January 12, 2019
Bhutan could be plagued by steep fertility decline for the next three decades unless some interventions are in place, according to population projections the National Statistics Bureau (NSB) released yesterday.
The total fertility rate has declined from 2.5 in 2005 to 1.7 children per woman during her reproductive age in 2017.
Projections show that the population will continue to increase but at a slower pace than in the recent past. The population was enumerated at 735,553 persons in 2017 out of which 8,408 were non-Bhutanese or tourists found in hotels on the census reference day and 727,145 were resident population.
The population of 735,553 in 2017 will increase to 896,866 in 2047 after adding the projected tourist population. The resident population will increase to 883,866 by 2047, an increase of 21.6 percent from the current level.
There will be 453,000 males and 431,000 females by 2047, with a sex ratio of 105 males per 100 females in Bhutan, a decline from the current level of 110.


Due to the declining fertility rates, the birth rate will decline substantially to 11 births per 1,000 population and the annual growth rate will fall from 0.99 percent in 2017 to 0.27 percent in 2047.
NSB official Pema Namgay said that this decline in TFR has resulted in less number of babies being born annually. It is generally accepted globally that once the fertility rate has gone below the replacement level of 2.1, it is unlikely to reverse.
“In Bhutan, fall in the growth rate of population is a concern and therefore, specific measures to lower fertility are not expected,” he said.
“In almost all the countries, it was observed that once fertility reaches a low level, it does not show any sustained rise, even in the presence of pro-natalist policies.”
Even if it is to improve, it will be marginal and will fluctuate in a narrow range. However, with the government coming up with measures to incentivise the births with maternity allowance, the TFR is expected to improve.
The share of population below 15 years will fall considerably from 26 percent to 17 percent while the 65 years and above will rise from six percent to 13 percent by 2047.
The young dependency ratio will fall from 38 percent in 2017 to 25 percent in next 30 years and the old dependency ratio will gradually increase over this period. The overall dependency ratio will fall to 41.4 percent from 2027.
However, the silver lining of the problem is that the best time to derive the demographic dividends is yet to come.
The share of the working age population will peak at around 71 percent during the period 2027 to 2042 and thereafter it will gradually decline, which shows the window of demographic opportunity in the country.
Prime Minister Dr Lotay Tshering said it is imperative that this imminent dividend is efficiently harnessed by making investments in education and by providing scope for use of the increased labour force or working age population.
At the same time, the increasing size and share of elderly population calls for developing health and social services for the aged. In particular, the health services may need to be well equipped
Likewise, with ageing of population, the median age is projected to increase to 40 years by 2047 from 26.9 in 2017 meaning half of the population in Bhutan is going to be above 40 years, which would mean increased Non-Communicable and degenerative diseases, giving more pressure on health and other social services.
Life expectancy is projected to increase from 67.6 in 2016-17 to 75.2 years in 2047 for male, and from 70.6 to 78.5 years for female.
Mortality rate is expected to fall but due to the ageing population, the crude death rate is going to maintain at around the same level as in 2017 with marginal increase to about eight deaths per 1000 population by 2047.
The age structure of the population is projected to change notably overtime. The population of children below 14 years will fall considerably from 26 percent to 17 percent, and that of those above 65 years will increase from six percent to 13 percent in the next 30 years.
Prime Minister said the country would have serious consequences should the population pyramid become inverted.
The urban population
By 2037, half the population of Bhutan will be living in urban areas. The urban population of 275,000 in 2017 is likely to increase to 502,000 in next 30 years in the country. The urbanization in Bhutan from its current level of 37.8 percent is expected to increase to 56.8 percent by 2047.
The population growth is expected to vary across dzongkhags. The projection report reveals that about 30 percent of the population, 260,000 persons will reside in Thimphu dzongkhag by 2047. No other dzongkhags will have more than 100,000 persons.
The dzongkhag-level projections indicate that Thimphu population will increase from its current level of 138,000 to 263,000 in next 30 years.
While the size of Chukha population will not increase much, the population of Paro is likely to increase from 46,000 to 74,000 during the projection period.
The report has details at national level for 30 years and dzongkhag level for 10 years.
NSB officials said that the population projection was done to provide data for the purposes of policy formulation, socio-economic planning, service delivery, and indicators for measuring progress towards the achievement of key government targets.
The population projection, which is one of the post census technical report of the Population and Housing Census 2017, was produced with technical and financial assistance from the UNFPA.
Tshering Palden

India-Bhutan relations strengthened: PM
January 3, 2019

India extended unconditional support to the development programmes of the 12th Plan, Prime Minister Dr Lotay Tshering said at the first press briefing after returning from his State visit to India last week.
“The top agenda of the state visit was the Indo-Bhutan relations. We’re losing the bigger picture while talking too much on smaller issues,” Lyonchhen said.
The hydropower tariff and other issues raised during the visit are nowhere compared to the relationship between the two countries.
That’s why lyonchhen’s focus was to boost the ties the two countries shared.
“If possible to find the device or any mechanism to take the relationship to a much greater height and I conveyed that to the Indian counterpart too,” Lyonchhen said.
Before leaving or India, while he looked forward to meet the Indian Prime Minister personally and strengthen the relationship, Lyonchhen said that he was equally anxious if he would be able to live up to the expectations.
But they have so much respect and goodwill for brand Bhutan that he hardly had to do anything, he said adding that the path he was treading has been set for centuries and the records set. “Brand Bhutan is very easy to sell because of our visionary leaders, as we mention His Majesty The King and brand Bhutan, it’s well received everywhere,” he said. “That was something unique and we only need to think how to value-add to it.”
On the budgetary assistance for the 12th Plan, he said that the message was simple – ‘lets know what we can do.’
Besides the Nu 45 billion assistance for the 12th Plan, the Indian government also agreed to a higher tariff rate than that its officials negotiated for Mangdechhu power.
Lyonchhen said that even at Nu 4.12 a unit from Mangdechhu hydroelectric plant, Bhutan still benefitted even though it may not have met the revenue estimated by the Bhutanese side.
“But since our expectation was Nu 4.27 per unit and since we were a new political power and that being our first visit, I thought that was an excellent gesture,” he said.
To match up with the Bhutanese delegation’s expectations, lyonchhen said the Indian side gave numerous concessions on the negotiations including giving Nu 1 billion to make up for the loss of projected revenue.
As a goodwill gesture, Bhutan also received another Nu 4 billion for trade facilitation and boosting economic linkages.
“The message from the other side was that there is a lot of room for negotiations and we will not send you back with anything less,” he said.
Lyonchhen attributed the successful negotiations and budget for the 12th Plan to his predecessors and the former government.
Foreign minister Dr Tandi Dorji said the delegation was given excellent hospitality and reception, a reflection of the strong bond of friendship between the two countries.
Tshering Palden

GNH in action
January 12, 2019

The Gross National Happiness Index was developed to help anchor politicians and bureaucrats to the long-term goals of GNH.
The quantification of GNH, said the President of the Center for Bhutan studies and GNH, Dasho Karma Ura, was done in preparation for the transition where democratically elected governments could potentially change every five years.
Speaking on Development with Integrity: Bhutan’s development and its GNH index at the Sheldonian Theatre in Oxford, England, the president said that GNH, takes a broader set of conditions related to societal and individual happiness.
“Those who achieve the conditions for happiness, are excluded from further calculation, but what it tells policy makers is to focus on those who do not achieve these conditions,” he said.
At a time when the parliament members are recommending suggestions to insulate GNH from the whims of political parties and questioning the GNH framework of the 12th Plan, GNH, the president shared with a community of scholars on Bhutan that GNH is used in official decision making primarily in five ways.
First, all 17 baseline goals of five year plans, he said, are drawn from GNH indicatives and these baselines relate to such things as mental health, safety level, community vitality as a whole, voting rights, values, assets and income among others.
Second, GNH is used as a weighted criterion in allocation of budget to local governments.
“Third, policies are screened with the GNH screening tool, which is a simple way of checking the impact of the policy on 22 criteria which are drawn from GNH index,” he said.
On the national council’s observation on past projects such as central schools and mega farms being implemented despite criticism, Kuensel learnt that these decisions did not have policies as such to be screened. Some observers said that these are cabinet decisions, which are the prerogative of the government of the day and that GNH screening tool should not be seen as a panacea to all issues.
Fourth, GNH index is used to evaluate projects, such as a horticultural project in eastern Bhutan to assess the benefits and fifth, GNH certification for business has been designed for various businesses. “Its implementation on a bigger scale will begin from this year,” he said.
A research on GNH legislation policy outputs in Bhutan from 1972 to 2014 by Michael Givel, a political science professor at the University of Oklahoma, USA found that in these 42 years, Bhutan enacted 115 national laws. From 1972 to mid 90s, GNH legislation almost solely focused on cultural preservation pillar – on maintaining the traditional cultural identity and values of a Mahayaya Buddhist monarchy and society.
In the second phase, Bhutanese policy outputs emphasized all four pillars of GNH, aligned with the long-standing government policies to modernise Bhutan.
Beginning mid 2000s, the research found that several good governance policies were enacted to limit corruption, promote greater transparency and raise accountability in government. “The happiness policy has morphed,” Michael Givel said.
The Sheldonian Theatre, the official ceremonial hall of the University of Oxford also saw the former Prime Minister Dasho Tshering Tobgay, His Majesty’s representative, speak on Does Bhutan Matter? Stories from a young democracy.
“GNH is what defines us as a nation and what guides us as we move forward as a society. GNH has become Bhutan’s brand image and that image is so effective and powerful that many are convinced that we are the happiest people in the world,” he said.
GNH has also quietly become Bhutan‘s soft power and has contributed to the development of Sustainable Development Goals.
“Our democracy is not an end in itself, but the means to protect our sovereignty, nurture our the culture, preserve our pristine environment, to strengthen our welfare system and to ensure that political leaders and decision makers upheld the ideals of GNH.”
International Society for Bhutan Studies
The Sheldonian Lectures were a part of the inaugural conference of the International Society for Bhutan Studies (ISBS), which was held at the Magdalen College, University of Oxford in the United Kingdom from January 8-10.
Founded in Paro in 2015, the ISBS seeks to develop the study of Bhutanese culture, life and nature in all aspects and encourage, inspire and motivate interest in lesser known aspects and promote and strengthen the areas of existing concentration.
ISBS president Sabina Alkire said the conference assembles a community of thinkers, particularly young scholars to encourage academic exchange, and to contribute to the happiness of future generations. The conference’s opening, which coincided with the 109th anniversary of the Treaty of Punakha, saw more than 40 research papers on linguistics, ecology, anthropology, law and international relations, Buddhism, GNH and development, education and governance.
Dasho Tshering Tobgay, who opened the inaugural conference said Bhutan is changing fast and that a lot needs to be studied, researched and archived.
“The ISBS is a study of Bhutan from all aspects and that it is self evident and necessary like happiness,” Dasho Karma Ura said.
Sonam Pelden | Oxford

Health ministry introduces PCV into routine immunisation
January 12, 2019

With the introduction of pneumococcal conjugate vaccines (PCV) into the routine immunisation yesterday, the vaccine would now be given to infants at six weeks, 10 weeks and nine months of age in all health facilities.
The vaccine prevents transmission of pneumococcal bacterial diseases such as pneumonia, otitis media, bacteraemia, and meningitis in children under 5 years.
The health ministry, with support from Global Alliance for Vaccines and Immunisation (GAVI) and UNICEF introduced PCV 13 into the routine immunisation.
Director of public health department, Dr Karma Lhazeen, said that pneumococcal infection affects children and adults causing morbidity and mortality, especially in low and middle-income countries.
Dr Karma Lhazeen said pneumococcal disease burden in Bhutan is high. In the last six years, 71,595 pneumonia cases were reported in the country. A total of 83,425 otitis media and 1,744 meningitis were reported during the same duration.
“Incidence of Pneumonia is comparatively high and increasing among children under the age of five. The data shows the mortality trend among the population is increasing,” she said.
From 2008 to 2016, about 631 deaths due to pneumonia and 237 deaths due to meningitis were recorded in the country. This translates to 70 deaths due to pneumonia and 26 deaths due to meningitis, annually.
She said that respiratory infections remain a major cause of morbidity and mortality among children in Bhutan. “The government spends huge resources on the treatment of pneumococcal diseases.”
These diseases, she said, also contribute to high societal costs, as parents have to take time off their work to tack care of their sick children.
Due to the high disease burden, the National Technical Advisory Body for immunisation services recommended the health ministry to introduce the vaccine for children.
A feasibility study was undertaken and completed in June 2017. The study result indicated that introduction of PCV would be cost-effective and provide good value for money and would prevent mortality and morbidity due to pneumococcal diseases.
The study findings showed that the introduction of PCV 13 would avert 3,177 cases and prevent 42 deaths per study cohort. It also showed that the introduction of the vaccine would reduce the workload of various categories of health workers.
The vaccine would cost the Bhutan Health Trust Fund Nu 9.2M annually.
The GAVI provided support for one time operational or introduction cost, which includes training and other logistics through a grant amounting to Nu 7.5M. WHO and UNICEF provided technical support for the introduction of this vaccine
“We trained all Maternal and Child Health expanded programme on immunisation focal persons and BHU staff before we introduced the vaccine,” Dr Karma Lhazeen said.
The head of the national referral hospital’s community health department, Dr Sonam Ugen, said that immunisation was one of the greatest public health success stories in Bhutan, preventing sufferings and saving more lives.
“The introduction of the PCV 13 is another significant milestone for the vaccine preventable disease programme in Bhutan,” she said. “We firmly believe that the introduction of the pneumococcal vaccine is most timely and a crucial step to reduce pneumonia associated illness.”
The PCV 13 and two other vaccines were launched in the country on June 4, last year coinciding with the birthday of His Majesty the Gyaltsuen.
Senior programme officer with the vaccine preventable disease programme, Tshewang Dorji Tamang, said the ministry was carrying out cost-effectiveness study on the introduction of rotavirus and flu vaccines.
He said that the National Committee for Immunisation Practice in Bhutan noted that there was currently insufficient data to support Pneumococcal vaccination for the elderly population and that there were documented positive effects of herd protection in adult age group following routine infant immunisation with PCV 13.
With the addition of PCV, a total of 12 vaccinations will be provided through routine immunisation programme in the country.
Dechen Tshomo

Promoting Dzongkha, everyone’s responsibility: PM
January 10, 2019

Promoting Dzongkha, the national language, should not be left to the government alone.
This was the message from Prime Minister Dr Lotay Tshering as the national language comes under the radar of parliamentarians once again while discussing the 12th Plan. “If the elected members put their concerns into actions and if every Bhutanese esteem the national language, the government need not put in place a separate policy or rules to promote Dzongkha,” said the prime minister.
In doing so, promoting Dzongkha would be the easiest task to achieve as one of the indicators of the 12th Plan’s key result area on culture preservation and promotion, according to the Prime Minister Dr Lotay Tshering.
“Economy of scale, he said has impeded both trade and farming. Promoting Dzongkha is also confronted with similar challenges,” Lyonchhen said. “Because usage of Dzongkha is only limited to Bhutan, it is difficult to make a living by learning Dzongkha alone,” he said.
Notwithstanding the fact that Dzongkha is an alien language when it comes to foreign dealings, Lyonchhen said that it has improved. Written Dzongkha, he said is exceptionally well scripted in various documents. Spoken, he added, could be heard in every speech many Bhutanese deliver.
“Yet, we still feel it is not enough. Where is the gap?” he said.
Lyonchhen pointed out that every citizen is responsible to promote the country’s language culture. “If we are concerned, we must practise what we preach instead of leaving it to the government,” he said.
On the policy front, he acknowledged that there is a lack of coordination among the stakeholders like home ministry, Dzongkha Development Commission and education ministry.
Home Minister, Sherab Gyeltshen said that Dzongkha as a subject is not rewarding. In schools, he said every other subject is taught in English, which is given top priority. “We have set a wrong precedent,” he said adding English has become the official language in every official meeting and daily order of business in every agency. Likewise, he said that every Bhutanese product is labelled in English and other agencies like the trade department could also contribute in promoting Dzongkha.
Education system, the home minister said is the key in promoting Dzongkha. However, he said there are no jobs that require a background in Dzongkha in today’s job market. The Royal Civil Service Commission, he said must look into exploring jobs that would require Dzongkha expertise to encourage students take up courses in Dzongkha.
Panbang MP Dorji Wangdi said that some 45 recommendations were given to the DDC in the 10th Plan. “The 11th Plan failed to implement these recommendations, which could have affected promoting Dzongkha.”
One of the indicators under the National Key Result Area in the 12th Plan is to ensure that 95 percent of People enjoy sufficiency in speaking native language. The Opposition Leader questioned whether such indicators were measurable. For instance, another target is to bring the percentage of population meeting sufficiency threshold of knowledge and practice of Driglam Namzha to 50 percent.
Home Minister, however said that there is already a baseline defined by the GNH survey. Proficiency in speaking, he said is already high and now the focus should be in reading and writing.
MP Dorji Wangdi also suggested on setting a minimum proficiency to speak Dzongkha and introducing radio program in local dialects like Khengkha.
While an amount of Nu 2.2B has ben earmarked to promote and preserve culture in the 12th Plan, challenges are aplenty.
The 12th Plan document states that many of the rich historical, cultural and spiritual sites that existed for centuries are under continuous threat from both natural and manmade disasters. These monuments are exposed to a range of disasters such as earthquakes, fires, windstorms, and landslides. Conservation, restoration, and making these sites disaster resilient are critical. In addition, meeting the financial resources for restoration and preservation of cultural infrastructure is a recurring challenge.
Tshering Dorji