To ensure a healthier nation, the health sector’s priorities in the 12th Plan include providing access to equitable quality healthcare, reducing the incidence of non-communicable diseases (NCDs) and ensuring the sustainability of healthcare.
To achieve the objectives of the 12th Plan, the budget report 2019-20 states that the health sector is allocated a total of Nu 5.7 billion in the financial year 2019-20. Of the total allocation, Nu 2.3 billion is for the health ministry.
According to the report, the health ministry’s allocation includes Nu 420 million for the on-going construction of 150-bed Gyaltsuen Jetsun Pema Mother and Child Hospital and 40-bed hospital in Dewathang.
An addition of Nu 350 million is allocated in the dzongkhags for infrastructure development and Nu 212.5 million for construction and maintenance of rural water supply scheme.
Nu 60 million has also been allocated for the construction of additional wing at JDWNRH.
About Nu 75.5 million is allocated to pursue health promotion and disease prevention programmes to combat the emerging challenges with increasing healthcare costs associated to communicable and NCDs.
For the procurement of medical equipment and spare parts, the ministry and JDWNRH are allocated Nu 135 million and Nu 63.4 million respectively; Nu 19.2 million for the procurement of two ambulances and three service vehicles; Nu 56.8 million for human resources development programmes; Nu 13.5 million for continued medical education, and Nu 9.7 million for promotion of traditional medicines.
Flagship programme
Of the seven 12th Plan flagship programme, health is relevant to three programmes – water, Digital Drukyul and health.
According to the budget report, Nu 130 million for the health flagship programme is provisioned under the general reserves.
The heath flagship programme includes strengthening services at the regional hospitals, improving and strengthening the eight trauma centres, improving BHU IIs in six strategic areas, strengthening services at BHU II, especially lab services, and strengthening health-screening services at the grassroots.
For Digital Drukyul, health ministry’s chief planning officer, Tashi Penjor, said that the ministry had gathered a fund of USD 4 million for a project, EPIS (electoral patient information system) that would have patient’s clinical reports.
Health indicators
Mother and child health is one area that measures the nation’s health. In terms of trends in health indicators, maternal mortality ratio, infant mortality rate, under-five mortality rate, deliveries attended by skilled health personnel, institutional delivery and percentage of the population who live three hours of less from the nearest heath facility are the major health indicators.
Going by the major health indicators, the country has made a significant progress over the years. In 2000, the maternal mortality ratio was 255 per 100,000 live births. The health sector aims to reduce the ratio from 89 to 83 per 100,000 live births in the 12th Plan.
Infant mortality rate has been reduced from 60.5 in 2000 to 15.1 per 1,000 live births. The sector aims to further reduce it to less than 15 per 1,000 live births in the next five years.
Similarly, the under-five mortality rate per 1,000 live births is targeted to reduce to 20.3 per 1,000 live births from 34.1. In 2000, under-five mortality was 84 per 1,000 live births.
The sector also aims to increase institutional delivery to more than the current rate of 93.40 percent and the percentage of the population who live three hours or less from the nearest health facility to more than 90 percent.
Declining health financing, rising incidence of NCDs and chronic diseases, rising healthcare costs, the triple burden of disease, human resource constraints especially at the tertiary care level, scattered and hard to reach settlements and poor health-seeking behaviour are some of the challenges faced by the sector in the 12th Plan.
Dechen Tshomo