DAWA ZANGMO | Thimphu
Ministry of Health (MoH), in collaboration with the Japan International Cooperation Agency (JICA), convened the dissemination and launch programme for the Impact Evaluation Report of the Integrated Continuous Telemedicine of Fetal Heart Rate and Uterine Contraction (iCTG) Initiative in Thimphu on May 22.
The programme was organised under the “Project for Strengthening Maternal and Child Health through Telemedicine System Establishment,” jointly implemented by the MoH and JICA from August 2023 to March 2026. The initiative aims to strengthen maternal and neonatal healthcare services in Bhutan through the introduction of innovative telemedicine technologies and evidence-based interventions.
The event brought together senior officials from the MoH, representatives from JICA Headquarters and the JICA Bhutan Office, healthcare professionals, technical experts, development partners, members of academia, and media representatives from Bhutan and Japan. Experts from Kagawa University and Melody International Ltd. also participated in the programme.
Ahead of the project’s completion, the Health Informatics and Research Division under the MoH, in partnership with the JICA Bhutan Office, carried out an impact evaluation of the iCTG initiative between January and March this year. The assessment examined the effectiveness of the iCTG system and its contribution to maternal and child healthcare services across the country.
According to the report which was presented during event, the telemedicine enabled fetal monitoring system has supported early risk detection, improved clinical decision making, strengthened referral coordination, and expanded access to quality maternal healthcare services, particularly for women living in remote and hard to reach areas.
The programme served as a platform to disseminate the findings of the evaluation, share lessons learned from the implementation of the initiative, and discuss the future direction of digital health and telemedicine services in Bhutan.
The report found that nearly half of pregnant women in the country now have access to Intelligent Cardiotocography, commonly known as iCTG, a smart and wireless pregnancy monitoring service designed to support maternal healthcare.
The portable technology enables healthcare workers in rural clinics to instantly share fetal heart rate data with specialists, allowing quicker identification of high-risk pregnancies and timely medical intervention.
The iCTG device, introduced in Bhutan in 2020, is used for fetal monitoring and connects frontline health workers with specialists through internet-based technology. More than 80 devices have been deployed across over 70 strategically located health facilities nationwide.
The system works through two small wireless sensors placed on a pregnant woman’s abdomen to monitor the baby’s heartbeat and uterine contractions. The information is then transmitted to a smartphone and uploaded to a cloud-based platform within seconds.
Through the system, specialists located far from the health facility can monitor the data in real time and immediately guide healthcare workers if signs of fetal distress are detected.
Health Secretary Pemba Wangchuk, said the ICTG/CPC project has helped bridge healthcare gaps in remote areas by deploying 80 portable cloud-connected devices across 72 health facilities, enabling real-time specialist monitoring for maternal and neonatal care.
He highlighted that the project represents Bhutan’s commitment to digital health and equitable universal healthcare, adding that the MoH will now focus on sustainability through improved training, stronger integration of ICTG data into the national health system, and enhanced connectivity infrastructure
JICA Chief Representative Yoichiro Kimata, said the project focused on strengthening the capacity of healthcare workers to effectively operate the devices and use the technology in maternal healthcare services.
During the event he said that the collaboration also reflected the continued partnership between Bhutan and Japan in building resilient, inclusive, and people centred healthcare systems.
“We trained health workers and nurses in the use of these devices. Through these capacity development efforts, we contributed to reducing neonatal mortality through the early detection of abnormal fetal heart rates,” he said.
Senior Researcher with the Health Informatics and Research Division under the MoH, Kinley Dorjee, said the technology has improved access to specialist consultation for expectant mothers, particularly those in rural communities.
“In addition to helping identify abnormal fetal heart rates, the system has also reduced travel expenses and time spent by mothers who otherwise had to visit hospitals for specialist consultations,” he said.
The report also highlighted a steady increase in the use of the technology across health facilities. The number of monitoring sessions conducted using the iCTG system increased from more than 4,600 in 2023 to over 5,300 in 2024.
Data presented in the report further showed that deaths caused by birth asphyxia, a condition resulting from lack of oxygen during birth, declined significantly from 20 cases in 2020 to three cases in 2025.
However, experts involved in the evaluation noted that additional studies and assessments would be required to determine the extent to which the reduction could be directly attributed to the implementation of the iCTG technology.
