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Health Care

The population’s health status has dramatically improved in Mongolia in the 20th century. Within this period of time infant mortality has decreased by a factor of 16, while maternal mortality had experienced almost a 100-fold decline, and such communicable diseases as louse-born epidemic typhus, genital lymphgranulomatosis, smallpox and poliomyelitis were eradicated, predetermining an almost four-fold increase in population number, and improvement in population health. Although such profound changes have been associated with a number of socio-economic factors, they have been unbreakably bound to the contemporary science-based health sector development in Mongolia, while the first hospital was established only in 1924 with 3 health workers and 15 beds.
Before the 1990s the health system was state owned, and centrally run with financing from general government revenues. Health care was free of charge at the point of delivery. The system was very much reliant on curative services, very resource intensive, based upon high bed numbers and large numbers of medical personnel. Despite many achievements, including improved equity and access to health care and control of communicable diseases, there were weaknesses, including low efficiency and a lack of sensitivity to consumers’ rights.
The acute economic distress associated with the transition after 1990 severely affected the health sector. The system experienced a major loss of resources which led to some inevitable deterioration of health services. However, the Mongolian government has not reduced its policy commitment to the equitable provision of services and it has re-assessed its strategies in the light of experiences of transition. Therefore, the health sector ownership and financing have been diversified, a health insurance scheme and a policy shift towards greater emphasis on primary health care was introduced in the early 1990s. In accordance with the recent amendment in the Health Insurance Law, the Scheme covers some outpatient services and hospital services, however the insured make co-payments from 5-15 percent depending on the level of hospitals.
The family group practice (FGP) model was introduced since 1998 by the Health Sector Development Program with the support of ADB to provide primary health services free of charge to the population. Family doctors were reorganized into private group practices, with guarantees of income through risk-adjusted capitation payments from the government. In 2002 the FGPs covered 56 percent of the Mongolian population, and were employing about 940 family doctors. The National Public Health Policy was adopted in 2001, establishing a long-term framework for public health.
The health status of the people in Mongolia is relatively better than that of an average low-income country. There have been improvements in child mortality in spite of the difficulties of transition. Mongolia historically has a strong commitment to immunization which is evident from the high coverage rates (over 90 percent for tuberculosis, DPT, measles, hepatitis B, and polio). The country is undergoing an epidemiological transition characterized by a decline in communicable diseases and a rise in non-communicable diseases in total mortality. The leading causes of mortality from 1995 up to the present are diseases of the circulatory system, cancer, accident and injuries.
Despite successful efforts, the health sector is facing problems related to the deepened marginalization of some of the population, internal migration and the number of homeless people as well as poor living conditions which are causing the increase of poverty-related diseases such as TB and STDs. In addition, there are problems of unequal health status and access to health services between the rural and urban populations, and between different income groups, high maternal and child mortality, despite recent improvements.
The health sector is comprised of 17 specialized hospitals and centers, 4 regional diagnostic and treatment centers, 12 district and 21 aimag general hospitals, 323 soum hospitals, 18 feldsher posts, 233 family group practices, and 536 private hospitals and 57 drug supply companies/pharmacies. At present, there are 27.7 physicians and 75.7 hospital beds per 10.000 population overall.
A large portion of the health budget is still spent on curative services. There are weaknesses in hospital services: inefficiency, patient dissatisfaction, outdated treatment protocols and equipment. Since January 2003 the government started to implement the Public Sector Management and Finance Act, a new phase of health system organization and financing with output-based funding. The successful implementation of the new regulation is an immediate challenge to increase cost-effectiveness and greater responsibility of health organizations in the country.

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1 Response for “Health Care”

  1. Sunny Dong says:

    We are a manufacturer in the field of hospital furniture. If have any chances, we are like to export our product to this good country.

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