Community perception of ecosystem services from commercially managed forests in Bhutan

Given the direct dependence rural communities have on forests, understanding ecosystem services can empower communities and align stakeholders to define priorities and objectives for the sustainable management of forest resources. In this qualitative study on the forest ecosystem services in Bhutan, we assessed community awareness and perceptions of local forest ecosystem services, identified their top priorities, and evaluated how they have changed over time. The study focused on state reserve forest areas designated for commercial timber production, formally known as forest management units (FMU). We held focus group discussions separately with women and men associated with five FMUs in the central belt of the country. Participants identified 45 ecosystem services, with soil productivity, freshwater, timber, fresh air, construction stone, carbon sequestration, spiritual value, pollination, and local weather regulation comprising the most highly valued services critical to local livelihood and well-being. Participants felt that forest ecosystem services have been generally declining over the past decade in the FMUs and identified a need for forest restoration activities to improve their delivery. We recommend that state forest entities conduct an awareness campaign to empower communities with the conceptual framework and globally recognized concepts to advocate for their needs related to forests. We also recommend that biophysical and economic studies be conducted in these areas to seek evidence for causal linkages between natural resource use and the status of ecosystem services. This study contributes to a growing literature on ecosystem services in Bhutan and provides a basis for future studies to understand how management activities can impact the delivery of critical services

Gender‐neutral HPV elimination, cervical cancer screening, and treatment: Experience from Bhutan

Cervical cancer is preventable and also curable when detected early and treated adequately, yet it remains a leading cause of morbidity and mortality among women. In Bhutan, cervical cancer is the most common cancer among women. Bhutan was the first country among the low- and middle-income economies to have instituted a national HPV vaccination program, in 2010, and has achieved >90% coverage. In 2019, Bhutan launched a cervical cancer elimination flagship program well ahead of WHO's launch of the global strategy for accelerated elimination of cervical cancer. Bhutan initiated vaccination of adolescent boys and adopted a gender-neutral vaccination program beginning September 2020 through its well-established network of primary healthcare centres. The flagship program aims to screen women aged 30-69 years with HPV testing using liquid-based cytology (LBC) as triaging for screen positive women. For women aged 25-29 years, LBC will be continued as per American Society of Colposcopy and Cervical Pathology guidelines. Colposcopy and treatment will be performed in camps to decrease loss of follow up of screen positive women. This program is also expected to improve early diagnosis of cervical cancer and provide timely and adequate cancer treatment and palliative care services. This article reviews the progress made and the challenges facing the 2030 cervical cancer elimination targets in Bhutan