Health in Bhutan

The Ministry of Health (MoH) steers the system. The Department of Health Services is responsible for curative care, standards, quality and financing. The Department of Public Health organizes, among other things, vaccinations, disease surveillance, health promotion, screening for noncommunicable diseases, and programs covering maternal and child health, sexual health, tuberculosis, HIV and other infections, malaria, dengue and rabies. The Royal Centre for Disease Control handles laboratory diagnostics and infectious-disease responsibilities. The National Centre for Traditional Medicine Services oversees officially integrated traditional medicine (Sowa Rigpa) in Bhutan. The Bhutan Food and Drug Authority regulates the quality, import and distribution of medicines; National Medical Services procures medical products. The Jigme Dorji Wangchuck National Referral Hospital and the Khesar Gyalpo University of Medical Sciences of Bhutan provide tertiary and specialized care. Access usually begins at a Primary Health Center, Basic Health Unit or Outreach Clinic. Village Health Workers, mobile services and outreach programs reach remote areas. Mobile Medical Units provide, among other things, screening, outpatient treatment, maternal and child care, sexual and reproductive health services, health promotion, referrals and critical transport. Exact dates depend on the facility and district (Dzongkhag). A current ministry overview lists 28 hospitals, 156 Basic Health Units and 654 Outreach Clinics. The National Health Survey 2023 uses a different classification with one National Referral Hospital, two Regional Referral Hospitals, 51 hospitals, 187 Primary Health Centers, 50 Sub-Posts and 551 Outreach Clinics; these two classifications cannot be added together. In the National Health Survey 2023, 72.9 percent of households or respondents reached the nearest health facility within 30 minutes. As their nearest facility, 55.7 percent named a hospital and 34.5 percent a Primary Health Center. In the previous twelve months, 78.6 percent of people aged 15 to 69 had visited a health facility. Satisfaction was 91.2 percent. Use was higher in rural areas, at 85.2 percent, than in urban areas, at 72.8 percent. A total of 2.8 percent of households used healthcare outside Bhutan; the figure was 3.9 percent in urban areas and 2.1 percent in rural areas. The National Immunization Strategy 2025–2029 aims for at least 95 percent coverage of routine vaccinations and focuses particularly on unvaccinated and hard-to-reach groups, the cold chain, new vaccines, and surveillance of vaccine-preventable diseases and adverse vaccination reactions. In mental-health crises, the national specialist mental-health service (The PEMA) supports the chain of prevention, crisis assistance, treatment, rehabilitation, reintegration and follow-up care. The number 1098 provides psychosocial and protection support around the clock; 1010 is a national helpline that redirects callers to The PEMA. For medical crises and suicide risk, the Ministry of Health gives 112. The Psychiatry OPD at Jigme Dorji Wangchuck National Referral Hospital is another formal point of contact. For acute symptoms, the care pathway typically runs from a Primary Health Center, Basic Health Unit or Outreach Clinic through the district hospital and a Regional Referral Hospital to the National Referral Hospital. Under the Healthcare Services Rules and Regulations 2025, every health facility stabilizes an emergency. If the required capabilities are unavailable, it provides first aid and arranges an appropriate referral. Designated emergency departments belong to categories I, II, IV or V. The toll-free number 112 connects callers to the Health Help Center; ground ambulances are available around the clock. The air-medical retrieval system (Bhutan Emergency Aeromedical Retrieval System) can initiate helicopter transport through 112 or the Health Help Center. An emergency specialist or the National Referral Hospital decides on admission and the appropriate destination hospital. Weather may delay the flight and require another form of transport. No general guaranteed response time is specified. At the National Referral Hospital, appointments are possible in person, by telephone or online. Walk-in treatment is also available, often with a queue or token; opening hours and procedures differ by department. The National Essential Medicines List 2025 specifies which medicines are intended at the various levels of care, from the Primary Health Center to the National Referral Hospital. The availability of an individual medicine therefore depends on the facility and level of care. Medicines outside this list may require private co-payments or other procurement routes. Under Article 9(21) of the Constitution, Bhutanese citizens have access to basic public health services in modern and traditional medicine. The Healthcare Services Rules and Regulations 2025 apply nationwide; their implementation for health facilities began on 13 March 2026. The stated rights include complete and timely information, appropriate consent, privacy, confidentiality and a complaints procedure. Care may not be refused in emergencies. For chargeable services, patients may request an itemized price statement. Exceptions to free basic care may include private cabins, cosmetic or high-end dental treatment, medical certificates and medicines outside the National Essential Medicines List. The current eligibility and fee rules for visitors and other non-citizens are not clearly established in publicly available information. After discharge or referral, a plan for continuing care should be in place. The facility documents the treatment and provides medical records; referrals should continue through follow-up at the next level of care. Physiotherapy is part of regular care, and the National Essential Medicines List also includes pain and palliative medicines. If specialized treatment is unavailable in Bhutan, the Referral Division can arrange a formal referral abroad, particularly to India, Thailand, Nepal or Bangladesh. During treatment, patients should provide accurate health information, ask questions, participate in the treatment plan and follow the facility's rules.