As Bhutan prioritises reducing non-communicable diseases (NCDs) in the 13th Plan, Dr Bhupinder Kaur Aulakh, WHO’s Representative to Bhutan, discusses with Kuensel’s reporter Jigmi Wangdi on how WHO will partner with the government over the next five years to enhance Bhutan’s health system
How would you describe the current public health landscape in Bhutan, and which are the areas that need focus?
Bhutan’s health system is exemplary, providing universal health coverage that includes free services, diagnostic tests, medicines, and even international referrals. This system is a model for universal health care, demonstrating an impressive commitment to inclusivity. However, with the rise in non-communicable diseases, there’s a critical need to extend advocacy efforts beyond the health sector. It’s essential to address risk factors such as tobacco and alcohol use, physical inactivity, and other lifestyle-related issues. Engaging non-health sectors and collaborating with various agencies are key to improving public health and managing these risks effectively.
What are some of the key public health priorities for WHO in Bhutan?
WHO’s priorities are closely aligned with those of the Ministry of Health and the broader government agenda. The 13th Plan provides a framework that guides WHO’s activities alongside those of other ministries. Our focus remains on promoting overall health, ensuring universal health coverage, and enhancing access to high-quality health care services for all individuals. By supporting these objectives, WHO aims to contribute significantly to Bhutan’s health sector development.
There has been a noticeable spike in non-communicable diseases (NCDs) in Bhutan. How is WHO collaborating with the government to address NCDs?
NCDs, often referred to as lifestyle diseases, are responsible for over 70 percent of deaths in Bhutan. Several factors contribute to this concerning trend, including increased alcohol and tobacco consumption, physical inactivity, and rising rates of obesity. WHO is working hand-in-hand with the Ministry of Health to address these issues through health promotion activities and advocacy. Our goal is to reduce risk factors and encourage healthier lifestyles by promoting balanced diets and physical activity. We believe that targeted efforts in these areas will help curb the prevalence of NCDs.
Bhutan’s fertility rate of 2.0 is below the replacement level of 2.1. What is WHO and the health ministry doing to improve the fertility rate?
Bhutan’s fertility rate of 2.0 is currently below the replacement level of 2.1. This decline is influenced by various factors, including increased educational and career opportunities for women. The government is actively working to support women in balancing career aspirations with family life. Policies that promote flexible working hours and provide support for child-rearing are crucial. WHO is assisting the Ministry of Health in developing infertility programmes and facilitating learning opportunities from international practices. We are working to ensure that the necessary support systems are in place to encourage family growth and address fertility issues.
How is WHO supporting Bhutan’s 13th Plan, particularly in the area of health?
The 13th Plan is a guiding document for both the Ministry of Health and WHO. We are fully committed to supporting the plan’s objectives, which include improving access to care, enhancing the quality of health services, and building the capacity of the health workforce. Workforce attrition is a significant challenge, so we are also focused on strengthening the skills of existing health professionals and establishing standards for health services. Our collaboration aims to ensure that the health sector can meet current and future needs effectively.
What are WHO’s recommendations for improving healthcare access and equity in Bhutan?
To improve healthcare access and equity, WHO recommends that Bhutan focus on reaching marginalised and vulnerable populations. This includes highland communities, tribal groups, transgender individuals, and residents of remote and urban areas. The goal is to ensure that no one is left behind and that all segments of the population receive high-quality health services. By addressing these disparities, we aim to create a more equitable health system that serves everyone effectively.
Post pandemic, how can Bhutan better prepare for and mitigate the impact of potential public health emergencies?
Bhutan’s response to the Covid-19 pandemic demonstrated effective use of immunisation platforms and resulted in relatively low morbidity and mortality rates. Moving forward, WHO is assisting the Ministry of Health in enhancing preparedness for future public health emergencies. This includes conducting simulation exercises, assessing preparedness for high-risk factors such as earthquakes and glacial lake outburst floods, and strengthening disaster management capacities. We are working with disaster management agencies to build their skills and enhance their ability to handle emergencies. Additionally, WHO is providing equipment and capacity-building support to ensure that Bhutan is well-prepared for any potential health crises.