Jigmi Wangdi
The Ministry of Health (MoH) is intensifying efforts to address the shortage of healthcare professionals in the country—an issue that continues to strain hospitals and clinics across all 20 dzongkhags.
Despite measures to maintain minimum staffing levels, the shortage of doctors, nurses, and technicians is a major issue, particularly in remote gewog health centres.
Health Minister Tandin Wangchuk attributes the shortfall to several factors, including staff attrition, extended leaves of absence, and a growing trend of medical graduates opting out of civil service roles.
Currently, 30 out of 187 primary healthcare centres lack female health assistants, primarily due to deployment challenges in rural areas. While dzongkhags have been provided with adequate numbers of female health workers based on the number of health facilities, gaps exist.
The government’s pledge to deploy doctors to gewog health centres on a monthly basis is yet to be fully implemented. The ministry is however working on a plan to deploy general doctors to gewog health centres, based on population, caseload, and workload.
The National Medical Service is also working on instituting an outreach programme for the doctors from a district hospital to a gewog centre, like the outreach programme provided by health assistants to the outreach clinics (ORCs) on a monthly basis.
Currently, health assistants in primary healthcare centres continue to provide outreach services on a fortnightly basis.
The health ministry also plans to introduce Mobile Medical Units in the coming fiscal year to extend healthcare services to remote regions, supplementing existing outreach programmes.
“We will be more effectively able to implement the doctor’s visit to the gewog health centres once the mobile medical units are procured and fully operational,” the health minister said.
The plan to assign at least one General Practitioner (GP) or medical specialist to each district hospital has also faced delays. However, medical specialists are currently deployed on a rotational basis to tertiary health centres.
“Ever since the 12th Plan and the development of the HR standards for health, the ministry’s goal was to deploy one general practitioner to each district hospital. However, this has not been possible due to the low uptake of the medical doctor (MD) programme in General Practice offered by the Faculty of Postgraduate Medicine under the Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB),” the health minister said.
Other measures to strengthen the workforce include the launch of an MBBS programme, expanding MD courses to all clinical fields except pathology and radiology, and increasing nursing student intake by 100 annually since 2023 through public and private nursing colleges.
Staffing shortage is also addressed through Health Volunteers Overseas programme and international healthcare camps with international partners, including the Himalayan Cataract Project and Doctors Without Borders.
The ministry is also working on career pathways for health professionals, including competitive pay packages for specialists, sub-specialists, technologists, technicians, nurses, traditional medicine professionals, and general doctors. This initiative aims to improve retention and incentivise specialisation in critical areas.
The MoH has aligned its deployment strategy with the HR Standard for health services. “In the 13th Plan, we intend to monitor the deployment of doctors and specialists to appropriate health facilities by gauging the ministry’s ability to fulfil our aspirations enshrined in the HR Standard,” the health minister said.
In collaboration with the Faculty of Nursing and Public Health and KGUMSB, the ministry has also increased the intake of female students and instituted a quota for female students to ensure every gewog eventually has at least one female health worker.