Bhutan’s life expectancy has increased from 32.4 years of age in 1960 to 69.5 years of age in 2014. This development can be linked to Bhutan’s Primary Health Care (PHC) system, which provides integrated modern and traditional health care services to all Bhutanese citizens, and dates back to the early 1960s. Bhutan’s National Health Policy is linked to the country’s five year strategic planning framework and is implemented by the Ministry of Health through a network of 31 hospitals, 178 basic health unit clinics and 654 outreach clinics in more remote areas. There are currently no private health care facilities in Bhutan. Access to free health care is a core component of Bhutan’s Gross National Happiness development strategy and its implementation is monitored by the Gross National Happiness Commission.
The PHC scheme is available to all citizens of Bhutan on the basis of universality and provides access to a comprehensive package of health care services including the provision of a list of essential drugs and services free of charge. The basic package of essential services ensures access to traditional medicines, maternal and child health services, diagnostic and curative services, full emergency services as well as specialised services for vulnerable groups, such as older persons and persons with disabilities. The health care system also offers non-essential services to all citizens, subject to user fees. Effective implementation of the PHC programme has resulted in the eradication iodine deficiency disorder in 2001, ahead of all other countries in South and Southeast Asia. Health services in Bhutan are currently accessible to more than 90 per cent of the population through an extensive system of rural clinics. While also entitled to free health care, the remaining 10 per cent of the population currently lives more than three hours walking distance from the nearest health clinic.
Public health care in Bhutan dates back to the 1960’s, which received an increased mandate in 1978 when Bhutan signed the Alma Ata Declaration and introduced the primary health care approach, resulting in today’s PHC scheme. While the health care system in Bhutan has greatly improved, suggesting successful implementation, some challenges still remain in providing equal access to remote areas of the country, developing a sustainable health financing system and also in addressing a current shortage in qualified medical professionals. Despite accessibility issues, Bhutan’s national health care scheme forms an important part of a national social protection floor that is designed to ensure universal accessibility to basic health care services.
Further Reading:
Government of Bhutan (2009). National Health Policy. Accessed from http://www.health.gov.bt/wp-content/uploads/moh-files/2015/11/National-Health-Policy.pdf on 11 January 2016.