Excellency, Lyonpo Zangley Dukpa, Minister of Health, the Royal Government of Bhutan; honourable Health Secretary, Dasho Wangdi; honourable guests; ladies and gentlemen,
It is my great honour to address today’s gathering at the launch of the B.Sc. Degree Programme in Nursing and Midwifery of the Royal Institute of Health Sciences. I overwhelmingly thank the Royal Government of Bhutan for the invitation.
This launch is indeed another key milestone in the development of nursing and midwifery profession for the country. Nurse-midwives constitute the backbone of human resources or HR for the health services delivery system. They work at all levels from specialized medical institutions to primary health care centres at the grassroots in the community. The launch of this programme will have a far-reaching impact on the strengthening of Bhutan’s health-care system. It is indeed a privilege for WHO, along with other partners, to work with the Royal Government of Bhutan towards this historic landmark.
As we are aware, the Bachelor Degree Programme in Public Health was launched in Bhutan in 2010 and the government is now in the process of establishing an institution to produce medical doctors. These initiatives clearly indicate the high-level commitment of the government to the development of human resources for health (HRH), which is a critical component of effective functioning of health care systems.
The Royal Institute of Health Sciences, formerly a “health school”, has more than three decades of experience in producing nursing workforce at certificate and diploma levels. Through collaboration with the La Trobe University in Australia, a conversion programme was undertaken during 2001-2008, to upgrade nursing education from diploma to degree level. Three batches of 52 nurses graduated from this conversion programme. Today, they are leaders in providing and managing nursing and midwifery services at various levels of national health care systems.
The Royal Institute of Health Sciences is now under the administration of the Royal University of Bhutan. The majority of its teaching staff have studied abroad and are holding Masters degrees in nursing, midwifery, public health and related fields. The country now has the required capacity to run its own degree programme in nursing and midwifery. A lot more professional nurse-midwives are needed in Bhutan. While only 660 are available, the number needed is at least 2100. It was to become self-reliant in the production of nurses-midwives that the government decided to launch this degree programme.
Ladies and gentlemen,
This degree programme will certainly contribute to improving the quality of health care in the country by helping to raise the status of community-based health workforce to the “professional” level. It is indeed commendable. We need many more “professional” health staff to work with people right in the community itself, at the grassroots level. As far as health of the entire population is concerned, community health work is not less important than the work in medical institutions. Through community health work, we can do much more in promoting and protecting the health of the population at large.
We need many more nurse-midwives at the primary health care level in the community to provide education directly to people, and to help people to help themselves, as far as health matters are concerned. The nurse-midwives are primarily needed for maternal, newborn, child and elderly care. They are the ones who can cover all levels in the community to also reach the hard-to-reach people. They are in the vanguard to serve the poor and the underserved.
Ladies and gentlemen,
This degree programme is another response of the country:
to the complexity of health problems and health systems;
to the advancement in medical sciences;
to the expansion of hospital services;
and to the demand of people in general for more and better services.
The programme also aims to prepare nurse-midwives for further development of their nursing and midwifery careers through higher education. It is particularly important that nurse-midwives play their comprehensive roles in health promotion, disease prevention, and care and rehabilitation through the services they provide at individual, family and community levels throughout the “life-course”. The country needs nurse- midwives:
who are able to manage health conditions in a holistic and systematic manner;
who can manage health facilities efficiently;
who can apply evidence-based information for effective nursing and midwifery interventions; and
who can be able leaders and advocates, especially in promoting and supporting the basic health services and primary health care.
The nurse-midwives need to work efficiently and effectively in a “multidisciplinary” and “multisectoral” environment. They are the “core group” of the “community health team” that works through “organized community efforts”. Indeed, the curriculum of this programme needs to be regularly reviewed updated and reoriented as necessary to ensure its continued relevance to the country’s needs in nursing and midwifery services. The curriculum must also clearly reflect Bhutan’s philosophy, health problems, health system and the prevailing social determinants of health.
The nurse-midwives must inculcate a positive attitude towards their profession and towards the clients they serve. The teachers, apart from imparting knowledge and skills, must be good “role models” for students to imitate. With regard to programme implementation, close collaboration between the Royal Institute of Health Sciences and various health service providers at all levels is essential indeed.
Ladies and gentlemen,
This is just the beginning of the programme. A realistic and practical plan needs to be developed to ensure increasing capacity, in both quantitative and qualitative terms, ability to take up more students, improved quantity and quality of teaching staff, and better teaching and learning facilities and others.
WHO is ready to support the next stages of the development of this educational programme. We are also ready to promote collaboration between the Royal Institute of Health Sciences and other institutes in the Region in the areas of nursing and midwifery education and research. In all these efforts, WHO will continue to work closely with our partners, both within and outside the UN system, in mobilizing the resources required for the programme. I look forward to witnessing this educational programme achieve full maturity one day in the foreseeable future.
In conclusion, let me sincerely congratulate the Royal Government of Bhutan for this extraordinary effort that will contribute greatly to improvement of health care and services in the country. With these words, I wish the Royal Institute of Health Sciences all success in implementing the B.Sc. Degree Programme in Nursing and Midwifery. I hope that the students enjoy their studies under this programme, and that they become competent nurse-midwives in the near future.
Thank you.