Bhutanese spend more than 58 percent of their expenditure on rimdo or puja and seven percent on purchase of medicines and health accessories, the Bhutan Living Standards Survey (BLSS) 2017 states.

According to the report, on an average, the patients spend Nu 2,304 on treatment and services.

About three percent of the population had stayed at least an overnight at a medical facility due to sickness or injury.

According to the report, elderly people aged 60 years and above are more likely to stay overnight at a medical facility. Their average healthcare expenditure was Nu 7,992. Generally, female spent more than males but in urban areas, males spent more than females.

The report states that the high expenditure on rimdo or puja reflects the Bhutanese’s strong affinity towards spirituality and the centrality of spiritual support. While, the high proportion of transportation costs (25.1 percent) indicates that the indirect costs of getting treatment can be more significant than direct treatment costs like hospital charges and medicines.

“The direct costs might be low because of free or subsidised services at government health facilities,” the report states.

Of those who visited a health provider, 20 percent visited a Basic Health Unit/ Satellite/sub-post, 17 percent visited district hospitals, while 16 and 13 percent visited Jigme Dorji Wangchuck National Referral Hospital and regional referral hospitals.

It was found that 31 percent of those who were sick or injured did not consult a health provider or stayed overnight at a health facility if they did consult one. Majority of them in both urban and rural areas did not consult a health service provider because they felt there was ‘no need.’

Mongar has the highest rate of persons sick or injured at 21.9 percent followed by 20.3 percent in Gasa and 15.2 percent in Bumthang. While, Zhemgang and Dagana had the lowest rates of sickness or injury with less than four percent.

According to the report, the elderly population is more vulnerable to sickness or injury than the younger age groups. Females in both rural and urban areas are more vulnerable to sickness or injury than males.

Only eight percent of the household members spend on other health-related expenditures including routine medication, family planning kits, oral rehydration (ORS), and vitamin supplements.

Dechen Tshomo