Modern healthcare was introduced in Bhutan in the 1960s. However careful attention had always been given to traditional practice and the people’s perception of illness. This has ensured that the modern healthcare services and indigenous medical services develop simultaneously.
Herbal-based, traditional medicine is well established and integrated into the general health services and remains a popular form of healthcare. Access to traditional medicine in the country has been greatly increased with 31 traditional Drungtshos (Doctors) providing indigenous medical services in all Dzongkhags (Districts). Traditional medicine continues to hold an important place in the formal healthcare system as it not only adds an important dimension to the country’s system of healthcare, but also provides an alternative form of healthcare.
An integrated healthcare delivery system was foreseen as an effective strategy to reach the scattered population in Bhutan’s rugged terrain. The declaration of Alma Ata in 1978 adopting a primary healthcare approach to achieve ‘Health for All’ has also served accelerate health service development in this direction.
The government has maintained a system of complete free healthcare for not only the Bhutanese citizens but also all those who reside in the country. In 1961 there was hardly any modern facility in Bhutan. Today, the country has more than 29 hospitals, 160 Basic Health Units and a 90 percent health coverage with basic services. The health status of the population has improved markedly, especially during the last 10 years. National surveys conducted in 1984, 1994, and 2000 showed a tremendous increase in the access to safe drinking water and dramatic decrease in mortality and morbidity. The population growth rate has been brought down from 3.1 percent in 1994 to 2.5 percent in 2000.
The national healthcare delivery system is characterized by the central level being responsible for the administration, training and major referrals , and the Districts managing the delivery of basic services to the population through a network of Districts hospitals, Basic Health Units (BHUs) and outreach clinics (ORCs).
Until the 1950s, monastic education was the only form of education available in the country. While, monastic education continues to play an important role in Bhutan, modern, western form of education has been promoted and expanded and is now available throughout the country. Since its introduction, within a period of four decades, the government was able to create a modern education system spanning from primary to tertiary level.
Enrolment at all levels had grown at an impressive rate from approximately 400 students prior to 1961 to 1,26,718 students in 2001, spread over 382 schools and institutes. The gross primary enrolment ratio was estimated to be 72 percent in 2001, and is increasing annually at the rate of 6-7 percent.
The increase in enrolment had been attributed to the awareness on the value of education amongst the public, the population growth as a result of improvement in the health services and the priority being accorded to Education services by the government. Furthermore, the Education Department has since 1993 begun an Adult Literacy Program. Another major policy shift in recent teims had made secondary education more relevant by introducing a basic skills training program within the curriculum.
Sherubtse College, the National Institute of Education in Paro and Samtse, the Institute of Language and Cultural Studies, the National Institute of Health Sciences and the National Institute of Traditional Medicine, offer higher education in Bhutan .
The tradition of entitlements and welfare in the country has emphasized free education even in the medieval period when the state supported free monastic education. Similarly, in modern Bhutan, education is accessible to everyone. Students are provided with free tuition, test books, sports equipment, meals and boarding facilities required. Students in rural schools are provided with even free stationary. This free provision is balanced by appropriate contributions from the parents to engender a sense of participation amongst the communities.