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Bhutan: Preparing the Health Sector Development Program

Sovereign (Public) Project | 51141-001 Status: Closed

The transaction technical assistance is required for designing the program and enhancing program readiness through appropriate advance actions.

Project Details

Project Officer
Win, Hayman Kyaw South Asia Department Request for information
  • Bhutan
  • Technical Assistance
  • Health
Project Name Preparing the Health Sector Development Program
Project Number 51141-001
Country Bhutan
Project Status Closed
Project Type / Modality of Assistance Technical Assistance
Source of Funding / Amount
TA 9352-BHU: Preparing the Health Sector Development Program
Technical Assistance Special Fund US$ 500,000.00
Strategic Agendas Inclusive economic growth
Drivers of Change Gender Equity and Mainstreaming
Governance and capacity development
Sector / Subsector

Health / Disease control of communicable disease - Health care finance - Health system development

Gender Equity and Mainstreaming Effective gender mainstreaming
Description The transaction technical assistance is required for designing the program and enhancing program readiness through appropriate advance actions.
Project Rationale and Linkage to Country/Regional Strategy

Bhutan has made significant investments into developing its health system from a low base and achieved remarkable progress in key health outcomes over the past several decades. Average health indicators have vastly improved from being among the poorest in the world to mostly achieving the Millennium Development Goals. Bhutan's total health expenditure is 3.8% of gross domestic product, which is predominantly government financed (approximately 75.0%). Household out-of-pocket expenditure is relatively low, implying a fair level of equity and financial protection. Coverage of health facilities is also extensive, with 96% of the population living within 3 hours walk of the nearest health facility, which is a considerable feat of physical access given the challenges posed by the country's difficult terrain and scattered, remote populations.

Despite these impressive gains in key health outcomes, and a high government priority given to health, challenges remain in Bhutan's health sector performance, including wide district-level variations in service quality and coverage, and regional disparities in health outcomes. Bhutan's relative performance in some health indicators compared with other lower middle-income countries could also be further improved. The sector also needs to evolve to effectively deal with growing health security threats and epidemiological and demographic transitions, including the increasing burden of noncommunicable diseases and rapid urbanization with increasing rural urban migration. Long-term sustainability of health care financing needs critical attention, given rising population expectations and planned introduction of new technologies and services. The need for solutions to address the critical shortage of human resources is a further challenge to sustainably improving health care quality and access.

The proposed assistance will bridge critical gaps in Bhutan's health system and will enhance overall sector performance. The proposal is aligned with priorities in the National Health Policy of the Ministry of Health (MOH) and will support implementation of the upcoming Twelfth Five-Year Plan (2018 2022). The program is included in the country operations business plan, 2016- 2018 of the Asian Development Bank (ADB), and reinforces ADB's inclusive growth agenda in the Midterm Review of Strategy 2020.

Project Outcome
Description of Outcome
Progress Toward Outcome
Implementation Progress
Description of Project Outputs
Status of Implementation Progress (Outputs, Activities, and Issues)
Geographical Location Nation-wide
Summary of Environmental and Social Aspects
Environmental Aspects
Involuntary Resettlement
Indigenous Peoples
Stakeholder Communication, Participation, and Consultation
During Project Design
During Project Implementation
Business Opportunities
Consulting Services A total of 37 person-months (19 international and 18 national) of consulting inputs are provided under the TA. The firm's contract (PwC) will end on 30 September 2018 and international health financing specialist's services has been completed.
Procurement N/A
Responsible ADB Officer Win, Hayman Kyaw
Responsible ADB Department South Asia Department
Responsible ADB Division Human and Social Development Division, SARD
Executing Agencies
Ministry of Health
PO Box 108, Kawangsa, Thimpu, Bhutan
Concept Clearance -
Fact Finding -
Approval 10 Aug 2017
Last Review Mission -
Last PDS Update 26 Sep 2018

TA 9352-BHU

Approval Signing Date Effectivity Date Closing
Original Revised Actual
10 Aug 2017 01 Sep 2017 01 Sep 2017 31 Mar 2018 30 Sep 2018 -
Financing Plan/TA Utilization Cumulative Disbursements
ADB Cofinancing Counterpart Total Date Amount
Gov Beneficiaries Project Sponsor Others
500,000.00 0.00 100,000.00 0.00 0.00 0.00 600,000.00 10 Aug 2017 450,049.99

Project Data Sheets (PDS) contain summary information on the project or program. Because the PDS is a work in progress, some information may not be included in its initial version but will be added as it becomes available. Information about proposed projects is tentative and indicative.

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Evaluation Documents See also: Independent Evaluation

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Related Publications

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Tender Title Type Status Posting Date Deadline
International Health Financing Specialist Individual - Consulting Closed 11 Aug 2017 17 Aug 2017
PPTA Firm Firm - Consulting Closed 02 Aug 2017 08 Aug 2017

Contracts Awarded

Contract Title Approval Number Contract Date Contractor Contractor Address Executing Agency Contract Description Total Contract Amount (US$) Contract Amount Financed by ADB (US$)
Project Preparatory Technical Assistance 9352 10 Nov 2017 PricewaterhouseCoopers Private Limited, IND(INDIA) in association with Phuensum Consulting Services(BHUTAN) #8-2-293/82/A/1131A; Road No. 36, Jubile derabad, India/Andhra Pradesh 500 034 In 17th Flr,Bldg10,TowerC,DLF Cyber City Gu Consulting Services 401,152.00

Procurement Plan

None currently available.