What the Sheep reminded about health care

Yearender/Health: Administrative and clinical issues may have kept the health sector on its toes but the sheep year was fairly calm for a sector that often gets dragged into unhealthy cases.

For the health sector, the sheep year was about putting in place policies. Suicide was recognized as a public health concern more than a crime after a study revealed that the country’s suicide death rate 14 per 100,000 population was higher than the global average of nine to ten deaths.

An action plan was instituted and suicide prevention is now an indicator in the heath ministry’s and the local government’s Annual Performance Agreements.

While suicides were claiming young lives, the country was also buckling under the burden of rising non-communicable diseases (NCDs). Prevalence of diabetes and physical inactivity in Bhutan, the sheep bleated was the highest in the South-East Asia region.

Accounting for 53 percent of all deaths in the country, NCDs had surpassed the burden of infectious illnesses to become Bhutan’s biggest health challenge.

To address the growing threats of NCDs, Bhutan released a five-year multi sectorial action plan.

One of the 10 targets set in the action plan is to reduce harmful use of alcohol since Bhutan’s per capita consumption of alcohol is eight liters against the global consumption of 6.2 percent of alcohol per person 15 years and older.

An important milestone in the sheep year is the Cabinet’s endorsement of the National Policy and Strategic Framework To Reduce Harmful Use of Alcohol. The policy would among others, control access and consumption by levying tax based on the alcohol content of products.

It would ensure that minors (below 18 years) are restricted from entering entertainment venues that exclusively promote alcohol consumption and has also acknowledged the authority of the local government.

Alcohol is, however, not the lone cause. The sheep reminded that the country’s health problem is compounded with ageing, a still high prevalence of communicable diseases, and a steady decline in spending on health care services.

From 5.7 percent of gross domestic product spent on health in 2000, Bhutan’s spending on health over the years had declined to 3.5 percent when the sheep year began.

With sustainability issues looming large against the growing health challenges, health walks were organized nationwide to raise funds in financing the supply of essential drugs and vaccines.

The Bhutan Health Trust Fund was injected with Nu 11.6 million (M) which was collected in a health walk drive from Bhutanese and foreign donors.

The Trust’s role in supporting essential health care services was acknowledged when the World Health Organization conferred the Excellence in Public Health award to former health and education minister Sangay Ngedup in Dili, Timor-Leste.

To generate reliable scientific information on health and diseases for well-informed policies, the government of India supported Royal Centre for Disease Control, which was instituted in Thimphu.

The sheep ensured that mother and child health continue to receive priority and work to construct a 150-bed Gyaltsuen Jetsun Pema Mother and Child Hospital has begun. A decision to introduce epidural labour analgesia for free to ensure painless childbirth was also recently taken.

Although the year saw important policies being instituted, it also revealed loopholes in some existing polices. A post on social media alleging a drunk HIV positive woman posing a risk raised issues of not just patient confidentiality but also questioned about who had the authority to reveal a person’s HIV status in the interest of public health.

For the health sector, the sheep year was about reminders. It reminded the importance of taking preventive measures and that the threat can come from even a mosquito.

Sonam Pelden 

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