Maternal, newborn and child health

Infant mortality accounts for 70 percent of all newborn deaths in Bhutan. UNICEF is at work with partners, around the country, to reduce and prevent such tragedies.

Mother and child health
UNICEF/2017/PBrown

Challenge

Bhutan has witnessed unprecedented progress in child and maternal health over the last two decades. This is evident from the two-third reduction in maternal deaths: from 255 per 100,000 live births in 1990 to 86 per 100,000 in 2012.

Similar decreases have been observed in the infant mortality (from 102 to 30 per 1,000 live births and under-five mortality rates (from 162 to 37.3 per 1,000 live births since 1984. This means that many more children are celebrating their fifth birthday than a decade ago, and many more mothers are surviving pregnancy and delivery-related complications to celebrate it with them.

Many more children are celebrating their fifth birthday than a decade ago, and many more mothers are surviving pregnancy and delivery-related complications to celebrate it with them.

Despite this significant progress, newborn mortality — deaths of children within the first four weeks of life — is still high (21 per 1,000 live births). Evidence has shown that the chances of a child surviving increases when the mother delivers in a health facility, with the help of a skilled birth attendant. Yet, nearly two of five women still deliver outside health facilities. It is mostly these women, often in remote areas, who consequently do not receive adequate delivery and postnatal care.

Infant mortality is still high, accounting for 56 percent of under-five deaths and 70 percent of all infant deaths in Bhutan.

21 out of every 1,000 newborn babies die within the first month. 75 percent of these deaths are due to prematurity and associated complications at birth, which are largely preventable with good antenatal, natal and Post-Natal Care (PNC).

Care during labour, delivery and immediately after birth can prevent 40 percent of newborn deaths. Only 74 percent of mothers and babies receive PNC with urban areas reporting higher rates of PNC than rural areas.

Immunization
UNICEF/2017/Bhutan

What we are doing

With sustained health efforts undertaken in the past two decades, Bhutanese health workers are today equipped with knowledge and skills to provide quality services in:

  • Essential newborn care
  • Emergency Obstetric and Newborn Care
  • Immunization
  • Prevention of Mother to Child Transmission of HIV
  • Voluntary counselling and testing of HIV

UNICEF Bhutan’s Health programme is in line with the Royal Government’s objectives of improving Mother and Child Health (MCH); reducing infant, child and maternal mortality; and sustaining high immunization coverage.

We have helped the country sustain immunization coverage of more than 90 per cent since achieving Universal Child Immunization in 1991. Together with the government and other partners, UNICEF continues to give priority to improve both quality and coverage of immunization services for all eligible children and women across the country. This includes making vaccines and cold chain equipment available at all health facilities and building capacity of service providers for effective vaccine management, injection safety and maintenance of cold chain equipment.

Underthe health programme, we are also working towards implementing Early Essential Newborn Care and Kangaroo Mother Care (KMC) in all health facilities. Newborn mortality can be reduced by adopting KMC and early breastfeeding start. Early and exclusive breastfeeding until six months reduces neonatal and infant deaths by 20 percent: it provides essential nutrients for growth and prevention of infection.

Together with the Royal Government, the Bhutan Every Newborn Action Plan has been rolled out since 2017. We are also starting the Child Development Screening Tool to identify birth defects, developmental delays and disability in under-five children, for timely intervention. Early Infant Diagnosis Tool is also implemented to achieve zero vertical (mother to child) transmission of HIV by 2020.

In Bhutan, we must also strengthen water, sanitation and hygiene in health facilities. One in four newborn deaths can be prevented by simple handwashing with soap by health staff and caregivers.

Early essential newborn care
UNICEF/2017/PBrown