Maternal and child health
The Government of Mongolia has placed a high priority on achieving Millennium Development Goal 5. Some of the major achievements in this area are associated with high coverage of antenatal care (87.7%) and delivery by skilled birth attendants (99.8%). However, providing maternal services to mobile and migrant population is a challenge.
Strong political commitment and support from several international and national partners has led to a steady decline in the maternal mortality ratio (MMR) over the past two decades. The MMR was 49 per 100 000 live births in 2008.
There is a wide variation in MMR between urban and rural areas. In some remote aimags especially in the west of the country, the MMR is as high as 213 to 365 per 100 000 live births. This is four to six times the rate in the capital, Ulaanbaatar. One unfavorable trend in the past 5 years has been an increasing birth rate among adolescents. The percentage of births among adolescents in 2008 varied from 26.3% in the rural areas in the south to 18.3% in provincial centres and 5.3% in Ulaanbaatar.
The MDG targets of under-5 mortality rate (29.2 per 1000 live births ) and infant mortality rate (22.0 per 1000 live births ) rates were attained in 2006 (Fig. 1) . However, there has been reverse trend observed for both MMR and under-5 mortality rate over the past two years, largely due to the global financial crisis and pandemic influenza.
Common diseases of childhood such as diarrhoea, respiratory infections, malnutrition and measles have been greatly reduced due to cost-effective interventions such as routine immunization against targeted diseases, the introduction nationwide of an integrated management of childhood illness strategy, improving infant and child nutrition, including, breastfeeding, micronutrients and vitamin A and D supplementation.
Maintaining and further reducing child mortality will depend on improving neo-natal health, as about 65% of all infants deaths take place in first 28 days of life, with 70% of these occurring in the first week [3]. The main causes of deaths are asphyxia, sepsis and congenital defects.
Strategic priorities
- Strategic priority 1: Health system strengthening through primary health care approach
- Strategic priority 2: Scaling up prevention and control of noncommunicable diseases (NCDs), injuries, violence and their determinants
- Strategic priority 3. Sustaining and accelerating the achievement of health related MDG targets
- Strategic priority 4. Strengthening health security, including control of communicable and vaccine preventable diseases
- Strategic priority 5: Strengthen Environmental health programme