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Tinley Nangai
According to the National Health Survey (NHS) 2023, Bhutan has achieved new milestones in maternal and child health, with both maternal and child mortality rates declining significantly.
Between 2012 and 2023, the maternal mortality ratio (MMR) decreased from 86 to 53 per 100,000 live births, while the proportion of institutional deliveries increased from 73.7% to 98%, indicating an increased reliance on institutional deliveries.
NHS 2023 also reported that 81.1% of newborns had skin-to-skin contact with their mothers immediately after birth – a practice known as kangaroo care.
This approach is essential for establishing a mother-infant bond and enhancing the health of the newborn by stabilizing body temperature, heartbeat, and other vital functions. Kangaroo Care can also promote breastfeeding and help reduce postpartum bleeding in the mother.
Child mortality has also fallen significantly. The neonatal mortality rate (a measure of the number of deaths in the first month of life per 1,000 live births) fell from 21 in 2012 to 6.9 in 2023.
Likewise, the infant mortality rate (number of deaths under the age of 1 per 1,000 live births) fell from 30 to 15.2. The under-five mortality rate (number of deaths under the age of 5 per 1,000 live births) also fell from 37.3 to 19.5.During the same period, the proportion of births attended by skilled health personnel increased from 74.6% to 98.5%. This remarkable improvement reflects the country’s commitment to strengthening health care services and ensuring that more births are attended by trained professionals.
Health ministry officials attributed the significant drop in maternal and infant mortality to the hard work of medical staff and widespread support.
Officials said it also reflects Bhutan’s strong initiatives, e.g. Antenatal care, contraceptives, Immunization, emergency obstetric and newborn care, and accelerated maternal and child health Achievement projects, etc.
The Ministry of Health has been committed to ensuring 100% facility coverage since 2005, a goal that has contributed significantly to the decline in mortality. Social factors such as improved road connectivity, rising education levels and economic development have also contributed to this success.
The ministry aims to achieve zero maternal and child mortality and health officials said existing facilities will be further strengthened for this purpose.
The main challenge is Covering remote upland communities with limited medical centers.
Officials of the World Health Organization (WHO) said the WHO has been playing a catalytic role in reducing maternal and infant deaths and reiterated its continued support in providing technical assistance and guidance to the Ministry of Health.
Globally, Target 3.1 of the Sustainable Development Goals (SDGs) for 2030 aims to reduce the maternal mortality ratio to less than 70 per 100,000 live births. Bhutan has successfully achieved this target. In comparison, the global maternal mortality ratio was estimated at 223 per 100,000 live births in 2020, down from 339 in 2000.
According to the World Health Organization, approximately 287,000 women died during and after pregnancy and childbirth in 2020, 95% of which occurred in low-income and lower-middle-income countries, and most of these deaths were preventable.
Many of these deaths could be avoided with adequate antenatal and postnatal care.
Since 1990, the global under-five mortality rate has fallen by 59%, from 93 deaths per 1,000 live births to 37 in 2022. In addition, the number of neonatal deaths worldwide fell from 5.2 million in 1990 to 2.3 million in 2022.
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