Paro has one of the strongest maternal-health records in the country. Nearly every baby born in a hospital, and last year, not a single mother or newborn was lost. Yet the district has gone a decade without a resident gynaecologist. Now, its local leaders want one back. During the Dzongkhag Tshogdu, members voted unanimously to write to the health ministry regarding the matter.
For a district of Paro’s size, the numbers tell a story of quiet success. According to the district health sector, Paro recorded more than 600 (625) pregnancies last year, with around 557 institutional deliveries. That is an institutional delivery rate of about 99 per cent. The district also did not report any maternal or neonatal deaths last year.
But behind those figures is a gap the Dzongkhag Tshogdu says can no longer be ignored. Paro Hospital last had its own gynaecologist between 2013 and 2015. In 2016, the health ministry rolled out a cluster Emergency Obstetric and Neonatal Care system across 10 hospitals, and the specialist stationed in Paro was reassigned to the cluster service.
Local leaders argued that Paro’s population has increased since the specialist left, and that a growing district warrants dedicated services of its own. Last year, the district referred 125 cases, around 22 per cent of the total deliveries, to the national referral hospital because they involved high-risk pregnancies.
“If the country does not have enough gynaecologists, at least a specialist could visit Paro once a week or a few days every month. This would help improve maternal and newborn care while also easing the patient load at the national referral hospital,” said Tshewang Rinzin, Wangchang Mangmi, Paro.
“If possible, we would like a gynaecologist to be permanently posted in Paro. If that is not feasible, we request regular gynaecology services once or twice a week so that women in the district can access timely care,” said Kinley Wangmo, Dopshari Mangmi, Paro.
The request, however, runs into a national reality. District health representatives acknowledged that Bhutan continues to face a shortage of gynaecologists, making it difficult to deploy one to every hospital. Going by national review research published earlier this year, as of 2024, Bhutan had 22 obstetricians and gynaecologists, including three maternal-foetal medicine specialists. This works out to approximately one obstetrician-gynaecologist for every 35,000 people.
This scarcity is one of the main reasons the cluster model exists, to stretch a handful of specialists across many hospitals. Under the system, Paro Hospital falls within the Thimphu cluster, meaning all obstetrical and neonatal emergencies are referred to the national referral hospital.
For now, the deliberation concluded with a unanimous decision to request the health ministry to either permanently post a gynaecologist at the hospital or establish a regular gynaecology outreach programme.
Karma Samten Wangda, Paro
Edited by Sonam Wangdi
