COUNTRY BACKGROUND - Gross National Happiness Commission

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Health Services Table 13.4 Morbidity Patterns for Major Diseases as Percentage of BHU Cases (1985-19889) 13.13 Lack of hygiene and poor sanitation causes many infectious diseases. Diarrhoea and respiratory tract infections remain by far the most frequent diseases treated by the health services. Worm infestations are estimated to occur in up to 80% of the population. The majority of the diseases treated are seasonal and there is a marked fluctuation in the out-patient department attendance between summer and winter. Nutritional deficiencies are an important part of the disease pattern in Eastern Bhutan. A large proportion of the population suffer from gastric problems such as gastritis, peptic ulcer and ventricular cancer due to dietary habits and consumption of doma (a mixture of wet betel nut, paan (leaf) and calcium paste). Sexually transmitted diseases are also common among some sections of the population. Nutrition StatusNutrition Status 13.14 A nationwide nutrition survey was carried out between December 1986 and March 1988. It generated information on the nutritional status of children up to 3 years and women between the age range of 15-45 years. It was found that 56.1% of the children were small for their age and 37.9% of children were found to be underweight for their age according to the WHO classification. 13.15 In the same survey, 13.8% of women examined were found to have Body Mass Index below 18.4 indicating a serious calorie deficiency. Vitamin A and iodine deficiency and anaemia were also found to be unacceptably high. C. ConstraintsC. Constraints Poor Sanitation and HygienePoor Sanitation and Hygiene 13.16 The existing morbidity pattern shows a high prevalence of respiratory infections, diarrhoea and worm infestations. The incidence of these diseases can be minimised and prevented to a large degree by improving the water supply system and promoting sanitation and hygiene. A change in personal hygiene would make a considerable impact on the health of the population. Remote and Scattered PopulationRemote and Scattered Population 13.17 Because the population is scattered, with an undeveloped road network, the District and Regional level health facilities are fairly unaccessible to the majority of the people. These factors also make the cost of health delivery very high. In most remote areas, the modern health services are sought as a last resort, resulting in diagnostic and therapeutic delays. A delay and in some cases failure to demand health services leads to insufficient utilization of existing health services. The effectiveness of modern health services is thus reduced. 13.18 The low literacy level, especially among women is thought to be a leading obstacle to the improvement of the health status of most people. Giving high priority to the education of women is recognised as an investment in health. Shortage of Trained PersonnelShortage of Trained Personnel 13.19 As in most other sectors, the health sector is constrained by a lack of trained national staff. The Department is dependent on expatriate personnel. Of the total DHS staff of 1019, 283 were expatriates in 1991. II. Review of Past PerformanceII. Review of Past Performance 4 Disease 1985 1986 1987 1988 1989 Diarrhoeal disease 18.3 17.5 15.6 15.0 15.2 Respiratory disease 16.6 16.5 16.7 18.2 19.5 Worm infestation 11.6 11.7 11.0 12.9 10.0
A. Objectives and Strategies in the 6FYPA. Objectives and Strategies in the 6FYP Health Services 13.20 In broad terms, the objective for the Health Sector in 6FYP was to strengthen the health infrastructure, especially primary health care and enable the people to attain a level of health which would allow them to lead productive lives. The strategies adopted were the eight essential elements of primary health care: · Education concerning prevailing health problems and methods of controlling and preventing them · Adequate supply of safe drinking water and sanitation · Promotion of food supply and proper nutrition · Maternal and child health care, including family planning · Immunization against six major infectious diseases · Appropriate treatment of common diseases and injuries · Provision of essential drugs and · Treatment and control of communicable diseases. B. Achievement of ObjectivesB. Achievement of Objectives InfrastructureInfrastructure 13.21 As regards the expansion of infrastructure, the 6FYP target was to increase the number of beds from 922 to 1,130 and the number of BHUs from 68 to 90. As of 1991, the number of beds provided was 944 and the number of BHUs was 76. Expanded Programme for ImmunisationExpanded Programme for Immunisation 13.22 Universal child immunization (84%) was achieved in 1990. In the same year, a survey revealed that 64% of pregnant women had been immunized with T.T.. Communicable DiseasesCommunicable Diseases 13.23 Leprosy, which was a substantial threat, is now near eradication. The number of infectious cases has been brought down from 300 in 1982 to 250 in 1991. On the negative side, it was not possible to prevent the spread of malaria nor to reduce the incidence of tuberculosis. Both are becoming major causes of morbidity and mortality. Short Chemo Therapy has been introduced for all cases of TB. Malaria is now one of the major communicable diseases in Bhutan. In 1989, 19,162 positive cases were diagnosed. Malaria is spreading into formerly malaria free areas and the parasite is developing resistance to the existing drugs and the vector to DDT. Health EducationHealth Education 13.24 In order to educate the public on the need for improved health, hygiene and nutrition practices, the Information, Education, Communication for Health Bureau (IECH,B) was established. The Bureau began to work with other Departments and agencies, including the <strong>National</strong> Womens Association of Bhutan and the monk body. Improved Water and SanitationImproved Water and Sanitation (Refer to Chapter 14 on Human Settlements) 13.25 A Public Health Laboratory was established in Thimphu where 13 laboratory technicians received training to conduct tests on water samples. Food and NutritionFood and Nutrition 13.26 High potency Vitamin A capsules were provided biannually to all children under five who were seen at BHUs and Hospital clinics and to all postnatal women seen at clinics after delivery. Vitamin A capsules were also distributed to patients with measles and all diagnosed cases of Vitamin A deficiency. Iron/folic tablets were given to those pregnant and lactating women attending clinics and those with cases of iron deficiency. Iodised salt sales and monitoring continued through the IDD programme. Iodine deficiency remained a serious problem but new occurrences of iodine deficiencies cases are very rare. III. Objectives and Strategies for the 7FYPIII. Objectives and Strategies for the 7FYP 5
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COUNTRY BACKGROUND I. Physical Char
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COUNTRY BACKGROUND Minerals The exa
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COUNTRY BACKGROUND Bhutan is the le
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COUNTRY BACKGROUND personnel polici
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CHAPTER 2 ECONOMIC PERFORMANCEECONO
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2: Gross Domestic Product 1980 —
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Figure 2.2 Economic Performance IV.
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Table 2.4 Government Expenditures 1
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Table 2.5 Summary of RGOB Budgetary
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Figure 2.5 Economic Performance 2.2
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Economic Performance of Infant Mort
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Approach to Development · sustaina
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Approach to Development 3.19 The fo
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Environment and Sustainable Develop
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Environment and Sustainable Develop
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Women's Involvement in Development
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CHAPTER 6 PRIVATISATION AND PUBLIC
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unacceptably high inequalities of i
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CHAPTER 7 ECONOMIC OUTLOOKECONOMIC
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Economic Outlook 7.9 This section e
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Table 7.2 Seventh Plan Outlay and S
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Figure 7.2 Figure 7.3 Capital Expen
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Economic Outlook economic sector wi
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Renewable Natural Resources Institu
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Renewable Natural Resources 17.67 A
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Renewable Natural Resources Wildlif
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Renewable Natural Resources TOTALS
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Chapter 18 MANUFACTURING AND TRADEM
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18.8 (see Chapter 19 on Mineral Dev
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Input supplyInput supply Manufactur
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Manufacturing and Trade Polythene P
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Manufacturing and Trade Formulation
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Manufacturing and Trade V. Financia
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Mineral Development Coal mining and
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Mineral Development Table 19.2 Esti
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Mineral Development be purchased: 3
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CHAPTER 20 ENERGY SECTORENERGY SECT
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Exports and ImportsExports and Impo
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Energy Sector 20.21 Most of the rur
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shortages. Energy Sector 20.34 Alte
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Energy Sector items will include pu
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COUNTRY BACKGROUND - Gross National Happiness Commission

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