Bhutan has made significant progress in improving healthcare and reducing poverty, but access to essential health services remains uneven for some rural and vulnerable communities. Continued investment in healthcare in Bhutan could help the country build on its health gains while supporting household well-being and long-term poverty reduction.

Bhutan reduced its national poverty rate from 28% in 2017 to 11.6% in 2022, according to the World Bank. However, poverty remains predominantly rural, with 87% of the country’s poor people living in rural areas. These disparities make access to essential services particularly important for communities that may already face economic and geographic challenges.

Bhutan Has Made Significant Health Gains

Bhutan has recorded substantial improvements in health outcomes over the past two decades. According to the World Health Organization (WHO), maternal mortality fell from 255 deaths per 100,000 live births in 2000 to 53 in 2023. During the same period, under-five mortality declined from 84 deaths per 1,000 live births to 19.5.

The country has also maintained immunization coverage above 99%, while institutional delivery rates reached 98.5% in 2023. These improvements reflect Bhutan’s continued investment in health services and efforts to expand access to essential care.

The 2023 National Health Survey also reported improvements in access to health services across the country. These gains provide a strong foundation for continued progress in healthcare in Bhutan, while remaining gaps show the importance of ensuring that vulnerable communities can benefit from these improvements.

Rural Communities Still Face Healthcare Gaps

Despite these improvements, geography can affect access to healthcare in Bhutan. The country’s mountainous terrain and dispersed communities can make travel to health facilities more difficult, particularly for people living in rural areas.

Bhutan’s 2023 National Health Survey found that 72.9% of the population lived less than 30 minutes from the nearest health facility. However, 8.6% lived between one and two hours away, 2.5% lived between two and three hours away and 0.8% lived more than three hours away.

The survey also found differences between urban and rural households in the type of health facility located closest to them. Hospitals were the closest facility for 87.4% of urban households surveyed, compared with 37.6% of rural households. Primary health centers were the closest facility for 52.8% of rural households.

These differences highlight the importance of strengthening primary healthcare and referral services so that people living outside major population centers can access appropriate care.

Healthcare Access Can Affect Household Finances

Access to healthcare can also affect household finances. Illness can create financial pressure through medical expenses, transportation costs and time away from work.

Bhutan’s 2023 National Health Survey found that 46.7% of households incurred health expenditures. Households spent an average of Nu 1,000.8 per month on healthcare-related expenses.

Transportation accounted for 60.7% of health expenditure among rural households. For families living farther from health facilities, transportation can therefore add to the financial burden associated with seeking medical care.

These costs are particularly relevant for households with limited financial resources. When families must spend money traveling to receive healthcare, fewer resources may remain available for other household needs. Improving access to healthcare can therefore help reduce some of the financial and geographic barriers that vulnerable households face when seeking essential services.

Continued Investment Can Strengthen Bhutan’s Progress

Bhutan’s health achievements provide a foundation for addressing remaining gaps. The WHO Country Cooperation Strategy for Bhutan for 2026–2030 focuses on strengthening collaboration with the Royal Government of Bhutan to improve health and development outcomes.

The strategy builds on a partnership between WHO and Bhutan that began in 1982 and identifies continued improvements in health services and health-system capacity as part of the country’s health priorities.

Bhutan is also strengthening its preparedness for health emergencies. In March 2026, the Ministry of Health and WHO convened a consultation to finalize the country’s National Action Plan for Health Security. The process produced a five-year strategic plan and a prioritized 24-month operational plan addressing gaps in health security capacities.

The plan brings together multiple sectors and focuses on strengthening Bhutan’s ability to prevent, detect and respond to public health emergencies. Continued investments such as these can strengthen the country’s health system while improving resilience to future health challenges.

Conclusion

Bhutan has made significant progress in improving healthcare and reducing poverty, but gaps in access remain for some rural and vulnerable communities. Differences in travel time to health facilities and healthcare-related expenses show the importance of continued attention to accessibility. Building on the country’s health achievements while addressing these gaps can help more communities benefit from Bhutan’s development progress and support healthier, more resilient households.

– Adebisi Aliyah Adeola

Adebisi is based in Cairo, Egypt and focuses on Technology and Solutions for The Borgen Project.

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