ANNUAL HEALTH BULLETIN 2004 - Ministry of Health

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The overall CPR improved to 46% if wornell not at risk of pregnancy are excluded from the denominator. This group of women also includes women who are pregnant, post partum within 6 wks and wo~en who are in fecund. 46.57% CPR is comparable to any other developing country though it is slightly lower. Contraceptive prevalence in teenaged girls, though looks improved, needs further improvement. Also in the other extreme group (45 -49 yrs) it is low. 1. Contraceptive prevalence rate is far below the expected increase. 2. Contraceptive use by extremes of Reproductive age women is low. 3. Use of condom as a method of contraceptive is almost non-existent. 4. ruCD use as a method of contraception is not improving as expected. 5. Medical side effects are one of the common reasons for non-use or discontinuation of contraceptives. Also it is the most common problem faced by the user. 6. Misconception about contraception like, may cause cancer ete are prevalent among some users. 7. Infertility though not explicit is prevalent among 5 % ofF.P non-users. 8. Fertility rates are very high in cOJ;Ilparisonto similar countries in the region 9. Pregnancies among teenagers are common. C,onclusion: The study has attempted to give a picture of the status of Reproductive Health, in particular the Family Planning aspect at the community level. Although the study has been carried out using only 3 gewogs, the findings reflects to some extend the situations that rest of the country is currently in. With continuous support from the government, the situation seems to be improving as reflected by the 46.57% CPR of the three villages. Although there is an increase in the CPR, it is still far behind the target of 60% CPR to be achieved by the end of ninth five year plan. 6. Some Priority Issues: Some issues, which are apparent from the report and also implied from reviews and observations made during the year that needs to be addressed in priority basis, are mentioned below: 1. Low and Inadequate ANC attendance:- Approximately 63% of pregnant women are attending ANC at least once and it is far below the target of 100% attendance that has to be achieved by the end of ninth five year plan period. Ideally a pregnant woman must at least make 4 ANC visits. 2. Low institutional deliveries:- Institutional deliveries (Hospital and BHU deliveries) and deliveries attended by a trained person constitute only about 32% of the total deliveries. 3. No policy support on Post-natal care- no information is collected on postnatal care at any level except information on couple of complications. So routine monitoring is impossible. 4. Low Contraceptive Prevalence rate :- Contraceptive prevalence rate though shows gradual improvement, is still low at about 41%. Other issues related to F.P have been described in the study report.
5. Abortion Complication:- Though the incidence of complications following abortion is not known, prevalence of abortion as a complication of pregnancy is very common. 6. Infertility and RTIs including STIs:- Though prevalence of infertility is not yet studied, from the 3 gewog Family Planning study, it is revealed that quite a high number of women are unable to conceive. Major causes are probably from the Reproductive tract infections (RTIs) and sexually transmitted infections (STIs). 7. Low Cervical Cancer screening coverage:- Only 8% of target population could be screened in the year 2004, which is inadequate for any impact on reduction of cervical cancer in the communities. 8. Teenage Pregnancy and Contraceptive use:- Teenage mothers constitute about 15% of the antenatal attendees. In some of these young mothers, the index pregnancy is already second or third pregnancy. Contraceptive prevalence in this group of women is negligible.
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ROYAL GOVERNMENT OF BHUTAN MINISTRY
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Page 10 and 11:
National Referral Hospital JDWNRH O
Page 12 and 13:
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Page 14 and 15:
Activities The Royal Institute of H
Page 16 and 17: The structure for QAS has been inst
Page 18 and 19: • Establishment of goals and stra
Page 20: quality assurance activities and re
Page 24 and 25: SN Cases Male Female Total 1 New ca
Page 26 and 27: 1. The National Institute of Tradit
Page 28 and 29: Introduction The laboratory service
Page 30 and 31: • Hematology services for routine
Page 32 and 33: • Since 2000, annual intake of la
Page 34 and 35: The vision of IC&HWM program is to
Page 36 and 37: Nursing services in Bhutan is the b
Page 38 and 39: Nilme of Hospit41s/ Bed Patients lo
Page 40 and 41: Besides the routine curative care,
Page 42 and 43: Oral health is an important compone
Page 44 and 45: An X-Ray service in the country was
Page 46 and 47: History In the 1990s, radio telepho
Page 48 and 49: Some of the main constraints faced
Page 50 and 51: Perinatal medicine services are goi
Page 53: J!])cPJ, rmffil:mcPJ1Yfl il: ([J)f
Page 56 and 57: • 11 new doctors trained on Basic
Page 58 and 59: Type of -. . complications 2001 200
Page 60 and 61: Complied by: Dr. K.C Buragohain, JD
Page 62 and 63: About 30% (29.71%) of the populatio
Page 64 and 65: discontinuation. Medical side effec
Page 68 and 69: Expanded Program On Immunization (E
Page 70 and 71: Sl. District BeG Measles DPT- OPV O
Page 72 and 73: Str~gthen the DOTS component of DOT
Page 74 and 75: v. Treatment outcome (%) 2000 2001
Page 76 and 77: ~~::; ...~~.:=---- ."' 0 Diseases 1
Page 78 and 79: The National Control of Dirrhoeal D
Page 80 and 81: Background The Village Health Worke
Page 82 and 83: Donor supported vertical programme.
Page 84 and 85: • Function as coordinating body i
Page 86 and 87: SI.No Gender No. of cases 1 Male 39
Page 88 and 89: Background. The National Malaria Er
Page 90 and 91: Malaria case load contributed by f"
Page 92 and 93: 45 40 .. - . Malaria mortality 35T
Page 94 and 95: 13. Professional Human Resource Dev
Page 96 and 97: The integration of Community Based
Page 98: Establishment of Audio logy Unit at
Page 102 and 103: District ANC atte"dances Average 1s
Page 104 and 105: Child attendances Total District In
Page 106 and 107: District IUD Cycles of DMPA Male Fe
Page 108 and 109: Procedures Cases % Caesarian sectio
Page 110 and 111: District Caesarian General General
Page 112 and 113: District X-ray X-ray X-ray Ultrasou
Page 114 and 115: Outreach Clinic Tsimalakha Hospital
Page 116 and 117:
Districts Hospitals Basic Health Un
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~ ICD Priority Health ProblemlDisea
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ICD Priority Health Problem/Disease
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ABER ACO AEFI AFP AGUS AIDS AN ANC
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OCP OPD OPV ORC ORT OT PEM PHC PHD
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ANNUAL HEALTH BULLETIN 2004 - Ministry of Health

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