Quality Neonatal Care at the Center of Service

Bhutan’s healthcare system is increasingly prioritizing the strengthening of quality, accessibility, and resilience in neonatal care services across the country, rather than focusing solely on expanding the number of Neonatal Intensive Care Unit (NICU) beds, according to health officials.

Speaking on the state of neonatal services during the Meet-the-Press session on June 6, Dr Mimi Lhamu Mynak, President of the National Medical Services, expressed deep gratitude to Her Majesty The Gyaltsuen for spearheading the construction of a 150-bed Mother and Child Hospital (MCH) in Thimphu and a 65-bed MCH in Mongar.

“These Mother and Child Hospitals are a sacred gift to the people of Bhutan and will immensely benefit the health of our mothers and infants,” Dr Mimi said. Both facilities are expected to be completed within the next two months, marking a major milestone in maternal and child healthcare infrastructure.

Neonatal care remains one of the most critical pillars of Bhutan’s health system, as newborns are most vulnerable to illness and mortality during the first days of life. Ensuring equitable access to high-quality neonatal services continues to be a national priority under the Royal Government’s health agenda.

Currently, Bhutan has one trained neonatologist and 16 pediatricians serving the entire country. Specialist pediatric services are available in eight of the 20 dzongkhags, while NICU services are concentrated in the three referral hospitals. Across these facilities, the country has a total of 24 dedicated NICU beds.

In 2025, NICU units across the three referral hospitals treated 596 critically ill newborns. Of these, 500 were managed at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), 49 at the Central Regional Referral Hospital (CRRH), and 47 at the Eastern Regional Referral Hospital (ERRH). The overall NICU mortality rate stood at 6.4 percent.

According to Dr Mimi, these units handle the country’s most vulnerable newborns, including premature infants and those with severe complications. Despite resource constraints and geographic challenges, she noted that clinical outcomes reflect steady improvements in neonatal care delivery.

“However, for Bhutan, every neonatal death is one too many, and we remain committed to further improving newborn survival and quality of care,” she said.

The Ministry of Health highlighted that Bhutan’s demographic profile has shifted significantly over the past decade, with annual births declining from 11,430 in 2015 to 8,501 in 2025. This demographic transition is reshaping planning priorities in maternal and child health services.

International benchmarks indicate that countries such as Singapore maintain between 1.5 and 2 NICU beds per 1,000 live births, while high-income countries like the United States provide between 2 and 4 beds per 1,000 live births. Bhutan’s current capacity of 24 NICU beds translates to approximately 2.82 beds per 1,000 live births, placing it within internationally accepted planning standards.

Against this backdrop, the Ministry is deliberately shifting focus from expanding bed capacity to strengthening the quality of care, clinical skills, and system efficiency.

Several initiatives are currently being implemented to improve neonatal outcomes nationwide. These include the establishment of cluster hospitals staffed with pediatricians to ensure timely specialist intervention for newborns with complications, and expanded training for General Duty Medical Officers (GDMOs) and nurses in Neonatal Advanced Life Support.

During the 13th Five-Year Plan period, which runs until 2029, the Ministry plans to train three neonatologists, eight additional pediatricians, and eight neonatal nurses. This investment in human resources is expected to significantly strengthen specialized newborn and child health services across the country.

In parallel, the Ministry is investing in advanced neonatal equipment and technology. Health officials emphasized that while Bhutan’s declining birth rate means fewer babies are being born each year, it simultaneously raises the importance of ensuring that every newborn receives the highest possible standard of care.

“The Ministry remains fully committed to ensuring that every newborn has access to safe, high-quality care and the opportunity to thrive,” Dr Mimi said.

Sangay Rabten, Thimphu

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