— Opposition also strongly supports the deployment of doctors and female health workers
KINLEY KHANDU CHODEN | Thimphu
The shortage of Health Assistants (HAs), particularly female health workers, in remote communities was brought to the National Assembly’s attention after the Member of Parliament for Thrimshing-Kangpar Constituency Damchoe Tenzin questioned the government on its progress in fulfilling a key healthcare pledge.
Thougha question addressed to the Health Minister, the MP Damchoe Tenzin highlighted that the People’s Democratic Party (PDP), under Pledge No. 4 of its manifesto, had committed to ensuring that all Gewog Health Centres are staffed with one doctor and adequate health personnel, including at least one female health worker.
According to the MP, the pledge played a significant role in securing public support for the party during the elections. However, more than two and a half years after the government assumed office, many rural communities continue to face shortages of Health Assistants and female health workers.
The MP said the Opposition also strongly supports the deployment of doctors and female health workers in every gewog, emphasizing that such staffing is crucial for addressing the healthcare needs of people living in rural and remote areas.
Drawing attention to the situation in his constituency, the MP said that the Thungkhar, Phegpari and Passaphu sub-posts under Thrimshing and Kangpar gewogs in Trashigang Dzongkhag currently have only one male Health Assistant stationed at each facility.
These three health facilities collectively serve approximately 1,460 residents, including students residing on school campuses within their service areas.
The MP noted that the limited staffing creates significant challenges for communities, particularly when the sole Health Assistant is absent from the health facility due to official duties, training programmes, outreach services or personal leave.
“In such situations, the public is often compelled to travel long distances to access even basic healthcare services, leaving communities without immediate medical assistance,” the MP stated.
He added that the issue extends beyond his constituency and appears to reflect a broader national challenge regarding the deployment of Health Assistants, particularly female Health Assistants.
Female health workers are often considered essential in rural health facilities due to their role in delivering maternal and child healthcare services, reproductive health counselling, antenatal care and other health services that many women may feel more comfortable seeking from female professionals.
The MP said that inadequate deployment of female Health Assistants across the country could affect the delivery of essential healthcare services, especially for women and children living in remote communities.
Inlight of the government’s commitment and the current staffing situation, the MP sought clarification on the status of deployment and redeployment of Health Assistants nationwide. He also asked what plans and measures are being implemented to ensure adequate and equitable staffing, particularly of female health workers, in all gewogs.
Responding to the concerns, the health minister Lyonpo Tandin Wangchuk acknowledged that shortages remain a challenge in the country’s healthcare system.
According to the minister, the approved staffing requirement for the country’s 298 healthcare centres stands at 637 Health Assistants. However, the current workforce consists of only 558 Health Assistants, including those on Extraordinary Leave and Long-Term Training.
This leaves a nationwide shortfall of 79 Health Assistant positions.
Lyonpo Tandin Wangchuk said that the shortage has created difficulties in maintaining full staffing coverage at healthcare facilities, particularly in remote and hard-to-reach areas where access to healthcare is already constrained by geographical and logistical challenges.
The minister explained that available personnel are currently deployed based on factors such as patient load, accessibility, disease burden and population vulnerability to ensure that limited human resources are utilized as effectively as possible.
Regarding female health workers, the Lyonpo Tandin Wangchuk stated that efforts are made to prioritize their deployment in areas with greater maternal and child healthcare needs whenever feasible.
To address the workforce shortage, the ministry has undertaken several measures aimed at strengthening the health workforce over the medium and long term.
One of the key interventions includes increasing the annual intake of Health Assistant students at the Khesar Gyalpo University of Medical Sciences of Bhutan from 25 to 40 students.
The minister stated that the increased intake is expected to gradually improve the availability of Health Assistants and strengthen staffing levels across healthcare facilities in the coming years.
At the same time, efforts are continuing to improve staff deployment and retention, particularly in remote areas were attracting and retaining healthcare professionals remains challenging.
Lyonpo also highlighted the introduction of Mobile Medical Units (MMUs) as part of broader efforts to improve healthcare access for underserved communities.
According to the minister, 29 Mobile Medical Units have been secured through support from the Asian Development Bank’s Japan Fund for Poverty Reduction.
The first 10 units have already been deployed and are operational in several dzongkhags.
These units are expected to provide a range of essential healthcare services, including outpatient consultations, maternal and child health services, reproductive healthcare, screening for non-communicable diseases and health promotion activities in remote communities.
However, Lyonpo acknowledged that staffing the mobile units with the required healthcare professionals remains a challenge due to the existing shortage of human resources.
To address this issue, a proposal seeking additional human resources has been submitted to the Royal Civil Service Commission. Budget provisions have also been proposed to support the operation and maintenance of the mobile units.
