population with safety and provide quality of care. The country also needs Medical Institutes and training facilities to overcome the shortage of medical professionals.

Expansion of health facilities will play a critical role in bridging access gaps not just in the health sector but also in a multitude of socioeconomic development programmes for the rural communities. The huge expansion of the network of roads, would improve the population’s access to health services.

if you need any support in planning and designing of a new hospital you can contact us: Hospaccx healthcare business consulting Pvt. Ltd on: hospaccx.india@gmail.com. Or you can visit our website  www.hhbc.in.

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