Investigator(s)
| Submitter |
Dhan Kumar Bhujel Birmingham City University/Daffodil International University Dhan Kumar Bhujel 
|
| Principal Investigator |
Dhan Kumar Bhujel Birmingham City University/Daffodil International University Dhan Kumar Bhujel
|
Title(s) and abstract
| Scientific title | Public Perception and Policy Implications of Increased Health Contribution in Bhutan: An Exploratory Study towards Equitable Health Financing |
| Public title | Public Perception and Policy Implications of Increased Health Contribution in Bhutan: An Exploratory Study towards Equitable Health Financing |
| Background | The Government of Bhutan provides universal access to healthcare, primarily funded through general taxation, contribution from health trust fund, external aid and donor support, and a nominal health contribution from salaried employees. However, with the increasing healthcare costs, increasing demand from the public, and aspirations to sustain Universal Health Coverage (UHC), the government is exploring alternatives like public private partnerships and ways to increase funding in healthcare. One likely source would be doubling the mandatory health contribution from 1% to 2% of employee salaries. This policy if adopted will have direct implications on public acceptance, especially among civil servants, employees of state-owned enterprise, and business communities. So, understanding public perception is critical for effective, equitable, and inclusive policy implementation. |
| Objectives | General Objective: To explore the perceptions, expectations, and willingness to pay among different population groups in Bhutan concerning the proposed increase in health contribution from 1% to 2%. Specific Objectives: • To assess levels of support or opposition toward the contribution increase. • To analyze differences in perception across occupational and income groups. • To estimate the public’s willingness to pay and conditions influencing it. • To examine expectations related to service quality and system improvements. • To recommend equity-based and publicly acceptable implementation strategies. |
| Study Methods | Descriptive cross-sectional mixed-method study (survey and key informant interview) will be applied. Approximately 200-300 participants for the survey, and two to three key-informant interviews will be held. Stratified random sampling for the survey and purposive sampling for qualitative components is designed. Inclusion and Exclusion Criteria will be as follows: Inclusion: Bhutanese citizens who are above 18 years and who consent to the survey. Exclusion: Unwilling/unavailable respondents. And Data Collection Method will employ a structured questionnaire and few open-ended questionnaires for perception and willingness to pay. Key informant interviews with policymakers and health professionals is also anticipated. |
| Expected outcomes and use of results | This study will fill a crucial knowledge gap by understanding people’s attitudes, willingness to pay, and perceived fairness regarding the proposed health financing change. The findings are expected to support evidence-based policy design that reflects the voices of diverse socioeconomic groups, ultimately aiding Bhutan's progress toward sustainable UHC. |
| Keywords | Bhutan health financing, health financing |
Research Details
| Student research | Yes |
| Institution: daffodil International University, Birmingham City University | |
| Academic degree: Master | |
| Supervisor of the student(s) | |
| Full Name and title: Dr. ABM Alauddin Chowdhury, Professor and Head of Department | |
| Email: dralauddin@daffodilvarsity.edu.bd | |
| Start Date | 18-Jun-2025 |
| End Date | 28-Aug-2025 |
| Key Implementing Institution | Self |
| Multi-country research | No |
| Nationwide research | Yes |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | Health Financing |
| Involves human subjects | Yes |
| Health System and Policy Research | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | No |