Bhoutan

Histoires vécues

Safe motherhood now a national priority in Bhutan

© Bhutan 2004/Silvers

A mother and her baby wait outside a health clinic

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Thimphu, Bhutan, 11 November 2004 - By 7 a.m., the basic health unit of the Thimphu General Hospital is overflowing with parents and children, who will wait two hours (until 9 a.m.) for the hospital to begin seeing patients.  Medical staff in other countries would probably balk at the patient load, but here in Bhutan's capital, Senior Doctor Obstetrics and Gynecology  Duptho Wangmo and the obstetric unit welcome the influx. 

Bhutan has one of the highest rates of maternal mortality in the region.  As more women seek pre- and post-natal care, this rate is expected to go down - and the proportion of healthy children will go up. Maternal mortality in Bhutan is currently 260 per 100,000 live births and while this is number is still very high, it has improved in the last decade.

Given its forbidding terrain and scattered population, Bhutan has difficulty in making women aware of the signs of danger during pregnancy, and in getting women in remote areas to make use of emergency obstetric care when necessary. Only 51 per cent of women attend antenatal clinics at least once.
 
"Women do not have access to emergency Ob/Gyn [obstetrical and gynecological] care, because 85 per cent of deliveries take place in home," says UNICEF Representative in Bhutan Anoja Wijeyesekera. "Women who live in remote areas and mountaintops, etc., have a very difficult time reaching a hospital with Ob/Gyn care.  So that's the main reason 15 per cent of all pregnancies end up in complications, which can't be detected in advance."

For many women in Bhutan, post-partum haemorrhaging is the gravest danger. Some 45 per cent of all maternal deaths in the country result from haemorrhaging; most of these deaths occur among women delivering their babies at home.

"It is necessary to convince women that it is important to deliver in hospital so that complications can be treated promptly, thus saving their lives. If you have a healthy mother, she can take better care of her kids and have better health," says Dr. Wangmo.

With technical and material support from UNICEF, the Government of Bhutan recently made safe motherhood a national priority.  In partnership with international donors, the UNICEF project assessed weaknesses and strengths, trained medical and non-medical staff in emergency obstetric competency, and upgraded or expanded facilities throughout the country.

In addition to improvements in capacity, it is important to get the message out to mothers. "There is more advocacy and awareness to encourage mothers to use facilities. Gradually this message will reach all mothers in Bhutan," said Ms. Wijeyesekera.